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How do hearing aids help tinnitus?

Audiologist in Prairie Village

05 December 2016 - 23.8K Views

First and foremost it's important that you work with an audiologist to have a comprehensive hearing evaluation performed if you are experiencing bothersome tinnitus. In some cases, medial referral is warranted and recommended.  In addition, it would be advisable to work with a practice that has audiologists who specialize in tinnitus if that is necessary for you.  With that being said, there are many options available to help with tinnitus.  In many cases, the use of hearing aids is helpful with tinnitus.  The general principle is that through stimulation of the auditory system there may be some masking properties which are probably the result of neural/nerve stimulation which is providing sound input to the brain.  One easy to understand this concept is the use of light.  If you look at a candle in a dark room, it will appear bright but when you turn more light on in the room, the candle appears less bright even though it's actual brightness hasn't been changed.  In a similar fashion, using sound can often help diminish the perception of other sound such as tinnitus perceived by the brain.  We can use sound to change the perception of other sound.  It is also possible that technology like that developed by Widex using their Zen feature, may also be helpful.  We have found this as a benefit to many of our patients especially those stuggling with tinnitus.  

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Paula L. Schwartz, AuD

Doctor of Audiology

05 December 2016 - 23.8K Views

Many people find that amplification alone addresses the tinnitus.  One of the many theories of tinnitus is that it is neurological activity resulting from cochlear damage or hearing loss. Therefore, address the hearing loss and potentially address the tinnitus. Secondly, amplification of the ambient environment presents contrast sound making the tinnitus less noticeable and therefore less bothersome.  For some persons with intrusive tinnitus, the limbic system (emotional system) is involved and amplification alone is not sufficient.  All of the hearing aid manufacturers now have combination units which address the hearing loss and also offer the contrast sound which addresses the tinnitus. Many persons also need TRT, CBT DBT or Mindfulness training to address this emotional component of intrusive tinnitus.  Finding an audiologist who specializes in tinnitus is very important. 

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Julie Norin, AuD

Doctor of Audiology

05 December 2016 - 23.8K Views

Not always, but in a significant number of cases, the tinnitus coincides with hearing loss. So the first step is to treat the hearing loss, which provides the indivdual with access to sounds that he or she was otherwise not getting due to the hearing loss. In turn, this will help alleviate the preception of the tinnitus. This does not make the tinnitus go away - unfortunately, nothing really will (unless the tinnitus is a result of ototoxic medication or chemical exposure, in which case, restriction of the meds or avoidance of the chemical may result in the tinnitus going away). But for the majority of individuals with tinnitus AND hearing loss, hearing aids will likely alleviate the perception of the tinnitus. because they provide the user with more sound, which makes the tinnitus less noticeable.

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Dan Schwartz

Professional Member

05 December 2016 - 23.8K Views

The key to solving tinnitus issues is in addressing the underlying hearing loss, no matter how minimal it appears to matter to the clinician, or even if the patient admits to any.

Everything you need to know is in this article:
Hearing aid amplification and tinnitus: 2011 overview, by Doug Beck AuD

 

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Jonell Block, AuD

Doctor of Audiology

05 December 2016 - 23.8K Views

Sorry for the long answer, but tinnitus diagnosis and therapy is a pretty complicated business.  There is much yet that the audiology and medical fields do not understand about the various types of tinnitus, their causes and what might releive them.  There is most often no 'cure' for tinnitus.  Masking with hearing aids is not a cure, but can be a helpful treatment when it works 

Please note: Each individual is unique and the experience and cause of tinnitus is also unique to each individual.  So just because something works for one person, does not necessarily mean it should be expected to work for everyone with tinnitus.  Some find relief from hearing aids and some do not.  It will depend on many variables such as the cause of the tinnitus, its pitch, loudness, and other auditory characteristics, how long one has experienced it, how one processes sound in the brain, and medical conditions the person may have.

Hearing loss and tinnitus often co-exist.  When someone has both hearing loss and tinnitus, it is possible for hearing aids to offer a tinnitus solution.  Sometimes we use a special feature built into the hearing aids and sometimes tinnitus can be relieved just by amplifying environmental and speech sounds in the area of your hearing loss.

