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Author: admin, 24.01.2016. Category: Cause Of Ringing In Ears

Amazing all-natural Tinnitus breakthrough permanently eliminates Tinnitus issues without drugs or surgery. INTRODUCTION: Traditional masking efforts have presented broadband noises, most typically white noise.
OBJECTIVES: To evaluate the efficacy of a web-based delivery of customized sound therapy in reducing tinnitus loudness and increasing the residual inhibition. MATERIALS AND METHODS: Thirty-two subjects matched their tinnitus frequency using a web-based protocol. Tinnitus is the perception of sound by the brain in the absence of an external acoustic stimulus. It is acknowledged that targeted (customized) acoustic energy at the LEF provides more effective masking than broad-based acoustic energy. To address these issues, we have developed Harmonic Sound Therapy as a method of tinnitus treatment.
In the current study, we evaluated the efficacy of Harmonic web-based delivery of customized sound therapy in reducing tinnitus loudness and increasing the residual inhibition (a temporary suppression of tinnitus following exposure to therapy sound).
Thirty-two participants were enrolled in the study through the Otolaryngology clinic at our institution or through patients who found the study via the web.
The study protocol only included one introductory session with each participant to ensure the eligibility criteria and process of written informed consent. In the second step, the participants were asked to rematch their tinnitus with a choice of the tinnitus frequency and one octave above and below the tinnitus frequency. The last step was to download the customized Harmonic Sound Therapy file, generated by the website, onto the MP3 player. Tinnitus loudness and annoyance were measured by visual analog scales (VAS) before and after treatment. Means, standard deviation (SD) and range of values were calculated for loudness and annoyance before and after treatment. The median duration of residual inhibition was 33 minutes, with an average of 75 minutes (SD ± 132; range, 0-720).
In the current study, participants were only seen once to be introduced to the study, sign the consent form and to be provided with the research equipment (MP3 player and headphones).
There is controversy about the exact region of damage that leads to the perception of a specific tinnitus frequency.
Recent studies have demonstrated the advantage of customized sound therapies over traditional sound therapies (i.e. Web-based delivery of customized sound therapy for tinnitus is a practical and potential solution for the treatment of tinnitus. Paper submitted to the RBCMS-SGP (Publishing Management System) on December 7, 2011; and accepted on August 16, 2012.
Targeted (customized) sound therapies have been introduced to overcome the limitations of traditional maskers. A customized Harmonic Sound Therapy file was produced by the web-based software and downloaded by the patient onto an MP3 player.
Some reduction in loudness was seen in 81%, while 72% experienced a reduction of 25% or more. This perception of sound is most often caused by damage to the peripheral auditory system, specifically the cochlea.
Sound therapy induces suppression of the spontaneous firing in the auditory cortex's LPZ, and hence provide tinnitus relief.
In other words, the more closely the masking sound corresponds with the LEF, the more effective is the tinnitus suppression6-11.
Harmonic Sound Therapy is a customized masking strategy specifically designed to deliver non-noxious targeted acoustic energy to the LPZ, yet at the same time allow significant portions of the hearing spectrum to remain unmasked. The inclusion criteria were being aged 18 years or older, presence of tinnitus for 6 months or more and constant tinnitus.
After signing the informed consent form, each participant was introduced to the website created for the study with minimal further instructions.
AirDrives Interactive Stereo earphones: the speaker sits outside of the ear and transmits sound via the tragal cartilage.
This allowed the elimination of octave confusion, which can occur when selecting the tinnitus frequency12. Third step in web-based protocol of Harmonic Sound Therapy for tinnitus treatment: balance adjustment on a scroll bar to compensate for asymmetry in tinnitus and hearing loss. A sample spectral plot of a Harmonic Sound Therapy File with the center frequency around 12000 Hz and first (6000 Hz) and fifth (375 Hz) sub-harmonics. Then, participants were instructed to place both headphones around the ear in a way that the speaker sits in front of the ear canal and then listens to the therapy file for an hour at a level equal to tinnitus loudness (mixing-point).


