Loss of auditory fibers discovered in individuals with tinnitus

Photo credit: Hasan Albari

by Daniel Fink, MD, Chair, The Quiet Coalition

Eureka Reports, the online news publication of the American Academy for the Advancement of Science, reported that researchers at the Massachusetts Eye and Ear Infirmary discovered a loss of auditory fibers in individuals with tinnitus. Here is another link to the article in Scientific Reports.

This is good news for the estimated 55 million Americans who suffer from tinnitus, and for me personally. Tinnitus is commonly described as “ringing in the ears,” but the technical definition is: the perception of sound when there is no external sound stimulus. As principal investigator Stéphane Maison said, “we won’t be able to cure tinnitus until we fully understand the mechanisms underlying its genesis. This work is a first step toward our ultimate goal of silencing tinnitus.”

This is personal to me for two reasons. First, as I have often written about, I have tinnitus. I developed tinnitus and hyperacusis (a sensitivity to noise that doesn’t bother others) after a one-time exposure to loud noise at a New Year’s Eve party in a restaurant in 2007. In December of 2014, after reading an article about hyperacusis in The New York Times, I decided to see what I could do to make the world a quieter place.

I also served on the board of the American Tinnitus Association from 2015 to 2018.  One of the ATA’s stated goals is finding a cure for tinnitus. At the very first board meeting I attended, I incurred the ire of several of my fellow board members by asking the innocent question, “what is the locus of tinnitus?” I pointed out that I had been stationed in Washington, D.C., in the U.S. Public Health Service in 1972, when former President Richard Nixon declared war on cancer. More than 40 years later, despite the federal government and pharmaceutical industry each spending approximately $50 billion on cancer research, we were still fighting the disease. How would the ATA find a cure for tinnitus when it was spending far less than that on tinnitus research, and nobody even knew what tinnitus looked like under a microscope?

In the years since then, research has shown that altered pathways in the brain may explain at least something about tinnitus, and Susan Shore at the University of Michigan developed a treatment that might help. Shore’s discovery is now in the process of being commercialized. Maison and his colleagues’ research has shown that auditory nerve loss is also a part of tinnitus. Unfortunately, some individuals have such severe tinnitus that they take their own lives.

I am fortunate because my tinnitus symptoms are minor and not life-altering. Even if an effective treatment for tinnitus is developed, I probably wouldn’t bother taking it unless it was a simple, inexpensive pill that was 100% effective without any side effects. That’s a high standard and unlikely to be achieved.

My focus for the last nine years has been on preventing people from developing tinnitus and other noise-induced auditory disorders, like noise-induced hearing loss and hyperacusis. Tinnitus has many causes — head trauma, ear infections and multiple medications including aspirin  — but the major cause of tinnitus is noise exposure.

We don’t need any research breakthroughs to advise people on how to avoid getting tinnitus because it’s simple, easy and cheap: avoid exposure to loud noise, turn down the volume, leave the noisy environment or use hearing protection. If people do that, their ears should last a lifetime, with preserved hearing and no ringing in the ears.

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