1. Tinnitus Understanding Ringing in the Ears- Affects 70-85% hearing impaired people

2. Anatomy of the ear

3. What is Tinnitus ? Tinnitus is a symptom not a disorder / disease Hearing loss Medical disorders Drugs Diazpam -valium Regardless cause- high correlation with hearing loss Peripheral hearing loss – less stimulation to brain- increase brain activity- brain compensating for hearing loss. Brain has ability to ignore Tinnitus Humming, ringing, buzzing., continuous, periodic, different pitch, loudness variation When brain hears tinnitus – produces stress hormones

4. Assessing a patient with Tinnitus Pure tones Speech tests Pressure of middle ears Hearing test Pitch Loudness Duration Tinnitus matching- Patients reaction to tinnitus Tinnitus handicap questionaire

5. Management of patient with Tinnitus Sound therapy Hearing aids- stimulating brain reducing tinnitus Takes attention away from tinnitus Reduces quiet time Reduces sound noise ratio Counselling and education

6. Sound Therapy Hearing aids- only therapy recommended for most patients Broadband and narrow band sound generators – tinnitus maskers Environmental sounds- programmed into hearing aids Music therapy- programmed into hearing aids

7. Music Therapy Slow music and non changing - soothing effect High pitches and fast music - causes excitement Repetitive music pleasant – active listening Non repetitive music – passive listening Induces relaxation- stimulates part of brain releasing mood hormones and tinnitus

8. Music and Stress People use music without thinking Carefully selected music helps tinnitus Changes vicious cycle of stress Set program in hearing aid with Zen tones. Different Zen tones catering individual needs Invokes passive listening Binaural stimulation necessary

9. Programming the Hearing Instrument Need remote or program button First program – master program- general listening Second program- Zen with microphone on music in background while amplifying speech Third program- Zen only – meditating and quiet times.

10. Cure for Tinnitus ? No Cure Goal is alter patients reaction to Tinnitus Habituation Acceptance – no danger Improve quality of life