Hyperacusis Desensitization Therapy Negatively Impacting Tinnitus?

[HiThere]

Hello Dr. Hubbard:

Thank you for your willingness to devote time to helping others in this way.

I've had both tinnitus and hyperacusis, I will assume, since birth both conditions recently confirmed by an audiologist during a full hearing eval. I understand a treatment for hyperacusis is desensitization therapy (getting used to loud sounds). Loud sounds, however, aggravate my tinnitus. If I'm exposed to loud sounds for short periods of time, for example, my tinnitus will ring louder for a period of days before returning to it's usual level (frequency at approx 7500 Hz).

The audiologist recommended a very expensive MP3 player with sound therapy recordings on it at a cost of $3000+ for the tinnitus which is not affordable for me. I did find an online sound therapy sight that masks or strips out the frequency at which my tinnitus rings at for there downloadable sound files. I found it very relaxing but have not stuck with it. I'm more concerned about what seems to be conflict between increasing loud sounds to treat hyperacusis and how I fear it would affect my tinnitus.

Desensitization would seem to me to a very logical therapy for hyperacusis for someone who has hyperacusis without tinnitus. My concern is that I perceive the treatment of the former to exacerbate the latter.

Any info you could provide would be appreciated.

Thank you.

Chris

 

[Dr. Hubbard]

Hey Chris
that's a tough one, though i have heard it before. Sounds like your tinnitus is a "reactive" type. This is an informal description and seems to describe a subset of people with tinnitus. There's no research on this type of tinnitus so i'm speculating on what might help. So i would proceed slowly and experiment with what might help. One can definitely desensitize (i.e., habituate) to hyperacusis through the graded exposure to the sounds that trigger it. I don't know that the sounds would need to be loud though. So you may be able to find a sound that helps with hyperacusis but doesn't trigger your tinnitus. Tinnitus Retraining Therapy has been shown to help with hyperacusis and that uses fairly simple (white, pink or brown) low level sound. TRT can also be quite expensive, so you can try the budget self help version using earbuds or headphones turned to a careful volume. There's no evidence that i'm aware of that more complex forms of sound therapy really help any more than exposure to naturally occurring sound over time.
Hope that helps,
Dr Hubbard