Hearing Loss Help  

by Neil Bauman, Ph.D.

A concerned daughter wrote:

My mother is hearing a repetitive song and I would like to know what I can do for her. She is 99 years old, very hard of hearing, and because she does not hear people, has withdrawn and spends a lot of time alone. Even though I have told her that it is all in her head, she still keeps referring to the lady next door playing her music.

Being elderly, having a hearing loss, withdrawing, and being alone in a quiet environment are all factors that predispose people to hearing phantom music. The name for this condition is Musical Ear Syndrome (MES).

You can’t do anything about your mother’s age, but you can help her with the other factors. For example, she needs to enrich her environment with real sounds. She can do this by getting and wearing hearing aids, or by using various assistive listening devices that let her hear people talking to her. The more she stimulates her brain with real sound, the less time her brain will have to play the phantom sounds.

Getting her involved with people again—probably only one at a time since it is difficult to understand people in groups when you have a severe hearing loss—will give her something to focus on besides her phantom music.

When a person withdraws, they generally feel depressed and that often means they also focus on things going wrong with their bodies such as the phantom music your mom is hearing. The best way to treat this depression is to become involved in life again.

Incidentally, I have found that it is very hard to get people over the age of 85 or so to understand that the music they are hearing is phantom. They can’t seem to get it through their heads that this music is not real, so that approach may be a losing battle. Also, they may refuse to accept that what they are hearing is phantom because to them, hearing phantom sounds equates with being crazy, and no one wants to admit to that. Thus they continue to blame the music on others (neighbors).

Furthermore, since the phantom music seems to have directionality—coming from the lady next door—it is even more difficult to convince an elderly person that this music is not real, but phantom.

The trick is to get your mother’s mind focused on other things (and thus off her phantom music) by having her become involved in various activities again. When people do this, their phantom music often fades into the background to some degree.

Unfortunately, her phantom music may come back at night when her mind isn’t focused on anything. If her hearing loss isn’t too great, she could listen to real music on a bedside radio to mask the phantom music while she falls asleep, but if her loss is too severe (like mine is), this won’t work as the volume required would wake the whole neighborhood—and they’ll be upset at hearing real music in the wee hours!

If you want to learn more about Musical Ear Syndrome and some of the things you can do to help bring it under control, see the book, “Phantom Voices, Ethereal Music & Other Spooky Sounds“.

by Neil Bauman, Ph.D.

A concerned parent wrote:

Our six-year-old daughter was recently diagnosed with LVAS. Our doctor tells us she has already lost all useful hearing in one ear, so we are obviously very protective of her good ear. We are now struggling with the right balance on activity restrictions. She is an enthusiastic swimmer on our community’s summer swim team. The swimmers are taught to enter the water using a racing dive. We understand that diving is not recommended, but we could use some help with the fine points.

It’s clear to us that she should stay off of the high dive, but what are the risks associated with diving from a low diving board? What about a racing dive from the side of the pool (used in competition)? Are the pressure changes in the ear the main concern (which wouldn’t seem like a risk with a racing dive) or is there a significant risk of hitting the water wrong and causing head injury?

Also, any advice you have on whether or not participation in gymnastics (mat activities like tumbling, not a high balance beam) would be reasonably safe would be very helpful. We are erring on the side of caution right now and not allowing it, but our daughter is doing somersaults and cartwheels in the grass anyways. She may well be safer if she is taught to do them properly and practicing on a better padded surface.

It is interesting that so far in her life, the various “trauma” incidents she has already experienced have only caused your daughter to lose her hearing in one ear, but not the other. To me, this indicates that her good ear is more robust, or not as affected by trauma as her bad ear. This is good news. Perhaps her LVAS will not affect the hearing in her good ear in the future either—but there are no guarantees—hence the need to still be cautious.

As far as pressure is concerned, since your daughter has LVAS, she should only shallow dive—in other words, not let her head go more than 5 or 6 feet underwater. This keeps the pressure change to a minimum and should not aggravate her LVAS which could cause more hearing loss.

When she dives, whether on a diving board or a racing dive, if she has her hands over her head, which breaks the force of the water hitting her head, there shouldn’t be any “trauma”. Thus, as far as I can see, this should be ok.

