Tinnitus and Hearing Aids: Causes and Solutions

Tinnitus and Hearing Aid Issues

I have been experiencing tinnitus in both ears for over 20 years.
Initially, it started as a sound similar to insects, and over the years, it gradually evolved into a high-frequency tinnitus resembling mechanical noise.
A hearing test diagnosed me with mild high-frequency hearing loss.
During this period of discomfort, I sought treatment from otolaryngology clinics, traditional Chinese medicine clinics, and acupuncture, but none were effective.
The high-frequency tinnitus has become increasingly loud, and considering the potential impact on my work, I applied for and received a digital mini hearing aid implant for both ears two years ago.
During a pure-tone audiometry test, my left ear showed a hearing loss of approximately [specific decibel level], while my right ear showed a loss of about 61 decibels, indicating sensorineural hearing loss.
Although the hearing aid has multiple frequency bands for improvement, I only chose to amplify the high frequencies.
After wearing this inner-ear mini hearing aid for over a year, I began to experience low-frequency tinnitus in my right ear, which had never occurred before.
This low-frequency tinnitus sounds like a compressor motor and has gradually increased in volume over time.
I inquired with the manufacturer whether wearing the hearing aid could amplify sound levels in my ear and cause this low-frequency tinnitus.
They informed me that using a hearing aid should not increase the occurrence of tinnitus.
However, I am experiencing it.

Could you please explain the possible reasons for my low-frequency tinnitus? What outpatient treatments or therapies could help improve the coexistence of both high and low-frequency tinnitus?

Xiao Chen, 40~49 year old female. Ask Date: 2008/09/16

Dr. Chen Jianzhi reply Otolaryngology

Dear Xiao Chen,
I apologize for the fact that tinnitus remains a challenging issue in the medical field.
Currently, our hospital is still employing conservative treatment methods for tinnitus, and I am actively researching better treatment options.
However, regarding your inquiry about the "implanted cochlear hearing device," our hospital does not have experience with such surgical implants.
Therefore, I regret to say that I do not have sufficient knowledge or experience to answer your question at this time.
I recommend that you consult with Dr.
Liu Dian-Zhen at the ENT department of National Taiwan University Hospital, as he is currently an expert in this area.
Sincerely,
Dr.
Chen Jian-Zhi
Attending Physician, ENT Department, Taoyuan Hospital, Ministry of Health and Welfare
Lecturer, Department of Medicine, Fu Jen Catholic University

Reply Date: 2008/09/16

More Info

Tinnitus, commonly referred to as "ringing in the ears," is a condition that affects many individuals, often manifesting as a persistent sound that can vary in pitch and intensity. Your experience of having tinnitus for over 20 years, evolving from a high-pitched sound to a more complex auditory sensation, is not uncommon. Tinnitus can be associated with various underlying causes, including hearing loss, exposure to loud noises, ear infections, and even stress or anxiety.

In your case, the diagnosis of mild high-frequency hearing loss, coupled with the presence of tinnitus, suggests that the auditory system has been affected in a way that may be contributing to your symptoms. The fact that you have sought treatment through various avenues, including ENT specialists, traditional Chinese medicine, and acupuncture, indicates a proactive approach to managing your condition. Unfortunately, as you have experienced, tinnitus can be notoriously difficult to treat, and many conventional therapies may not yield the desired results.

The use of hearing aids, particularly digital ones, can be beneficial for individuals with hearing loss and tinnitus. Hearing aids can amplify external sounds, which may help mask the tinnitus and make it less noticeable. However, it is essential to ensure that the settings on your hearing aid are appropriately adjusted to your specific hearing loss profile. You mentioned that you have chosen to amplify high frequencies, which is a common approach for individuals with high-frequency hearing loss. However, the emergence of low-frequency tinnitus in your right ear after using the hearing aid raises some concerns.

The development of low-frequency tinnitus could be attributed to several factors. One possibility is that the amplification of sounds through the hearing aid may have altered the auditory feedback loop in your brain, leading to changes in how your auditory system processes sound. Additionally, the presence of hearing loss itself can lead to changes in the auditory pathways, which may contribute to the perception of tinnitus. It is also worth considering that the low-frequency tinnitus may be unrelated to the hearing aid and could stem from other underlying issues, such as changes in ear pressure, Eustachian tube dysfunction, or even temporomandibular joint (TMJ) disorders.

To address your concerns about both high and low-frequency tinnitus, I recommend the following steps:
1. Consult an Audiologist: Schedule an appointment with an audiologist who specializes in tinnitus management. They can conduct a thorough evaluation of your hearing and tinnitus, assess your hearing aid settings, and provide tailored recommendations.

2. Tinnitus Retraining Therapy (TRT): This therapy combines sound therapy with counseling to help individuals habituate to their tinnitus. It may be beneficial for you to explore this option.

3. Cognitive Behavioral Therapy (CBT): If your tinnitus is causing significant distress, CBT can help you develop coping strategies and reduce the emotional impact of tinnitus.

4. Regular Follow-ups: Since you have experienced changes in your tinnitus, regular follow-ups with your ENT specialist or audiologist are crucial. They can monitor your condition and make necessary adjustments to your treatment plan.

5. Lifestyle Modifications: Consider lifestyle changes that may help reduce tinnitus symptoms, such as stress management techniques, avoiding loud noises, and maintaining a healthy diet.

6. Sound Masking Devices: In addition to hearing aids, sound masking devices can provide background noise that may help mask the tinnitus, making it less noticeable.

In conclusion, managing tinnitus, especially when it coexists with hearing loss, can be challenging. It is essential to work closely with healthcare professionals who understand the complexities of tinnitus and hearing loss. With the right approach and support, it is possible to find relief and improve your quality of life.

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