Hearing Loss & Tinnitus

How are hearing loss, tinnitus, and balance related?

Features

• Life with Tinnitus
• Hearing Loss & Falls
• Research Corner: The Future of Hearing Loss Treatment

Does Anyone Else Hear That Sound? Life With Tinnitus

Tinnitus is the clinical term for sound in the head with no external source. Most people have experienced some form of tinnitus in their lives. Whether caused by a blockage in the outer ear, exposure to loud noise, or as a side effect of certain medications, tinnitus is an extremely common condition. It is also very personal and subjective, as it can appear to come from one ear or both, from inside the head, or from a distance. It can also take on different sound qualities for different people. For many, it can be a high-pitched ringing; for others a buzz, chirp, or hum. If this condition persists for over six months, it is known as chronic tinnitus, which affects as many as 50 million people in the United States, many of them over 55 and already experiencing some form of hearing loss. And while chronic tinnitus is not necessarily an indicator that one is losing all of their hearing or experiencing another serious medical problem, it can interfere with one’s daily life to the point where professional treatment may be necessary.

Tinnitus can be caused by a number of factors, many of which also contribute to hearing loss, including loud noise, certain medications that can damage the nerves in the ear, impacted earwax, ear infections, and aging. And while tinnitus can occur anywhere along the auditory pathway, from the outer ear to the inner ear, it is most commonly present when the hair cells of the cochlea have been damaged by exposure to loud noise or ototoxic drugs (drugs that may cause ear damaging side effects). These hair cells are what help transform sound waves into electrical signals that are then sent to the brain’s auditory cortex for interpretation. If they become damaged, the brain does not receive the signals it is expecting, causing the brain to “turn up the volume” on those auditory pathways in order to locate the missing signals. This can cause abnormal activity in the neurons, resulting in the illusion of sound.

If you are experiencing tinnitus, it is important to be evaluated by your hearing care provider so he or she can locate the source of the problem and rule out some of the more rare underlying health issues that could be the root of it. Tinnitus that is steady, continuous, and high-pitched is the most common and may indicate that the problem is located in the auditory system. This type of tinnitus is best treated by visiting your hearing care provider for a hearing test so they can assess the symptoms and prescribe treatment. While there is no FDA approved drug treatment for tinnitus, there are several strategies for making tinnitus more manageable. No single technique works for everyone, and a combination of approaches may be necessary to achieve results.

The most common forms of treatment include behavioral strategies and sound-generating devices, often used in combination. Learning about the nature of tinnitus, particularly the type you are experiencing, can help mitigate some of the stress and annoyance by developing coping skills and relaxation techniques that can improve quality of life. Hearing aids can help to amplify external sound, which can effectively mask some of the inner noise from tinnitus. There are also sound masking techniques such as low volume radio noise, fans, and white noise machines that can help when there is no other external sound present and the tinnitus seems louder. If you are experiencing tinnitus, you are not alone, and while there is no single experience or cure-all prescription, a visit to your hearing care provider can be the first step toward creating a treatment plan that can make living with tinnitus less stressful and more manageable.

Research Corner: The Future of Hearing Loss Treatment

Hearing loss can be caused by a variety of factors, from aging, prolonged exposure to excessive noise, side effects from certain antibiotic or chemotherapy drugs, viral infections, or genetic factors. Modern treatments for hearing loss such as hearing aids or cochlear implants are effective in amplifying and processing sound to address the symptoms of hearing loss like never before, however, they are not designed to repair the underlying cause of the hearing loss. Exciting new research has begun to produce promising data regarding certain treatments that may have the ability to address the problem at its root on a cellular level.

Some drugs being developed are aimed at damage prevention. As cancer treatments advance, new attention is being given to the prevention of some of the more harmful side effects that can occur while a chemotherapy drug is attacking cancer cells. Boston-based company Decibel Therapeutics is working on an injectable compound that can combat the hearing loss associated with the chemotherapy drug cisplatin, which causes the destruction of sensitive hair cells in 60-80 percent of patients. In another study, conducted by Southern Illinois University School of Medicine, researchers have found that a liquid concentration of the micronutrient d-methionine, commonly found in yogurt and cheese, may protect against noise induced hearing loss and tinnitus by neutralizing harmful molecules known as free radicals that are released by the hearing cell mitochondria in response to loud noises. This compound could potentially be significant in treating people who are exposed to loud noises often through work, such as soldiers, farm workers, construction workers, and miners.

In addition to these preventative treatments, researchers have also made strides in effective treatment through therapeutics or gene therapy that can actually stimulate the re-growth of cells within the inner ear. A new compound under clinical trial at the Translational Hearing Research Program of the National Institute for Health Research Biomedical Research Centre at University College London Hospital—known as a gamma secretase inhibitor—may be able to activate certain genes, which then convert so-called “supporting cells” into sensory hair cells within the inner ear. If successful, this compound could help stimulate the regeneration of hair cells that have been damaged, replacing those cells with new ones that can once again functionally transform sound into electrical nerve impulses and send them to the brain.

The research into these treatments is still in the early stages of testing and clinical trials and may require years of further research and fine tuning before they are ready. The good news is that, for now, the advances made in hearing aid and cochlear implant technologies are helping more people than ever live the life they wish to live by improving the hearing that they have.

Gormley, B. (2019). “Cures for Hearing Loss May Be Found in New Drugs”. Wall Street Journal, retrieved from www.wsj.com/articles
Phan, Sueanne MBA Inner Ear Drug Delivery: Tomorrow’s Treatment for Hearing Loss?, The Hearing Journal: July 2019 – Volume 72 – Issue 7 – p 22,23,26,27
doi: 10.1097/01.HJ.0000575344.83197.6d