Report by: Catharine Crabtree, Royal Surrey Hospital in Guildford
The Biggest Show on Earth on Tinnitus, held at the G Live Theatre, Guildford, provided a great way to kick off the first day of the National Tinnitus Awareness Week 2020. The seminar was attended by audiologists, ENT specialists, psychologists, GPs and researchers as well as the general public to learn more about the latest developments in assessment and management of tinnitus. Over 800 people attended the event.
The audiology department from the Royal Surrey NHS Foundation Trust hosted the event, providing exhibitions on audiology specialities, hearing care charities and local volunteer services, and hearing aid manufacturers. In addition, there were twenty research posters on display covering a wide spectrum of clinical topics on tinnitus and hyperacusis ranging from how to make audiological tests more comfortable for tinnitus and hyperacusis sufferers and how to diagnose hyperacusis.
Five expert speakers gave talks. Professor Richard J Salvi, Director of the University at Buffalo’s Centre for Hearing and Deafness, USA, talked about his research on human brain imaging and animal models of tinnitus, hyperacusis and hearing loss. Tinnitus and hyperacusis are often triggered by damage to the cochlear portion of the inner ear. He presented experimental evidence showing that hearing loss causes the neural output of the cochlea to decrease. However, as these weak neural signals from the cochlea are relayed up through the ascending auditory pathway, the signals are progressively amplified. In some cases, the neural amplification is excessive and results in spontaneous hyperactivity. He concluded that these aberrant neurophysiological changes have been linked to tinnitus and hyperacusis in both humans and/or animal models.
Professor Brian C J Moore, an Emeritus Professor of Auditory Perception at the University of Cambridge, reviewed the research evidence about the use of therapeutic sounds to alleviate tinnitus. He followed up on the conclusion made by Professor Salvi that tinnitus may arise as a result of changes in the central auditory system, following damage to the peripheral auditory system. He described that if this theory is correct, then it might be possible to partially reverse the central changes by increasing the input from the auditory periphery, either via hearing aids the use of therapeutic sounds. He offered a comprehensive review of studies that used sounds to mask tinnitus.
The third presentation was given by Mr Peter Valentine, a Consultant ENT Surgeon at the Royal Surrey County Hospital, specialising in ear surgery and the treatment of hearing and balance disorders. He shared some videos of surgical procedures which can treat certain types of middle ear disorders which in some patients lead to minimising the perception of tinnitus. He described that most cases of tinnitus are associated with deterioration of hearing due to age or noise exposure. There are, however, some examples of tinnitus that are associated with particular medical conditions. Examples that commonly include tinnitus combined with hearing loss as symptoms include otosclerosis, ear infections, Ménière’s disease, and disorders of the auditory nerve. He concluded by discussing the treatment procedures he uses to help patients experiencing such conditions.
The fourth presentation was given by Dr Hashir Aazh, team lead for the Tinnitus and Hyperacusis Therapy Specialist Clinic at the Audiology Department, Royal Surrey NHS Foundation Trust. He talked about a specialised method of cognitive behavioural therapy (CBT) delivered by audiologists which aims to help to modify the process that causes tinnitus-related annoyance. He described a study which explored the views of patients who completed audiologist-delivered CBT, reporting that 97% of the patients found it was very acceptable to receive tinnitus-focused CBT from specialist audiologists and 87% of patients reported that they were able to manage their tinnitus differently compared to before their treatment started.
The seminar was a valuable experience for all who attended, including myself as an audiology student, to gain a deeper insight into tinnitus and possible ways to manage it.
