The hi-tech headset that could SILENCE tinnitus for good
WHEN 19-year-old Harry Goad went to see his GP last October, he hoped it would be a simple case of obtaining a prescription, perhaps, or getting some reassurance. He had booked the appointment following a week of having a persistent noise in his left ear.
‘I was concerned about a ringing and hissing sound in my ear,’ says Harry, now 20, a retail customer assistant from Maidstone, Kent. ‘My GP examined my ears and found no problem with either my ear canal or my eardrum.
‘He then said it was probably tinnitus, which I didn’t really know much about. Then he said it might not ever go away and there’s not a lot you can do about it. I left feeling quite shocked that this noise in my ear might be with me for ever.’
Tinnitus — which is characterised by a noise without an outside source, often described as a ringing, buzzing, hissing, humming or whistling sound — is often a symptom of an underlying condition such as a viral infection, or can be the result of an injury such as whiplash.
The most common cause is hearing loss — tinnitus is more common in people aged 50 and above, although it can strike at any age.
While it’s typically thought of as an ear-related problem, it is better considered as something that’s triggered in the brain, suggests Duncan Collet-Fenson, an audiologist at Aston Hearing in Amersham, Bucks.
‘It is a brain issue linked to hearing loss, which causes miscommunication between the brain and the inner ear.’
ONE theory is that in the absence of genuine sound, the brain ‘makes it up’. ‘Tinnitus can also be linked to the spontaneous firing of the inner hair cells [called cilia], creating a sound which isn’t measurable, so we don’t know if it is really there or not,’ adds Mr Collet-Fenson.
Stress and sleep deprivation can play a part.
‘Tinnitus is very stressful in itself,’ explains Mr Collet-Fenson. ‘Worrying about it makes it worse and is thought to be linked to the limbic system.’ This is the part of our brain involved in emotions.
In some cases hearing aids can help, by introducing environmental sounds.
Another approach is ‘masking’ techniques, such as listening to white noise as a distraction. Over time this can help the brain filter out tinnitus, so those with it are not so aware of it.
But there is hope that a new non-invasive brain stimulation technique could soon offer some sort of ‘cure’ for tinnitus.
This is currently being trialled in a three-year study funded by the Royal National Institute for Deaf People. This trial builds on a previous smaller study that found the treatment ‘switched off’ tinnitus for a few hours or even days in some people.
The technique, known as highdefinition transcranial direct current stimulation (HD-tDCS), involves stimulating certain regions of the brain via five tiny electrodes placed on specific parts of the head. These include the auditory cortex, where sound is processed, and the prefrontal cortex, where our emotions are processed.
As Professor Raj Shekhawat, a clinical audiologist who is leading the study, explains: ‘One theory is that tinnitus is the result of an error message.’
The idea is to ‘shake up’ the network in the brain involved in tinnitus perception, disrupting whatever is causing the tinnitus. ‘Work I have done in the past demonstrates that brain stimulation caused some people’s tinnitus to disappear for a few hours or a few days and reduced its perception in several others. So we know it can work in some people and we want to find out why some respond to it better than others.’
In the study, 70 participants will undergo either six sessions of the treatment for 20 minutes twice a week over a three-week period, or receive ‘sham’ stimulation. All will also undergo an EEG — a recording of brain activity — along with other hearing-related checks.
‘What we’re trying to discover in the new study is how we can elongate this temporary effect on tinnitus,’ says Professor Shekhawat, who is now based at Flinders University in Adelaide, Australia (having launched the trial when he was at University College London).
‘Imagine what it would be like to suppress it for two days, two months or two years. Maybe in the future we can develop a therapy where people will go for a brain stimulation session every few months to dampen the tinnitus down,’ he says.
‘Even if this type of treatment helps some, if not all patients, it would make a huge difference. One day they could use a special type of headband at home to carry out brain stimulation and then get on with their lives without it bothering them for a period. That would be fantastic.’
So far there has been no evidence of side-effects apart from mild tingling, itching and sometimes a warm sensation.
The trial has been welcomed by clinicians such as Matthew Trotter, a consultant ear, nose and throat (ENT) surgeon at University Hospitals Coventry and Warwickshire NHS Trust.
‘I think this is a fascinating approach with huge potential, especially for those with tinnitus where conventional treatments we currently offer — which are mainly distraction therapies — have little impact.
‘There’s a small but significant group who have tinnitus but do not have hearing loss, who are much harder to treat. It’s this group where a more experimental therapy like this could one day help before becoming much more mainstream.’
MEANWHILE, Harry has undergone surgery to treat his tinnitus. He has no idea what caused it. Although among some younger people loud music is a common cause, Harry says he never had his music on ‘really loud’ on his headphones. He has also only been to one concert and twice to a nightclub.
Following his diagnosis, Harry tried using the sound of waterfalls or chirping crickets playing through the speaker in his bedroom to mask the tinnitus after reading about it on the British Tinnitus Association website. He said it helped him to sleep a bit better.
‘But the longer I had tinnitus, the more anxious it would make me as there was no “off” switch from it,’ says Harry. ‘I turned 20 a month after my diagnosis, so felt I could have decades of living with it, which is a lot to take in.’
At the start of this year, Harry paid to see an ENT surgeon privately, who suggested that his very large adenoids — lumps of tissue high in the throat that are part of the immune system — might be pressing against the eustachian tube, which connects the middle ear to the back of the nose, causing the tinnitus.
Harry had both adenoids removed in February during a 45-minute procedure under general anaesthetic. While his tinnitus did improve slightly in the weeks following the surgery and was not as loud as it was at the start, it’s not disappeared.
‘I don’t think it will ever completely go away, although I can deal with it better now,’ he says. ‘But I now take precautions — for example, I have a pair of silicone ear plugs and put them in if I’m going anywhere that might be loud such as a noisy bar. I’m very wary about not making it worse.’