In regards to doing gymnastics, I’m with you. She should learn to do it right and avoid trauma to her head. If she does not hit her head, or flip with such force that internal pressure builds up in her skull, she should be ok as I see it.

As always, there are no guarantees. If any activities result in hearing loss, those (and kindred) activities are out unless she wants to risk further hearing loss in the future. However, if any activities do not produce any hearing loss (or balance issues), then you should let her continue to do them. In other words, don’t unduly restrict her unless/until that activity (or similar activity) is proven harmful to her ears.

by Neil Bauman, Ph.D.

Researchers are busy looking for ways to reduce tinnitus. A recent study (1) that caught my eye, and one that shows promise, consists of listening to your favorite music for about 2 hours a day for a year. How hard can that be when one of the benefits is reducing the volume of your tinnitus?

In order for this to work, there are two conditions you must meet. First, your tinnitus must be a tonal kind of tinnitus that stays at a constant frequency. Second, the music you listen to must be digitally modified to take out the frequency of your tinnitus—hence the term “notched music”—as you have a notch where there is no sound at your tinnitus frequency.

(The way the researchers created this “notch” was to filter out a whole octave of sound centered around the frequency of the person’s tinnitus.)

Then, you just listen to your music for about 2 hours a day for the next year. By the end of 6 months, you’ll notice that the volume of your tinnitus is dropping significantly.

After 12 months, the people in this study found their tinnitus had dropped in volume by about 28%, and their annoyance at their tinnitus had dropped around 22%. In contrast, those in the placebo group (who listened to their favorite music without the notch) actually had their tinnitus increase about 9% and their annoyance at their tinnitus increase about 7%. (There was no indication as to what kind of music people listened to, nor at what volume.)

The reason this notched music therapy appears to work is that our brains are “plastic”. That means they can adapt and change their responses over time. Apparently our brains are more amenable to changing based on listening to sounds we like rather than to ones we dislike—hence the need to choose music you particularly like.

Researchers are beginning to understand that tinnitus arises when the auditory cortex in our brains inadvertently changes in inappropriate ways.

Researchers feel that tinnitus is “associated with a relative excitatory-inhibitory cortical neural network dysbalance, at the expense of the inhibitory system.” Say what? In plain English, what this means is that when everything is functioning properly, some auditory neurons in our brains may get too excited and “talk” out of turn so to speak. When they do this, the surrounding neurons tell them to “shut up”. This maintains order in the auditory cortex.

However, when too many begin to talk out of turn and not enough tell them to “shut up”, things get a bit wild and the result is tinnitus. If this situation is allowed to continue, it becomes the new norm and you end up with constant tinnitus.

Furthermore, if you have a hearing loss, some neurons in your auditory cortex are deprived of normal sound signals. Since neurons are not happy doing nothing, they “rewire” themselves so that they are no longer excited by the frequencies they were originally tuned to. Instead, they tune in to the frequency of their neighboring neurons. When a bunch of them do this, the resulting synchronized spontaneous neural activity apparently results in what we call tinnitus.

The good news is that previous research has shown that this “rowdy” behavior can be modified by behavioral training. The way the researchers did this in this study was to eliminate sounds at the frequency of the person’s tinnitus. Now, since there was no “sound stimulus” at the frequency of the “tinnitus neurons”, but at all other frequencies, the “neurons that weren’t stimulated were suppressed via lateral inhibitory inputs originating from surrounding neurons.” In other words, enough of the surrounding neurons told the “tinnitus neurons” to “shut up” and thus the volume of their tinnitus went down, and things became more normal once again.

It appears that notched-music therapy may prove to be an enjoyable, low-cost and casual (relaxed) treatment for reducing tinnitus a significant amount.

If you want to learn more about tinnitus and some of the things you can do to help bring it under control, see the book, “When Your Ears Ring—Cope with Your Tinnitus—Here’s How“.

(1) “Customized notch music training reduces tinnitus loudness” by Henning Stracke, et. al. Communicative & Integrative Biology 3:3 pp. 1-4, May/June 2010.

by Neil Bauman, Ph.D.

