Hearing Aid Feature Helps

[Mark K.]

Hi Dr. Nagler:
I have a question. Recently, I've been using my Widex Zens hearing aid feature for about 4 hours a day. My hearing is actually okay, even though my left ear cant hear some high frequencies. What I've noticed is when I put on the hearing aid feature, the outside sounds are amplified, and when I take off the hearing aids. Everything sounds much softer, including the ringing. I'm not sure if this is good for reducing my T or not. It seems to be working, but I don't know if it's because I'm using the hearing aids, or if its because I'm habituating and my ringing is fading because I'm not noticing it as much. Anyway, let me know if using hearing aids is actually helpful in habituation.

Thank you,
Mark K.

 

[Dr. Nagler]

What I've noticed is when I put on the hearing aid feature, the outside sounds are amplified, and when I take off the hearing aids. Everything sounds much softer, including the ringing. I'm not sure if this is good for reducing my T or not. It seems to be working, but I don't know if it's because I'm using the hearing aids, or if its because I'm habituating and my ringing is fading because I'm not noticing it as much. Anyway, let me know if using hearing aids is actually helpful in habituation.

What you are experiencing is temporary residual inhibition of your tinnitus due to the magnification of external sounds.

Best way to explain it is to forget the hearing aids for a moment, and consider a wearable tinnitus masker. When tinnitus is masked (i.e., totally or partially suppressed) using a masker for a period of time and then the masker is removed, a certain percentage of individuals will experience continued suppression of their tinnitus for a variable length of time - seconds, minutes, or (rarely) hours. The phenomenon was first described in the literature by Dr. Jack Vernon. Unfortunately nobody has figured out a way to induce residual inhibition for those individuals who do not experience it, nor has anybody figured out how to predictably prolong residual inhibition for those who do. In your case, Mark, your use of the hearing aid feature on your Widex devices magnifies external sounds that then function physiologically like a masker. And your residual inhibition results in continued suppression.

Now the reason external sounds sound softer to you upon removing your hearing aids is through a different mechanism; it is something that every hearing aid wearer experiences and has to do with relative loudness, not residual inhibition.

Is residual inhibition a predictor of habituation? No. In fact residual inhibition has no predictive value whatsoever.

Are hearing aids helpful in habituation? Only if you have clinically significant hearing loss and use the hearing aids primarily to decrease contrast, as opposed to using them primarily to enhance communication. the two aforementioned purposes overlap, of course, but the settings for each are different.

Hope this helps more than confuses.

stephen nagler