1. Introduction to Tinnitus
February 25, 2019
Jane Doe Hearing Center. Chicago, IL

2. Session Overview Introductions Hearing Hearing loss What is tinnitus?
Treatments for tinnitus
Helpful options
Self-help
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3. Introductions Your first name
What does your tinnitus sound like? (ringing, humming, etc.)
How long have you had tinnitus?
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9. Nerve Activity Nerve activity carries information to the brain
Vibration of bones causes fluid in cochlea to move
This causes tiny hairs on top of cell to move
There is a chemical reaction between the hair cell and the nerves which causes the nerves to become active
The nerve activity goes to the brain
Brain interprets nerve activity as sound
Loud sounds activate more nerves than soft sounds
Jane Doe Hearing Center. Chicago, IL

10. Testing Hearing
Testing typically shows the softest level one can hear at different frequencies (pitches)
Results are mapped on an audiogram
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11. Frequency in Hertz (Hz)
Hearing Level in Decibels (dB)
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12. Jane Doe Hearing Center. Chicago, IL
Hearing Loss
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14. Common Sounds and Speech
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15. Whisper Refrigerator Normal Conversation Ambulance siren Dishwasher
30 dB
Whisper
40 dB
Refrigerator
60 dB
Normal Conversation
75 dB
Dishwasher
110 dB
Chain saw
Rock concert
120 dB
Ambulance siren
140+ dB
Firecracker
Firearms
85 dB
Heavy city traffic
School cafeteria
95 dB
Motorcycle
100 dB
Snowmobile
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16. Causes of Hearing Loss
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17. Damaged Hair Cells = Hearing Loss
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19. Jane Doe Hearing Center. Chicago, IL
Tinnitus
Causes
Prevalence
Mechanisms
Reactions
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20. What do you think caused your tinnitus?
Your Turn
What do you think caused your tinnitus?
Jane Doe Hearing Center. Chicago, IL

21. Causes of Tinnitus Noise Head Injury Medications Age Disease
Many of the same things that cause hearing loss also cause tinnitus
However, hearing loss does not cause tinnitus, nor does tinnitus cause hearing loss
An individual may have hearing loss but not have tinnitus OR may have tinnitus but no hearing loss
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22. Prevalence of Tinnitus
10 in 100 people have tinnitus (10%)
20 in 100 people over 60 have tinnitus (20%)
1 in 100 people are bothered by tinnitus (1%)
Millions of people have tinnitus, ranging from mild to severe
Our Goal = To help you move into the group of people who have tinnitus that doesn’t negatively affect their life.
Jane Doe Hearing Center. Chicago, IL

23. Nerve Activity Revisited
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24. Nerve Activity  Hearing
Vibration of bones causes fluid in cochlea to move
This causes tiny hairs on the top of the cell to move
There is a chemical reaction between the hair cell and the nerve, which causes the nerves to become active
The nerve activity goes to the brain
Brain interprets nerve activity as sound
Loud sounds activate more nerves than soft sounds
Jane Doe Hearing Center. Chicago, IL

25. Nerve Activity  Tinnitus
Tinnitus is likely the result of an increase in spontaneous nerve activity
People with tinnitus have increased spontaneous activity
Brain picks up activity, not knowing that it’s random/extraneous
The brain interprets the activity as an external sound, leading to tinnitus
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26. Hearing Loss w/o Tinnitus
Condition
Nerve Activity
Result
Normal Hearing
Hearing Loss w/o Tinnitus
Tinnitus
Hear Silence
Hear Sound
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27. Important -- Tinnitus DOES NOT Make you deaf Lead to senility
Imply mental illness
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28. Your Turn
What is the biggest problem you have that you believe has resulted from your tinnitus?
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29. Common Reactions to Tinnitus
Troubled Thoughts
Difficulty Hearing
Insomnia
Inability to Concentrate
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30. Your Turn For partners:
For those with tinnitus:
What is the most difficult thing to explain to your partner about your condition?
What could your partner do to help you the most with your tinnitus?
For partners:
What have you ben able to do to help your partner with their tinnitus?
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31. Jane Doe Hearing Center. Chicago, IL
Tinnitus Treatments
Myths
Facts
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32. What have you tried? What has been successful?
Your Turn
What have you tried? What has been successful?
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33. Curing Tinnitus…
At this time, there are NO widely accepted cures for tinnitus
There are NO studies that have shown a cure that have used appropriate research designs and that have been replicated by others
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34. Medication Treatments
There are NO drugs, medications, or supplements effective for treating tinnitus at this time
There ARE effective medications for sleep, anxiety, and depression which may be helpful to tinnitus sufferers if their tinnitus leads to these problems.
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35. Excellent Options DO Exist…
Counseling and sound therapy
Individualized Tinnitus Activities Treatment
Hearing aids
Tinnitus devices
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36. Tinnitus Activities Therapy
Individualized for YOU
Focus in areas of:
Thoughts and Emotions
Hearing
Sleep
Concentration
Activities, conversation, homework, review
Jane Doe Hearing Center. Chicago, IL