In a previous article “Nodding Chime Tinnitus“, a woman explained that she heard chiming tinnitus whenever she nodded or shook her head.

I asked anyone reading that article if they had ever had somewhat similar experiences. Here are five responses I received.

One lady reported:

I also have the same type of thing when I shake my head. At the same time, I have a constant sound in one of my ears regardless of what I am doing.

A man explained:

This is one of my symptoms. The note is slightly different for yes and no—yes is higher-pitched. I think I’ve experienced this for many years, but only started to notice continuous tinnitus at the age of 50, about 8 years ago. I have been wearing higher-frequency hearing aids since then, have had tests for acoustic neuromas, and have undergone tinnitus retraining therapy with some success.

In addition to the nodding/shaking symptoms, I get similar chimes when I jog. I can also reduce or increase my steady- state tinnitus by pressing quite hard on various parts of my jaw. Pressing the jaw into the joint tends to decrease the tinnitus, pushing my chin to one side tends to increase it. The effect is quite dramatic.

A lady wrote:

I also have a type of tinnitus that happens when I shake my head up and down or side to side. It’s not chimes to me but more like a static or buzzing. I can’t remember when it started, but I have a progressive hearing loss that resulted in my surgery one year ago for a cochlear implant. I can provoke it at will—pretty much all the time.

Another phenomena I’ve had for a few years—worse before the CI—has what I’ve found on the web as an “audible wakening”. Basically when changing consciousness stages I sometimes hear a “wraaanggg” type of almost screaming “sound”. Can’t explain it much better—sorry. I wonder whether others have reported this to you.

Another lady reported:

I’m writing regarding the woman who hears a chime sound when she nods or shakes her head.

In addition to ongoing mild tinnitus, I experience movement-induced sound as well. Unfortunately, the sound is not a pleasant chime tone, but a very startling loud buzz—like a noisy fly or bee right inside my ear! The first time I heard it I was terrified that an insect had flown into my ear and would sting me or get stuck and have to be removed surgically. The sound (so far) only happens when I shake my head from side to side to signify “no”.

I hear a variety of other tinnitus sounds intermittently that don’t seem to be related to any particular activity or situation—loud squeals, clicks, and the occasional whooshing noise. They are irritating when they happen, but aren’t terribly disruptive.

Still another lady explained:

I identify with the “chime” tinnitus report—I just tested myself by nodding my head vigorously. I confirmed that indeed, the movement changed the volume of my tinnitus, especially on the head upward movement of a “yes” head nod, and a leftward head movement in a “no” nod. (The ‘yes’ movement yields more dramatic results.) I have unilateral sensorineural loss in my right ear, with tinnitus that is not bothersome—it’s simply “there”.

When I wear my hearing aid, it plugs that ear with the ear mold, and this somehow calls attention to my tinnitus—when I walk, I get a modulation of the tinnitus that reflects the rhythm of my footsteps. That’s annoying. This is akin to my ability to “ding” my head—if I plug my right ear, and flick my finger just so around my cheekbone, I can produce a “ding” sound in my head. (Fun, huh?)

Interesting, isn’t it? Thank you all for sharing some of the weird tinnitus sounds you experience. This once again proves the enormous variety of tinnitus sounds we hard of hearing people experience.

by Neil Bauman, Ph.D.

A lady wrote:

I was diagnosed with Meniere’s disease. I have horrible tinnitus and can tell my hearing has gone horribly downhill. My question is, can a hearing aid help with the tinnitus to shut it out or anything? When I’m in a room with stuff going on I don’t usually hear it AS well as I do in a quiet room, but it’s still enough to really bug me.

Excellent question. Hearing aids in and of themselves do not affect the loudness of your tinnitus as such. Rather, they amplify sounds so you hear more (and louder) sounds. The good news is that this partially masks your tinnitus so you don’t notice it as much.

It is basically the same effect as you have already found when in a noisy room—your tinnitus doesn’t appear to be as loud because your brain has lots of real sounds on which to concentrate. Furthermore, in a noisy situation, the contrast between the background sound level and your tinnitus is much less than if you were in a quiet room.

