Category: ENT

How do we treat tinnitus?

Posted on by nextAdmin1

Hi again, Audiology fam!

We at Andros hope you are all healthy and relatively happy, and continuing to #maskup as we all find
our way through the current landscape.

Welcome to part TWO of our tinnitus series – oh, how time flies when we’re all having fun (sincerely hope). Today we’re going to be discussing the various ways that we (your neighborhood friendly audiologists) treat and/or manage tinnitus.

First, I’m going to get this statement out of the way: you won’t find any magic bullet cure here that will immediately disappear your tinnitus. I am so sorry, but we just aren’t there yet. HOWEVER (and you see, I used the capital letters to indicate emphasis because that is a major however), there are many many many ways to manage tinnitus successfully and make life better for people who suffer from tinnitus.

The first type of management strategy we’ll discuss is the use of sound therapies. Sound therapies
involve changing a person’s perception of or reaction to their tinnitus, and they do this in a variety of ways. This can mean reducing the prominence of the tinnitus in relation to background noise by partially or completely covering your tinnitus with a sound of your own choosing, using soothing sounds to reduce the stress associated with tinnitus, using an interesting sound in order to distract yourself, or increasing the level of background sound to promote your brain’s habituation or acceptance of your tinnitus over time.

It should be noted that there is an insufficient amount of research available to fully support the use of sound therapies in the treatment of tinnitus, particularly because there are many different ways to implement sound therapy. However, many authors have seen high anecdotal rates of success with different types of sound therapy, and it is still considered a good option for patients with chronic, bothersome tinnitus, as long as realistic expectations are taken into consideration.

The devices used for sound therapy were, at one point, stand-alone devices; purely made for sound generation. Those devices still exist and are available, but at this point, most hearing aids are now what’s considered “combination” devices, and have tinnitus maskers that come standard in many, if not all of the current offerings. As stated in previous blogs regarding this subject – hearing loss is a common comorbidity (pal) of tinnitus, and if we’re treating the hearing loss with a hearing aid, it only makes sense to get a device that is also capable of sound generation. Many people find that the act of treating the hearing loss, and giving the brain something else to listen to (amplification! Birdsong! The ticking of your car turn signal!) helps to minimize their tinnitus, without having to do any other type of sound generation, but more options is better than no options. A very common type of sound therapy that many people (including the friendly neighborhood audiologist writing this article) come to on their own without having to be coached is something called sound enrichment. Sound enrichment is the use of sound in the background during the day or going to sleep to help distract from your tinnitus. Many people use music, podcasts, or even a common household box fan for this task – it is an easy and simple way to give your brain a little relief.

Next management technique is also pretty straightforward: counseling and education! Surprisingly, for some people, just knowing what exactly tinnitus is, and potentially why it is happening helps them adjust to their new normal and go from there. If you’ve been following this series from the beginning, then you already have more information about tinnitus than the general public – go you! The goal of patient education is to increase knowledge about tinnitus, which will hopefully help people to cope and manage their reactions to their tinnitus a little better. The level and type of counseling providing will vary based on individual needs – for many patients, a little education will go a long way. For others, the counseling needed may prove to be outside the scope of the audiologist, and a referral to someone who specializes in cognitive-behavioral therapy (a type of therapy that focuses on reframing thought patterns and behaviors) may be necessary. This does not mean the work you’ve done with your audiologist has failed – this means that you are continuing on the path to better quality of life with tinnitus, and just need someone else to guide you along the path for a little while.

Another subset of tinnitus management strategies include guided tinnitus protocols, where the audiologist and the patient work through a series of prescribed activities and counseling sessions. There are several currently en vogue, including, but not limited to such protocols as TRT (Tinnitus Retraining Therapy), or PTM (Progressive Tinnitus Management). The guided tinnitus protocol favored by Andros Audiology and Hearing Aid Center is a protocol called the Tinnitus Activities Therapy (TAT), which was developed by the University of Iowa. The Tinnitus Activities Therapy integrates sound therapy (see above) with counseling (also see above) and Cognitive Behavioral Therapy (also see above. Gee, I’m thorough). There are four major components or aspects to this form of tinnitus management, each with its own series of activities and counseling to move through: thoughts and emotions, hearing and communication, sleep, and concentration. While the TAT protocol has not been studied systematically, because it is a more modern protocol, there is evidence backing each component used in TAT (sound therapy, counseling, and CBT, as previously discussed).