After downloading the Harmonic Sound Therapy file and before starting to listen, participants were asked to score the loudness and annoyance of their tinnitus on separate scale lines numbered from 0 to 10. Non-parametric tests were used to compare the reduction in each participant's loudness and annoyance, and to evaluate the difference in reductions and residual inhibitions between different levels of independent variables. Harmonic Sound Therapy is effective in temporarily reducing the intensity and loudness of tinnitus in a significant group of patients; 2. They were given minimal instructions on the web-based protocol before using it, though a research staff was present by their side as the procedures were completed. Although some authors have suggested that tinnitus frequency corresponds to the region of maximal hearing loss12,13 or some opposed the LEF theory15, many studies have supported it2,3,11,16.
Findings of the current study should be interpreted with caution due to the small sample size and lack of a control group. This study has shown that Harmonic Sound Therapy is effective in at least temporary reduction of tinnitus in a large number of subjects.
Division of Neurotology and Skull Base Surgery, Department of Otolaryngology and Head and Neck Surgery - University of California, Irvine - Irvine - AC - United States. MD; Division of Neurotology and Skull Base Surgery, Department of Otolaryngology and Head and Neck Surgery, and Department of Biomedical Engineering - University of California, Irvine - Irvine - United States. Traditional (non-customized) masking efforts have presented broadband noises, most typically white noise.
Unfortunately, with this approximation, the therapeutic sound might also become more noxious. This design makes it possible to have dramatically increased exposure to the therapeutic sound because the ambient acoustic space is left open.
The exclusion criteria were: active illicit drug use or alcohol dependence, active ear infections, treatable cause of tinnitus, history of psychosis, abnormalities of the ear canal, subjects on medications known to cause tinnitus (aspirin, ibuprofen, naproxen, etc) which could not be stopped, and currently under another sound or masking therapy for tinnitus. The website contained general information on the tinnitus, aim and procedure of the study, and instructions on every step of the web-based protocol. The subjects were instructed to have the level of the sound therapy file such that the tinnitus can still barely be heard. After one hour of listening to the file, they were asked to score the loudness and annoyance again. There were no associations between reduction in loudness or annoyance and other independent factors (age, gender, ear side and tinnitus pitch). Among those with a 25% or more reduction in tinnitus loudness, median residual inhibition was 60 minutes (mean 99 ± 148 SD).
However, after they followed the online protocol, their tinnitus loudness and annoyance scores were significantly reduced temporarily. Harmonic Sound Therapy files are centered on the patient's tinnitus frequency and not only stimulate the LEF but its neighboring octave frequencies as well and theoretically will decrease the hyperactivity in the LPZ.
In the current study, we sought to test the feasibility of providing customized sound therapy over the internet. However, the results highlight the feasibility of a potentially cost-effective, customized treatment of tinnitus over the web. This will illuminate the path towards future studies and applications of internet-delivered customized Harmonic Sound Therapy in larger populations and controlled trials. Auditory cortical plasticity: Does it provide evidence for cognitive processing in the auditory cortex?
Listening to tailor-made notched music reduces tinnitus loudness and tinnitus-related auditory cortex activity. The windowed sound therapy: a new empirical approach for an effectiv personalized treatment of tinnitus. Residual inhibition functions in relation to tinnitus spectra and auditory threshold shift. Psychoacoustic characterization of the tinnitus spectrum: implications for the underlying mechanisms of tinnitus. Median duration of residual inhibition was 32.5 minutes, with an average of 75 minutes ± 132 SD. First, damage or insult to a region of the cochlea increases the spontaneous firing rate in its corresponding area of the brain. A disadvantage with broadband noise is that it masks the subject's hearing at all frequencies. There are a number of drawbacks with most of the introduced sound therapy treatments as they require multiple visits to care provider, special equipments or they are simply too expensive. To unify the delivery method, each participant was provided with a unique username and password. In bilateral cases, they were instructed to adjust the balance on a scroll bar to hear the pitch-matched sound equally in both ears, to allow for asymmetry in tinnitus and hearing loss (Figure 2).


