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Dr. Dungan is a clinical audiologist at Appalachian Audiology in Knoxville, Tennessee and has been practicing audiology for nearly 35 years. She was previously the director of Speech and Hearing Services and Director of Children’s Special Services for the East Tennessee Regional Public Health Department, as well as a faculty member at the University of Tennessee Department of Audiology and Speech Pathology.
Hearing protection is generally recommended when exposed to sounds louder than 85
decibels. How does the recommendation change for patients with tinnitus? Should I be using hearing protection at lower decibel levels?
Loud sounds can cause hearing loss. Loud sounds can also act as a “trigger” to start or re-start tinnitus, to increase tinnitus loudness, or even change the tinnitus sound. Hearing protection can prevent this trigger and can prevent hearing loss when used judiciously. However, overuse of hearing protection could also interfere with your tinnitus treatment. For some patients, too much hearing protection may actually make the perception of tinnitus worse because it quiets the normal, ambient background noises which often mask tinnitus.
The situation for each patient is different. You should review with your audiologist the sounds that are uncomfortable for you. Often a judicious mix of sound protection and low level sound, designed to mix with your tinnitus, will be the best help.
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I’ve seen research articles where a patient’s tinnitus is measured by its “Minimum
Masking Level.” What is this? Why is it useful?
Picture this: you are in a sound booth having a tinnitus evaluation by a trained audiologist. The audiologist performs a series of low volume measurements to find the exact pitch and loudness of your tinnitus, and to determine the most effective treatment for you. A noise (perhaps white noise,
Tinnitus Today | Summer 2014
Guest Hearing Health Professional Janice R. Dungan, Au.D., CCC-A ATA Board Member since 2014
pink noise, speech noise, or narrow band noise) is softly introduced through earphones into one or both of your ears. The volume slowly increases until you are unable to hear your tinnitus. The exact volume at which that noise effectively “masks” your tinnitus is the Minimum Masking Level. This level forms the basis of the mixing sound used to begin your tinnitus treatment.
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Sometimes I can change the sound of my tinnitus by touching my face
or moving my jaw. What’s going on?
Tinnitus is related to the auditory (hearing) system. Some people with tinnitus report they can control the loudness or pitch of their tin- nitus by stimulating their somatosensory system, which relates to touch, pain, pressure, tempera- ture, and muscle/joint position. Researchers and clinicians believe this happens because there is cross-over between the somatosensory and the auditory systems. The human body functions as a whole unit, so a change in one system can often affect another system.
Changing your tinnitus through facial move- ments is obviously not a permanent solution to tinnitus. However, it will not cause any short- or long-term harm, and may provide some valuable temporary relief.
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Why is tinnitus considered a symptom and not a disease in and of itself?
Tinnitus is considered a symptom of an underlying cause, just as pain is a symp- tom for other disorders. In other words, tinnitus is a reaction to something else going on within the body. The underlying cause could be hearing loss, or too much ear wax, or a foreign object on the ear drum, or allergies, or too much salt in the diet, or another one of the over 200 disorders associated with tinnitus symptoms.
You should work with your ENT, physician or audiologist to uncover the root cause of your tinnitus, and develop an appropriate treatment
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