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In this section we’ll cover white noise for tinnitus as well as touching very briefly on pink noise and brown noise.
White noise has the full scale of sound frequencies discernible by the human ear all blended together to make a continuous sound.  The sound could be likened to the static produced by a radio or TV when off station. Sound therapy sometimes referred to as “white noise” has been successful in reducing the stress created by tinnitus.
If you decide to use white noise for tinnitus therapy it is recommended that you visit a qualified Audiologist, as the frequency of the masking sounds must be tailored to the individuals needs, usually at a slightly lower frequency than the tinnitus noise. Variable sound streaming to suit the user and offering in particular, sounds they can choose to offer the greatest comfort. Remember that white noise in the treatment of tinnitus is not a cure, it will only help to mask the noise and possibly reduce stress levels in some patients. Pink noise is also used as a “masker” utilizing a smaller sound range and sounds similar to the hum experienced around electricity transformers.
Brown noise is again used as a masker operating at a lower frequency producing a continuous sound like the continuous roar of the ocean.
All 3 noises can be and are used in the treatment of tinnitus, with white noise for tinnitus being the most common. I’ve set up this website to provide useful information and to help other tinnitus sufferers learn how to manage and live with this annoying condition. Top 3 Articles (voted by our visitors!)Tinnitus Remedies 2 CommentsTinnitus is the technical term for a persistent ringing in the ears.
Tinnitus is a common symptom for which few existing therapeutic approaches can produce reliable reduction or elimination.
Chemical perfusion is a treatment option that involves the delivery of medication directly into the inner ear via the round-window membrane, thus achieving higher cochlear concentration without systemic side effects. This study describes the application of glucocorticoids, specifically dexamethasone, or gentamicin to the round-window membrane in individuals who have various inner ear diseases and in whom disturbing tinnitus is one of the symptoms. Chemical perfusion of the inner ear with gentamicin was offered to patients who had Menière's disease, frequent vertigo with attacks, and fair to poor hearing and in whom vestibular nerve section or endolymphatic sac surgery had failed or who were poor surgical candidates. Of the 20 patients reported in this study, the initial 14 patients (5 male, 9 female; age range, 27-79 years) underwent chemical perfusion of the round window.
The intratympanic method of chemical perfusion does not permit accurate instillation of any medication into the inner ear.
The Round Window Microcatheter (IntraEar, Inc., Denver, CO) appears to be a major advance in permitting the precise delivery of medication over a specified period. Additionally, chemical perfusion may lessen the need for some types of traditional surgery and for alternative therapies provided for tinnitus. Precise delivery of medication into the inner ear is a goal, which is obtainable because the round-window micro catheter technique can deliver the required precise quantity of medication into the inner ear. This study was presented at the International Tinnitus Forum Meeting, San Antonio, TX, September 22, 1998. How to cite this article Oliveira TSC, Sampaio ALL, Granjeiro RC, Kehrle HM, Braga SCL, Almeida ALA, Oliveira CACP, et al.
OBJECTIVE: To investigate whether hormone replacement therapy modifies the auditory brainstem response in postmenopausal women. METHODS: Nineteen postmenopausal women received hormone replacement therapy (study group) and 25 received no treatment nor placebo (control group). Estrogen is classically known to influence the growth, differentiation and function of the female and male reproductive tract1. There is no visible nuclear staining of progesterone receptors (PR's) in the stria vascularis, organ of Corti or spiral ganglion in either of human or rat inner ears, indicating that progesterone could not have a direct effect on the hearing modulation in the inner ear via its nuclear receptors. The functional role of estrogen and receptors in hearing physiology and pathophysiology is beginning to be elucidated1,6,13. A number of studies have shown that estrogen (E) and progesterone (P) can alter hearing thresholds14-16 and auditory brainstem response (ABR) latencies17-19. Elkind-Hirsh et al.17 observed no significant changes in ABR latencies in women using oral contraceptives. Women tend to hear better than men throughout life but during menopause the hearing thresholds deteriorate at more rapid space26.
The ABR has become an important objective measure of hearing since its first description by Jewett and Williston in 197128. The term climactery is defined as the transition from reproductive years to a non-reproductive stage of life. The objective of the present study was to evaluate the effect of combined HRT (estrogen plus progestin [synthetic progesterone]) on the ABR of postmenopausal women after three months of continuous use.
