by Giovanna Baracca, Medical Doctor with a specialization in Audiology and Phoniatrics at Columbus Clinic Center
Known as Tinnitus in medical terms, those affected by this condition usually describe it as hissing, whistling, or buzzing. Tinnitus may have a gradual onset or occur suddenly in one or both ears, in the absence of external noises, and never goes away. In fact, while experiencing occasional whistling in one ear is quite common, the impact of its uninterrupted presence is different, from day to night, for months or even years. In this case, it can affect significantly a person’s life, altering the ability to concentrate, sleep, and relax.
According to recent research, nearly 2.5 million Italians suffer from this disorder. Statistics show that the most affected groups are those aged 50 and over, yet it is not uncommon for many doctors in the medical field to deal also with a high number of young people.
The strong discomfort that encourages patients to see a doctor arises when Tinnitus alters the quality of life, activating a chain reaction: the more it bothers me, the more I hear it, the louder I feel it. Indeed, the psychological aspect of the disorder is a heavy burden to bear, which is somehow backing it, too. The impossibility of enjoying silence feels like a condemnation. For a long time, patients have been told there was no solution, further worsening the psychological consequences of the disorder. Yet, we do have solutions!
In order to understand the nature of this symptom, it is first necessary to point out that Tinnitus comes in many forms. In fact, Tinnitus triggers are countless and often caused by multiple factors; in most cases, they are due to a set of co-factors. Damage to the ear, even minimal and clinically silent, can be associated with postural and hormonal dysfunctions, allergies and intolerances of various types, which all contribute to the annoying persistence of the symptom. Tinnitus is the indicator of a dysfunction; it is therefore up to the doctor to search for the cause and then identify the appropriate treatment.
Although the therapies to remove the cause of Tinnitus are extremely individualized, a rehabilitation treatment of the disorder exists which can benefit everyone, suitable for being carried out alongside the one aimed at treating the actual cause. This treatment has been appraised and approved by multiple scientific studies tested on thousands of patients. It is based on a model described by PJ Jastreboff in the 1990s, which radically changed the doctor’s approach to Tinnitus, leading to the development of what is known as Tinnitus Retraining Therapy, or simply TRT.
TRT aims to re-accustom the brain to Tinnitus so as to reduce or stop its perception. The starting principle is simple. The unconscious part of the brain, the limbic system, amplifies those sounds recorded as “warning signals” through continuous selection while placing others in the background. The sound of an ambulance, for instance, may alert us, while noises in the street when we are at home don’t. Tinnitus is sometimes interpreted by the brain as a warning signal and therefore amplified. This is precisely when it becomes invasive. TRT exploits the plasticity of our brain and its ability to adapt to new situations. Through a clear and precise counseling aimed at the patient, followed by sound therapy, the perception of the auditory pathways is re-programmed, offsetting the attention placed exclusively on Tinnitus. In this way, Tinnitus is reinterpreted by the brain as a neutral sound which should not be given importance. TRT, therefore, does not remove Tinnitus, but rather neutralizes it through a learning that remains stable for years. At this stage, in a high percentage of cases, patients report that Tinnitus is no longer a problem in their life.