Tinnitus and Harmonic Therapy

Ringing in the ears According to Tinnitus treatment expert, Tinnitus is the perception of sound in the absence of any real sound.  These sounds are heard as periodic or constant noises. Ringing in the ears type noises are usually described as ringing, hissing, humming, buzzing, roaring, chirping or whistling. Tinnitus may be the result of hearing loss, sounds produced by adjacent structures, or other disease processes. While tinnitus has traditionally been thought to be produced in the ear, research has shown that tinnitus is produced by electrical activity in the brain (see the figure below or to the right).

To understand why this happens, we first have to explain how hearing works says tinnitus treatment specialist. See the figure below for the anatomy.

  1. Sound, which is transmitted as sound waves (vibration of the air), enters the ear canal and reaches the eardrum.
  2. The sound waves lead to the vibration of the eardrum, which also vibrates the small bones behind the ear drum.
  3. The vibration motion of the bones makes the fluid in the inner ear or cochlea to vibrate.
  4. The vibration waves in the inner ear fluid causes the sensory (hair) cells in the inner ear (cochlea) to bend. The hair cells change the movement into electrical signals.
  5. These electrical signals are transmitted through the hearing (auditory) nerve and up to the hearing part of the brain (auditory cortex), where they are interpreted.

In this way, the pitch (frequency) of a sound is translated to a physical space located in the inner ear.  For this reason, we say that the cochlea is “tono-topically” organized, meaning that each spot in the inner ear picks up a certain pitch of sound say tinnitus treatment specialist. If you were to take the inner ear membrane and flatten it out, it would be organized exactly like the keyboard of a piano.  This organization is maintained from the inner ear all the way up to the brain.

Tinnitus occurs when there is damage to the inner ear.  Further, the “ringing” that we hear approximates to the region of the inner ear that is damaged.  If the area  of the inner ear that detects high pitch sounds is damaged (for example by loud noise exposure, aging, hereditary, or toxic reasons), we hear a high pitched “ringing”.  When the damage corresponds to lower pitches, we hear a “buzz” or a “hum”.   Interestingly, most people with tinnitus have a high pitch ringing because the area of the inner ear that detects high frequencies is closest to the middle ear, and is therefore more susceptible to damage from infection, noise damage, aging, and general wear and tear says Tinnitus therapy specialist.

There is one more important concept to understand about why tinnitus happens, and this one is the most counter-intuitive.  It has to do with how the brain interprets signals coming from the inner ear.  One would expect that when there is silence, the brain is not receiving signals from the inner ear.  This is actually not the case.  Instead, the brain receives a constant and steady source of information from all areas of the inner ear.  The way that the brain interprets sound is by picking up increases in this steady state of background activity in the hearing areas of the brain.


Neuromonics for Tinnitus Treatment

Neuromonics is a device that is dispensed by an audiologist or a doctor that uses music for tinnitus treatment. Because music routes through the hearing parts of the brain, there is the potential for music to mask tinnitus.  Perhaps more importantly, music also has clear associations with the emotional parts of the brain.  Even passive listening to pleasant music can stimulate the parts of the brain that are associated with pleasant emotional states.

The use of music as a masker had been proposed as early as the late 1980’s, and the successful applications of music therapy for tinnitus has been demonstrated by numerous institutes.  Newer more sophisticated approaches are using music signals to achieve neuroplastic changes in the brain in order to achieve tinnitus relief.  For instance, in the Neuromonics approach, the music signal is adjusted to conform to the hearing test of the tinnitus sufferer, such that the frequency profile of the music is amplified in regions of hearing loss and attenuated in regions of normal hearing.

In a study performed by the company, Davis and colleagues (2008) compared the effectiveness of a customized sound/music tinnitus retraining (Neuromonics Tinnitus Treatment) with counseling alone. Patients were divided into one of four groups: 1) Neuromonics device at high intensity for two hours per day, 2) Neuromonics device at a lower intensity, 3) tinnitus therapy with a broadband stimulator and counseling, or 4) counseling alone. Subjects were instructed to listen to the devices for two hours per day at the time of day when symptoms were most severe.

Tinnitus Reaction Questionnaire (TRQ) improved over the 12 months of the study for the Neuromonics group. TRQ scores were not significantly improved in the control groups. At the six-month follow-up, 86% of patients in the customized acoustic stimuli groups had met the definition of success based on 40% improvement in the TRQ scores. Normalized visual analogue scores for tinnitus severity, general relaxation, and loudness tolerance were improved relative to both baseline and control group’s scores at 12 months. Perceived benefits were also greater with the customized acoustic stimulus.