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Facts About Noise #9, What is Tinnitus?

BASELINE, A hearing conservation newsletter from the National Hearing Conservation Association. Tinnitus: Will This Ringing Never Stop?

BY DHYAN CASSIE: Tinnitus/Hyperacusis Management Center, College of New Jersey, Ewing, New Jersey

What is Tinnitus?

Tinnitus is a ringing, buzzing, hissing or other head noise that does not come from an external source.

What is the cause of tinnitus?

One of the most common causes is exposure to loud noise. Workplace noise can cause hearing loss and tinnitus. If those exposed to loud sound do not wear proper hearing protection devices, they may find they gradually lose their hearing and suffer from tinnitus. Excessively loud sound can also be from music, power tools and chain saws, gunfire, explosives, and motorcycles.

Tinnitus may only be an annoyance for some people; however, for others it is a chronic condition, which can cause sleeplessness and lack of concentration. This can be a serious problem that can be avoided by proper precaution.

A person who tells a physician about tinnitus may be told to "Go home and live with it." This is possible for some, but others need treatment. Feeling there is no cure for tinnitus can turn a benign symptom into a feeling of helplessness and despair. Negative counseling which provides no hope can actually increase the patient's perception of tinnitus as he feels it will go on forever, may get worse and cannot be effectively treated.

There is help! There is a national organization dedicated to silencing tinnitus. Any person suffering from tinnitus should con- tact the American Tinnitus Association (ATA) at 1-800-634-8978. They will be told about tinnitus clinics throughout the United States that work with patients in alleviating tinnitus. Self-help groups sponsored by the ATA provide information and support.

There are several things that the occupational health nurse or safety professional can do to promote feelings of hope and control for employees experiencing tinnitus.

Make an appointment with an audiologist who specializes in tinnitus management. Understand the auditory system, the damage that may be present in the inner ear, and the pitch and loudness level of the tinnitus. The understanding of what is happening is fundamental to taking the mystery out of tinnitus and to developing a tolerance for the ringing.
Avoid silence. Tinnitus is almost always worse in quiet, which is why most individuals with tinnitus feel their tinnitus is worse at night. To provide broadband, non-threatening sound during quiet times, sound machines can be purchased from many retail stores. Indoor waterfalls are effective. Fans, heaters and the sound from fish tanks also provide a constant broadband sound.
If the person suffering from tinnitus has a hearing loss, the use of amplification with compression circuitry may be an option for providing external sound to the auditory system. Again the individual must be advised to be in the presence of background sound as the use of hearing aids is effective only when there is background sound to be amplified.
If it is obvious the person needs further counseling and follow-up, the individual should be provided with a list of clinics in your area that specialize in tinnitus evaluation and management. A list of audiologists who have been trained in Tinnitus Retraining Therapy (TRT) can be obtained by accessing the TRT Association at www.tinnitus-pjj.com, or calling the Emory �Clinic in Atlanta at (404) 778-3109. Physicians and audiologists who specialize in tinnitus can be obtained from the American Tinnitus Association (ATA) at (800) 634-8978.
If the individual has other factors causing stress, these must be dealt with before or during tinnitus treatment. It may be necessary to refer this person for stress management or psychological counseling. The tinnitus specialist will be prepared to make this determination after reviewing a detailed questionnaire regarding the patient�s medical, audiological and environmental history.
Those with perseverant tinnitus should also be referred to the ATA, the national association dedicated to;) helping individuals with tinnitus through information, tinnitus materials, research, support groups and access to a hotline. Individuals can become members of the ATA and receive Tinnitus Today, a quarterly magazine dedicated to silence tinnitus through education, advocacy, research and support. ATA may also put them in touch with a professional who is prepared to listen and offer counsel.
A list of support groups in your area can be obtained by calling the AT A. Most support groups present speakers from different disciplines that offer advice and relief from tinnitus. Support groups are helpful as long as they are informational. An emphasis on �shared pain� may exacerbate the tinnitus. Although continued participation may not be necessary, often a support group will help the individual through the most difficult times. Attend a tinnitus support group yourself and learn more about tinnitus than could ever be studied in textbooks.
The audiologist, ATA or self -help group facilitator can provide a list of nutritionists, psychologists and other health-related professionals in your area who have shown themselves to be understanding and knowledgeable about tinnitus. Often a sup- port group facilitator will be aware of the professionals who have shown knowledge and experience in treating the tinnitus patient.
Become a member of the American Tinnitus Association. Have their materials available for the worker who says that tinnitus is causing distress, sleeplessness and affecting his or her work. Provide the employee with ATA� s website information, http://www.ata.org. The information on this site is reliable so the individual is not reading anecdotal information from unknown sources.
An initial professional consultation for a person who suffers from tinnitus consists of audiological testing, including special tests, and an extensive questionnaire. Based on these results it is often possible to determine the site of the damage to the auditory system. Treatment plans are recommended based on the information gathered. Treatment often consists of Tinnitus Retraining Therapy, which is refocusing the brain�s attention to the tinnitus. This therapy is over 84% successful in alleviating tinnitus. Other treatment plans may be recommended. There is help, and no one should be told to just go home and live with it.
Dhyan Cassie, AuD, CCC-A, is coordinator of the Tinnitus/Hyperacusis Management Center at the College of New Jersey, Ewing, New Jersey. She has specialized in tinnitus for eleven years and is currently a member of the board of directors of the American Tinnitus Association.

National Hearing Conservation Association: http://www.hearingconservation.org

Letter from a Tinnitus patient and author.

Facts About Noise #9, What is Tinnitus?

BASELINE, A hearing conservation newsletter from the National Hearing Conservation Association. Tinnitus: Will This Ringing Never Stop?

What is Tinnitus?

What is the cause of tinnitus?

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