231 |
Tinnitus in Patients with Sensorineural Hearing Loss : Management and Quality of LifeZarenoe, Reza January 2012 (has links)
Approximately 15 % of Swedish people experience tinnitus, but only 2.4 % of them experience severe problems. Treatment modalities for tinnitus are varied, but the most common treatment model is counselling. The majority of patients with tinnitus report some degree of hearing loss, and in addition, hearing aids have been used for many years in patients who suffer from both tinnitus and hearing impairment. The aim of the present thesis was to investigate the disease management and identify the quality of life in patients with tinnitus and sensorineural hearing loss. Both studies described here are retrospective, descriptive studies of patients who sought care for tinnitus and hearing loss at the two ENT clinics in Östergötland County, Sweden, during 2004 - 2007 and who also received a diagnosis code. A medical record review of all patients (study I contained 1672 subjects) revealed that 714 patients were diagnosed with both tinnitus and SNHL between 2004 and 2007 and could be included in study II. The results showed that 70% of our cohort had tinnitus, but many of the patients initially did not receive a diagnosis for their tinnitus. Information about the patients’ vertigo, heredity for hearing loss and tinnitus, diabetes history, cardiovascular disease history and other factors related to their health was often missing from the medical records. Our findings showed that the Stepped Care Model, which however was only used in a minority of the cases, could be effective in patients with tinnitus and could provide a better care process for these patients. Of the cohort, 56% of the patients received a diagnosis of bilateral hearing loss. The pure tone average (PTA) of the left ear was significantly higher than that of the right ear. There were 314 patients (44%) who had hearing aids out of the total of 714, even though it is likely that hearing aids could be beneficial for these patients. We found that the overall scores for the Tinnitus Handicap Inventory (THI) were higher in female patients than male patients. All patients who participated in study II estimated their life quality and general health at a good level. This could be due to the fact that they were investigated 4.5 years after they first reported their tinnitus and that tinnitus annoyance decrease over time. Further, the outcomes of study II demonstrated that the majority of patients, who were dissatisfied with the care they obtained, had no hearing aids. This could indicate a support the use of hearing aids fitting as main treatment model in patients with both tinnitus and hearing loss. Future research is needed to investigate how hearing aid professionals could motivate patients who suffer from both tinnitus and hearing loss to use hearing aids.
|
232 |
Tinnitus-related hyperactivity through homeostatic plasticity in the auditory pathwaySchaette, Roland 25 April 2008 (has links)
Tinnitus, die Wahrnehmung eines Phantomgeräuschs, geht in den meisten Fällen mit Hörverlust einher. Es ist jedoch unbekannt, wie Hörverlust zu Tinnitus führen könnte. In Tierversuchen wurde gezeigt, dass Verhaltensanzeichen für Tinnitus nach Hörverlust mit erhöhten spontanen Feuerraten von Neuronen im zentralen auditorischen System korreliert sind. Zunächst untersuchen wir ob sich bei lärmbedingtem Hörverlust die Audiogramme von Patienten mit und ohne Tinnitus unterscheiden. Im Vergleich zu Patienten ohne Tinnitus haben Tinnituspatienten im Mittel weniger Hörverlust, einen steileren Abfall des Audiogramms, und die Audiogrammkante befindet sich bei höheren Frequenzen. Mit einem theoretischen Modell zeigen wir, wie tinnitusartige Hyperaktivität durch eine Stabilisierung der mittleren Feuerrate von Neuronen im zentralen Hörsystem mittels homöostatischer Plastizität entstehen kann: verringerte Aktivität von Hörnervfasern nach Hörverlust wird kompensiert durch eine Erhöhung der neuronalen Verstärkung. Dies stabilisiert die mittlere Rate, kann jedoch zu einer Erhöhung der spontanen Feuerraten führen, die dann von Art und Stärke der cochlearen Schädigung abhängen. Wir testen das Modell, indem wir es auf die Audiogramme von Patienten mit tonalem Tinnitus und Lärmschwerhörigkeit anwenden. Für jedes Audiogramm sagen wir mit dem Modell Veränderungen in der Spontanaktivität von auditorischen Neuronen vorher. Das resultierende Hyperaktivitätsmuster hat typischerweise eine deutliche Spitze, die mit einem steilen Abfall des Audiogramms einhergeht. Wenn solch eine Spitze als Grundlage für einen tonalen Tinnitus interpretiert wird, dann sagt das Modell Tinnitusfrequenzen nahe den empfundenen Tinnitustonhöhen vorher. Unser Modell stellt also eine plausible Hypothese, wie Hörverlust zu Tinnitus führen könnte, dar. Basierend auf dem Modell zeigen wir außerdem wie Hyperaktivität und somit eventuell auch Tinnitus, durch zusätzliche akustische Stimulation reduziert werden könnte. / Tinnitus is a phantom auditory sensation that is associated with hearing loss, but how hearing loss can lead to tinnitus has remained unclear. In animals, hearing loss through cochlear damage can lead to behavioral signs of tinnitus and can increase the spontaneous firing rates of central auditory neurons. To study the relation between hearing loss and tinnitus, we first analyze audiometric differences between patients with hearing loss and tinnitus and patients with hearing loss but without tinnitus. We find that tinnitus patients have on average less hearing loss, a steeper slope of the audiogram, and the audiogram edge is located at higher frequencies compared to patients without tinnitus. We then derive a computational model that demonstrates how tinnitus-related hyperactivity could arise as a consequence of a stabilization of the mean firing rates of central auditory neurons through homeostatic plasticity: decreased auditory nerve activity after hearing loss is counteracted through an increase of the neuronal response gain. This restores the mean rate, but can also lead to increased spontaneous firing rates, which depend on the type and degree of cochlear damage. Finally, we test the ability of our model to predict tinnitus pitch by applying it to audiograms from patients with noise-induced hearing loss and tone-like tinnitus. Given an audiogram, the model is used to predict changes in the spontaneous firing rates of central auditory neurons. The resulting hyperactivity pattern typically exhibits a distinct peak that is associated with a steep drop in the audiogram. If such a peak is interpreted as the basis for a tone-like tinnitus sensation, the model predicts a tinnitus frequency that is close to the patient''s tinnitus pitch. Thus, our model presents a plausible hypothesis of how hearing loss could lead to tinnitus. Based on this model, we also show how hyperactivity, and possibly also tinnitus, could be alleviated through additional acoustic stimulation.
