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TINNITUS is an "Aura Symptom" in Need of a Multidisciplinary Approach to Facilitate Diagnosis and Treatment

TINNITUS is an "Aura Symptom" in Need of a Multidisciplinary Approach to Facilitate Diagnosis and Treatment

Teaser: 

Dr. Pradeep Shenoy, MD, FRCS, FACS, DLO,1 Dr. Eric Deschenes, Au. D.2

1Otolaryngolost , Campbellton, NB, Canada.
2Audiologist, Campbellton, NB. Canada.

CLINICAL TOOLS

Abstract: Tinnitus is a perception of sound in the absence of sound stimulation (Figure 1). Various reasons are blamed for the causes of the tinnitus. Very rarely, tinnitus is seen in normal-hearing children where no obvious cause is detected. In these instances, tinnitus does not persist for long. In some people it may occur spontaneously as in old age, and in some individuals it is induced by noise exposure, ototoxic drug use, stress, smoking, or excessive coffee consumption (Figure 2). In some, tinnitus may be associated with other symptoms like vertigo and deafness. Such symptoms can be correlated with congenital sensorineural hearing loss, wax accumulation, serous otitis media, Meniere's disease, vestibular neuronitis, acoustic neuroma, vascular causes like a/v malformation or fistulae, and also in some patients, temperomandibular dysfunction. Tinnitus can cause anxiety, depression and sleep disorders, and in some individuals, extreme anxiety can lead to suicidal tendencies. Conventional medical treatment uses medication, sound therapy and relaxation. Management using electromagnetic stimulation and low intensity laser is also reported in the literature.
Key Words: Tinnitus counselling, sound therapy, hyperacusis, ototoxic drugs, presbyacusis, noise induced deafness (acoustic trauma), electromagnetic therapy, relaxation exercises.
Tinnitus is the perception of sound without external acoustic stimuli and is often described as ringing, whistling, buzzing, gushing of water, or a pulsatile noise.
Most researchers theorize that tinnitus is caused by initial damage to the outer hair cells in the cochlea, followed by impairment of the inner hair cells.
Tinnitus can cause anxiety, depression, sleep disorders, and in some cases, extreme anxiety that can lead to suicidal tendencies.
There is no method to eliminate tinnitus entirely; the goal with patients suffering from tinnitus is to provide the tools necessary to effectively manage their reaction to tinnitus symptoms.
Tinnitus can be attributed to a wide variety of causes, and it is difficult to study and treat tinnitus because of the lack of objective diagnostic tools.
To help manage tinnitus symptoms, sound therapy (tinnitus masking and tinnitus retraining) can be used in conjunction with alternative therapies like relaxation exercises, breathing exercises, hypnosis, vitamins and herbs, low level laser treatment, and electromagnetic treatment.
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The Management of Tinnitus

The Management of Tinnitus

Teaser: 

 

John P. Preece, PhD, Department of Communicative Disorders, University of Rhode Island, Kingston, RI.
Richard S. Tyler, PhD, Department of Otolaryngology-Head & Neck Surgery, Department of Speech Pathology & Audiology, University of Iowa, Iowa City, IA.
William Noble, PhD, School of Psychology, University of New England, Armidale, NSW, Australia.

Hearing loss in the elderly is a frequently acknowledged problem. Prevalence of hearing loss clearly increases with age, to as high as 50% of persons older than 70 years. Less recognised is an often-related problem, tinnitus. We are concerned here about pathological tinnitus: that which lasts more than five minutes more than once a week. In this article we review the prevalence of tinnitus as a function of age, and its causes and mechanisms. We also describe problems commonly associated with chronic tinnitus and some treatment options. We conclude with some special considerations for the elderly patient.
Key words: tinnitus, prevalence, counseling, sound therapy.