And with that, we close out our THIRD tinnitus discussion! Next time, we’ll be discussing some tinnitus odds and ends, a few things that are important to note, but don’t really fit in the previous categories.

I hope you all are having a wonderful time taking this wild ride into tinnitus education with me!

Until next time, please stay safe, be well, and as always, remember that Andros Audiology and Hearing
Aid Center is here to help.

What is tinnitus?

Posted on by Andros Audiology

Hi Audiology Friends and Fam!

Hope this message finds you well and you’re continuing to find a socially distant way to connect with people! To keep up our tradition of educating and (hopefully) entertaining our patient population, I’ve decided to embark on a grand journey – the journey of tinnitus education.

What is tinnitus? How on earth do you say it? How do we make it better? Is it indicative of a super scary
underlying diagnosis? HELP?!?!

We are going to tackle all of these questions and many more – never fear, your friendly neighborhood audiologists are here! With a five-part series on all things tinnitus! You heard me, FIVE PARTS, we have a lot to cover!! Today, we’re going simple and discussing what tinnitus is. Over the coming weeks we’ll also cover how to assess, and treat tinnitus, as well as our own Andros Protocol for tinnitus evaluation.

We’re going to start here, with the basics – what is tinnitus? You’re about to find out!

Tinnitus is defined as the perception or sensation of hearing sound when no external sound is present –
the hallmarks include perceiving/hearing the sound involuntarily, and the sound originating in the head
rather than being externally produced.

People can hear a variety of sounds, all of which are covered under the umbrella of a tinnitus diagnosis,
but the most common variations include: ringing, buzzing, roaring, chirping, or hissing.

The first step in assessing a person’s tinnitus involves placing the symptoms into a series of classifications or categories. The different types of tinnitus affect the management plan that will be put into place, or help your audiologist decide if you even need a management plan! See below for the different category types for tinnitus, and see if you can pinpoint which category you fall into.

  • Primary
    • Related to an unknown cause
    • May or may not be associated with SNHL
  • Secondary
    • Associated with an identifiable underlying cause or organic condition
  • Recent onset
    • Less than 6 months in duration
  • Persistent
    • 6 months or longer in duration
  •  Spontaneous
    • Sudden tonal tinnitus in one ear that is accompanied by a sense of fullness and hearing loss in the same ear
      • All of a sudden, everything gets very quiet, and you hear a whine come on in that ear
    • All symptoms resolve within a minute or two
      • It can be quite jarring, but is considered a natural phenomenon that
        most people will experience at least once in their lifetimes
  • Temporary
    •  Tinnitus caused by noise or some other ototoxin that may last for a few days or up to about a week
  • Occasional
    •  Occurring every few weeks or months
  •  Intermittent
    • Occurring daily or weekly
  •  Constant
    • Always present
  • Non-bothersome
    • Tinnitus does not have a significant impact on quality of life
    • You may be curious or concerned about the cause and natural progression of the tinnitus, but it hasn’t interrupted the daily flow of your life
  • Bothersome
    • Tinnitus is having a significant impact on quality of life
    • You may feel distressed and are seeking therapy/management strategies to alleviate symptoms

There are many sources of information that suggest many types of risk factors and potential underlying
contributors to tinnitus (see below for a graphic of risk factors/associated conditions for tinnitus listed
by www.asha.org).

However, there is no one answer to what causes tinnitus, and how it originates in our brain and auditory
system. The brain is an intensely complex piece of machinery, and we are still theorizing about the
intricate process of tinnitus, and why it happens. Currently the predominant theories suggest that all
tinnitus – including tinnitus believed to be caused by cochlear damage (associated with hearing loss) –
originates in the central auditory system (in the brain, not the cochlea).

