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Differentiating the Two Types of Tinnitus

By Dave Siever

May 29, 2015

There is much confusion about ringing in the ears called tinnitus. It’s my belief that this is mainly because most people are not aware that there are two very distinct types of tinnitus, which are:

  • Muscle tension resulting from malocclusion (a poor bite), stress and anxiety.
  • Neuroplastic changes from cochlear dropout (lost frequencies).

The tension type involves tight jaw-closing muscles such as the masseter and temporalis, which are easily tested under palpation. Typically, what happens is that the mandible posteriorizes from the tension and the condyle (ball on the mandible) puts pressure on the auricular and tympanic nerves and arteries, which in turn causes tinnitus. In my TMD (Temporomandibular Joint Dysfunction) days, we treated hundreds of cases of tinnitus simply by anteriorizing the mandible with a splint. The stress form of this also involves the masseter and temporalis muscles, but also may include the levator-palatini muscles. There are two of these and they are small. Their job is to vent the eustachian tubes during swallowing. Under stress, they often go into spasm and don’t provide venting during swallowing and therefore the air in the middle ear becomes stale, builds up pressure and causes ringing to occur. Any relaxation technique will help alleviate this form of tinnitus. Audio-Visual Entrainment (AVE) and Cranio-Electro Stimulation (CES) work great for this. So does adjusting one’s lifestyle, or getting a splint, or getting a poorly shaped filling or cap filed down a bit.

The cochlear dropout type involves a loss of a frequency range from cochlear damage or damage to the nerves feeding up to the pons or medial geniculate. Because the frequency range is now lost, the brain recruits more neurons to get it back and in the process causes ringing. TDCS (transcranial DC Stimulation) has shown some promise at resolving this form of tinnitus.

The tension type will typically show soreness on palpitation of the masseter, temporalis and lateral-pterygoid muscles, often accompanied with TM joint soreness and often clicking when opening and closing and the jaw.

The cochlear dropout type will show a loss of hearing at certain frequencies during and audiology exam.

by Dave Siever, C.E.T. -

Differentiating the Two Types of Tinnitus

By Dave Siever

May 29, 2015

There is much confusion about ringing in the ears called tinnitus. It’s my belief that this is mainly because most people are not aware that there are two very distinct types of tinnitus, which are:

  • Muscle tension resulting from malocclusion (a poor bite), stress and anxiety.
  • Neuroplastic changes from cochlear dropout (lost frequencies).

The tension type involves tight jaw-closing muscles such as the masseter and temporalis, which are easily tested under palpation. Typically, what happens is that the mandible posteriorizes from the tension and the condyle (ball on the mandible) puts pressure on the auricular and tympanic nerves and arteries, which in turn causes tinnitus. In my TMD (Temporomandibular Joint Dysfunction) days, we treated hundreds of cases of tinnitus simply by anteriorizing the mandible with a splint. The stress form of this also involves the masseter and temporalis muscles, but also may include the levator-palatini muscles. There are two of these and they are small. Their job is to vent the eustachian tubes during swallowing. Under stress, they often go into spasm and don’t provide venting during swallowing and therefore the air in the middle ear becomes stale, builds up pressure and causes ringing to occur. Any relaxation technique will help alleviate this form of tinnitus. Audio-Visual Entrainment (AVE) and Cranio-Electro Stimulation (CES) work great for this. So does adjusting one’s lifestyle, or getting a splint, or getting a poorly shaped filling or cap filed down a bit.

The cochlear dropout type involves a loss of a frequency range from cochlear damage or damage to the nerves feeding up to the pons or medial geniculate. Because the frequency range is now lost, the brain recruits more neurons to get it back and in the process causes ringing. TDCS (transcranial DC Stimulation) has shown some promise at resolving this form of tinnitus.

The tension type will typically show soreness on palpitation of the masseter, temporalis and lateral-pterygoid muscles, often accompanied with TM joint soreness and often clicking when opening and closing and the jaw.

The cochlear dropout type will show a loss of hearing at certain frequencies during and audiology exam.

Comments

Mimi Castellanos

Thanks for the good work David.

November 30, 2015, 6:05 AM
Reply
Bob W

Thanks

November 30, 2015, 7:46 AM
Reply
Phil Safier

How would one use tDCS to treat cochlear dropout?

December 1, 2015, 10:26 AM
Reply
Dave Siever

Cochlear dropout is damage to the cochlea, so tDCS cannot help cochlear dropout. On the other hand, tDCS has been shown to reduce the tinnitus that results from cochlear dropout.

December 1, 2015, 12:41 PM
Reply
Phil Safier

How would one position the electrodes for tinnitus?

December 1, 2015, 1:23 PM
Reply
Dave Siever

I have forwarded you several articles about this subject. If anyone else would like the articles emailed to them, just let us know.