A prospective clinical study was conducted between January 2009 and March 2012 and involved 44 postmenopausal women (88 ears) who were recruited by the Gynecology Department of the Hospital do Gama, Brasilia, DF, Brazil and sent to the Otolaryngology Department of Hospital de Base, Distrito Federal.
Both groups were submitted to a detailed physical examination involving complete otolaryngological and gynecological examination and complete blood count.
Statistical analysis was performed considering the results obtained for the number of ears (n = 88) instead of the number of patients, since the results of the right and left ears in the same individual are independent. In the control group, ABR were abnormal in 5 (20%) patients at baseline and in 3 (12%) after 3 months. The mean (SEM) absolute latencies of waves I, III and V, I-III, III-V and I-V interpeak intervals obtained for the study and control groups are shown in Tables 3 and 4. The mean of each parameter of ABR of the groups was compared between right and left ear at baseline and after 3 months and the results are shown in Table 5. The effects of estrogen and progesterone on hearing have been extensively investigated and the results are contradictory. Hedestierna et al.35 observed better thresholds in pre-, peri- and postmenopausal women using HRT when compared to postmenopausal women not receiving HRT. Guimaraes et al.27 investigated the auditory system of postmenopausal women receiving combined hormone treatment (E + P) and compared this group to a group treated only with estrogen (E) and to a control group (CG).
Kilicdag et al.34 reported that pure tone thresholds of postmenopausal women using E were better than pure tone thresholds of those on E + P and in CG. Sator et al.40 in a first prospective randomized study observed good response with the administration of tibolone. In our study we did not find positive or negative effects of estrogen and progesterone, but we had a limited sample.
The present results suggest that HRT consisting of estradiol and progestin has no positive nor negative effect on ABR latencies in postmenopausal women when given for three months. Institution: Otolaryngology Department of the Hospital de Base do Distrito Federal, Brasilia, DF, Brazil.
Paper submitted to the RBCMS-SGP (Publishing Management System) on August 11, 2014; and accepted on August 13, 2014. White noise for tinnitus is not a cure but a method used to mask the sound, therefore reducing the perception of the background noise. Furthermore there are additional advantages such as improved concentration, assisting with sleep apnea and relaxation.
Chemical perfusion involves the delivery of medication directly into the inner ear via the round-window membrane. It is primarily a subjective complaint for which objective indicators usually are sparse and lack a proven animal model.
Chemical perfusion shows great promise in controlling severe peripheral tinnitus either as the sole symptom or in association with other symptoms present from a variety of causes (Menière's disease, frequent attacks of vertigo, failed vestibular nerve section, sudden sensorineural hearing loss, inner ear vestibular dysfunction, and failed endolymphatic sac shunt surgery). Various reports have shown that, in selected cases, these medications can control vertigo, improve hearing, and reduce tinnitus [3-11]. Of these 14 patients, 6 suffered Menière's disease, 6 had severe tinnitus, and 3 had experienced sudden deafness. These patients had dry Gelfoam placed into the round-window niche through an extended tympanostomy incision, allowing the practitioner to inspect the round window to ensure the absence of false membranes or mucosal bands [16]. This impediment is significant to the precision necessary to control, monitor, and gain a desired outcome and not a failed or deleterious effect. The catheter tip of the dual-lumen microcatheter is a fenestrated, hollow, compressible bulb that fits snugly into the round-window niche.

The delivery of medications into the inner ear (chemical perfusion) shows promise in controlling a host of cochleovestibular symptoms, including tinnitus, without systemic effects.
Effect of hormone replacement therapy on the auditory brainstem response of postmenopausal women.
In both groups, age ranged from 45 to 60 years and pure-tone sensitivity was 25 dB or better at frequencies between 500 and 2000 Hz. No significant differences in wave latencies, or interpeak intervals were observed between the two groups (p > 0.05). However, PR's have been shown in both osteoblasts and osteoclasts in the bone of humans, rats, and mice. There are also case reports of irreversible20 or reversible21 sudden hearing loss after the use of the contraceptive pill or hormone replacement therapy (HRT)22.
In contrast, Caruso et al.19 suggested that steroids present in oral contraceptives affect ABR. The results showed thresholds elevation at the ABR in 47% of animals, with severe hearing loss in two of them, and increase of the amplitudes (mean) of the waves I, II, III and V.
But little is known about the effect of lack of sex hormones and their replacement on the hearing of women before, during, or after menopause.
