There is no known cure, but new technology offers relief
By Deborah Jeanne Sergeant
On March 21, Kent Taylor, the founder and CEO of the Texas Roadhouse restaurant chain, died from suicide at age 65. In a press release his family sent to the Associated Press, Taylor “took his own life” following “a battle with post-COVID related symptoms, including severe tinnitus.”
Tinnitus, also called “ringing in the ears,” is not a disease but usually a symptom of damage to the auditory system. People with tinnitus hear “phantom sounds” such as buzzing, humming, clicking, chirping or, rarely, looped, repetitive music.
For some people, the unwanted sounds become extremely bothersome and contribute to depression and anxiety. They cannot sleep and worry that they will never escape from the problem. Scattered anecdotal reports have linked COVID-19 with tinnitus. Shortly before his death, Taylor, a longtime philanthropist, committed to funding research on tinnitus.
COVID-19 has also been linked with depression and anxiety. Left untreated, depression and anxiety raise the risk of suicide.
Research printed in a November 2020 issue of Lancet Psychiatry indicates that after reviewing 69.8 million electronic health records, 20% of the 62,000 patients diagnosed with COVID-19 were also diagnosed with a psychiatric disorder such as anxiety, depression or insomnia within three months. Of those, 5.8% were a first-time mental health diagnosis. The study compared people with COVID-19 with patients without COVID-19 during the same period, which means that the illness itself, and not just societal shifts and stress, contributed to the increase in mental health diagnoses.
Of the more than 45 million Americans with tinnitus, only 4% say that it significantly interferes with their activities of daily living such as sleep and work. More than 200 known medical conditions can relate to tinnitus. However, Gregory Horton, doctor of audiology and director of audiology at Rochester Hearing and Speech, said that hearing loss and noise exposure are more commonly associated with tinnitus.
“It is also possible to have tinnitus in the absence of hearing loss,” Horton said. “However, for many people, tinnitus is usually the first indicator that something is wrong with their auditory system.”
Horton has experienced tinnitus in both ears for 15 years.
Other causes can include trauma, certain medications, temporomandibular joint (TMJ) issues, blood flow issues, psychiatric disorders, tumors, vestibular issues such as dizziness or vertigo, and autoimmune diseases. Diet, stress, alcohol and caffeine can worsen tinnitus. Though it has no cure, interventions can mitigate its effect.
For most patients with tinnitus, wearing a hearing aid to amplify the sounds they miss can help reduce the effects of hearing only the unwanted sounds.
“Even people with normal hearing can experience relief from their tinnitus just from wearing hearing aids,” Horton said. “In addition to typical hearing aid use, most hearing aid technology now has programming algorithms that can be used to create gentle masking noises that we can activate to take our mind off the tinnitus. Masking noises should not be used to completely drown out the tinnitus, but can be used to give ourselves something more pleasurable to listen to.”
Some people use white noise machines or apps that create white noise to help mask tinnitus sounds.
Horton also said that much evidence indicates that mental health initiatives such as cognitive behavioral therapy, tinnitus retraining therapy and practicing mindfulness and meditation can help manage the response to tinnitus.
Ron D’Angelo, doctor of audiology with Clear Choice Hearing and Balance in Brighton and Greece, said that anxiety and tinnitus can cause a cycle where anxiety worsens the tinnitus and the tinnitus in turn worsens the anxiety. However, relaxation techniques like yoga and deep breathing “can help relieve stress and the stress associated with tinnitus,” D’Angelo said.
Much like people who eventually become used to the different sound of a new refrigerator, many people with tinnitus can learn to not pay attention to the phantom sounds. An audiologist specializing in tinnitus care can help, but it is more challenging for hearing than other senses to develop tolerance.
“The brain is selective in what it pays attention to,” D’Angelo said. “With tinnitus, it’s not as easy as with the sense of smell. If you work with foul smelling things, you stop noticing within a few days. With hearing we have to take a few extra steps.”
In addition to treating any hearing loss, his office also uses sound therapy to train the brain to not recognize the sound as threatening. D’Angelo said that tinnitus is “a brain phenomenon more than an ear phenomenon. The nerve sends a signal for a sound that doesn’t exist.”
He compared tinnitus to phantom pain experienced by amputees. For patients with tinnitus, the part of their brain that interprets sound becomes overly active because of inner ear damage.
Every patient is different, which is why a professional evaluation is important. Rarely, a different cause may be behind tinnitus, such as excess accumulation of earwax or a tumor. Both would require professional removal.
Most tinnitus is associated with hearing loss.
“The effectiveness of the most popular treatment option, hearing aids, is really dependent upon patient motivation,” said Ally Centola, doctor of audiology at Hart Hearing and Balance Centers in Irondequoit, Brockport, Brighton, Fairport and Greece. “A patient must wear his or her hearing aids all waking hours to increase the chances of finding tinnitus relief.
“Patients who consistently wear their hearing aids tend to find some type of relief in either the duration or loudness they hear their tinnitus. From personal experience, I’ve also seen that patients who accept their tinnitus and aren’t trying to look for other cures, seem to have the best outcomes. As we know, there currently isn’t any cure for tinnitus; there are only ways to manage it.”
For more information, visit: American Tinnitus Association (www.ata.org), Hearing Loss Association of America (www.hearingloss.org), American Speech and Hearing Association (www.asha.org), American Academy of Audiology (www.audiology.org) and the National Institute of Deafness and Other Communication Disorders (www.nidcd.nih.gov).