Dr. Julie Prutsman’s team of audiologists offer a higher standard of expertise. She has been deeply involved with tinnitus for more than 15 years, long before effective treatments had been developed beyond hearing aids and maskers. Dr. Julie also studied under one of the industry’s most respected and leading medical experts, Dr. Pawel Jastreboff, and she has personally trained each and every one of her doctors.
Resetting the tonotopic map. Researchers are exploring how to take advantage of the tonotopic map, which organizes neurons in the auditory cortex according to the frequency of the sound to which they respond. Previous research has shown a change in the organization of the tonotopic map after exposing the ear to intense noise. By understanding how these changes happen, researchers could develop techniques to bring the map back to normal and relieve tinnitus.
Wearable sound generators are small electronic devices that fit in the ear and use a soft, pleasant sound to help mask the tinnitus. Some people want the masking sound to totally cover up their tinnitus, but most prefer a masking level that is just a bit louder than their tinnitus. The masking sound can be a soft “shhhhhhhhhhh,” random tones, or music.
Sound-masking devices provide a pleasant or benign external noise that partially drowns out the internal sound of tinnitus. The traditional sound-masking device is a tabletop sound machine, but there are also small electronic devices that fit in the ear. These devices can play white noise, pink noise, nature noises, music, or other ambient sounds. Most people prefer a level of external sound that is just slightly louder than their tinnitus, but others prefer a masking sound that completely drowns out the ringing.
Sound waves travel through the ear canal to the middle and inner ear, where hair cells in part of the cochlea help transform sound waves into electrical signals that then travel to the brain's auditory cortex via the auditory nerve. When hair cells are damaged — by loud noise or ototoxic drugs, for example — the circuits in the brain don't receive the signals they're expecting. This stimulates abnormal activity in the neurons, which results in the illusion of sound, or tinnitus.
TRT depends upon the natural ability of the brain to "habituate" a signal, to filter it out on a subconscious level so that it does not reach conscious perception. Habituation requires no conscious effort. People frequently habituate many auditory sounds -- air conditioners, computer fans, refrigerators, and gentle rain, among them. What they have in common is that they have no importance, so they are not perceived as ''loud.'' Thus, the brain can screen them out.
For some people, the jarring motion of brisk walking can produce what is called a seismic effect which causes movement in the small bones or contractions in the muscles of the middle ear space. You can experiment to find out if this is the cause by walking slowly and smoothly to see if the clicking is present. Then, try walking quickly and with a lot of motion to see if you hear the clicking. You can also test for the seismic effect by moving your head up and down quickly.