The measurement of ABR is part of a battery of routine tests used to evaluate peripheral auditory sensitivity and neural integrity of the auditory central nervous system. Exclusion criteria were undiagnosed genital bleeding, known or suspected malignant or premalignant disease, neurological diseases, metabolic problems, vascular diseases, any previous otologic disease detected in the patient's history, acoustic trauma, a history of ototoxic drug use, middle ear disease, previous ear surgery, a history of vestibular problems, and recent aspirin intake. Postmenopausal women of the study group were experiencing moderate to severe menopausal symptoms (Kupperman index > 2029,30) and had no absolute contraindications to HRT use. The audiologic tests used were a conventional audiometry (AC 40 Clinical Audiometer -Interacoustics, Assens, Denmark), standard earphones (Telephonics TDH-39P, Denmark), impedance audiometry (AT 235H - Interacoustics, Assens, Denmark) and ABR (Chartr EP - GN Otometrics, USA). Changes in auditory function have been demonstrated in postmenopausal women, which were attributed in part to lower levels of ovarian hormones33.
Age-related hearing loss is one of the top three chronic medical conditions of elderly persons and makes verbal communication difficult39. The results of pure-tone audiometry, tympanometry, distortion-product otoacoustic emissions, transient otoacoustic emissions, and the hearing in noise test showed worse performance for the E + P group when compared to E and CG. No control group was included in the study and the authors concluded that progestin does not antagonize or potentiate the effects of estrogen. They showed a significant decrease in ABR latencies of the waves II, III and V with administration of tibolone for 3 months in 12 healthy postmenopausal women compared to 12 postmenopausal women who received placebo.
Tibolone used for at least 1 year had no negative effect on hearing function when they compared the tibolone group (n = 33) with the nontibolone group (n = 50). But as we can see, the results of the influences of HRT on the auditory system do not have a consensus. Otolaryngology and Head and Neck Surgery Department - Brasilia University Medical School - Brasilia - DF - Brasil. The masking sound is usually delivered by such devices as MP 3 or CD players and from speakers in the bedroom under the pillow for assisting in sleep.
This report discusses the use of dexamethasone or gentamicin in 20 individuals who had inner ear diseases in which disturbing cochlear tinnitus was one of the symptoms. Though tinnitus often is associated with other symptoms, the degree of suffering it produces ranges from an occasional awareness to the contemplation of suicide [1].
Dexamethasone has as its probable mechanism an increase in blood flow to the cochlea, a decrease in any inflammatory component, and antioxidant properties [14]. A ventilation tube was placed, the gentamicin was instilled, and patients remained supine with their head turned away 30 degrees for 45 minutes. The inflow-outflow design permits the physician, with the device in place, (1) to add medication, (2) to remove medication, (3) to flush the device, and (d) to relieve or avoid buildup of air or fluid pressure.
However, further investigation and analysis of chemical perfusion's role in the control of tinnitus are needed.
Dexamethasone perfusion of the labyrinth plus intravenous dexamethasone for Menière's disease. Corticosteroid pharmacokinetics in the inner ear: A comparison of different drugs and route of administration.
Predictive monitoring of highfrequency vestibulo-ocular reflex rehabilitation following gentamicin ototoxicity.
Auditory brainstem response was evaluated before and after 3 months of hormone use in the study group.
These findings lead us to conclude that there is no direct effect of progesterone on hearing, but possibly indirect effects via other signaling pathways11,12. Swanson and Dengerink14, Petiot and Parrot15 and Cox16 reported that 4 kHz thresholds were worse during the menstrual phase, when both estrogen and progesterone levels were lowest. Climacteric symptoms were hot flushes, night sweating, sleep problems, vaginal dryness, and tiredness.
All patients were evaluated by the same investigator who was unaware whether the subjects used HRT or not. Some clinical and experimental studies have shown positive effects of gonadal hormones on the maintenance of normal hearing in young and middle-aged women, whereas a negative or no effect on hearing has been reported by others34-41. The actions of estrogen and progestin have been linked to sensory and central nervous system processes and disorders such as cognition, memory and dementia40. Caruso et al.36 showed shorter latencies of ABR waves and interpeak intervals after 3 months of estrogen therapy when compared to baseline.