Here’s something to consider when thinking about your tinnitus – it really is more common than most people think. The friendly neighborhood audiologist writing this blog entry is currently experiencing her constant, non-bothersome tinnitus in both ears with some level of amusement! Per the U.S. Center for Disease Control in 2011-2012, 15% of Americans have tinnitus. For most people, tinnitus is non- bothersome (it doesn’t really get in our way), but for others, it can be quite debilitating and troublesome. There is no one way to experience tinnitus – it is a highly subjective condition, and each case is going to be unique, with its own trials and tribulations. No matter how you feel about your tinnitus – your feelings are valid! Left to its own devices, debilitating tinnitus may impact a person’s quality of life in a variety of different ways, including thoughts, emotions, sleep, concentration, socialization, physical health, and even economic well-being, so it’s important to ask for help in trying to manage tinnitus if it begins to overwhelm you. That’s what we’re here for!

Well, THAT was a LOT of information, but I believe that covers the bases as far as basics are concerned.
Oh wait! I forgot to answer the number one question I get about tinnitus on a daily basis:

it can be pronounced two different ways, TIN-ni-tus or tin-EYE-tus. Both pronunciations are technically
correct, but these audiologists were taught the TIN-ni-tus version, so that’s what we go with. That’s our answer – WE’RE ALL CORRECT!

I hope this has been instructive and (at least a little bit) fun! I’ve got a few more of these ready to go, but am also open to suggestions if you have burning questions that you’d really like answered about tinnitus – send them to the following email and we’ll try to get them covered!

Stay safe and be well, all of you, and we’ll talk soon!

Getting Used To A Hearing Aid

Posted on by Andros Audiology

Getting Used to a Hearing Aid

Making the decision to improve your hearing is a big step towards improving your overall quality of life. It can take time to get used to hearing aids once you receive them. Every new hearing aid user experiences an adjustment period.  Getting used to a hearing aid takes time, practice, and patience.

The brain

Your brain is the main reason it takes time to get used to a hearing aid. Do you remember the first time you drove a car? It was hard work. In the first place, we had to learn the basics of how to run the car. After that, we learned how to operate the car in traffic. With time and practice, these motions are now automatic. This is because of muscle memory. The brain creates a memory for the movement, and they become automatic. Hearing is no different. The hearing part of our brain needs to practice and thus, build memories of sounds.

Flipping on the light

Getting a hearing aid is like flipping on bright lights after sitting in the dark for a while. At first, sound might seem too loud or bright. Give yourself time to get used to all of the new sounds. The amount of time it takes to get used to a hearing aid is different for everybody. On average, four to six weeks of consistent use will allow all the new sounds to become normal. For some people, time is all it takes.

Small doses or all at once

It is generally recommended that hearing aids are worn consistently, all day, every day. You take them out at night for sleeping, and can’t wear them in the shower. For some people, this is too much in the beginning. Generally, you should try to wear them as much as possible. If needed, you can start small, and work your way up to a full time wear schedule.

When you’ve been missing out, it can be hard to know what is normal. Ask others around you what they are hearing. It is a noisy world and your brain forgets about all the little sounds around you when you have hearing loss. It takes patience, but rest assured that your brain will get used to all that sound again.

Call your hearing aid professional if you are still having troubles getting used to your hearing aids. Hearing aids are adjustable. Levels that worked for one person may not be the right levels for you. Keeping a journal helps. Writing down your experiences can help guide the fine tuning process.

Best of luck as you go out there and start exploring our noisy world with your new hearing aids!

Hearing Aid Batteries- Tips and Tricks

Posted on by Andros Audiology

How to get the most out of your hearing aid batteries

Photo by Hilary Halliwell from Pexels

 

One of the most important parts of your hearing aid is the battery! Did you know that some simple steps can help prolong the life of your hearing aid batteries?

