Welcome to the Tinnitus & Hyperacusis Group Education Session Richard Tyler, Ph.D., Audiologist University of Iowa Hospitals and Clinics Group session 1
Overview Introductions Discuss hearing, hearing loss, and tinnitus Review treatments for tinnitus Our options counseling and sound therapy, hearing aids, tinnitus devices Group session 2
Introductions Your first name What does your tinnitus sound like? (e.g. ringing, humming)? How long have you had tinnitus? Group session 3
How do we hear? The Human Auditory System: Group session 4
Hair cells in cochlea Group session 5
Nerve carries information from cochlea to brain Hair Cell Nerve Activity To Brain Nerve Fiber Group session 6
Testing your hearing Audiogram Softest level that you can detect sound Group session 7
Audiogram of Everyday Sounds 110 Group session 8
Hearing Loss (db HL) Normal Hearing thresholds on an Audiogram 0 20 40 NORMAL MILD 60 MODERATE 80 100 SEVERE PROFOUND 120 250 500 1000 2000 4000 8000 Frequency (Hz) Group session 9
Hearing thresholds after noise exposure Group session 10
Hair cells in normal ear Group session 11
Damaged hair cells Group session 12
Normal vs. damaged auditory nerve fibers Retrieved from: http://www.cdc.gov/niosh/topics/noise/factors.html Group session 13
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Sound levels from soft to loud Group session 15
Overview of tinnitus Causes Prevalence Mechanisms Group session 16
What do you think caused your tinnitus? Group session 17
There are many different causes of tinnitus Unknown Head Injury Medications Noise Causes Age Your Cause? Disease Group session 18
Tinnitus is Common 15 in 100 (15%) people have tinnitus 1 in 100 (1%) people have troublesome tinnitus 30 in 100 (30%) people over 60 years old have tinnitus Group session 19
Tinnitus is an Increase in Spontaneous Nerve Activity Normal Hearing Hear Silence Hearing Loss (No Tinnitus) Hear Silence Tinnitus Hear Sound Nerve Fiber Response Group session 20
Tinnitus does not Make you deaf Lead to senility Imply a sign of mental illness Group session 21
What is the biggest problem you have that you believe has resulted from your tinnitus? Group session 22
Reactions to tinnitus Thoughts and emotions Hearing difficulties Sleep Concentration Group session 23
For those with tinnitus What is the most difficult thing to explain to others about tinnitus? What could others do to help you with your tinnitus? Group session 24
For partners of someone with tinnitus What have you been able to do to help your partner with their tinnitus? Group session 25
Treatments for tinnitus What have you tried? What has been successful? Group session 26
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Expectations for relief At this time, there are no widely accepted cures for tinnitus There are no studies that have shown a cure for tinnitus None using appropriate research designs and that have been replicated by others Group session 29
Medications Currently no drug or surgery can reliably eliminate the source of tinnitus There are effective drugs for: Sleep, anxiety, and depression Group session 30
Excellent options to treat tinnitus Individualized counseling Sound therapy Wearable tinnitus devices Hearing aids Group session 31
Individualized counseling Tinnitus Activities Treatment (Tyler, 2006) Focus on areas impacted by tinnitus: Thoughts and emotions, Hearing, Sleep, Concentration Group session 32
Counseling Private Consultation in Tinnitus Clinic (1 hour $160) Private Multiple Sessions (three, 1 hour sessions - $320) Group session 33
Our Thoughts and Emotions Doorbell Neutral Doorbell Doorbell Fire Injury Angry neighbor Flowers Friend Delivery Anxiety Happiness Group session 34
Tinnitus and Attention If brain determines tinnitus is not important, the tinnitus can be ignored If brain determines tinnitus is important, we will pay attention to it Group session 35
After Grant Searchfield Group session 36
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Sound Therapy Options Non-wearable sound generators Sound Pillow Sound Generators Smartphone applications CDs, radio, etc Group session 39
Wearable tinnitus devices General Hearing Instruments Neuromonics Desyncra Widex GN Resound (combination unit) Levo Group session 40
Hearing Aids Improve hearing and communication Reduce stress of effortful listening Hearing aids often help tinnitus Facilitates positive reactions to tinnitus Helps to mask tinnitus sound UIHC Hearing Aid Center provides excellent service Group session 41
Low level noise makes tinnitus more difficult to detect Tinnitus Low Level Noise Tinnitus in Low Level Noise Group session 42
Decrease Prominence of Tinnitus Level Tinnitus Level Tinnitus Group session 43
Background sound partially masks a barking dog Group session 44
Self-Help books for tinnitus Group session 45
Support Groups for tinnitus www.ata.org Group session 46
Summary Hearing loss and tinnitus are related Tinnitus is a change in spontaneous activity of auditory nerve There is no cure for tinnitus Options include counseling and sound therapy, hearing aids, tinnitus devices Group session 47
Stage 1 Medical Clearance Stage 2 Group Session Stage 3 Stage 4 Counseling Sound therapy devices Counseling and sound therapy devices Individual tinnitus evaluation and counseling Group session 48
Individual Tinnitus Evaluation and Counseling Audiogram Measure your tinnitus Pitch, loudness and ability to mask Tinnitus Questionnaires Discussion of results and next options counseling, hearing aids, devices Group session 49
How do you want to manage your tinnitus? 1. Focus on other areas of your life and put tinnitus in the background 2. Use low level sound in your environment (sound machine, CDs, App, television, etc) 3. Use wearable tinnitus devices 4. Use hearing aids with maskers for hearing loss 5. Begin individualized counseling Group session 50