First, how might it work with no special tinnitus feature on the hearing aids?  Hearing aids amplify sound and are programmed especially for your hearing loss.  Sometimes, simply amplifying environmental and speech sounds not normally being detected by the damaged area of the cochlea (inner ear) can relieve tinnitus by 'masking' it with real sound from the environment, and/or from the sound generated by the hearing aids as they run.  Here is one theory of how that can happen: The hearing nerve has one function, and that is to send sound from the environment to the hearing centers of the brain.  When someone has hearing loss, the 8th nerve (the hearing nerve) can be starved for stimuli at certain pitches (usually high pitches).  In spite of or because of the hearing loss, the nerve may still be active or even over-active, sending a neurological signal and causing the brain to hear sound that is not really in the environment.  Tinnitus.  Hearing aids amplify sounds which are not typically audible to this person without amplification.  This gives the brain 'real' sound to send to the brain.  In some people, it can tend to mask the tinnitus, as long as one is wearing amplification.  Once the hearing aids are removed, the tinnitus may, and most likely will, return.

Second, how might it work with the new tinnitus features in hearing aids?  Your hearing aids can have a special program which will introduce a specially designed masking sound to the ears.  This can be a white or pink noise, sometimes an ocean or other type noise, and can be shaped to your specific hearing loss.  In general, it works as in the first example, but much more intentionally and with more flexibility in terms of frequency (pitch) and loudness of the sounds generated.  Again, this tinnitus feature 'masks' the tinnitus the person usually hears while that person is using the specially programmed hearing aids.

Without hearing loss, a hearing aid or special masking device can be programmed to provide this same type of masking sound without the accompanying amplification of hearing aids.

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Mike Schneller

Hearing Healthcare Provider

05 December 2016 - 23.8K Views

There is a company called Widex that has come out with a technology called Widex Zen. The hearing aids equipped with this feature play gentle zen tones in a random pattern. The pattern essentially distracts your brain and quells the intensity of the ringing.  Tinnitus is typically an indicator that there is significant hearing loss in a specific range. Your brain trys to compensate for the loss by "turning up the volume"  this is what causes the ringing. 

Even just normal hearing aids, when properly fitted can help reduce the occurance of tinnitus because you are reducing the overall strain put on your body from hearing loss. 

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Professional Member

Professional Member

28 December 2016 - 23.7K Views

 Hearing aids can augment the volume of external noise to the point that it masks the sound of tinnitus. Patients with hearing loss and tinnitus may find relief from the use of hearing aids. 

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James Roberson

Hearing Healthcare Provider

05 December 2016 - 23.8K Views

I concur with the previous answer to this question. It should be noted, however, that most all hearing aid manufacturers now include software programs for hearing aids to help the rehabilitiation (which is what the Widex Zen does) by promoting various chosen soundscapes that help "retrain" the brain to focus on sounds other than the tinnitus. Hope this helps.

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Mark Butler, AAS

Hearing Healthcare Provider

11 May 2017 - 23.3K Views

As an industry the hearing aid business really doesn't understand tinnitus very well in spite of all the research being done.  There are a number of major theories about how the sound is actually created and some or all of them may be true for certain people.  What we do know is that about 85% of the time when people with tinnitus wear hearing aids they get some measure of relief.  Many tinnitus sufferers notice the ringing much more when they are in a very quiet environment so replacing missing sounds with hearing aids provides addition stimulus to the brain that in essence distracts the brain from the tinnitus.  The amount of relief can vary greatly from one person to the next.  Most hearing aids now also offer some form of masking.  The hearing aid actually generates a secondary sound that can be tailored in a number of ways to help reduce the severity of the tinnitus.  There are two manufacturers who are offering something slightly different.  In addition to the normal types of masking, Signia (formerly Siemens) now offers notch therapy.  For people with moderate to severe hearing loss and tonal tinnitus (constant pitch and volume) this can be very successful.  Widex uses a feature called "Zen" which uses random musical tones instead of just noise to provide masking.  Some people have describe the masking sound as "New Age" or "Japanese" music which can be very soothing.  Using the hearing aids alone is a pretty straight forward process.  The masking can be much more difficult since there are a number of parameters that can be adjusted to achieve the best possible results for any particular individual.  It is a trial and error process to find the combination that works best for any one patient.  Find a provider who has spent the time to become familiar with tinnitus and masking procedures and who is willing to spend the time to find the best combination of masking for you.

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