Areas of Practice

Tinnitus

An estimated 40 – 50 million Americans complain of tinnitus (ear or head noise).  Tinnitus can be a constant or intermittent sound that can occur in one or both ears.  People describe their ear noise numerous ways including but not limited to ringing, hissing, rushing, and chirping.

It is thought that tinnitus most oftencomes from damage to the hair cells or nerve endings of the inner ear.  Damage to the inner ear, due to the natural aging process, noise exposure, and/or ototoxic medicines will often manifest itself as hearing loss and often tinnitus.  In some cases tinnitus may be caused by diabetes, thyroid problems, injury to the head or neck, tumor, or can be blood pressure related (circulation problems).  There are some medications that also may exacerbate your tinnitus including anti-inflammatories, antibiotics, antidepressants, and aspirin.

The following can have a negative impact on your tinnitus:

  • Exposure to loud noises
  • Excess caffeine, salt, nicotine
  • Fatigue/sleep disorders
  • Stress

 
The following can have a positive impact on your tinnitus:

  • Exercise
  • Adequate rest
  • Relaxation exercises/therapy
  • Noise maskers – Tinnitus is generally more bothersome when in a quiet environment.  Playing a constant low level sound in the background may help make it less noticeable.
  • Some people suffering from tinnitus have found the use of amplification beneficial.
  • Recognize your tinnitus as an annoyance, which allows your brain to habituate to it as much as possible.

 
** More information regarding tinnitus can be found at the following web sites:

 

Balance Rehabilitation

Should I see an audiologist?

If you are experiencing lightheadedness, a sensation of losing your balance, or a sense of feeling unsteady, you may be one of the millions of Americans who experience dizziness (vertigo).

Your hearing and balance should be evaluated by an audiologist certified by the American Speech-Language-Hearing Association to determine the cause and possible courses of actions to treat the balance disorder. Since balance disorders and/or vertigo can be associated with a number of conditions that may occur at any level of the auditory system, the audiologic evaluation will yield extensive information regarding cause and options for treatment.

When your balance is impaired, you may feel unsteady, woozy, disoriented, have blurred vision, or have a sensation of movement. It may seem that the room is spinning. You may not be able to walk without staggering, or you may not even be able to get up. Sometimes nausea, vomiting, diarrhea, feeling faint, changes in heart rate and blood pressure, fear, anxiety, or panic accompany the dizziness and balance problems.

Audiologists perform audiologic and balance assessment in order to gather information on your hearing and balance functioning. Test results help determine the possible causes of vertigo. Results of these assessments, in combination with medical findings, will provide diagnostic information on how to treat your dizziness and balance difficulties.

The organ of balance is located in the inner part of the ear close to the auditory nerve. Many times, but not always, the cause of dizziness is in this part of the ear. Consequently, individuals who are experiencing a balance disorder often have a hearing loss in one or both ears. Tinnitus, which is often described as ʺringing in the earsʺ or ʺhead noise,ʺ may also occur.

Audiologists can give you information to increase your understanding of dizziness. Understanding what is happening is often relief in itself. Knowing the cause of your dizziness is also relief from having to live with the uncertainty of the condition.

Dizziness can be associated with conditions that occur at all levels of the auditory system. Some of these conditions are swimmerʹs ear, insertion of foreign objects into the ear canal (external ear); ear infection, pressure changes, vascular problems, perilymph fistula (middle ear); Meniereʹs disease, ototoxic medications, circulation disorders, labyrinthitis (inner ear); and, at the central level, tumors (especially of the vestibular portion of the eighth nerve) and head injury.

How is dizziness treated?

The most effective treatment for vertigo is to eliminate the underlying cause, if possible. Because vertigo can be a symptom of a treatable disease or medical condition, medical or surgical treatment may be helpful. This is true for some cases of ear infection, stroke, or multiple sclerosis. For people with Meniereʹs disease, dietary changes such as reducing salt intake may help. For some people, reducing alcohol or caffeine and avoiding nicotine have been found to be helpful.

What should I do?

Dizziness and balance difficulties are symptoms of a problem. The first thing you should do is to try to find out the underlying cause. You should have a medical examination with special attention given to checking for factors associated with balance problems such as viral or bacterial infections, head injury, disorders of blood circulation affecting the inner ear or brain, visual disorders, medicines/drugs, tumors, and diseases involving the auditory system such as Meniereʹs disease.

Medical treatment varies and will be based on symptoms, medical history, general health, medical tests, and medical examination.

Unfortunately, in many cases, the vertigo and balance difficulties cannot be treated medically or surgically. In these cases, the vertigo itself may need to be treated.

What is vestibular rehabilitation?

Your audiologic, balance, and medical diagnostic tests help indicate whether you are a candidate for vestibular rehabilitation. Vestibular rehabilitation is an individualized balance-retraining exercise program. The retraining teaches compensations that may decrease dizziness, improve balance, and improve general activity levels. Many ASHA-certified audiologists provide vestibular rehabilitation services.

To locate ASHA-certified audiologists who provide audiologic vestibular assessment and/or rehabilitation, call the Action Center at 800-638-8255 or visit our Web site at www.asha.org and click on the words “Find a Professional.”

For more information about hearing loss, hearing aids, or referral to an ASHA-certified audiologist, please contact:  www.asha.org