Some background on hearing aid batteries:

Hearing aid batteries are zinc-air and come in 4 sizes (yellow10, brown312, orange13, or blue675). All zinc-air batteries will come with a sticker-like tab on the back. Therefore, you will need to remove the tab prior to using the battery. This tab prevents air from activating the zinc chemical until you need it. Hearing aid batteries are sensitive to extreme temperatures and moisture. If hearing aid batteries touch other metal or other batteries, this can cause them to short out.

How to get the most of your hearing aid batteries:

-Let battery sit un-tabbed one to five minutes prior to using. This allows the power to ramp up before use.

-Store batteries at room temperature in their original packaging.

-Do not store batteries in humid or moist environments.

-Open the battery door of your hearing aid when it is not in use to extend the life of the battery.

Some other tips that can help:

-Keeping track of your battery usage can help you spot changes to the cycle.

-Dispose of dead batteries immediately to avoid mix-ups. You can throw batteries in the trash or take them to a local recycling center.

-Keep spare batteries on you. Your hearing aid batteries are most likely to go out when you are going about your normal day.

Don’t forget that batteries are not safe to be ingested. Keep them out of reach of small children, vulnerable adults, and pets. If batteries are swallowed, see a doctor immediately and call the National Button Battery Hotline at (202) 625-3333.

 

Additionally, if these tips and tricks did not help improve the performance of your devices, please call to visit with our professionals today at (651) 888-7800.

 

How Does the Ear Work?

Posted on by Andros Audiology

How does the ear work? Hearing is an essential sense that we rely on every day for communication and safety. Most people don’t realize how important this sense really is on our day-to-day life. For information on the importance of hearing, check out our previous blog. So, how do we hear? How does the ear really work?

In a normal auditory system, the ear is comprised of 3 distinct sections: the outer ear, the middle ear, and the inner ear. They work together to funnel and capture sound and thus, feed it into our brains. As a result, our brains do all the hard work of understanding.

The Outer Ear

The outer ear is the portion that is visible to us and is typically what people will think of when they think of ears. The portion that captures and therefore funnels sound into the pinna. Sounds are airwaves and these are funneled into the ear canal by the pinna. Once the sound is trapped in the ear canal, everything is directed towards our tympanic membrane, or eardrum. The eardrum is a very thin membrane that vibrates like a drumhead due to sound hitting it.

The Middle Ear

The eardrum marks the start of the middle ear space. This portion of the ear is where we will find the ossicles, or 3 small bones suspended behind the ear drum. Although medical professionals will call these bones the malleus, incus, and stapes, you might know them as the hammer, anvil, and stirrup. The stapes, or stirrup, is the smallest bone in the body! The 3 bones work together to pass the vibration of sound from the eardrum (outer ear) to the cochlear (inner ear). It is important that the middle ear hold air and not fluid. The Eustachian tube works to keep the air pressure equalized so the eardrum can vibrate freely.

The Inner Ear

The stapes, or stirrup, connects to the final part of our ear, the cochlea. The cochlea is snail shaped and resides in the temporal bone of our skull. The cochlea contains fluid and has 2 parts. The snail shaped half deals with the sound waves and hearing, and the other half contains 3 semi-circular canals which we call the vestibular system. We use the 3 semi-circular canals to maintain our balance and sense of motion in space. If something interrupts the fluid in the semi-circular canals, the person will likely become dizzy.

To hear, we use the coiled portion of the cochlea. Once the sound enters the cochlea, it travels like a wave through the fluid inside the ear. The entire length of the cochlea contains outer and inner hair cells. These hair cells will dance and sway as a result of sound waves passing by. The bundles of hair cells have nerves attached that will therefore fire the signal into the brain.

The Bottom Line

The important thing to remember about our hearing is that we really hear with our brains. Our ears capture the sound wave and therefore converts it to a nerve impulse. Our brains need constant practice and should not go without sound for too long.

