New Approach Could Relieve Ringing Ears

May 25, 2012— -- On the evening of his 62nd birthday, Sal Gentile suddenly began hearing a never-ending stream of loud, raucous noises in his ears.

"I was bothered, I was frightened," Gentile recalled of the experience, which began over dinner at a busy restaurant. "It kept me up all night."

Gentile, a retired IBM executive from Florida and a self-described health enthusiast, was an avid cyclist with a busy social life and a rigorous workout routine. He wasn't used to seeing the doctor with a health problem, and he was even less accustomed to an issue like this one, which he said kept him in bed until mid-afternoon. So when Sal's doctor told him that the noise he was hearing was from a condition called tinnitus -- best known for buzzing or ringing in the ears -- all he wanted was a solution.

He was told that tinnitus has no cure -- an answer he said he could not accept. What followed next for Gentile was a 10-month search for a way to cope with the cacophony of hissing, rattling and machine-like sounds constantly playing in his ears. Much to Gentile's frustration, he saw medical specialist after medical specialist including multiple ear doctors and audiologists without an effective solution.

"I only wish there was a class these doctors had taken to help people with tinnitus and let them know what to do," he said.

Now, for the first time, research suggests an approach that may yield a solution. A new study released Thursday in the journal Lancet offers evidence of an effective treatment for Gentile and the nearly 16 million Americans who have sought medical attention for tinnitus.

"In extreme forms, patients are unable to function, go to work or other social events, and are deprived of enjoyment in life," said the study's primary investigator, Rilana Cima, a clinical psychologist at Maastricht University in the Netherlands.

In the study, 247 tinnitus patients received standard therapy, while 245 patients instead received treatment with specialized care involving an integrated multi-disciplinary team of audiologists, psychologists, speech therapists, movement therapists, physical therapists and social workers. What the researchers found was that those patients treated by the multi-disciplinary team had improvements not only in tinnitus symptoms, but also in quality of life.

"The results of this trial are especially convincing and relevant for clinical practice," writes Dr. Berthold Langguth, associate professor of medicine at the University of Regensburg in Germany, in an editorial accompanying the new study.

"Specialized care was significantly better than usual care for the whole sample," continues Langguth. "The researchers did not identify a new treatment -- rather, they identified the most useful treatments."

The new integrated, multi-disciplinary approach outlined in this study includes a combination of standard tests and medical evaluations in addition to a special type of therapy called cognitive behavioral therapy.

So why is cognitive behavior therapy so helpful?

"It's not the sound but the negative reaction to the sound that prevents suffers from habituating to it," Cima said. "Once they hear it, it's very hard to divert their attention away... People get a fear reaction because they think something is wrong -- it becomes the attention-grabbing thing that prevents them from doing their normal activities."

Cognitive behavioral therapy is a way to redirect tinnitus sufferer's attention away from the fearful thoughts that often remind them of the ringing in their ears.

Cima added that no two cases are entirely alike. In fact, up to 50 million people in the United States experience tinnitus symptoms, accordingto the American Tinnitus Association; however, only a small minority of people with tinnitus develop problems as a result. Of these sufferers, some are cured with few interventions while others require more intensive therapy like cognitive behavioral therapy to retrain their brain on how to re-interpret the noise so it's not as distracting.

For tinnitus suffers like Gentile, these findings offer proof of an effective intervention designed to improve their quality of life. After seeing a number of experts, Gentile eventually sought out cognitive behavior therapy -- an approach he said helped him ignore the noise and get on with his life.

"I was always told you have to live with it, but that was it…and in my case that wasn't good enough," he said. "If there wasn't a cure, there had to be a way to get back to a high-quality life."