Brainy mindBMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7174.1693 (Published 19 December 1998) Cite this as: BMJ 1998;317:1693
All rapid responses
It is truly hard to compare sensations. But one of the worst sensations to evaluate is subjective tinnitus. It is experienced by over 50 million Americans, ten million of whom have sought relief from medical or non-medical intervention (1). By definition, subjective tinnitus is evidenced by an acoustic like sensation, usually located within the head, for which there is no external cause. It is defined in a variety of ways by those who suffer from it. Such statements as roaring, hissing, music, crickets, a cacophony of sounds, and static-like are only a few of the descriptions provided by our patients regarding this ongoing disorder.
Tinnitus is giving the patient a lot of problems including depression - sometimes even leading to suicide. The origin of this sensation is still unknown. So far there is no way of objective examination of this sensation, which can not be heard by anybody else, not even by a functional magnetic resonance tomography. Still some therapies are successful - one of the most promising therapies is the so called Tinnitus Retraining Therapy (2,3), also known as Habituation Therapy, is a relatively new approach to the management of tinnitus. Tinnitus Retraining Therapy is based on strong neurophysiological evidence that any person can habituate to acoustic, or acoustic like, sensations in their environment. With constant use of special sound generators coupled with careful counseling, habituation usually occurs within the first 18 months. This is not to suggest that the tinnitus disappears.
The success of the Tinnitus Retraining Therapy seems to be an evidence of "qualia" - sensations of consciousness created by the brain.
(1) Gold, S.L., Gray, W.C., Jastreboff, P.J. Audiological evaluation and follow up. Proceedings of the 5th International Tinnitus Seminar, Portland, Oregon, 1995, eds. G. Reich and J. Vernon, American Tinnitus Association, Portland, Oregon, pp. 485-487, 1996.
(2) Jastreboff-PJ, Gray-WC, Gold-SL. Neurophysiological approach to tinnitus patients Am-J-Otol. 1996 Mar; 17(2): 236-40
(3) Baguley-DM, Beynon-GJ, Thornton-F. A consideration of the effect of ear canal resonance and hearing loss upon white noise generators for tinnitus retraining therapy. J-Laryngol-Otol. 1997 Sep; 111(9): 810-3
Competing interests: No competing interests