An audiologist can evaluate how all 3 sections of your ear are working, along with the brain. To schedule an evaluation, call (651) 888-7888.

Tinnitus: What is it? Why do I have it? And What to do about it?

Posted on by Andros Audiology

People who experience tinnitus know that it can be very bothersome. Tinnitus (pronounced ten / ih / tus) is the perception or sensation of hearing sound when no external sound is present. These sounds are typically described as ringing, buzzing, roaring, chirping, or hissing.

The noises may vary in pitch from a low roaring sound to a high-pitched squeal. You can experience tinnitus in one ear, or both ears.

Tinnitus can significantly affect quality of life. Although it affects people differently, if you have tinnitus, you also may experience:

  • -Fatigue
  • -Stress
  • -Sleep problems
  • -Trouble concentrating
  • -Memory problems
  • -Depression, anxiety, and/or irritability

What causes tinnitus? Are there risk factors?

A number of health conditions can cause or worsen tinnitus. In many cases, an exact cause is never found.

A common cause of tinnitus is inner ear cell damage. Tiny, delicate hairs in your inner ear move in relation to the pressure of sound waves. This triggers ear cells to release an electrical signal through a nerve from your ear (auditory nerve) to your brain. Your brain interprets these signals as sound. If the hairs inside your inner ear are bent or broken, they can “leak” random electrical impulses to your brain, causing tinnitus.

Anyone can experience tinnitus, but these factors may increase your risk:

  • -Loud noise exposure. Prolonged exposure to loud noise can damage the tiny sensory hair cells in your ear that transmit sound to your brain. People who work in noisy environments — such as factory and construction workers, musicians, and soldiers — are particularly at risk.
  • -Age. As you age, the number of functioning nerve fibers in your ears declines, possibly causing hearing problems often associated with tinnitus.
  • -Gender. Men are more likely to experience tinnitus.
  • -Smoking. Smokers have a higher risk of developing tinnitus.
  • -Cardiovascular problems. Conditions that affect your blood flow, such as high blood pressure or narrowed arteries (atherosclerosis), can increase your risk of tinnitus.

 How is tinnitus diagnosed?

Because tinnitus is a perception, there is no way to truly test for tinnitus. Your doctor will diagnose tinnitus based on your symptoms, your medical history, and exam findings. A hearing test will likely be ordered to rule out any underlying conditions and to assess if any hearing loss is present. Your doctor may also may want you to have an x-ray, a CT scan, or MRI of your head.

How is tinnitus treated?

To treat your tinnitus, your doctor will first try to identify any underlying, treatable condition that may be associated with your symptoms. If tinnitus is due to a health condition, your doctor may be able to take steps that could reduce or eliminate the noise. Examples include:

  • -Earwax removal. Removing impacted earwax can decrease tinnitus symptoms.
  • -Treating a blood vessel condition. Underlying vascular conditions may require medication, surgery or another treatment to address the problem.
  • -Changing your medication. If a medication you’re taking appears to be the cause of tinnitus, your doctor may recommend stopping or reducing the drug, or switching to a different medication.

In some cases white noise may help suppress the sound so that it’s less bothersome. Your doctor may suggest using an electronic device to suppress the noise. Devices include:

  • -White noise machines. These devices, which produce simulated environmental sounds such as falling rain or ocean waves, are often an effective treatment for tinnitus. You may want to try a white noise machine with pillow speakers to help you sleep. Fans, humidifiers, dehumidifiers and air conditioners in the bedroom also may help cover the internal noise at night.
  • -Hearing aids. These can be especially helpful if you have hearing problems as well as tinnitus.
  • -Tinnitus retraining. A wearable device delivers individually programmed tonal music to mask the specific frequencies of the tinnitus you experience. Over time, this technique may accustom you to the tinnitus, thereby helping you not to focus on it. Counseling is often a component of tinnitus retraining.

There’s little evidence that alternative medicine treatments work for tinnitus. However, some alternative therapies that have been tried for tinnitus include acupuncture, hypnosis, ginkgo biloba, zinc supplements, and B vitamins.

