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Tinnitus is the perception of a sound when there is no physical stimulus external to the head. In defining tinnitus, it is important to note how often it occurs and whether or not it is bothersome, explains Richard Tyler, PhD, professor, Department of Head and Neck Surgery, University of Iowa, Iowa City, IA.
"The person's reaction is really what defines tinnitus. It can be experienced as an uncontrollable sound, one that develops fear or anger," Tyler says.
The prevalence depends on how it is defined, he adds. "If you say something like a sound that lasts for more than 5 minutes, is present for at least 30 minutes during the day, and occurs at least 1 day a week, the prevalence can be about 10-30% of the population. It increases with age and approximately doubles for those with noise exposure."
The most common cause of tinnitus is noise exposure. Tyler explained to ADVANCE how a little noise, though - specifically music - can help those suffering from tinnitus.
ADVANCE: Can you describe in some detail your research into music therapy for tinnitus?
Tyler: We started this many years ago with support from the American Tinnitus Association. Several prior articles had recommended background music for tinnitus. I discussed this with the music therapists in our hospital, and came up with two different approaches often used to help patients distressed by their health condition. We decided to compare the effectiveness of these two approaches.
Passive listening involved playing music in the background while the subject was performing other activities, like reading or preparing food. Active listening involved only attending to the music. The subjects were asked not be involved in other activities, only to focus on the music.
Both groups were asked to do this at least twice a day for at least 30 minutes at a time when their tinnitus was particularly bothersome. Both groups were also asked to listen to music as they were going to sleep at night. We worked with each individual to select music that was likely to be effective and acceptable to them.
ADVANCE: Is the music similar to what we hear on the radio or something entirely different?
Tyler: The music should be something that can easily be ignored or put in the background. This means that singing words is usually not desirable (chanting might be). Typically, it is some soft background music (e.g. Davis, 2006). It should be acceptable for the tinnitus person and make their tinnitus less noticeable, less prominent or softer. Some patients also tell me that at times they like to listen to their tinnitus sound therapy music because it can be enjoyable to listen to.
ADVANCE: What were some of the key findings in your research?
Tyler: We used the Tinnitus Handicap Questionnaire (Kuk, et al., 1990), designed for clinical trials, sensitive with its 0-100% interval rating scale, and widely used worldwide. The main finding was the music helped most people, but some much more than others. Individual differences are apparent in almost all tinnitus treatment programs and research trials. We observed no statistical differences between the two types of sound therapy, and concluded that individual patients should utilize music in a manner they believe it is most helpful.
ADVANCE: In October, you hosted your 20th annual tinnitus conference at the University of Iowa. Who is the intended audience, what is the purpose, and how did it all get started?
Tyler: Twenty years ago I wanted to learn more about treating tinnitus and so I searched for a workshop. I found none and a friend suggested I host one myself. The conference is always focused on the Management of the Tinnitus Patient, so the intended audience is clinicians. However, I also invite patients. Throughout the meetings they are often called on to provide their own personal experiences and insights. Select manufactures of products for tinnitus are invited to share information. Traditionally, a representative of the American Tinnitus Association has summarized what they have to offer. Audiologists, otologists, researchers, and psychologists come from around the world.
ADVANCE: What were some of the highlights of this year's conference, and what do you have planned for us next year?
Tyler: The focus is mainly on clinical management. We include reviews of possible mechanisms, primary and secondary tinnitus handicaps, measurements, medical evaluations and treatment. We always have an otologist and a psychiatrist share their experiences. This year the highlights included presentations on animal models, mindfulness, alternative treatments, sleep management, setting up a clinic, sound therapies and cochlear implants. This year we were fortunate to have Josef Rauschecker, a brain-function researcher from Georgetown University, as the guest speaker.
Next year's conference will be June 14-15, and readers can find more information at http://www.healthcare.uiowa.edu/otolaryngology/tinnituscourse or search "Iowa Tinnitus Conference." I hope the 21st annual Conference on the Management of the Tinnitus Patient will continue to be helpful and informative to all that attend.
Chuck Holt is community dedicated editor at ADVANCE and can be reached at cholt@advanceweb.com
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