Role of maskers in tinnitus management

Role of tinnitus maskers in the management of tinnitus:

Tinnitus maskers play a vital role in the management of tinnitus. Use of tinnitus maskers reduces the incidence of tinnitus in these patients.

Types of tinnitus maskers:

There are three different masking devices used in the management of tinnitus. The exact type used depends on the degree of patient's hearing loss, and the nature of tinnitus.

Type I: Conventional hearing aids. These conventional hearing aids produce masking of tinnitus by amplifying ambient noise which in turn covers up or masks the tinnitus. These hearing aids are useful in patients who have tinnitus associated with hearing loss.

Type II: These are classic tinnitus maskers that generate noise bands which can be adjusted by the user. The user can choose the noise band and the optimal volume that masks the tinnitus

Type III: Tinnitus instruments. These are a combination of both a high frequency hearing aid and a tinnitus masker within the same apparatus. Both these components have separate volume controls that can be used to adjust them individually.

Figure of tinnitus masker

Indications of various tinnitus maskers:

1. Patients with normal hearing commonly have high frequency hearing loss and hence should use tinnitus maskers that generate masking sounds with substantial high frequency content (6kHz and above).

2. Patients with high frequency hearing loss associated with high pitched tinnitus should use tinnitus instruments (type III).

3. Patients with low frequency hearing loss with associated low pitch tinnitus would benefit from using well fitted hearing aids. These hearing aids are sufficient to produce masking effect on the tinnitus.

It is always important to adjust the tinnitus masker so as to generate the lowest level of masking sound that is capable of masking the tinnitus.

If tinnitus is troublesome during sleep then bedside maskers can be used. Masking pillows are also available.

Tinnitus masking by using bone conduction of ultrasound: One recent advancement in tinnitus masking is the development of a new wearable high frequency bone conduction maskers. These maskers can be applied anywhere over the skull without the need to occlude the external auditory meatus.