Tinnitus and Hyperacusis – 25 years later

This week at Hearing International we are pleased to have guest author, Dr. Richard Tyler of the University of Iowa, Iowa City, Iowa.  Dr. Tyler has been working in the area of tinnitus research and treatment since the late 1970s and discusses how it was then and now and announces the 25th Annual conference on the Management of Tinnitus and Hyperacusis Patient.

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It’s debatable as to when and how the first treatments of tinnitus were conducted.  According to Willman (2004), some say it was in all the way back to Ancient Egypt when they would infuse oil, frankincense, tree sap, herbs, and soil administered by a reed stalk that put in the external ear. Others have suggested that it could have been the rituals and chants of the Mesopotamians or the Greco-Roman treatments where tinnitus cures were based upon based on the cause of the disease. 

The Greco-Romans thought that tinnitus stemmed from the head and believed that cures were exercise, rubbing, and gargling as well as dieting and placing radish, cucumber juice, honey, and vinegar in the ear. Later, the works of Hippocrates and Aristotle were the first to introduce the idea of masking, saying “Why is it that buzzing in the ear ceases if one makes a sound. Is it because a greater sound drives out the less?” 

First treatments could even have been the medieval tinnitus cure of pouring of things into the ear, or a rather interesting Welsh treatment that recommended taking a loaf of hot bread, dividing it in two, and putting it into each ear as hot as you could stand it and thus perspire and by the help of God you would be cured. Then there is also the burning candle put into the ear to try to draw out wax and other debris and  suggesting that this is a good treatment for tinnitus and sinus problems.

The Renaissance was the introduction of surgery into the treatment of tinnitus. Their thoughts were that wind would become entrapped in the ear and circle around and around inside it, so the cure was to perforate the mastoid allowing the wind to escape.  In the late 18th and early 19th centuries, the work of Frenchman Jean Marie Gaspard Itard, famous for his work with the deaf at the Paris School, advanced the study of tinnitus by associating it with hearing loss and suggesting that masking was a beneficial treatment.  Research in the areas of medicine, audiology, psychoacoustics and other disciplines did not really lead anywhere else for a century or so……

More recently, there were old time hearing aid salesmen willing to work with masking. Most physicians and audiologists did not really understand tinnitus or its treatments and considered these masking techniques as quackery to simply sell more hearing aids. There were just not that many clinicians prepared to treat tinnitus patients.  And…..that is the way it was 25 years ago. 

As a young audiologist, armed with a new Ph.D, I found myself working in the Institute of Hearing Research (IHR) at the University of Nottingham in the United Kingdom for my first professional position. The Institute of Hearing Research (IHR) is a world-leading center for research into hearing and hearing disorders. At IHR, I found that a new colleague Dr. Ross Coles, Deputy Director of Institute of Hearing Research and his team were involved in a tinnitus study.   As a newly minted PhD in Human Psychophysics, I also began working in the area of tinnitus, primarily on approaches for measurement of tinnitus.  During that time, I recall conducting some post-masking experiments, and one young tinnitus sufferer, came out of the sound room crying and saying that it was the first time in the last 3 years he had not heard his tinnitus.  This experience caused me to wonder about clinical approaches to tinnitus treatment.  To me, it was not clear if anyone was doing anything systematically with tinnitus patients, and when I moved to the United States and the University of Iowa, it seemed that most clinicians did not want to see tinnitus patients or was it maybe they just were not sure what to do?   

 I looked around for appropriate meetings on Tinnitus and its treatment, … and there were none.  So, to begin a dialogue and discuss possible treatment techniques I organized the first conference on assisting tinnitus patients in 1982.  Ross Coles, the Audiological Physician from the UK and my old boss from the United Kingdom, was the guest of honor for the inaugural conference.   For that first meeting, about 30 highly motivated people came to the meeting willing to share our experiences tinnitus research and treatment. 