However, when you are in a quiet location there is nothing to mask your tinnitus sounds. Thus, you perceive them as louder and more intrusive. Wearing a hearing aid in a quiet room will pick up the softer sounds you can no longer hear and thus help mask your tinnitus.

When your tinnitus is bothering you and you are in a quiet place, you need to enrich your environment with real sounds—turn on the TV, listen to a radio, stereo, iPod or MP3 player, and/or wear hearing aids.

This is especially important at night when the room is quiet. Some people find that just having a fan running, or a clock radio playing music really helps take their focus off their tinnitus. Use whatever works to give your brain real sounds to listen to so you don’t focus on your tinnitus.

You see, if you focus on your tinnitus, you will perceive your tinnitus as becoming louder and louder and more and more intrusive as the days go by. Therefore, you want to focus on the loves of your life, and the things you are doing, rather than on your tinnitus. When you do this, you’ll notice, if you stop at that point and think about it, that your tinnitus now appears softer and much less intrusive. This should be your goal.

If you want to learn more about tinnitus and the things you can do to help bring it under control, see the book, “When Your Ears Ring—Cope with Your Tinnitus—Here’s How“.

by Neil Bauman, Ph.D.

A woman explained:

When I nod my head, or shake it from side to side (yes-ing or no-ing), I hear chimes. Kind of like those chime toys that babies have, that when they are touched sway side to side and there’s a little chime inside. Do you know of anyone else that experiences this?

Hearing chimes when you nod or shake your head is not particularly common to be sure, but it is not unknown either. I knew a lady that every time she shook her head she heard the pure tone “F”. You have some thing like she has.

There are all sorts of strange kinds of tinnitus. For example, some people hear a special tinnitus sound when they turn their head all the way right or left, or bend over (somatic tinnitus). Others hear their tinnitus when they move their eyes (gaze-evoked tinnitus). Your tinnitus chimes when you nod or shake your head.

I’m curious how common this kind of tinnitus is. If any of you reading this have a similar kind of tinnitus, I’d love to hear of your experiences.

by Neil Bauman, Ph.D.

Here’s a shocking statistic—75% of 18 to 30 year-olds who go to nightclubs and concerts may experience tinnitus, according to an article published in a recent edition of the Journal of Clinical Nursing.

That’s a lot of people flirting with disaster to their ears. You see, in such situations tinnitus is your ears’ warning that you are damaging your ears by exposing them to sounds that are much too loud. When this happens, pay attention. Protect your ears, or get out of the noisy environment if you value your ears.

Fortunately, for most people this resulting tinnitus is temporary and disappears in hours or a few days. However, be warned, typically the more you listen to loud sounds, the louder your tinnitus becomes, and the longer it lasts, until finally it never goes away. You don’t want that to happen to you!

In addition to being a real “pain” in and of itself, tinnitus is also often a warning of impending or actual hearing loss. Studies reveal that 85% of people with hearing loss also have tinnitus.

Incidentally, some people are more susceptible to tinnitus than others. For example, some studies show that depression and bothersome tinnitus go hand in hand. If fact, 62% of tinnitus sufferers have a “lifetime prevalence of major depression” according to the above article. In addition, tinnitus causes things such as tension, frustration, anger, loss of concentration and sleep disturbance.

If you want to learn more about tinnitus and the things you can do to help bring it under control, see the book, “When Your Ears Ring—Cope with Your Tinnitus—Here’s How“.

by Neil Bauman, Ph.D.

A man wrote:

I have tinnitus. Tonight I was surfing the web and found a site that played pure tones at various frequencies when you clicked on the corresponding buttons. To my surprise, most of my high-pitched tinnitus went away for a while after listening to the higher-frequency sounds! Does this make sense to you? Might this sort of thing be a treatment for people?

Cool, huh? What you have discovered for yourself is a phenomenon called “residual inhibition”. Residual inhibition occurs when you mask your tinnitus with a frequency of sound that closely matches the pitch of your tinnitus and then turn the sound off. At that point, for numbers of people such as yourself, your tinnitus either disappears, or is greatly reduced in volume. This effect typically only lasts a few seconds, but in some people it can last for several minutes, hours, days or rarely, even permanently eliminate their tinnitus. (Such blessed relief!)

