FEBRUARY  17th CHAPTER MEETING RECAP

Tinnitus and Meniere's

The speakers at HLAA-NYC's February meeting - Craig Kasper, Chief Audiology Officer of New York Hearing Doctors and fellow of the American Academy of Audiology, and Emmy Visconti, the Senior Clinical Audiologist of New York Hearing Doctors and a New York State hearing aid dispenser - talked about two prevalent ear-related problems, tinnitus and Meniere's disease.

Regarding Meniere's, Dr. Visconti explained that there are two types of fluid in the ears - endolymph and perilymph - and Meniere's results from an overproduction of the former. According to Dr. Visconti, "In addition to being the organ we hear with, the ear provides balance. It lets your brain know where you are in space. If there's a disorder in the balance system, it causes you to feel dizzy."

The cause of Meniere's is unknown. Theories center on genetic links, autoimmune disorders, viral infections, and ear infections. High salt intake, dehydration, stress, and fatigue are also linked to Meniere's, but as Dr. Visconti points out, "It's unpredictable, very tough to manage, and hard to diagnose. Attacks may last from 20 minutes to a full day or even longer."

About 615,000 people in the United States have Meniere's, and there are about 45,000 new diagnoses each year. Symptoms include tinnitus, vertigo, sound sensitivity, headaches, and nausea. "During an attack patients report feelings of fullness in the ear," Dr. Visconti said. "After an attack, most patients feel exhausted."

Treatment involves limiting salt intake and increasing hydration in order to reduce pressure in the ear. Certain medications - including Diazepam, Lorazepam, and Meclizine Hydrochloride - reduce vertigo and nausea. Vestibular rehabilitation, an exercise-based program, "will help you regain balance and get you back on your feet," according to Dr. Visconti.

"Coping is hard, because attacks are unpredictable," Dr. Visconti noted. "You need to get as much information as you can, know how much medicine to take and when to take it, teach your family about it, and let them know how to help you in the event of an attack."

Dr. Kasper defined tinnitus as "The perception of sound in the absence of a corresponding external sound. It can be described as ringing, buzzing, crickets, hissing, roaring." Some 50 million Americans currently experience tinnitus - 16 million severe enough to seek professional help; 2 million who become so depressed that it disrupts their day-to-day activities. About 50 percent of today's combat soldiers are coming back from war with tinnitus because of all the noise exposure. It's one of the top service-connected ailments.

Tinnitus is not a new phenomenon. As Dr. Kasper pointed out, ancient Egyptian texts described humming in the ears, and Beethoven wrote that his ears whistled and buzzed each day. "One thing to keep in mind," Dr. Kasper said, "is that tinnitus is not a disease or health condition; it's a symptom of something else." Common causes include Meniere's disease, noise exposure, ear infections, medication-induced damage to the ear, head injury, and tumors inside the hearing nerve. Stress also plays a major role.

About 80 percent of tinnitus cases are associated with hearing loss. "Just like Meniere's," Dr. Kasper continued, "education is the key for those with tinnitus." Tinnitus retraining therapy, involving a device that creates static-like sound that helps mask the tinnitus, is one of the most common options available. Others can be helped simply by using an appropriately fitted hearing aid. "There's no cure at this point," Dr. Kasper said, "so what we try to do is retrain the brain so that the tinnitus is less noticeable."

This is a personal journey, Dr. Kasper emphasized, "and like any rehabilitation process, you have to work at it. In addition to the right tools and information, an educated, empathetic clinician can help you through the process.