Nineteen (59.4%) described their tinnitus as tonal or ringing and 13 (41%) as hissing or buzzing. There was no association between residual inhibition and other independent factors (age, gender, ear side and tinnitus frequency and type). We found 25%, 50% and 100% temporary reduction in tinnitus loudness after one hour of Harmonic Sound Therapy usage in 72%, 34% and 13% of patients respectively. About 72% of the participants experienced a 25% or more reduction in loudness and annoyance that on average lasted for a median of approximately 60 minutes. By doing so, concentrated delivery of therapeutic sound is achieved, while at the same time the noxious quality, which might result by stimulation of the tinnitus frequency alone, is avoided.
Although web-based treatments of tinnitus have been introduced using other approaches such as cognitive behavioral therapy18, this is the first study to evaluate customized sound therapy as a possible telemedicine application through automated web-delivery of sound files.
Thus, this sets limits on the duration a subject is able to have the hyperactivity in the LPZ suppressed, and ultimately, on the rate and degree of tinnitus rehabilitation6,7.
Furthermore, they were given a 2 GB Sansa Clip MP3 player (San Disk, Milpitas, CA) and an AirDrives Interactive Stereo Earphone (Mad Catz Inc, San Diego, CA). The participants were given the option of using a scrolling slider, to select the closest sound to their tinnitus if the multiple choices did not closely approximate their tinnitus.
The website would then implement participants' selections of frequency, loudness and inter-aural characteristics to construct a customized Harmonic Sound Therapy file (Figure 3). If the loudness was reduced then the participants were instructed to report the duration that the tinnitus suppression lasted, in minutes. We believe that customized web-based sound therapy for tinnitus could be an effective and promising alternative to current methods of tinnitus treatment. Furthermore, because Harmonic Sound Therapy only targets the regions of the hearing spectrum that involve the tinnitus frequency and its sub-harmonics, the remaining portions of the hearing spectrum are spared and allowed to pass through to the ear. The second phenomenon that occurs is that the tones that border the damaged zone in the cochlea become associated with the hyperactivity occurring in the LPZ. Additionally, there have been reports on deterioration of the intelligibility of speech with broadband noises compared with the other sound therapy signals in tinnitus treatment7.
The innovative design of these headphones, where the speaker sits outside of the ear and transmits sound via the tragal cartilage, prevented the participant from being acoustically isolated (Figure 1).
The Harmonic Sound Therapy file is composed of a series of narrow-band noise peaks centered on the tinnitus frequency and the first and fifth sub-harmonics. The Harmonic Sound Therapy could be used as a complement to routine tinnitus management or as a replacement for patients who are unable to have frequent visits to their care provider or live in remote locations.
This could be explained by the nature of the Harmonic Sound Therapy files that are composed of a series of narrow-band noise peaks centered on the tinnitus frequency and the first and fifth sub-harmonics. This innovative approach is further exploited by the use of Air Drives Interactive Stereo Earphones. The ringing tone that people hear when they perceive tinnitus actually corresponds to these border regions, called Lesion Edge Frequencies (LEF)2,3. The speakers in these headphones do not sit in the ear canal, and therefore, the environment sound could pass into the ear canal and reach the users' ear. The web-based protocol allows patients to change their sound therapy file with changes in their tinnitus frequency. Therefore, they provide partial coverage one quarter-octave below and above the tinnitus frequency and are more likely to resemble the participants' tinnitus spectra11.
These headphones transmit sound via the tragus, and thus do not occlude the external ear canal.
During this session, the participants were asked to run the MP3 player and headphone once to ensure they know how they work. The result was a file that sounded similar to generic white noise, but the amount of required acoustic energy was dramatically reduced and centered on the frequencies where therapy is needed. In general, the patients had no difficulty performing the web-based procedures and downloading the sound file onto an MP3 player. This allows the patient to listen to their therapeutic sound files during the course of their everyday activities. Some of the older patients, who had not used an MP3 player in the past, required some assistance.



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