Emory Report

April 26, 1999

 Volume 51, No. 29

New Emory center helps stop incessant ringing in ears

You might be surprised to find out you have something in common with several very famous people like Beethoven, Martin Luther and Francis Bacon, for example. All three suffered from tinnitus, which is the medical term for a "ringing in the ears."

Although transient tinnitus is a common experience after exposure to loud sound--a loud concert or an explosion, for example--persistent tinnitus can be devastating in some cases. "For 4 to 5 percent of the general population (12 million people), tinnitus causes significant suffering-including depression and severe sleep deprivation," said Pawel Jastreboff, director of Emory's new Tinnitus and Hyperacusis Center.

Tinnitus includes a wide variety of perceived noises, ranging from ringing or low roars to high-pitched beeps. Although sometimes a treatable medical cause can be found, said Jastreboff, in most cases there is no explanation for the incessant noise.

Thanks to groundbreaking innovation by Jastreboff, who is recognized as the world authority in the field, there is now a treatment known as Tinnitus Retraining Therapy (TRT) that provides relief of tinnitus for approximately 80 percent of patients. The key, he explained, is retraining how the brain perceives and reacts to tinnitus. "Our goal is to retrain patients' brains so that they treat tinnitus similar to the way they treat the sound of a refrigerator in the kitchen," he said. "It becomes something they hardly recognize."

First, patients are carefully screened by an otologist or otolaryngologist. Then they are counseled about the mechanisms of tinnitus, its perception and how the brain functions, so they can better understand their problem and how to implement the next step of TRT--sound therapy. Many patients use two inconspicuous, small sound generators either in or behind the ear.

"These devices do not compete with hearing and patients can talk or use the phone without any interference," Jastreboff emphasized. "The sound generators gently retrain the perception and reaction of people to tinnitus. The result is not a cure, but relief. People who have tinnitus no longer are bothered by it in the vast majority of cases." The treatment usually is required for about a year and a half, and according to Jastreboff, relapse is rare.

About 40 percent of the time tinnitus is accompanied by hyperacusis, a hypersensitivity or even painful response to sound. "In severe cases hyperacusis can prevent people from caring for their children or even holding jobs," said Jastreboff. A modification of TRT can now treat this condition.

"Tinnitus and hyperacusis are extremely common problems, and before TR physicians had been unable to offer anything other than marginal treatments. This is our first opportunity to significantly help patients with these conditions," said Douglas Mattox, chairman of the Department of Otolaryngology. "We look to the Tinnitus and Hyperacusis Center as being one of the flagship services of our department."

For more information, call Emory's Tinnitus and Hyperacusis Center at 404-778-3109 or visit their tinnitus web page at <www.tinnitus-pjj.com>.

--Holly Korschun

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