Tinnitus Vocabulary

Adaptation

In Physiology: A decreased response of the senses (vision, touch, temperature, smell, hearing, pain) to changed, constantly applied, environmental conditions. Example: Suppose an air conditioner is turned on in the room you are in. At first you notice its sound, but after some time you no longer notice it. This decrease in your response, or your noticing, is your adaptation to the new sound. You adapt, or "get used to" the new stimulus such that it no longer draws your attention. This is a different phenomenon than habituation.

Audiologist

Healthcare professional who evaluates, diagnoses, treats, and manages disorders of the auditory and vestibular systems. Audiologists hold masters or doctoral degrees and receive special training in the prevention, identification, assessment and non-medical treatment of hearing disorders. U.S. audiologists must be licensed in most states.

Auditory pathway

The system comprised of the cochlea, auditory nerve, brain stem nuclei, and auditory cortex.

Auditory cortex

The part of the brain that enables us to process and understand sound. There are many neurons in the auditory cortex that contribute to its function.

Broadband

Pertaining to a wide range of frequencies. Broadband sounds are commonly used as tinnitus maskers. Examples include white noise, the sound of rain, or the sound of a water running.

Cerumen

Earwax. A secretion of the ceruminous glands in the external auditory canal.

Habituation

The correction of an inappropriate perception of a stimulus (e.g., loud tinnitus) to a reduced, more normal perception of that stimulus (e.g., soft tinnitus). 
Sound therapy, when used correctly, facilitates habituation.  The goal is to reduce the misperception of tinnitus and restore normal perception through a process of gradual improvement, thus providing relief. With successful habituation, this corrected perception applies even when the treatment device is NOT being used, such that the tinnitus is:

• not noticed at all;
• is noticed less often;
• is less bothersome when and if noticed.

Habituation is effective about 70-90% of the time. It is a different phenomenon than adaptation.

Hair cells

Sensory receptors (cells, not actual hairs) of the inner ear. Their name is derived from the long projections of the cell membrane, which look something like hair. When stimulated by sound wave vibrations, inner hair cells stimulate neurons that send signals to the brain. Thus they change sound vibrations into electrical activity. Outer hair cells mechanically amplify low-level sound. Hair cells can be damaged by loud noise, causing hearing loss.

Hyperacusis

A rare disorder characterized by an abnormal sensitivity to sound in which normal environmental sounds may be perceived as painfully loud. In some cases sound therapy may be used to retrain the auditory processing center of the brain to tolerate everyday sounds. Hyperacusis, hearing loss, and tinnitus are separate conditions but may be experienced at the same time.

Hypermonitoring

The over-perception of tinnitus. Tinnitus can seem very loud to the patient, but is found to be soft when objectively measured. This perception of extreme loudness is real on the part of the patient, can contribute to his annoyance and suffering, and is often not well understood by non-sufferers. A goal of habituation through the use of sound therapy is to address hypermonitoring by adjusting, or correcting, the patient's over-perception of the tinnitus loudness to a lower, more accurate, and less bothersome level.

Masker/Masking

Auditory masking occurs when the perception of one sound is affected by the presence of another sound. A tinnitus masker is a device that generates a soft sound intended to cover up, obscure, or distract from, one's tinnitus. Common masking sounds include white noise, nature sounds, a whirring fan, radio static, etc. Maskers are available in various forms, such as tabletop devices, pillows with built-in speakers, or sounds built in to hearing aids.

Meniere's Disease

A relatively rare inner ear disorder characterized by recurring attacks of vertigo, fluctuating hearing loss, and tinnitus. Tinnitus in the affected ear may be constant or intermittent, buzzing or roaring; it is not related to position or motion. In a majority of patients, only one ear is affected. As the disease progresses, hearing impairment gradually worsens, and tinnitus may be constant. Prevalence is approximately 190 cases per 100,000 people, and Meniere's is more common in women than men.

