The Munk Difference
What is Tinnitus?
Tinnitus is an auditory phenomenon that is commonly described as the perception of sound in the ear (e.g. ringing or buzzing). Tinnitus can vary in how it sounds and can be perceived as coming from one or both ears, or in the head.
It is common to experience tinnitus temporarily following noise exposure (e.g. going to a concert) or briefly for a few moments from time to time. Medical follow-up is warranted when tinnitus is prolonged - we recommend speaking with your physician if you experience ongoing tinnitus. For bothersome tinnitus, there are treatment programs available that can help with managing the problem (see below).
What Causes Tinnitus?
The precise cause of tinnitus can be difficult to determine. Some potential causes include
hearing loss, noise exposure, ear infections/disorders, head injuries, and certain medications. It is believed that stress can make tinnitus more noticeable.
What Are My Treatment Options?
When researching tinnitus, it is important to make sure that you are getting your information from a trustworthy source. Many websites take advantage of tinnitus sufferers by claiming to offer a cure in the form of a pill or medication of some variety. Be advised that, to date, there is no known cure for tinnitus.
Thankfully, there are management programs available that can provide relief to those with bothersome tinnitus that negatively impacts daily life by helping to make the tinnitus less noticeable.
Progressive Tinnitus Management
Progressive Tinnitus Management (PTM) is a structured, multi-level therapy for tinnitus that has been adopted by the Department of Veteran's Affairs in the United States. We offer PTM through the Centre for Advanced Hearing and Balance Testing at Toronto General Hospital as a cost-effective approach to tinnitus management.
The aim of PTM is to help patients self-manage their reactions to tinnitus. The program offers different levels of support according to the individual needs of the tinnitus sufferer.
For more information and to book a consultation, please call us at 416-340-4800 x. 7067 or to request an appointment. Depending on your history with tinnitus and what assessments you've had in the past, we will work with you to recommend the best option for you. We require a referral from your physician if you have not had your hearing tested within the past 6 months and in select other cases.
What is Progressive Tinnitus Management?
Progressive tinnitus management (PTM) is a tiered tinnitus counseling program that uses audiologist-guided sound therapy, tinnitus education and relaxation techniques to manage a patient’s reactions to their tinnitus.
You mentioned that your program has two branches. What are they?
Our Progressive Tinnitus Management program essentially has two branches: an audiological branch for patients with hearing loss, which focuses on adding amplification and sound therapy plus coping strategies. The second branch is run by Dr. Phil Gerretsen (a psychiatrist) and Wanda Dillon (a mental health nurse), and is appropriate for patients with normal hearing thresholds, sound tolerance problems, and/or concerns that the tinnitus may be impacting overall mental health.
Is Progressive Tinnitus Management (PTM) the same as Tinnitus Retraining Therapy (TRT)?
No. There’s certainly some overlap but this program is considered distinct from TRT. Both programs have research to support that they can provide benefit to patients with tinnitus. The main difference between our program and some other similar tinnitus approaches is that the patient can stop as soon as they feel they have benefited and are able to manage tinnitus independently.
My problem is tinnitus. Why are you recommending hearing aids?
A trial with hearing aids can be the best first step for tinnitus when hearing loss is present. The hearing aids can also be programmed to provide sound therapy for tinnitus. Your audiologist will provide counselling and will recommend other steps of the program if the hearing aids do not provide the desired benefit.
My hearing is normal. Can you still see me for sound therapy?
Unfortunately, we are only able to see patients with hearing loss under the audiological branch of our program. For people with normal hearing, we often refer on to Dr. Phil Gerretsen and Wanda Dillon (a physician’s referral is required for the initial consultation).
I am a physician and my patient is looking for help with tinnitus. What are my next steps?
Our Progressive Tinnitus Management program essentially has two branches:
- An audiological branch for patients with hearing loss, which focuses on adding amplification/sound therapy and audiologist-guided sound therapy, tinnitus education and relaxation techniques to manage a patient’s reactions to their tinnitus. If you aren’t sure if your patient has hearing loss, please send them to us for an audiogram as a first step.
- The mental health branch of our program is run by Dr. Phil Gerretsen (a psychiatrist) and Wanda Dillon (a mental health nurse), and is appropriate for patients with normal hearing thresholds, sound tolerance problems, and/or mental health overlay from tinnitus. That program requires a referral to Dr. Phil Gerretsen (attn: Wanda, fax: 416-340-3327).
How much does your program cost?
Private pay fees apply for both branches of our tinnitus program, outside of the audiogram and the initial consult with Dr. Gerretsen (if applicable). However, we keep our fees very reasonable.
Do you offer cognitive behavioural therapy (CBT)?
Dr. Gerretsen (a psychiatrist) and Wanda Dillon (mental health nurse) help patients to better cope with tinnitus through a combination of counselling, medication when indicated, and on-demand follow-up care. CBT is not a standard component of the care they offer.
How does the program unfold for a typical patient?
Most patients start by being triaged by their family doctor or ENT to make sure there are no medical red flags that require attention prior to tinnitus management.
From there, we complete the audiologic evaluation and make necessary recommendations (i.e. hearing aids) and provide basic counselling.
From the audiologic evaluation, those with normal hearing, sound tolerance problems or certain other indications will be referred for further intervention from our partners, Dr. Phil Gerretsen and Wanda Dillon.
For some patients, hearing aids alone will provide sufficient benefit for tinnitus symptoms to be managed independently and the program will end there. Others will proceed to our audiologist-guided sessions, which use sound therapy, tinnitus education and relaxation techniques to manage a patient’s reactions to their tinnitus.
If the audiologist-guided sessions are not providing the desired benefit, the patient will typically be referred to Dr. Phil Gerretsen (a psychiatrist) and Wanda Dillon (a mental health nurse) for individualized support. Together, they recognize that while tinnitus is not imagined or in your head, it can have a profound impact on your life. They’ve been very successful in helping patients cope with and manage their tinnitus.
Where can i learn more?
For a good basic overview and links to helpful educational resources, please visit the Canadian Academy of Audiology (CAA) website: Tinnitus (CAA)