These findings suggest a protective effect of estradiol on the female auditory system and that the addition of progestin seems to have a negative influence on the peripheral and central auditory system. These findings suggest that adding progesterone to estrogen therapy may attenuate the positive effects of estrogen on hearing. A shorter period of time of HRT use and a small number of patients could maybe explain the lack of effects of hormone therapy.
Tibolone is a syntetic steroid hormone used frequently in treatment of menopausal symptoms and has estrogenic, gestagenic and weak adrogenic effects on different target organs.
In this study, even with the use of HRT for a short period of time and with a small number of patients, they observed positive differences on ABR latencies with HRT use. Broadly, estrogen seems to have more positive than negative effects to the auditory system. Estrogen receptors in the normal adult and developing human inner ear and in Turner's syndrome. Estrogen actions in the brain and the basis for differential action in men and women: a case for sex-specific medicines. Estrogen receptors alpha and beta in the inner ear of the 'Turner mouse' and an estrogen receptor beta knockout mouse.
The estrogen receptor beta subtype: a novel mediator of estrogen action in neuroendocrine systems.
Changes in pure-tone thresholds and temporary threshold shifts as a function of menstrual cycle and oral contraceptives.
Effects of the ovarian and contraceptive cycles on absolute thresholds, auditory fatigue and recovery from temporary threshold shifts at 4 and 6 kHz.
Inner ear disturbance following long-term usage of hormonal contraceptives (author's transl). Morphological and functional study of the cochlea after administration of estrogen and progesterone in the guinea pig. Auditory brainstem responses from graduates of an intensive care nursery: normal patterns of response. Effects of patch or gel estrogen therapies on auditory brainstem response in surgically postmenopausal women: a prospective, randomized study. Differential effects of exogenous estrogen versus a estrogen-progesterone combination on auditory evoked potentials in menopausal women. Discrepancy in improvement of hearing loss between left and right ears after postmenopausal hormone therapy. Effects of tibolone on auditory brainstem responses in postmenopausal women-a randomized, double-blind, placebo-controlled trial.

Some however have acute continuous noises, known as “phantom” sounds that lead to depression, insomnia and even suicide.
Preliminary results indicate that chemical perfusion is a promising option for the treatment of cochlear tinnitus. Approximately 20% of individuals with tinnitus have what is described as a severe or extreme form, which significantly interferes with the quality and productivity of life. Three patients had severe tinnitus as their most disturbing symptom; hearing loss, vertigo, and ear fullness were of greater concern to 17 patients. All three patients had severe vertigo or imbalance and severe tinnitus, two had poor hearing, and one had no hearing. Attachment to an infusion pump allows continuous and exact delivery of medication to the inner ear. Presented at the American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc., annual meeting, San Antonio, TX, September 13-16, 1998.
In the brain, estrogens affect both the activity and the connectivity of specific neuronal populations and thereby modulate physiological parameters that are important for the regulation of animal reproduction, but also of non-reproductive events such as learning and memory9. On the other hand, it was also observed a decrease of the latencies (mean) of the five waves of ABR, and this fact suggest a possible facilitatory action in the conductibility of the sensory auditory pathway, in contrast with the above exposed observations.
Because of the widespread prescription of hormone replacement therapy (HRT), it is critical to determine the effects of HRT on sensory systems in postmenopausal females27. Postmenopausal women of the control group had mild menopausal symptoms (Kupperman index < 20) or fear of HRT use based on the side-effects and risks of it31. The ABR recordings were obtained over the first 15 milliseconds after onset of an auditory stimulus, with the patient in a supine position in a silent electrically shielded room. The previous reports are based on papers dealing with different HRT and sometimes not well controlled. It has been suggested by many studies that HRT given at the time of menopause, especially during the menopausal transition, is effective in the prevention of some diseases, including neurodegenerative diseases, cardiovascular diseases and osteoporosis2-4,31. No control group was included in that study and the authors compared ABR between two groups receiving two different doses of estradiol (transdermal gel and transdermal patches). A higher dose of HRT used by these authors compared to our study perhaps is the second factor that could enhanced the positive effects of estrogen.
On the other hand, progestin seems to have more negative than positive effect on the auditory system.
Prevalence of hearing loss, audiometric configuration and relation to hormone replacement therapy. Each herbal medicine prescription is a blend of many herbs tailored to the individual patient, and their health needs.Nutrition -- Our doctors all believe in improving the awareness of nutritious meal choices and establishing long-term habits of healthy eating and thus preventing disease.