Narrowband

Sounds which occupy a limited (narrow) range of frequencies on the audio spectrum, as opposed to the wideband of frequencies known as white noise. In tinnitus treatment, narrowband noise is frequently used as a masker. It is characterized by a "shhh" sound at a specific pitch, usually correlated to one's tinnitus.

Neuron

A specialized, impulse-conducting cell that is the functional unit of the nervous system. Also called a nerve cell.

Otologist

A board-certified otolaryngologist trained to diagnose and treat illnesses and injuries related to the ears, balance system, temporal bone, skull base, and related structures of the head and neck. Not all otologists perform surgery on ears but most do. Otologists often work closely with audiologists. An audiologist may refer a patient to an otologist if she believes the patient's issue can be treated medically or surgically.

Ototoxic

Having a harmful effect on the hearing and balance system. ("Oto" = ear, and "toxic" = poisonous.) There are over 200 medications used today that are known to be ototoxic, meaning they can contribute to hearing loss, balance disorders, and tinnitus. Tinnitus is often one of the first signs that a drug is ototoxic. In some cases, exposure to loud noise while taking a certain drug will increase its damaging effects. Sometimes the problems caused by ototoxic medications can be reversed when the drug therapy is stopped.

Relief Contrast

The tendency of some medications or treatments, when discontinued suddenly, to cause a return of the symptoms they were used to relieve. Thus symptoms that were absent or controlled during treatment return when treatment stops. Also called the "Rebound Effect." With tinnitus, the sudden removal of the positive sound stimulus used during treatment can cause the tinnitus to seem as if it is louder than it was before the sound therapy session began. This is temporary.

Sound therapy

The use of specific sounds as a form of treatment. There are many forms of sound therapy available for the treatment of tinnitus. These are designed to make tinnitus less noticeable and less bothersome. Some are available over-the-counter, and others are prescribed by audiologists. Some are customized to the individual. Sound therapy is natural and has been shown to be one of the most effective forms of tinnitus treatment, especially when combined with patient education and counseling.

Temporal bone

The bone at the side of the skull, at the temple. The temporal bone houses the structures of the organ of hearing.

Tinnitus

Tinnitus is the perception of sound or noise in the ears which is not present in the external environment. It is also commonly referred to as "ringing in the ears" and may manifest as many different types of sound including humming, hissing, roaring, screeching, a high pitched tonal noise, or other sounds. Tinnitus is not a disease, but a symptom.

Tinnitus Retraining Therapy (TRT)

A tinnitus treatment approach based on the work of Dr. Pawel Jastreboff. TRT is a form of habituation therapy which combines patient education/counseling with sound therapy. Its goal is to retrain the tinnitus sufferer's brain to respond differently to the tinnitus.

Unilateral

Involving or occurring on one side only.

Vertigo

A sensation of tilting or being in whirling or spinning surroundings. Vertigo results from a disorder of the sense of balance. Vertigo is not a diagnosis – it is a description of a sensation. Vertigo may be accompanied by nausea, vomiting or difficulty with balance and/or gait. Causes may include:

• Benign paroxysmal positional vertigo.
• Meniere's disease. (May be accompanied by tinnitus.)
• Vestibular neuronitis.

Labrynthitis - viral or bacterial. (May be accompanied by tinnitus.)

White noise

A type of broadband noise characterized by a "shhhhh" sound. There are many different "colors" of noise; these are roughly analogous to colors of visible light on the color spectrum. White noise contains all frequencies of sound in it (just as white light contains all different frequencies of light). Other "colors" of noise, such as pink or brown, refer to specific, limited, frequency ranges. White noise is sometimes used as a masker and some tinnitus sufferers find it soothing. Some hearing aids include built-in white noise.

Windowing

A pattern whereby a tinnitus patient sometimes notices his tinnitus, and other times does not. During tinnitus treatment, patients may experience windowing. As habituation progresses, the patient may experience good days and bad days, but in general the amount of time during which he feels relief increases in both frequency and duration.