Dr Lucy Handscomb on the challenges of treating tinnitus

What attracted you to the area of tinnitus research?

I started out as a full-time clinician – a hearing therapist – and I saw a lot of tinnitus patients as part of my job. Early on, I went on a training course and came across some brilliant, inspiring people who were involved in tinnitus research as well as clinical work. They gave me the motivation to get started in research too.

What are some of the causes of tinnitus and is it becoming more prevalent?

Tinnitus is very often related to hearing loss; anything that can cause hearing loss can cause tinnitus alongside it, although this isn’t inevitable. Noise exposure (industrial or leisure noise) is a particularly common cause, and one of the few that can be prevented. Tinnitus also occurs in people with normal hearing and its onset is sometimes associated with stress.

There’s no reason to believe that tinnitus is becoming more prevalent. Although it is more often reported than previously, there are references to ear noises (and suggestions for cures) going back to around 300 BCE.

What types of treatments can help manage or cure the condition?

At the moment there is no cure for tinnitus. However, there is much that can be done to help people manage it. The treatment with the most evidence behind it is cognitive behaviour therapy (CBT), which has been shown in multiple studies to bring about substantial reductions in tinnitus-related distress. Most people with tinnitus also benefit from being better informed about it and learning self-management techniques such as stress reduction. Those who also have hearing loss often find that hearing aids make tinnitus less audible.

You lead a course at UCL on ‘Advanced management of tinnitus and hyperacusis’. Can you explain what hyperacusis is and how it relates to tinnitus?

Yes- this is one of our longest-running short course which has been going for 13 years now. Hyperacusis is a form of reduced sound tolerance. People with it can find ordinary levels of household and environmental noise uncomfortable, sometimes even painful, which clearly has a huge effect on everyday life. About 40% of people with tinnitus also have hyperacusis. A smaller number have hyperacusis without tinnitus. There are some similarities in approaches to management, but some important differences too. It’s currently an under-researched topic and people who have it find it hard to get appropriate help.

Can you tell us about the focus of your current research and what you think are some of the future challenges? 

At the moment I am interested in researching digital interventions to help improve access to CBT-based therapy. I find it very frustrating that we know CBT helps people with tinnitus a lot, and yet access to it is very limited. I’m in the process of setting up a research project involving NHS patients at the Royal National Ear Nose and Throat Hospital and an industry partner looking at a tinnitus management app. I think this has huge potential for getting appropriate help to more people quickly. The sooner people get help with their tinnitus, the better the outcomes.

Tinnitus is a complex problem and there is unlikely to be a single tinnitus site responsible for generating the perception of sound. Several brain areas are involved, which makes it tricky to identify the ‘off switch’ so many people desire. Obtaining funding for tinnitus research has always been a challenge and it’s difficult to get pharmaceutical companies to invest in it, in part because there are no objective measures of it.

What would you say to someone interested in studying at the UCL Ear Institute?

It’s a great place to study! Whether you’re interested in tinnitus, hearing loss, balance disorders or other aspects of the auditory system, you will learn from some of the top experts in their field. We’re one of the smallest institutes in the university which we see as a great advantage – you can really get to know people.

You are a Trustee of Tinnitus UK. How does this organisation support people who have tinnitus? 

Tinnitus UK is probably the best source of information for people with tinnitus in the world and we know that people access our resources from all over the globe. There is lots of clear, evidence-based information on the website and many ways to get help quickly including a phone helpline, webchat, online workshops and support groups. I know many people have described it as a lifeline when they were feeling alone and bewildered.

Related

• Dr Lucy Handscomb's academic profile
• Advanced management of tinnitus and hyperacusis
• UCL Ear Institute