It is important to know that these noises are real and not a figment of the sufferer’s imagination.
Despite numerous identifiable or idiopathic causes of tinnitus (Table 1), the variety of therapies used for its eradication or reduction has been uniformly disappointing, offering only temporary or no relief (Table 2) [2]. Patient evaluation and testing were dictated by the diagnosis and, for Menière's disease, by stage (Shea I-V).
Of the three, two experienced significant reduction in and one experienced elimination of tinnitus (Table 5).
The IntraEar Round Window Microcatheter was used in three patients in this report (Table 6).
Recent studies indicate that the lack of ERβ in animals leads to the degeneration of cortical neurons in the brain which increases with age10. Absolute contraindications to HRT use included thromboembolic disease, breast cancer, uncontrolled hypertension, undiagnosed genital bleeding, coagulopathies, or liver disease. The correction of the level of statistical significance in all 2 x 2 contingency tables was performed using Fisher's exact test.
The patients were considered to have abnormal results when they had at least one parameter of ABR that was not normal according to the adopted values. We decided to perform this controlled study in order to evaluate the effect of combined HRT (estradiol plus progestin - E + P) on the ABR in postmenopausal women during three months.
But the effects of HRT on hearing are controversial and there are need for more investigations as to whether HRT is actually beneficial or detrimental to sensory functioning in postmenopausal women39. These biases were avoided in the present study since only one type and dose of HRT was used.
We can observe that the long period of HRT use maybe is a factor that can influence the effect of hormone therapy.
The longer period of HRT use (more than 3 years) can be considered the third factor of HRT influence on the auditory system. Where indicated, tests included comprehensive audiometry, tinnitus matching, electronystagmography, electrocochleography, vestibular autorotation testing [12], osmotic diuresis, and radiological studies. Although each patient had different underlying pathology, all three had severe cochlear tinnitus.
Dehan and Jerger24 reported a decrease in wave V latency at the luteal phase during progesterone peak.
The ABR results were analyzed using a mixed model ANOVA that included the variables 'group' (control and HRT), 'time' (beginning and end), and 'ear' (right and left). We chose three months of study once it is the minimum period required for observation of clinical symptoms due to hormone therapy25. On the other hand, HRT has some known side effects31, and new studies investigating these possible beneficial improvements on hearing should be attempted. The authors postulated that there might be some other factor modifying the condition or effect of the drug such as laterality. One possible mechanism centers on progesterone's ability to down regulate estrogen receptors in breast and uterine tissue, balancing the effects of estrogen or possible irreversible receptor damage6. Failure to respond to reassurance, dietary and lifestyle changes, medical intervention (diuretics, vestibular suppressants, systemic steroids, calcium channel blockers, vasodilators, anticholinergics, and lipid reduction), and vestibular physical therapy, considered in conjunction with the stage of the disease, resulted in the option of chemical perfusion with dexamethasone or gentamicin. Under general anesthesia, the patients had their cathetersfilled with the gentamicin solution (l.25 ml)-placed into the round-window niche via a tympanomeatal flap and were released to home. On the other hand, Fagan and Church18 observed no changes in wave V during the menstrual cycle. The normal pattern described by Gorga et al.32 was used as a reference and modified for our population by the audiologic clinic of the hospital.
However, more studies are warranted in order to prove the hypothesis of patients with E reposition having a better hearing performance than the ones with E + P and to help in the designing of selective estrogen agonists in order to avoid negative side-effects, such as breast cancer. Periodically we hold weight loss seminars at the office to help educate our patients towards healthier lives.
At a follow-up office visit, the gentamicin within the catheter was removed and was replaced with new solution. The prevalence of normal and abnormal results of each parameter was calculated for each patient group, before and after 12 weeks. The statistical significance of multiple comparisons was corrected using the Bonferroni test. Especially significant improvement on right ear might be explained by differences in distribution of estrogen receptor (ER) in the ear.
No patients complained of any pain or discomfort from this brief procedure (approximately 40 minutes). Another possible reason might be difference in bone mineral density of sides of body which is lower on the right side. The mean of each parameter of ABR was compared between right and left ear using the paired t test.

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Comments Different tinnitus in each ear kopfh?rer

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  2. akula_007
    But, if you've eliminated these aspects and individuals still cover.
  3. Turkiye_Seninleyik
    Auditory canal by wax or other foreign bodies could trigger a sensation.