Transcript A brief history of hearing aids and tinnitus sound enrichment devices.

A brief history of hearing
aids and tinnitus sound
enrichment devices.
By James Stibbards
Audiologist
Aintree Tinnitus Support Group
3rd March 2010
Early days
1st written account of medical
treatment of tinnitus is all the way back to
the Egyptians.
 For the “Bewitched ear and humming in
the ears” they would infuse oil,
frankincense, tree sap, herbs and soil; and
they would administer it using a reed stalk
placed in the external ear.
 The

The Mesopotaminans
used to chant to get rid of
the whispering or singing
in their ears.
 “Whoever thou may be,
may Enki restrain me”
 Another incantation was
“It hath flown against me.
It hath attacked me. O
seven heavens, seven
earths, seven winds,
seven fires, by heaven be
ye exorcised
This is Enki,
the god of
water.
The Greeks and Romans
 Early
Greco-Roman medicine defined the
treatment of tinnitus based on the cause of
the disease.
 Later, the works of Hippocrates and
Aristotle really were the first to introduce
the idea of masking. They were fond of
saying, "Why is it that buzzing in the ear
ceases if one makes a sound. Is it
because a greater sound drives out the
less?"
Middle ages

Welsh treatment
recommended to take
a loaf of hot bread,
divide it in two, and
put it in each ear as
hot as you could take
it and thus perspire
and by the help of
God you would be
cured.
The Renaissance

They thought that
wind would become
entrapped in the ear
and circle around
inside it, and so they
would trephinate the
mastoid to allow the
wind to escape.
19th Century
 The
French physician, Itard, is widely
recognized as the father of audiology.
 He argued that the role of the physician
was to make the tinnitus bearable.
 A technique that rarely failed was to cover
the internal sound by an external one. The
sound should be matched as far as
possible to the tinnitus. For example, a
roaring fire should mask a roaring tinnitus
The 20th Century
 In
1903 a doctor named Spaulding used a
piano to match the frequency of tinnitus.
 He would increase the volume of the note
until the tinnitus became inaudible for his
patient.
The 20th Century
 In
1928, two researchers, Jones and
Knudsen bombarded the auditory system
with an outside sound similar to tinnitus
but louder.
 They developed a large instrument that
could be placed on a bedside table for
patients experiencing difficulty sleeping.
This became the very first bedside
masker.
The 1st wearable devices


In 1973, Jack Vernon,
Ph.D. led a research
group that was the only
group in the US formally
studying tinnitus.
One day he received a
visitor, Dr. Charles Unice,
who travelled from
California to visit him
regarding his severe
tinnitus.
 As
they passed an outdoor fountain, Dr.
Unice came to an abrupt stop. Reluctant to
leave the soothing sounds of the fountain
he told Dr. Vernon, “Standing right here I
cannot hear my tinnitus. It’s the first time
I’ve been unable to hear that
unconscionably wretched sound since it
began over two years ago. This is
wonderful!” After several more
discussions, Dr. Vernon formed the idea of
using a wearable masking device as a
method of providing relief from tinnitus.
The rest, as they say, is history.
Wearable Sound Generators
 WSG
may be prescribed to patients who
do not have significant hearing loss.
 The devices are similar to hearing aids
except that they do not amplify sound;
they produce white noise
 The brain can very easily learn to ignore
external sound, especially if it’s at a
constant level and frequency
Desk top devices
 Produce
 Can
a variety of environmental sounds
be linked to a “pillow speaker”
 Should
be switched on all day
Benefits of sound enrichment
 Weakens
the tinnitus signal by decreasing
the difference between tinnitus and the
background sound
 The
sounds should be non-intrusive,
pleasant and relaxing to listen to
 They
should not cover the tinnitus (i.e.
they must not mask the tinnitus sound)
Hearing aids
 Hearing
aids can help people with hearing
loss and in many cases they also reduce
tinnitus symptoms.
 First, tinnitus is exacerbated by silence
because the brain turns up its sensitivity
by seeking the neural stimulation it’s being
deprived of due to hearing loss.
 Second, hearing aids amplify enough
background noise to partially mask tinnitus
sounds for many people.
The 1st hearing aids
Concealed Hearing
Devices of the 19th
Century
Acoustic chairs

Acoustic Chairs were
a clever example of
incorporating a
hearing device within
an everyday object
 Perhaps the most
ingenious design of
an acoustic throne
was created by F. C.
Rein for King John VI
of Portugal
Beard Receptacle
Hair Receptor
Electrical devices

During the 20th century, aids for hearing evolved
from mechanical to electrical devices. Using an
external power source, sounds could now be
made louder than was possible with earlier
mechanical designs
 Early Electrical Hearing Aids were based on
telephone technology invented by Alexander
Graham Bell in the late 19th century

Acousticon Model 28,
1927 This hearing aid
is typical of early
electrical hearing aids.
It was large and not
easily transportable –
the batteries were
cumbersome and the
carbon components
were highly sensitive to
heat and cold.
Hearing aid
glasses
Internal workings of an analogue
BTE hearing aid.
Digital
hearing aids
In the ear aids
Otarion ECA (ear canal
aid) 1961
Oticon 1978
Oticon 1987
Bernafon ITC (in the
canal) 1997
The future
Who knows!
Main References

Tinnitus Retraining Therapy. Jastreboff PJ, Hazell JWP. Cambridge University Press
2004

Subjective Tinnitus
Jayson S. Greenberg, M.D.
March 12, 1998
Baylor College of Medicine
Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery

Tinnitus
Elizabeth Willingham, M.D
July 22, 2004
Baylor College of Medicine
Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery


Tinnitus Masking by Barry Keate
http://www.tinnitusformula.com/infocenter/articles/treatments/mask.aspx

How Hearing Aids Work by Stephanie Watson
http://health.howstuffworks.com/hearing-aid6.htm
References cont.

The History of Hearing Aids – From Seashells to Mini-computers
09/11/2008 Matt Jacks @ thehistoryof.net

Looking at the History of Hearing Aids: The Past, Present, and Future of Hearing Aid Technology
http://hearing-aids.americahears.com/aid-technology.html

Speech-Language Pathology and Audiology at Kent State University
Hearing Aid Museum Online http://ehhs.kent.edu/spa/museum.cfm

Deafness in Disguise:
Concealed Hearing Devices of the 19th and 20th Centuries
Washington University School of Medicine, St. Louis, Missouri
Published by the Bernard Becker Medical Library
http://beckerexhibits.wustl.edu/did/index.htm

Google images
http://images.google.co.uk