37. Counseling Private consultation in Tinnitus Clinic (1 hour = $xxx)
Private multiple sessions (three, 1-hour sessions = $xxx)
Jane Doe Hearing Center. Chicago, IL

38. Counseling
One purpose of tinnitus treatment is to alter our negative thoughts and emotions brought on by tinnitus.
The brain can “learn” a response to a sound, and can then learn a different response to the same sound
Depending on the context and interpretation of what’s going on, the brain produces a different response to the same sound
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39. Reactions to Sound Neutral Response Doorbell Doorbell Angry neighbor
Anxiety Response
Doorbell
Flower delivery
Happy Response
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40. Do any sounds make your tinnitus less noticeable?
Your Turn
Do any sounds make your tinnitus less noticeable?
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41. Sound Therapy Hearing Aids Improve hearing Improve communication
Reduce stress of intensive listening
Often help tinnitus
Less stress, facilitates positive reactions to tinnitus
Background noise creates partial masking
Our hearing aid center provides excellent service!
Jane Doe Hearing Center. Chicago, IL

42. Sound Therapy Non-wearable sound TV Music Sound machine
Wearable options
Hearing aids
Noise generators
Tonal sound generators
Processed music
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43. Tinnitus and Low-Level Noise
In quiet, the tinnitus signal is enhanced and the brain has nothing else to distract it from “hearing” the tinnitus
With low-level noise in the environment, it becomes harder for the brain to keep track of/detect the tinnitus
The low level sound interferes with the brain’s detection of tinnitus-related neural activity
As your emotional reaction to the tinnitus is reduced, the brain will interpret the tinnitus the same way it does other insignificant background noise and filter it out
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44. Tinnitus and Low-Level Noise
Tinnitus in Low-Level Noise
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45. Tinnitus and Low-Level Noise
Tinnitus in Low-Level Noise
Jane Doe Hearing Center. Chicago, IL

46. Tinnitus and Low-Level Noise
The goal here is to decrease the prominence of your tinnitus.
Imagine a small candle in a dark room – very noticeable. When you turn the lights on, it’s not as noticeable. The candle has not gone away, but it’s significantly less prominent.
Jane Doe Hearing Center. Chicago, IL

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48. Summary Hearing loss and tinnitus are related
Tinnitus is a change in spontaneous nerve activity
There is no cure for tinnitus
Management options include:
Counseling and sound therapy
Hearing aids
Tinnitus devices
Jane Doe Hearing Center. Chicago, IL

49. Stages of Management 1 = Medical clearance 2 = Group session
3 = Decision
Counseling
Sound therapy device(s)
Both
4 = Individualized care
Jane Doe Hearing Center. Chicago, IL

50. Individual Sessions Audiogram Measure your tinnitus
Tinnitus-related questionnaires
Discussion of results and options for next steps – counseling, hearing aids, devices
Jane Doe Hearing Center. Chicago, IL

51. As You Exit… How do YOU want to manage your tinnitus?
Focus on other areas of your life and put tinnitus in the background
Use low-level sound in your environment (sound machine, music, TV, etc.)
Use wearable tinnitus noise generators
Begin tinnitus counseling
Hearing aids with maskers for both hearing loss and tinnitus
Jane Doe Hearing Center. Chicago, IL

52. Thank you for attending!
Questions?
Thank you for attending!
Jane Doe Hearing Center. Chicago, IL

53. Jane Doe Hearing Center
555 Michigan Ave.
Chicago, IL 01010
(555)
Monday-Friday
9:00 AM to 5:00 PM
Contact Us
Jane Doe Hearing Center. Chicago, IL