Bottom Line:

If your tinnitus gets worse with stress, make sure to do things that decrease the stress in your life and help you to relax. Try to get enough sleep. Cut down on the amount of alcohol and caffeine you drink, and stop smoking if you smoke. These things can make your tinnitus worse. Avoid listening to loud noises. If you cannot avoid loud noises, use silicone earplugs or earmuffs to protect your ears.

Helpful Resources:

Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/tinnitus/home/ovc-20180349

American Tinnitus Association: https://www.ata.org

Check out our blag regarding Noise Induced Hearing Loss if you suspect you have hearing loss as well.

What is Eustachian Tube Dysfunction and How is it Treated?

Posted on by Andros Audiology

Now that winter is officially upon us, many people are experiencing some symptoms associated with colds and sinuses. These symptoms can range from mild to severe and affect all sort of areas in our bodies as well as in our daily lives. One of the most common symptoms associated with this time of year is eustachian tube dysfunction.

What is eustachian tube dysfunction?

We have 3 main parts of our ears: the outer ear, the middle ear, and the inner ear. All 3 of these parts need to be working properly for us to hear effectively. As our allergies act up, out middle ear is particularly susceptible to issues, particularly due to dysfunction of our eustachian tubes. The most common cause of eustachian tube dysfunction is excessive mucus and inflammation of the tube caused by a cold, the flu, a sinus infection or allergies.

The eustachian tube is a small passageway that connects the upper part of your throat (pharynx) to your middle ears. The purpose of our eustachian tubes is to equalize pressure the pressure in our middle ear. Sneezing, swallowing, or yawning will usually force open the eustachian tubes to allow air to flow in and out. But sometimes one or both of our eustachian tubes is plugged and the eustachian tubes cannot open. This is called eustachian tube dysfunction or ETD for short. When this happens, sounds can become muffled and your ear may feel full. You may also experience ear pain or other symptoms.

What are the symptoms of eustachian tube dysfunction?

Some common complaints of those with eustachian tube dysfunction are:

  • – Plugged or full sensation of your ears
  • – Muffled hearing
  • – Popping, clicking, or fluttering sensation in your ears
  • – Pain in your ears
  • – Ringing, or tinnitus, in your ears
  • – Mild dizziness or off-balance feeling

Some people will experience only a few of these symptoms and other may experience all of them. Activities such as flying or riding in an elevator can further affect the pressure in the middle ear.

How is eustachian tube dysfunction diagnosed?

An otolaryngologist (ENT) doctor can diagnose eustachian tube dysfunction. Your ENT doctor will be able to diagnose ETD by talking to you about your symptoms and by examining you. Your doctor will examine your ear canals and eardrums, and your nasal passages and the back of your throat.

An audiologist may also want to see you if you are having symptoms associated with eustachian tube dysfunction. The audiologist will do a tympanogram test to determine if there is an abnormal amount of negative pressure in your middle ear space. They may also want to conduct a hearing test to determine if there is any hearing loss associated with the eustachian tube dysfunction.

What is the treatment for eustachian tube dysfunction?

Sometimes eustachian tube dysfunction clears up on its own without any treatment. If it does not clear up, there are a number of things your doctor may do to help alleviate the eustachian tube dysfunction, including:

  • – Eustachian tube exercises to help force the eustachian tube to open
  • – Prescribing a decongestant to help reduce swelling of the eustachian tube
  • – Prescribing an antihistamine or steroid nasal spray to reduce allergic responses
  • – Surgically implanting pressure equalizing (PE) tubes to help equalize the pressure
  • – Performing a myringotomy – making a tiny incision in the eardrum to help equalize the pressure

Take Home

If you are someone you know is experiencing symptoms associated with eustachian tube dysfunction call us at 651-888-7800 to schedule an appointment with our doctor.

Check out our post from last week for more information about when to see your audiologist or see our Andros ENT and Sleep Center website to get more information.