Treatment for Tinnitus with Hyperacusis

Question

Answer

Thank you for your question. Yes, not only is Neuromonics Tinnitus Treatment clinically proven to be effective in treating patients with disturbing tinnitus, it has also been demonstrated to improve loudness discomfort issues over the course of treatment. The treatment utilizes a non-invasive, FDA cleared Class II medical device to provide a novel approach to acoustic stimulation which is combined with structured education, counseling, and support.

Although there is no clear consensus as to the definition of hyperacusis, it can functionally be considered the extreme end of loudness discomfort levels, whereby even soft everyday type sounds might be experienced as uncomfortable. One study of one tinnitus population found that eight percent of tinnitus sufferers also had hyperacusis (Sanchez & Stephens, 1997). Hyperacusis can be hugely debilitating and significantly effect a person's quality of life.

Currently there is evidence that some degree of peripheral hearing loss accompanied by central involvement is the common cause of tinnitus and tinnitus in combination with hyperacusis. It is thought that the brain compensates for a lack, or reduction, of auditory input due to hearing loss by increasing both spontaneous neural activity in the auditory system and its internal sensitivity. This concept known as "central gain", causes sounds that are moderately loud in the environment to be uncomfortably loud for the individual. This hypersensitivity to sound, or decreased sound tolerance, can in severe cases lead to hyperacusis.

Fortunately, over the 2nd and 3rd clinical trials of Neuromonics Tinnitus Treatment, as well as in subsequent private practice outcomes, there has been the consistent finding that loudness tolerance can markedly improve over the course of treatment. In the 3rd clinical trial, the improvement in LDLs was an average of 10 dB, (Davis, Paki, and Hanley, 2007), which translates into an enormous improvement in everyday listening comfort.

What makes the Neuromonics treatment so effective for the treatment of tinnitus with hyperacusis? The first key element is the treatment stimulus. To address the increased central auditory gain activity, Neuromonics uses music that has been spectrally modified according to each individual patient's hearing characteristics, for each ear independently. This customized music is specifically chosen for its frequency response that maximizes stimulation of the auditory system at a comfortable listening level for the patient. This customization of the treatment stimulus is key for the patient with tinnitus and hyperacusis, as it allows for more relief from tinnitus at a lower listening volume by desensitizing the patient's auditory system. Next, it is important that when both tinnitus and hyperacusis conditions are concurrent, the Decreased Sound Tolerance is addressed first. Once sound comfort issues have been addressed and improved, focus can now be on treatment for tinnitus. Finally, the combination of the customized acoustic stimulus provided concurrently with education, support, and monitoring from a Neuromonics trained clinician ensures positive outcomes for the tinnitus with hyperacusis patient.

For more information about Neuromonics Tinnitus Treatment, visit www.neuromonics.com/ or the Neuromonics web channel on AudiologyOnline.

References

Davis, P.B., Paki, B. & Hanley, P.J. (2007). The neuromonics tinnitus treatment: Third clinical trial. Ear Hear, 28: 242-59.

Sanchez, L. & Stephens, D. (1997). A tinnitus problem questionnaire in a clinic population. Ear Hear, 18: 210-217.

Casie Keaton, Au.D., CCC-A is a Clinical Sales Manager with Neuromonics and has extensive experience treating tinnitus patients. She has research published in the area of psychoacoustics.

Marta R. Hecocks, Au.D., CCC-A is a Clinical Specialist with Neuromonics, where she responsible for providing clinical support to clinicians in the areas of product and treatment training, as well as assistance with clinical appointments.