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                                           TINNITUS AND HEAD NOISES

                                                 Do We Know What Tinnitus Is?

The actual mechanism responsible for tinnitus is not yet known. We do know that it is real – not imagined
symptom of something that has gone wrong in the auditory or neural system. There is reason to be hopeful;
current research efforts using a physiological model may soon provide the necessary information for
identifying its cause(s).

                                                         What Causes Tinnitus?

At this time, the actual physiological cause or causes of tinnitus are not clear. The following factors have
been known to cause tinnitus or worsen tinnitus if it already exists: noise exposure, wax build up on the ear,
certain medications (aspirin, some antibiotics, etc.), ear or sinus infection/congestion, allergies, jaw or bite
misalignment (TMJ-temporomandibular joint disorder), cardiovascular disease, a tumor on the auditory
nerve, degeneration of bones in the middle ear, under
active thyroid, head or neck trauma and neck strain.

            Is Tinnitus a Common Problem?

Yes. It is currently estimated that 50 million American
adults have tinnitus to some degree. Of that number, 12
million have it severely enough to seek medical help.

         Is It Associated With Hearing Loss?

In most cases, tinnitus is associated with some hearing loss. For example, those who have been exposed to
excessively loud sounds may have a high frequency hearing loss. Usually, their tinnitus will be identified
as a high-pitched tone in the region of the hearing loss. Tinnitus can be perceived as being in the ears or in
or around the head, and can have one or a variety of different sounds such as ringing, hissing, or roaring. In
some cases, tinnitus is present where there is no loss of hearing. Treatment in these cases concentrates on
stress reduction and use of hearing aids. Hearing aids can greatly diminish tinnitus in those who suffer
from hearing loss.

In patients without hearing loss, tinnitus can be a sign of musculoskeletal disorders, Eustachian tube
dysfunction, allergies, previous head trauma, overuse of stimulants such as caffeine, nicotine and
chocolate. Please let your doctor know if the tinnitus is associated with your heart beat.

                                What Should a Tinnitus Patient Do?

Initially, an otolaryngologist should examine each tinnitus sufferer. The purpose of examination is to
determine if there is a medical condition causing tinnitus for which treatment could be prescribed. If that is
not the case, patients might consider non-medical treatments such as masking or relaxation therapies for
relief. It is important to remember that hearing aids are the most successful treatment for tinnitus if hearing
loss is present. Tinnitus without hearing loss come from stress, TMJ or teeth grinding, neck strain or

                                       Can Tinnitus Be Treated?

    There are various options for treating tinnitus that might provide relief.

Amplification (hearing aids): If a patient has a hearing loss and the tinnitus is in the mid or low pitches, a
hearing aid will often allow the wearer to hear normal sounds that can take the focus away from the
tinnitus. Hearing aids are the best treatment if a hearing loss is present. Contact one of our staff
audiologists if you have any questions regarding hearing aids and tinnitus. (970) 221-3372 or 593-1177

Masking: Tinnitus maskers resemble hearing aids and produce a pleasant sound of their own to “mask”
the clamor of the tinnitus. Maskers can be adjusted at any time, providing the wearer with an element of
control. For people needing both amplification and masking, a “tinnitus instrument” (a combination of the
two) is an option. Masking sometimes provides the added bonus of canceling the tinnitus for varying
lengths of time when the masker is turned off; a phenomenon called “residual inhibition”. Turning on a fan
or the radio or TV at a low volume also can provide the effect of masking. Cassettes and CDs are available
that play environmental sounds such as rain, waterfalls or the surf. In addition, masking units provide
sounds to help a person fall asleep. . (Sound Soother 20 at sharperimage.com) Custom tapes can also be
made. Contact one of our staff audiologists if you have questions or would like to try a professionally
customized tinnitus masker . (970) 221-3372 or 593-1177

Cervical Strain: Cervical strain is an important contributing cause to head noises. Teeth grinding, old
neck injuries, or muscle tensions can also cause contribute to the problem. Treatment is physical therapy,
anti-inflammatories and muscle relaxants. Your family doctor or neurologist can help as well.

Temporomandibular joint specialists report tinnitus relief for numerous patients suffering from both TMJ
and tinnitus. If you can alter the sound of your tinnitus by moving your jaw or pressing on it, or if you
grind your teeth, experience jaw joint pain, have trouble opening your mouth wide, , it is probably
worthwhile to seek out a qualified TMJ expert through your doctor or dentist. Please see our TMJ booklet.
Consider an over-the-counter mouth splint available at most pharmacies. Physical therapy can be most
helpful. Anti-inflammatories and help as well.

Biofeedback: Biofeedback training teaches the ability to control specific actions of the body, such as
blood pressure, heart rate and skin temperature. It also teaches stress management, which can be very
helpful in adjusting tinnitus. For more information about biofeedback, you may look in the yellow pages.

Cognitive-Behavioral Therapy: The way a patient “thinks” about the tinnitus affects the ability to cope
with it. This technique, commonly and successfully used for patients suffering from chronic pain, helps
identify and alter maladaptive thoughts and behaviors.For information about cognitive-behavioral therapy,
you will need to consult a psychiatrist or psychologist.

