Case history: Carol was a 73-year-old woman with debilitating tinnitus following a bout of viral meningitis nine years previously. Her tinnitus had become worse over the last six to eight months. She was seen at the Tinnitus and Hyperacusis Clinic following medical evaluation at Mayo Clinic.

Carol reported a constant "roaring tinnitus" pitch matched at 250Hz. A minimum masking level to broadband noise was obtained at 45dB SL. The Tinnitus Reaction Questionnaire reflected the impact that tinnitus was having on various quality-of-life issues. On a scale of 104 points, Carol initially scored a 46. A score of 17 or more is considered clinically significant. Her tinnitus had the greatest impact on her ability to sleep and concentrate. She was sleeping an average of three to four hours per night with sleeping medication. She experienced feelings of unhappiness, tenseness, distress, and hopelessness about her future. She had ceased most social activities, no longer traveled and did not enjoy spending time with her grandchildren.

Audiological evaluation revealed a mild sloping to moderate sensorineural binaural hearing loss, although Carol had not worn hearing aids. She also displayed borderline hyperacusis and reported noticing some hearing deficiency; however, her only priority at that time was addressing the tinnitus.

Carol was able to try a demo unit of the Neuromonics Treatment during her initial assessment. She broke into tears in the office because it gave her immediate relief from her tinnitus. She had not had relief in many years. Following the initial assessment and recommendations, Carol chose to begin Neuromonics Tinnitus Treatment. At treatment initiation, Carol reported awareness of her tinnitus 100 percent of her waking hours; of that time, she was distressed 100 percent.

Soon after her initial Neuromonics fitting, Carol was able to take charge of her life again. She went on a two-day Mystery Tour bus trip with friends-something she would not have considered before treatment. At Neuromonics Treatment completion eight months later, Carol reported awareness of her tinnitus 25 percent of her waking hours, and of that time reported distress 10 percent of the time. In addition, her Tinnitus Reaction Questionnaire score was a 3 (a 97 percent improvement). She reported significant improvements in her ability to sleep, relax, concentrate, and enjoy life again.

Following tinnitus treatment completion, Carol was fit with bilateral open ear acoustic hearing instruments. To date, she reports using the Neuromonics processor on days of high stress and wears her hearing instruments the remaining waking hours. Carol continues to enjoy tinnitus-free days and reports that, when she does hear the sounds, they no longer bother her. She described her results in a letter:

"I am writing in regard to the results I received from Neuromonics Tinnitus Treatment. Being close to a nervous breakdown, it brought me some wonderful results. It taught me how to control my problems. I have now completed the full treatment and if I have a bad day, I use the Neuromonics for awhile and I am fine. I could not enjoy my family, church and all activities before. Now, thanks to Neuromonics treatment, I am my old self and really enjoy life again."

Paula Schwartz, AuD, practices at the Tinnitus and Hyperacusis Clinic in 2004 in Edina, MN. She is an advisory board member of the Tinnitus Practitioners Association, www.tinnituspractitioners.com. To learn more about TPA, visit AAA booth 2919.

About the author:

Paula Schwartz, AuD, opened the Tinnitus and Hyperacusis Clinic in 2004 in Edina, MN. At that time, Dr. Schwartz's 8-year-old son reported constant tinnitus after attending a music concert. As both a mother and an audiologist, Dr. Schwartz was committed to finding options and answers for her son and others with unbearable tinnitus.

At the outset, Dr. Schwartz and her staff were trained by Dr. Pawel Jastreboff in Tinnitus Retraining Therapy and the Neurophysiological Model of Tinnitus. Currently, the clinic offers Tinnitus Retraining Therapy, Neuromonics Tinnitus Treatment and a variety of desensitization therapies using specialized hearing devices. To date, the Tinnitus and Hyperacusis Clinic has helped tinnitus patients throughout the Midwest, Canada, Europe, and China.