December 1, 2015, 5:03 PM
Reply
Glenn Gingell

Hi David

We would appreciate articles on tinnitus. i had ear surgery and had ringing ever after. Thanks so much.

Pat Gingell

December 4, 2015, 4:54 PM
Reply
Kevin

I have had horrible tinnitus for over two years and as I get older it is getting worse. Any information you could share will be greatly appreciated.

January 5, 2016, 7:08 PM
Reply
James Thompson

What are your thoughts on high pitched hum/buzz lasting for 20 seconds in children ages 7 to 12? Often this gets better or even disappears. Timing seems to be random.

June 20, 2016, 12:41 AM
Reply
Dave Siever

Hi James,

Good to hear from you and thanks for your inquiry.

There are basically 2 types of tinnitus: anatomical and neurological.

1) The anatomical type shows up a lot with dental issues. The brain tries to position the jaw where it thinks it fits best. This is called occlusal programming and is based on previous memory of one's bits. Poorly shaped fillings, crowns, caps and teeth shifting from wearing braces can all immediately increase muscle tension in the jaw. The problem with dentists when adjusting a filling is that they have their patient laying down when they put the articulating paper in the mouth and have their patient grind their teeth around in small movements. Because the patient is lying down, gravity causes the mandible to shift more posterior than a natural bite. This triggers muscle tension When getting any adjustments to occlusion, it's important to be sitting up right. If the dentist won't let you sit up, then bite a little bit anterior (forward) to maintain a proper occlusion, which in turn conflicts with the occlusal program and induces muscle tension. The primary muscles involved are the masseter, temporalis and zygomatic, and they can put undue pressure on the tissues behind the ramus of the mandible. This pressure can squeeze both the tympanic and auricular nerves and arteries and trigger a perception of a ringing sound. These issues plus stress and anxiety can also cause spasms of the levator palatini muscles. These tiny muscles vent the eustachian tubes and when they go into spasm, the air in the eustachian tubes becomes stale. The air in the tubes builds up with pressure and causes a ringing either straight from the cochlea or from the nerves exiting the cochlea. Children can get bouts of tinnitus as their nervous system and occlusal programming adjusts to their changing dentition. EMG biofeedback and Audio-Visual Entrainment help to reduce both childhood and adult dental-induced tinnitus. When poorly shaped dentition made by the dentist is the cause, it's important to get that fixed ASAP before temporo-mandibular joint (TMJ) damage occurs. I have seen some incredible muscle tension and pain caused by dentists. After the dentist asks you to sit up at the end of a procedure, sit up straight, open your mouth wide and let it slooooowly close over the course of a minute. Notice which teeth contact first, second, third, etc., and have your dentist correct these before you leave. Upper incisors that are too thick on the backside can also cause severe pain, tinnitus and TMJ damage in just a few hours.

2) The other type of tinnitus is non-dental. This is known as cochlear drop-out (CDO) tinnitus and is most often the result of cochlear damage from listening to loud music. Whereas CDO tinnitus was once mostly found in farmers who sustained damage from tractor and machine noise, today's CDO tinnitus is mostly found in teens from playing loud music into headphones. Once the cochlea or it's afferent nerves are damaged, there will be a "silent" spot in the neurons of the auditory cortex which are mapped into the part of the cochlea responsible for making that sound. Much like pain turning into chronic pain through neuroplasticity, the auditory cortex begins recruiting adjacent neurons to try and recapture the particular pitch associated with the hearing loss by in effect turning up the sensitivity - and as a result the neurons inadvertently generate their own "sound." The pitch is often in around 1 Khz, as that is where human hearing is most sensitive to sound. Music also is strong in around 1Khz (female vocals, guitar, piano and keyboards, horns of all types and drum harmonics. This can really "bounce" the eardrum and damage the parts of the cochlea that respond to these frequencies , so it's no wonder that cochlear damage occurs in around this range. Cathodal tDCS has been shown to reduce CDO tinnitus by calming down the auditory cortex. White noise and pink noise have also been shown to help mask it.

June 20, 2016, 1:00 PM
Reply
Peter Tregunna

I have the David Delight Plus unit, what settings work best for tinnitus and dementia?

Peter Tregunna from Ontario, Devon Tregunna father, we both have the same unit, bought shortly after we met you with Kevin, Abma.

January 19, 2017, 7:32 PM
Reply
Dave Siever

AVE can be helpful for tinnitus if it is related to jaw tension or TMJ. Try running alpha sessions. Can use Mood Boosters if there is anxiety or depression.

If the tinnitus is related to nerve, brain or ear damage, it probably will not help.

Suggest using the Brain Boosters 2, & 3 to help improve cognition and memory.

Please see Dave Siever's Article #3 for additional information.

http://mindalive.com/default/assets/File/Article%20-%20Biofeedback%20Mag-06-Seniors%20Issues.pdf

January 20, 2017, 1:51 PM
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