Auditory Habituation: This therapy attempts to retrain the ear to ignore (or habituate ) the tinnitus.
Patients wear hearing aid type devices that emit a “broad band noise” – noise that is quieter than tinnitus.
The course of this treatment can last more than one year. www.tinnitushelp.com

Neuromonics Tinnitus Treatment: Noninvasive tinnitus retraining which is FDA approved.
Uses Counseling , auditory stimulation device with relaxation techniques. www.neuromonics.com 1-866-

Drug Therapy: Many medications have been investigated for use in tinnitus treatment. Currently,
medications are primarily used to help with anxiety, depression, and sleep difficulties. Treating these
problems can indirectly help the tinnitus patient. Melatonin has been shown in studies to be quite helpful
for sleep disorders in tinnitus patients. Over the counter sleep aids and Cymbalta have been shown to help
in some cases. Herbal medications are available at www.tinnitusformula.com

Acupuncture: Acupuncture therapy operates on the principle that health depends on the free flow of “life
energy” through the body. If the flow is disturbed, illness will result. This procedure has brought some
relief for a few tinnitus patients, but usually on a temporary basis. For information about acupuncture, we
recommend you research this through the Yellow Pages and there are a number of practitioners in the Fort
Collins area.

Treat Allergies, dry nose, pop the ears as sinus and Eustachian tube conditions can cause or
worsen tinnitus. Try sinus rinse daily. We have information available if needed, please ask.

                                  Is There An Operation For Tinnitus?

    A surgical procedure has not proven successful. In fact, destruction of the hearing mechanism most
    often leaves tinnitus still present.

                              Do Certain Things Make Tinnitus Worse?

    Yes! The way the ear and tinnitus react to different situations varies greatly from person to person, but
    everyone should be aware of the following:

    1.   Caffeine/Alcohol/Nicotine/Chocolate can exacerbate tinnitus. Some tinnitus patients also find
         that their tinnitus is made worse by allergies and consuming certain foods. (Cheese, salt and red
         wine have been mentioned.) Caffeine, alcohol, and nicotine can be avoided for one month and
         then slowly reintroduced into the diet or daily routine. Any worsening of the tinnitus would be
         noticeable after the reintroduction and could be noted in a journal for future reference.

    2.   Over-exposure to noise can cause or worsen tinnitus and hearing loss. It is very important,
         especially if one already has tinnitus, to avoid or reduce further exposure. When around noise or
         anticipating a noisy event, always carry and use proper ear protection (earplugs or muffs).
         Remember the potential danger of noise from common sources such as lawnmowers, stereos, hair
         dryers, chain saws, leaf blowers, motorcycles, concerts, movies, and noise on the job.

    3.   Certain medications: Many drugs are ototoxic (damaging to the ear) and can make tinnitus
         worse. Tinnitus can be caused by loop diuretics such as Lasix, erythromycin, aspirin and some
         intravenous antibiotics. Chemotherapy, Cisplatin, Carboplatin and Topical Neomycin can cause
         hearing loss if absorbed.

     4.   Stress. Tinnitus causes stress; stress causes tinnitus: it can be a vicious cycle. Anything you can
          do to reduce stress will help break the cycle. Relaxation therapies such as yoga, meditation, and
          exercise can be useful. Consider counseling or meditations from your doctor if you cannot relieve
          stress issues.

                          How Can I Learn more About Tinnitus and Find Help?

     The American Tinnitus Association (ATA) is a national non-profit organization dedicated to helping
     tinnitus patients and funding tinnitus research. ATA produces and distributes public awareness and
     educational materials for health professionals and patients.

     Your annual ATA membership entitles you to receive the quarterly journal Tinnitus Today, which
     includes up-to-date reports on research, self-help, and treatments. ATA members also receive lists of
     local tinnitus clinics and self-help groups, discounts on books and tapes, and access to the Members
     Only section on the ATA web site. Please write, call or visit the ATA web site for more information:

     American Tinnitus Association
     National Headquarters
     Post Office Box 5
     Portland, OR 97207-0005
     Tel:         (503) 248-9985
                  (800) 634-8978
     Fax:         (503) 248-0024
     Web: www.ata.org

     Another resource available on the Internet is www.entnet.org/healthinfo/hearing/tinnitus.cfm

     For information on hearing aids or tinnitus maskers call one of our staff audiologists at any of our
     Cheryl Hadlock, Au.D.
     Rachel White, Au. D.
     1124 E. Elizabeth st. #E101
     Fort Collins, CO 80524

     Renita Boesiger, Au.D.
     3820 North Grant
     Loveland, CO 80538

1120 E. Elizabeth Building F. #101   3820 Grant Avenue          555 Prospect                3116 Willett Drive
Fort Collins, CO, 805024-4024        Loveland, CO 80538         Estes Park, CO 80517        Laramie, WY 82070
           970-221-1177                 970-593-1177                                          800-921-3277
      Fax 970-484-5990                Fax 970-593-0670



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