Hearing Aids with White Noise to Help Hyperacusis: Resulted in Tinnitus Spike and Worse Hyperacusis?

Hello forum!

I have a question about hearing aids. My ENT set me up with white noise through my hearing aids to help with the hyperacusis. I noticed my tinnitus getting louder after doing this, but she said it means my tinnitus is reactive, and to continue with the white noise. My tinnitus did go back to normal the next morning.

About three weeks ago I had a big spike in my tinnitus while using the hearing aids. I still have some head noise from that spike... and out of caution I stopped using the hearing aids.

Since then, my hyperacusis has been getting worse and more bothersome than my tinnitus.

The doc says I should continue with the white noise - she thinks the spike isn’t related to the white noise. I’m not sure. My spikes do seem to be random.

Anyone have similar experiences or any advice?

Best,
Tom

 

HI @MusicTeacher

I am sorry to hear about your discomfort. With respect to your ENT doctor who may be an excellent physician and knows all about the anatomy of the ear and how to treat underlying medical problems with it that causes tinnitus. However, in my opinion based on many years experience with noise induced tinnitus and hyperacusis, she knows very little about tinnitus or hyperacusis.

ENT doctors do not normally specialises in tinnitus or hyperacusis because this is not their area of expertise. Please see below a post that I wrote a short while ago in this forum that you may find helpful. My advice to you is not to use the white noise at the moment because you are finding it irritates your auditory system and causing tinnitus spikes. Just use the hearing aids for now and when you get used to them slowly introduce the white noise. By this I mean, turn on the white noise for just 1hr or 2 and then turn it off for the same amount of time then on again. Do this throughout the day for about a week. Slowly very slowly increase the duration of the white noise so your ears do not become irritated and the tinnitus spikes. Keep the volume of the white noise slightly below the tinnitus, it must not Mask the tinnitus. Please click on the link below and read my post: Hyperacusis, As I see it.

https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/

Hope you start to feel better soon

Michael


Most ENT doctors do not treat tinnitus because this is not their area of expertise. They are physicians not tinnitus specialists. They treat underlying medical conditions within the auditory system and ear nose and throat that causes the tinnitus. They treat these conditions medically or surgically. Those that have knowledge of tinnitus is as you've found to be quite lacking. Some have more insight into tinnitus because they have it, but usually it's mild and nothing like you or other members in this forum experience.

When a patient's tinnitus is not caused by an underlying medical problem as in Noise induced tinnitus, they should be referred from ENT to Audiology for treatment as is the current practice in the UK. Here, they will usually see an Audiologist sometimes a Hearing Therapist. The role of the Audiologist is to fit a patient with hearing aids, white noise generators and carry out hearing tests. They can also diagnose other problems affecting the ears and fit patients with cochlear implants and help with speech therapy. Some branch out and specialise in tinnitus and hyperacusis management and treatment. This can be particularly helpful when counselling is required which is often used in TRT and CBT. Usually these Audiologists will have tinnitus. They were either born with it or acquired it at some time in their life. Some also counsel people with phonophobia and misophonia. Both these conditions can affect a person that has tinnitus and hyperacusis.

The role of the Hearing Therapist is similar to an Audiologist. They counsel patients with hearing loss, tinnitus, hyperacusis and other problems affecting the auditory system. Many have tinnitus as does my hearing therapist who was born with it. I believe for an Audiologist or Hearing Therapist to give good quality counselling to a tinnitus patient, they have got to have tinnitus. Unless they have tinnitus they cannot understand or know how the condition affects a person's mental and emotional wellbeing. Therefore, at best the counselling will be unconvincing and mediocre something the patient will quickly realize.

For this reason I have no interest in attending tinnitus seminars and conferences, for they are often hosted by ENT doctors and Audiologists who are medically qualified and know about the anatomy of the ear and problems associated with it, but most have no understanding of tinnitus or hyperacusis because they have never experienced them. Through consultation with patients they can learn how these conditions can affect a person but their depth of knowledge and understanding will often leave a lot to be desired.

 

I know people that only had hearing loss and got tinnitus after starting to use hearing aids.

