Tinnitus: Noises in the head
In the absence of effective treatment, many `alternate therapies' have mushroomed. "Don't fall prey to quacks touting wonder cures," warns Dr Girish. "You need to be aware so you cannot be needlessly alarmed. Also, don't resent your condition or attempt to constantly monitor it. Learn to relax completely. Wear earplugs or moistened balls of cotton in your ears at bedtime [tinnitus is more pronounced at night when the noises of the day fade] if you find they help. Talk to your ENT specialist about maskers. They give off subtle sounds that mask the problem but do not block hearing."
SELF-MANAGEMENT
A new approach is gaining ground. Called tinnitus retraining therapy (TRT), it was developed at Yale University in 1980. It calls for retraining the subconscious auditory system to accept tinnitus as natural, not a threat or warning signal. It can take months and occasionally even years for this to happen. Ideally, a multi-disciplinary team (ENT specialists, audiologists, behavioural psychologists and habilitationists) should guide the patient with the process.
Tinnitus retraining first involves learning the cause of the problem. This is followed by resetting subconscious filters that look for alarming sounds. It also requires training the patient to get habituated to sounds, making them meaningless. Success is measured by absence of reaction to sounds while sleeping, working or when free. As a result, tinnitus becomes less of an enemy. "Today, TRT is accepted as the most successful tool for treating tinnitus the world over," says Dr Girish. "Once it loses its sinister meaning, however loud it has been, it begins to diminish."
Effective counselling is an important aspect of tinnitus management. Many patients get intimidated by it. They need to be made fully aware of the condition. This needs to be coupled with firm reassurance from both the neurologist and the audiologist that it can be made to fade away.
According to Dr Prakash Kumar who treats tinnitus sufferers at his clinic at Durgapur, West Bengal, patients must be trained to turn phantom sounds into the humming of the refrigerator. Dr Anirban Biswas, a Kolkata-based neurologist, who treats about a 100 patients every month, says he does not purport to offer a cure. "We can only offer a better quality of life," he says. "The annoyance can definitely be reduced by treatment and psychotherapy, but the sounds cannot be totally stopped." In cases of objective tinnitus, generated by an organic defect like a tumour or a developmental defect in a blood vessel in the vicinity of the ears, doctors can offer a surgical cure - but such cases are few. "Most of the cases are subjective, where we cannot point to the cause, and so a curative treatment is not possible," says Dr Biswas.
Ultimately, tinnitus sufferers need to help themselves. Realise that it's not a dangerous illness, label it a nuisance and file it away. Don't obsess over it. Stop listening for sounds. Keep busy; surround yourself with other kinds of sounds like soft music. Practice yoga, reflexology, undergo a soothing massage, do some form of exercise to keep the blood circulating - all these have been proven to help. Ultimate management is to reach a point where you don't let tinnitus affect your quality of life. It can be done. All you need are information and determination.
With inputs from Lt Col Sabari Girish, ENT surgeon, Army Research and Referral Hospital, Delhi; Dr Reginald Varadarajulu, neurologist, Wockhardt Hospital, Bangalore; and Dr Anirban Biswas, a Kolkata-based neurologist
Featured in Harmony Magazine
June 2007 |