TRT and Hyperacusis

[mexigrl64]

Hi Dr Nagler,

I met with Dr Hebert today and we discussed starting me on devices. She was considering the Oticon but settled on the ReSound Linx as a better choice for me. She was and still is slightly hesitant about me getting them now, 2 weeks before I leave for Mexico for 3 months. Her main concern is that I also have hyperacusis in the ear that has the tinnitus. She is worried that the devices could make the T worse or aggravate my hyperacusis. I appreciate a caring doctor and she certainly is that! I did tell her I was going to do some research, talk to a few experts (including you), and get back to her by Wednesday. They certainly are expensive but if TRT has a great chance of working for me then it is worth it.

My neuro and previous audiologist (Janice Howard) are both fairly sure that my M.S. is causing issues with the auditory pathways. It certainly makes sense. However, when I try to research M.S. and TRT I can't really find if TRT (or any other option) is better for those dealing with likely nerve damage.

I'd appreciate your thoughts as I make this decision.

Thank you!

 

[Dr. Nagler]

I met with Dr Hebert today and we discussed starting me on devices. She was considering the Oticon but settled on the ReSound Linx as a better choice for me.

There are a lot of variables involved in choosing devices for the sound therapy part of TRT. The biggest question has to do with whether or not you need to incur the added expense of hearing aid technology. If you do not need hearing aids for amplification, then a pair of broadband sound generators should be quite sufficient for the sound therapy component of TRT. Otherwise you would use (the more expensive) combination units that offer both hearing aid amplification and broadband sound.

She was and still is slightly hesitant about me getting them now, 2 weeks before I leave for Mexico for 3 months. Her main concern is that I also have hyperacusis in the ear that has the tinnitus. She is worried that the devices could make the T worse or aggravate my hyperacusis.

The sound therapy in TRT cannot make your tinnitus worse or aggravate your hyperacusis ... provided that (1) your devices are set properly and (2) you are using them properly. Those two things can require some tweaking to get it right. And the tweaking can be challenging to do long distance - especially if you require combination units, which appears to be the case in view of the brands of devices Dr. Hebert is recommending for you. So if you were my patient, I'd move ahead with the TRT counseling, but hold off on the sound therapy piece until your return.

My neuro and previous audiologist (Janice Howard) are both fairly sure that my M.S. is causing issues with the auditory pathways.

That's certainly a possibility, but it shouldn't interfere with habituation.