Over the years, the meeting has become somewhat larger and there are always people from varied backgrounds willing to share their experiences.  As the meeting matured, tinnitus patients came to the meeting and shared their experiences with the audience allowing them to learn from those were affected by the disorder. While manufacturers interested in tinnitus have come and gone, their contribution to tinnitus research and treatment was very significant. Due to this support and contribution a manufacturer’s forum was added to the agenda, where they could present new products to the clinicians that might serve their patients.

 Typically, the conference is a small, intimate meeting that attracts 40 to 50 people interested in tinnitus. The mix of professionals is usually 75% clinical audiologists but there are often attendees from companies interested in beginning trials with a new product, such as an innovative drug or an electrical stimulation approach, and they come with a myriad of perspectives. There are often three or four physicians from around the world, one or two psychologists and, occasionally, a nurse or two. As you know, at this time there is no cure to make tinnitus completely go away so there are lots of opportunities to assist patients. This conference is focused on practical things that can be done to make a difference, while reaching out to explore new conceptual areas to at least keep professionals thinking on the forefront.

How to Register

Please join us at the University of Iowa, Iowa City, Iowa, USA for the 25th Annual International Conference on Management of the Tinnitus and Hyperacusis Patient to be held June 15-16, 2017.  There will be discussions on Evaluation, Treatments, Medications, Psychiatry, Imaging, Surgery, Sound Therapy, and the Future.  The Guest of Honor this year is Craig Formby, Presenting:  Studies on Treating Hyperacusis. 

The purpose of this conference is to provide a review of current evaluation and management strategies for the treatment of tinnitus and is intended for otologists, audiologists, psychologists, hearing aid specialists and nurses providing clinical management services for patients with tinnitus. While the conference will provide information to patients who have tinnitus, their family and friends; it will NOT include individual diagnosis and treatment.  Click the links below for more information.

Registration Website                  Program Website

 

References:

Willingham, E. (2004).  The History of Tinnitus Treatment. Oregon Tinnitus & Hyperacusis Treatment Center.  Retrieved January 24, 2017.

 

Guest Author:

Richard S. Tyler, PhD.  Professor and Director of Audiology, Department of Otolaryngology, Department of Communication Sciences and Disorders, The University of Iowa.   Dr. Tyler was trained as a clinical audiologist at The University of Western Ontario and then completed a Ph.D. in Psychoacoustics and The University of Iowa.   He worked initially at the Institute of Hearing Research in the United Kingdom and is currently a Professor in both the Department of Otolaryngology – Head & Neck Surgery and in the Department of Communication Sciences and Disorders  at the University of Iowa.  He has edited three books on tinnitus, the first textbook, a clinical management guide, and a self-help book. Dr. Tyler sees tinnitus patients weekly, and hosts an annual Tinnitus Treatment Workshop.

 

 

 

 

 

 

 

 

 

 

 

About Robert Traynor

Robert M. Traynor, Ed.D., MBA is the CEO and practicing audiologist at Audiology Associates, Inc., in Greeley, Colorado with particular emphasis in amplification and operative monitoring, offering all general audiological services to patients of all ages. Dr. Traynor holds degrees from the University of Northern Colorado (BA, 1972, MA 1973, Ed.D., 1975), the University of Phoenix (MBA, 2006) as well as Post Doctoral Study at Northwestern University (1984). He taught Audiology at the University of Northern Colorado (1973-1982), University of Arkansas for Medical Sciences (1976-77) and Colorado State University (1982-1993). Dr. Traynor is a retired Lt. Colonel from the US Army Reserve Medical Service Corps and currently serves as an Adjunct Professor of Audiology at the University of Florida, the University of Colorado, and the University of Northern Colorado. For 17 years he was Senior International Audiology Consultant to a major hearing instrument manufacturer traveling all over the world providing academic audiological and product orientation for distributors and staff. A clinician and practice manager for over 35 years, Dr. Traynor has lectured on most aspects of the field of Audiology in over 40 countries. Dr. Traynor is the current President of the Colorado Academy of Audiology and co-author of Strategic Practice Management a text used in most universities to train audiologists in practice management, now being updated to a 2nd edition.