The closer you match the pitch of the sound to your tinnitus, typically the more your tinnitus is reduced, and the longer the residual inhibition lasts. Obviously, this works best for people whose tinnitus consists of a single, constant frequency of sound.

Thus, if your tinnitus is a constant tone, and you listen to a pure tone sound of the same frequency for 30 seconds or a minute, often you will find that your tinnitus disappears (or is greatly reduced) for several seconds (typically 30 to 60) immediately after you turn the tone off.

There have been several commercial attempts to use residual inhibition to help people that suffer from their tinnitus. One product that showed early initial promise was the Quiescence tinnitus management software, but unfortunately, it seems to have fallen by the wayside. Even so, researchers are still studying residual inhibition, trying to understand more of how it works. Perhaps, in the future, they will discover a way to make the effect last long enough that it becomes a useful treatment for tinnitus.

by Neil Bauman, Ph.D.

A mother explained:

My son has had a few bouts of tinnitus followed by a hearing drop in one ear. This always seems to be as a result of, or following, strenuous exercise. So far the ear has always recovered to its old level. I reported the last episode to my doctor who has now raised the question that it could be “labyrinthine hydrops.” The drugs that he recommended we consider are Betahistine or Cinnarizine, but the side effects seem severe. Up until now, these episodes only occur when my son has congestion, and this has thrown even more questions into the pot! I’d appreciate your advice.

Strenuous exercise can raise the internal pressure in the head, just like a blow to the head can. If your son has large vestibular aqueduct syndrome (LVAS), this can cause hearing loss. This is nothing new. Actually, it doesn’t even have to be exercise—any form of extreme straining can cause this in people with LVAS if they are susceptible. Fortunately, not all people with LVAS are susceptible to this.

It’s great that his hearing comes back after each episode. Of course, there are no guarantees that his hearing will always return, but it seems you can go by your son’s previous history—which is, it is a temporary hearing loss.

It could be labyrinthine hydrops or anything else, but if your son has LVAS, that would be the most likely cause. Maybe your doctor considers LVAS to be a form of labyrinthine hydrops?

Personally, I’d not take either Betahistine or Cinnarizine if I were in his shoes. To me, the solution is much simpler—just don’t strain so much when exercising. He should be able to find the level below which this doesn’t happen, and then limit himself to that much straining effort.

Incidentally, labyrinthine hydrops is an inner ear condition, whereas congestion is a middle ear condition.

If his hearing loss only occurs when he is congested, then it could be that the strenuous exercise is causing “gunk” (to use a fancy medical term), to clog up his Eustachian tubes and middle ears causing some degree of conductive hearing loss. When the gunk drains out, his hearing returns to normal. If this is the case, it has nothing whatsoever to do with LVAS.

One way to determine which is which is to go to an audiologist and have an audiogram done as soon as he loses some hearing from straining. If the audiogram shows only a sensorineural hearing loss, then it is LVAS (or another inner ear condition). If it shows a conductive loss, it is likely gunk in the middle ear or Eustachian tube. If he already has a sensorineural hearing loss from LVAS, and it is gunk in his middle ear, the audiogram should show an air-bone gap indicating the conductive component. Once you know what the audiogram shows, then you’ll better know how to proceed.

by Neil Bauman, Ph.D.

A lady asked:

Can HCTZ cause the constant roar I now hear in my ears?

Hydrochlorothiazide (HCTZ) is about the least ototoxic of all the diuretics. It is listed as sometimes causing dizziness or vertigo, but is not listed (as far as I have ever seen) as causing tinnitus.

However, one lady told me that whenever she takes HCTZ, her tinnitus gets louder. Thus, it could be the cause your constant roar (tinnitus) too.

Think back to when you started taking HCTZ. If you didn’t have the loud roar before you began this drug, and your tinnitus started soon after (in the following 14 days or so), then this is strong circumstantial evidence that Hydrochlorothiazide is indeed causing your tinnitus.

To learn which drugs are (or can be) ototoxic, see “Ototoxic Drugs Exposed“. This book contains information on the ototoxicity of 763 drugs, 30 herbs and 148 chemicals.