Photo credit: SHVETS production

by Daniel Fink, MD, Chair, The Quiet Coalition

Tinnitus is commonly known as ringing in the ears, but the technical definition is the perception of sound without an external sound stimulus. One of the things that has powered my noise activism is the fact that I have “skin in the game,” having developed both tinnitus and hyperacusis — a sensitivity to noise that doesn’t bother others but which is perceived as painful — after a one-time exposure to loud noise at a New Year’s Eve dinner in 2007. I know that noise exposure makes my tinnitus worse, in addition to possibly damaging my hearing. My interest in making the world a quieter place isn’t just academic or intellectual, it’s a personal health crusade.

This article in Scientific American discusses groundbreaking research done at the University of Michigan’s Kresge Hearing Research Institute by Susan Shore and colleagues, recently published in JAMA Network Open. One cause of tinnitus may be overactivity of the nerves in a brainstem structure called the dorsal cochlear nucleus. The brainstem is located between the brain and the spinal cord.

Shore’s team developed a “bisensory” treatment, consisting of an in-ear sound source and two external electrodes that deliver a combination of acoustic and electric stimuli. Somehow, that reduces electrical activity in the dorsal cochlear nucleus, relieving tinnitus symptoms. The study involved a treatment group and a control group. The control group received the auditory stimulus but not the electrical stimulus. The electrical stimulus was not perceptible, so the subjects in the control group didn’t know that they were not being treated with it.

Shore is pursuing approval from the U.S Food and Drug Administration for the new therapy.  If approved, it will join the only FDA-approved tinnitus treatment available, what appears to be a similar one called Lenire

The treatment protocol involves 30 minutes of treatment a day, for six weeks. Fortunately, my tinnitus is mild and I don’t know if I will try to get this new treatment — if it is approved. What I will continue to do is to avoid loud noise exposure and use hearing protection.

The dual focus of my noise activism has been trying to make the world a quieter place and educating everyone about the dangers of noise. Tinnitus has many causes, including ear infections and head trauma, but noise exposure is the major cause. The three noise-induced auditory disorders — tinnitus, hyperacusis and the most well-researched one, noise-induced hearing loss — can all be prevented by avoiding exposure to loud noise.

Follow this simple rule: If it sounds loud, it’s too loud and your auditory health is at risk. Turn down the volume, leave the noisy environment or insert your earplugs. Do this and your ears should stay healthy all your life.

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