I've read your articles and I have to say, I appreciate them a great deal. Thank you for them.
@Jack V
Thank you for your kind comments.
What I'm asking is why demonize headphones and not speakers since both can be responsible for this wicked condition, and both can also be used responsibly?
Why demonize one and not the other?
The advice I'm getting from doctors is to use headphones judiciously, for sound enrichment, and flying.
The advice that I give about headphone use and tinnitus is for people that are specifically affected by:
Noise induced tinnitus. Also known as tinnitus caused by exposure to loud noise. On your Avatar is reads: Tinnitus caused by entropy. I believe this is a gradual decline in hearing that has resulted in you developing tinnitus? Therefore, your tinnitus is not noise induced.
The ear canal is approximately 26mm in length 1 inch. A headphone placed over the outer ear or an earbud inserted into the entrance of the canal and music played, produces airwaves/sound pressure. These airwaves only have one course of travel and that is straight towards the eardrum. Behind the eardrum the cochlea is situated. People that have suffered an acoustic trauma/noise induced tinnitus the cochlea seems to be more sensitive to sound even after habituation has been reached. I believe the reason for this is because a lot of people that develop noise induced tinnitus, have some oversensitivity to sound known as hyperacusis.
People that have tinnitus which wasn't caused by exposure to loud noise do not usually have hyperacusis as a result of exposure to loud noise. However, I am aware some do experience oversensitivity to sound which may be classified as hyperacusis.
The severity of hyperacusis when caused by exposure to loud noise does seem to vary between people. However, even after it has been treated or improves by itself and a person no longer experiences oversensitivity to sounds. For some reason the auditory system has been affected in such a way it's not like it was prior to the onset of Noise induced tinnitus. One could say it's like being cut by a knife, although the wound heals a scar remains. This is what I have surmised having corresponded with people at various tinnitus forums and spoken to on the telephone that have noise induced tinnitus. Many of these people have returned to using headphones and used them at low volume and found their tinnitus has got worse. This may not happen immediately but once it does, the tinnitus doesn't usually return to its previous baseline level. In contrast to this some people with noise induced tinnitus use headphones and suffer no ill effects.
I have corresponded with a lot of people with noise induced tinnitus, who have returned to using headphones and regretted it because their tinnitus has increased. There are many posts in this forum written by people with NIT that have returned to using headphones after they have habituated and regretted it. I just don't think its worth risking your health, knowing how debilitating tinnitus can be when it reaches severe levels and this is sustained.
Music played through speakers can cause tinnitus to spike and increase to a new permanent level. However, providing a person with noise induced tinnitus, is careful of not being exposed to overly loud sounds from speakers they will usually be alright. Sound from speakers is dispersed over a wider area before reaching the ear. One must still exercise caution and don't put faith in noise reducing earplugs and think, going to a club or concert where loud sounds are played all night they will be safe. Nothing more could be further from the truth. If external sound is loud enough, it can pass through the head and be transferred to the inner ear by bone conduction and cause irritation spiking the tinnitus, which could increase it to a new permanent level.
ENT doctors are physicians they are not tinnitus experts. In fact they do not treat tinnitus, they treat underlying medical conditions within the auditory system Ear, Nose, Throat, that is causing the tinnitus. They treat them medically or surgically. When there is no underlying medical condition causing the tinnitus as in Noise induced tinnitus, the patient should be referred to Audiology. Here, they will see either a Hearing Therapist or Audiologist that specialises in Tinnitus and Hyperacusis treatment and management. This is the current practice in the United Kingdom. I do not know the procedures used in other parts of the world for people with Noise induced tinnitus.
Treatment for noise induced tinnitus at Audiology, can include: TRT (or elements of it) CBT, Counselling, Mindfullness, Relaxation therapy, Sound therapy using white noise generators, hearing aids and medication. One or a combination of these treatments may be used.
The advice I'm getting from doctors is to use headphones judiciously, for sound enrichment, and flying.
Using headphones as you have been told by your doctors will probably be fine for you. Those with NIT I advise caution.
As I have said ENT doctors are not tinnitus experts they are physicians. Therefore, some will tell tinnitus patients what they want to hear, without knowing the risks a person takes using headphones that has Noise induced tinnitus. Most of these doctors do not have tinnitus. Those that do probably have it mild and it may not be noise induced. I doubt the majority of them have experienced tinnitus at the levels most people experience in this forum. Therefore, how can they possibly understand how debilitating this condition can be for someone affected with it? Most of what they know about tinnitus is from consultation with their patients but they have little perhaps no experience of living with Noise induced tinnitus.
It is the reason so many people at tinnitus forums say: "My ENT doctor doesn't understand what I am going through". Some people give ENT doctors a sentimental reverence because they are medically qualified but this does not mean they know about tinnitus. They are physicians and understand the anatomy of the Ear, Nose, Throat. They treat these organs medically or surgically and I believe most will do this to the best of their ability, because this is their area of expertise.
My ENT doctor is an Audiovestibular physician with a Phd. I have a lot of respect for her and we have a good rapport. She once told me that I know more about tinnitus than her for the simple reason she has never experienced tinnitus. She also said ENT doctors do not treat tinnitus, they treat underlying medical problems that cause it. She continued and said: When there is no underlying medical problem found to causing the tinnitus, the patient is referred to Audiology to see either a Hearing Therapist or Audiologist that specialises in Tinnitus and Hyperacusis treatment and management. I also learnt that most (not all) of these health professionals were either born with tinnitus or acquired it at some time in their life. My Hearing Therapist who I saw for TRT treatment was born with tinnitus.
This is particularly useful in the treatment of TRT and CBT where counselling is given for tinnitus. In my opinion, unless a person has tinnitus, I do not believe they can give high quality tinnitus counselling. One can read about how tinnitus can affect a person and what can cause it but unless they experience tinnitus they cannot understand it.
Michael