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Tinnitus and Hyperacusis
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Audiological management is a combination of addressing any associated hearing loss with hearing aids, assistive listening devices or, if necessary, cochlear implants, using sound therapy, explanation, education and counselling, relaxation training and, if needed, advice regarding sleep. Various protocols have been developed using these principles in a structured way, including tinnitus retraining therapy, progressive tinnitus management and tinnitus activities treatment. There is a modest evidence base supporting these approaches.
The Limbic System, Oxytocin, and Pain Management
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Sahar Swidan, Charles E. Schultz
Limbic system retraining is minimally documented in the literature, and more robust studies are needed to provide evidence-based recommendations on its effectiveness. Tinnitus retraining therapy has been shown to be successful in multiple published studies and relies heavily on limbic system retraining. Just as the limbic system and auditory systems are highly integrated, the limbic system and pain perception are directly related.6 With tinnitus, it is not the auditory perception that is problematic but the presence of inappropriate associations between tinnitus-related neuronal activity and the reactions of the limbic and autonomic nervous systems. Therefore, in pain management, retraining the limbic system to recognize pain signals can lead to appropriate reactions of the limbic system and revive the protective mechanisms that can aid in the perception of pain.6
The Role of the Audiologist in Life Care Planning
Published in Roger O. Weed, Debra E. Berens, Life Care Planning and Case Management Handbook, 2018
William D. Mustain, Carolyn Wiles Higdon
Nonmedical management of tinnitus has traditionally involved masking or covering up the patient's internally produced head noises with externally generated sound. This can take the form of enhanced environmental sound provided by traditional hearing aids, since most patients with handicapping tinnitus also have hearing loss. If there is no hearing loss, or if hearing aid use is not appropriate, a tinnitus instrument, similar in appearance to a hearing aid, can be used to provide a masking sound. The particulars of the masking sound used will vary according to information provided by the patient, such as the loudness, pitch, and quality of the tinnitus. Treatment protocols for tinnitus involve habituation to rather than covering up of the tinnitus. This is known as Tinnitus Retraining Therapy (Jastreboff, 1996). This treatment approach involves directive counseling designed to remove negative associations attached to the tinnitus. Sound therapy is also used, but not to cover up the tinnitus. Instead an emotionally neutral sound, such as white noise, is paired with the tinnitus in order to facilitate habituation. Tinnitus Retraining Therapy takes 12–18 months, but its proponents cite significant relief from annoying tinnitus in over 80 percent of patients treated (Jastreboff, 1996).
Presence of hearing loss is predictive of return for further stages of tinnitus therapy following initial education and counseling
Published in International Journal of Audiology, 2021
Saikrishna C. Gourishetti, Chelsea Carter, Nicole K. Nguyen, LaGuinn Sherlock, David J. Eisenman
Tinnitus is the subjective perception of sound in the absence of an external auditory stimulus. When the sound perception arises from a non-mechanical source, it is commonly referred to as subjective tinnitus. The precise pathogenesis of tinnitus is still unknown, though there are likely numerous pathways leading to the common end phenotype (Baguley 2002). The significance of the psychological reaction to tinnitus as the dominant factor contributing to quality of life changes (e.g. disruptions in sleep, concentration and mood) is well established (Strumila et al. 2017; Zeman et al. 2014). Based on this understanding, several evaluation and treatment protocols have emerged, with a common approach of combining education and counselling with sound-based therapy. Each approach acknowledges the relationship between tinnitus perception and tinnitus reaction, and each is designed to mitigate the reaction to tinnitus and thus reduce the functional impact of bothersome tinnitus on daily activities of living. Some of the better-known approaches include Tinnitus Retraining Therapy (TRT; Jastreboff and Jastreboff 2000), Tinnitus Activities Treatment (TAT; Tyler et al. 2007) and Progressive Tinnitus Management (PTM; Henry et al. 2010). Various studies have examined the efficacy of these approaches in reducing self-perceived tinnitus handicap (Bauer, Berry, and Brozoski 2017; Henry et al. 2006, 2009, 2017; Herraiz et al. 2005; Jastreboff and Hazell 1998; Newman and Sandridge 2012; Tyler et al. 2007).
Sound therapy for cochlear implant users with tinnitus
Published in International Journal of Audiology, 2021
Jan A. A. van Heteren, Remo A. G. J. Arts, Matthijs J. P. Killian, Kelly K. S. Assouly, Cynthia van de Wauw, Robert J. Stokroos, Adriana L. Smit, Erwin L. J. George
Another treatment option is auditory stimulation with hearing aids or sound therapy (Hoare et al. 2014; Sherlock and Eisenman 2020; Tunkel et al., 2014). Sound therapy is well established in tinnitus patients with any (aided or unaided) degree of hearing loss. Used strategies and stimuli vary widely, from background noises and relaxation sounds, to broadband or narrowband stimuli for total or partial masking of the tinnitus (Hobson, Chisholm, and El Refaie 2012; Sereda, Davies, and Hall 2017; Sherlock and Eisenman 2020). Also more tailored forms such as notched sound therapy (with the frequency of tinnitus removed from the sound stimulus) or sound therapy in combination with extensive long-term counselling in tinnitus retraining therapy have been used (Chari and Limb 2018; Jastreboff and Hazell 2004; Phillips and McFerran 2010).
Process evaluation of Internet-based cognitive behavioural therapy for adults with tinnitus in the context of a randomised control trial
Published in International Journal of Audiology, 2018
Eldré W. Beukes, Vinaya Manchaiah, David M. Baguley, Peter M. Allen, Gerhard Andersson
The intended sample of those that had already had a medical examination due to tinnitus was evident as 93.15% had seen their General Practitioner and 70.55% reported having seen an Ear Nose and Throat specialist. It was also found that the greater part was underserved with tinnitus intervention as 77.5% had not had access to previous interventions. Of those that had had treatment, this included, audiological treatment (13.70%), tinnitus retraining therapy (2.05%) medical interventions (4.11%), psychological treatments (2.05%) and complementary therapies (1.37%). The majority (89.04%) were not attending tinnitus support groups and therefore not receiving additional tinnitus support. The reach, therefore, included adults across the UK who previously had no access to services that provided management strategies for their tinnitus.