 

@Michael Leigh
Thanks for your note, Michael. I’ll be trying this again in one hour intervals. I was really hoping to be further along at this point - such a frustrating process.

Best
Tom

 

@MusicTeacher

HI Tom,

If you are comfortable wearing your hearing aids and experience no spikes then introduce the white noise gradually as you intend. This process takes time so please be patient. My following comments are not meant to undermine your ENT doctor who I believe wants to do the best she can for you but think she is out of her depth, when it comes to being knowledgeable about tinnitus and hyperacusis. The term Reactive Tinnitus which she has mentioned, is used a lot in tinnitus forums but in my opinion no such thing or condition exists.

People that say their tinnitus is reactive (Reactive Tinnitus) are usually those that have noise induced tinnitus and developed hyperacusis or an oversensitivity to sound from it. Their ears do react to certain sounds but this is due to the auditory system having suffered an acoustic trauma. The hyperacusis or oversensitivity to sound can improve by itself over time but when necessary, professional treatment will need to be sought to treat the condition as described in my post: Hyperacusis, As I see it.

Reactive Tinnitus is a terminology that was made up in tinnitus forums around 15 years ago and has become common place and some in the medical field have latched onto this word and say, it is a separate condition from hyperacusis, and should be treated using sound therapy. This could mean the wearing of white noise generators the same devices used to treat hyperacusis. People that want to believe this that's entirely their choice but I don't and will leave it there.

Take care and I wish you well.

Michael

 

I'm not a doctor or an ENT and I've never used white noise generators myself, but I do have an audio background and having since developed hyperacusis I can only say that I'm horrified that white noise generators are an approved medical "treatment" for this condition and tinnitus.

@MusicTeacher You will find on this forum that there are many H sufferers on here, including myself, who have a real difficulty in dealing with sound from small devices - laptops, phones etc. The reason for this is because these devices do not have dedicated sound cards, they have tiny speakers, and these speakers are biased towards higher frequencies and distort very easily - and high frequency/distortion is the worst thing for hyperacusis sufferers. Guess what else has small speakers and distorts very easily? White noise generators. I am therefore hardly surprised that you are getting worse. I can only imagine that white noise generators, as a prescribed treatment, have prevailed because they were first prescribed for tinnitus. The research was never seriously reviewed or challenged when it first came out decades ago and if someone says something enough times it becomes the truth, or in this case, dogma. I can tell you that my own audiologist, who is incredibly honest and recognises how lacking this field is, has said that putting anything so close to your ears, whether it's headphones or even white noise generators, is bad for your ears - period.

Now, having said all this, I am sure I will get shot down by some who have had success with white noise generators. All I can say is that in all likelihood these people's ears managed to heal in spite of the white generators because of the body's incredible ability to sometimes heal itself.

I do want to say that there is probably some merit to sound therapy, but not in this form. This is something I did and I've only heard a couple of other people doing this, but I think you would be much better off putting your money into a high-quality sound system (Hi-Fi or good quality studio speakers with a dedicated sound-card or interface) and play hi-fidelity pink noise (recorded at a high sample rate in wav form) through that sound system and listen at low volume. You would obviously need to be in front of your speakers every day for an extended period of time (perhaps as long as 6 or 8 hours), but unfortunately this is the price we pay for this hell. I'm in 3.5 months in and I've gone from wincing at the sound of my own footsteps and typing on a keyboard to being able to drive again, go shopping and go for quiet walks outside (albeit with mild anxiety/worry). Whatever route you go down, make sure to give your ears rest as well.

I wish you all the best and a speedy recovery. Keep us posted.

 

Please do not be horrified about white noise generators because they can be a very effective treatment for tinnitus and hyperacusis when used correctly and backed up with counselling with an Audiologist or Hearing Therapist, trained in tinnitus and hyperacusis management and treatment. This is the correct way white noise generators should be used.

I have had TRT twice and used white noise generators for many years and still do. I am not going to shoot you down or get into a long winded debate about this. I will say your opinions on white noise generators are incorrect.

Goodbye and I wish you well.
Michael