As confirmed by the Department of Veterans Affairs (VA), tinnitus has become the No. 1 service-connected disability among veterans, surpassing post-traumatic stress disorder (PTSD). While hearing loss gets the lion’s share of attention from VA audiologists, tinnitus is a disability that affects more than 841,000 vets, compared to 710,000 with hearing loss.

Because military service members are exposed to aircraft, loud equipment, and explosive noises in training and combat that can exceed 160 decibels, they can suffer permanent damage to the auditory system. One blast can leave soldiers with tinnitus as a primary condition, or as a byproduct of hearing loss.

Tinnitus, or “ringing in the ears,” affects more than 50 million people in the United States, 10 percent of whom experience sounds that are so bothersome or distracting they can destroy one’s quality of life. Often, sufferers are anxious or depressed, and can’t relax or sleep. In fact, some go through a grieving process and must come to terms with the fact that they may never experience silence again.

For most people, if they had to listen to a constant piercing or screeching sound commonly associated with tinnitus and couldn’t turn it down, they would beg to make it stop. Yet because tinnitus is not a visible injury, most non-sufferers don’t realize the severity and psychological torment it can cause.

For most people, if they had to listen to a constant piercing or screeching sound commonly associated with tinnitus and couldn’t turn it down, they would beg to make it stop. Yet because tinnitus is not a visible injury, most non-sufferers don’t realize the severity and psychological torment it can cause.

 

There is Hope

While there is no definitive cure for tinnitus, there are treatment options available that can facilitate management and provide relief. For many patients, the most critical issue is how the tinnitus is perceived, or how bothersome it is on a daily basis.

One of the most successful ways to change the perception of tinnitus is through sound therapy. Sound therapy uses external sounds to interfere with the tinnitus, with a goal of habituation, or a reduced perception, of the tinnitus over time. This approach has been used for more than 30 years and has brought remarkable success. About 60 to 90 percent of patients who undergo sound therapy find at least some relief, according to the American Tinnitus Association.

For those with moderate to severe tinnitus, or whose primary complaint is tinnitus rather than hearing loss, new treatments, approved by the VA, are now available. One example is a sound therapy system called Serenade from SoundCure, which uses soft tones called S-Tones to offer patients relief. These tones have been found to be four times as likely as white noise to relieve acute tinnitus, according to “Temporary Suppression of Tinnitus by Modulated Sounds” in the Journal of the Association for Research in Otolaryngology (April 2012).

S-Tones are meant to be played more softly than the perceived tinnitus sound, and are intended to be listened to passively as background noise, much the way someone might hear an air conditioner or a refrigerator humming. The tones are customized to each patient relative to the pitch of their tinnitus sound, and are rapidly modulated. Research suggests that this modulation leads to a greater amount of neural activity, which is what allows them to perform at a softer level.

Veterans suffering from tinnitus can be evaluated by a VA audiologist, who will assess their condition and recommend a treatment plan, which may include SoundCure Serenade. The audiologist will fit the tinnitus patient with Serenade, which includes a programmable handheld device and ear buds.

Serenade is intended to be used when a patient’s tinnitus is bothersome to them. For most, this is two to five hours per day. The goal of habituation is the gradual reduction in the amount Serenade is needed over time.

Patients need to undergo a comprehensive evaluation of their hearing and tinnitus prior to being fitted with Serenade. The customization of Serenade itself takes 20 to 30 minutes and gives the patients four different sound therapy options to choose from. Serenade is intended to be used when a patient’s tinnitus is bothersome to them. For most, this is two to five hours per day. The goal of habituation is the gradual reduction in the amount Serenade is needed over time.

SoundCure Serenade has been on contract with the VA since August 2012. For further information visit www.soundcure.com. To find out if Serenade will work for you, contact your local VA audiologist.

This article first appeared in the The Year in Veterans Affairs & Military Medicine 2013-2014 Edition.