|
233 |
Analysis of Tinnitus by Multi-channel EEG and Development of Recording SystemMeng-Yi, Lin January 2005 (has links)
Thesis (M.A.)--National Taiwan University Graduate Institute of Biomedical Engineering / Includes bibliographical references
|
234 |
Cognitive Behavioural Therapy as Guided Self-help to Reduce Tinnitus DistressKaldo, Viktor January 2008 (has links)
Tinnitus is common, and some individuals with tinnitus display high levels of distress. Cognitive behavioural therapy (CBT) is effective in reducing tinnitus distress, but is rarely available. CBT-based self-help, with or without guidance, has yielded positive results in other problem areas, and one initial randomized controlled trial (RCT) has shown promising results for tinnitus. This thesis is based on four studies; Study I showed that Internet-based self-help treatment with e-mail guidance alleviated tinnitus distress among consecutive patients and was rated as credible as traditional treatments. Active participation in treatment predicted outcome. Study II, an RCT, showed that an extended and more interactive version of the Internet-based self-help treatment with e-mail therapist support appeared to be equally effective as a group treatment. In study III, another RCT, a self-help book with weekly telephone support was superior to a wait-list control group. No strong evidence for the importance of telephone contact on outcome was found. In both study II and III, the positive outcome remained after one year and self-help approaches appeared more therapist time-effective compared to group treatment. Also, the received treatment-dose for patients in guided self-help was not lower than in the group treatment. Study IV found that the ‘Stages of Change’, from the transtheoretical model, are probably not the right theoretical framework to use with tinnitus patients. Predictors of outcome were found, but they were not in line with the theory behind the Stages of Change. The predictors were better understood when conceptualized as coping, showing that helplessness and less coping before treatment correlated with better outcome. In sum, guided cognitive behavioural self-help can decrease tinnitus distress. It appears to be therapist time-effective and shows effects comparable to or slightly below traditional CBT for tinnitus. Effects remain one year after treatment and generalize to a routine clinical setting.
|
235 |
Patient recall of tinnitus information after initial audiological assessmentLogan, Kate January 2015 (has links)
Aims: This study addressed the challenge of evaluating and improving patient education material as well as recall of information from a tinnitus counselling session. The first aim was to examine the readability and suitability of two tinnitus patient education brochures provided by an audiology clinic to new tinnitus patients. If the readability of the brochures were higher than international recommendations for reading grade level (RGL), then an attempt to rewrite a brochure to a suitable RGL would be made. The second aim was to investigate a) the amount of information tinnitus patients can successfully recall directly following their initial appointment, b) the amount of information that is retained one to two weeks following their appointment, c) whether the amount of information recalled is related to patient variables, and d) the themes that arose from interviews with the patients.
Method: To address study aim 1, readability analyses were completed for two patient tinnitus brochures provided to new patients at a private hearing aid clinic using several readability formulas. If found to have a readability level over 5th grade level one brochure would be rewritten to an acceptable readability level while attempting to maintain the initial level of content. The suitability of the brochures was assessed by two experts in the area of health literacy using the Suitability Assessment of Material (SAM). To address study aim 2, eight participants consulting for tinnitus services were prospectively identified by a clinical audiologist at a private hearing aid clinic. Immediately following the initial tinnitus counselling session, participants took part in a digitally-recorded seven-item open-ended interview and provided demographic and audiological information. One to two weeks later, a second interview using the same questions was conducted.
Results: After analyzing the readability of the brochures it was evident that both exceeded the recommended RGL on the Flesch-Kincaid (F-K), Fry, Fog, and Simple Measure of Gobbledygook (SMOG). The experts rated Brochure 1 as “unsuitable” for patient education and Brochure 2 as “adequate” for patient education using the SAM. Brochure 1 was revised and was within the internationally recommended RGL as measured by the F-K, Fry, and Fog, whilst keeping the content similar to the original. Overall, participants correctly recalled only a small amount of information in the immediate (36.8%) and one to two weeks later (33.7%). There was no significance difference in amount of correctly recalled information between appointments, and none of the correlations performed for recall and participant variables were statistically significant. Effect sizes were calculated and no trend was found for audiometric variables, although demographic variables did tend to explain more of the variance in recall in the short-term than immediately. The most notable themes identified in the interview immediately after the appointment were: Hearing aids, Understanding/Empowerment, and Masking/Music therapy. At the short-term follow up interview, Hearing aids, Cost, and Hope/Positive were commonly reported.
Conclusions: As over half of New Zealanders do not have adequate health literacy skills to meet the demands of life and work (Ministry of Health, 2010) it follows that written and verbal health information should be easy understandable to allow patients to take an active role in their health care and experience the best possible health outcomes. Overall, participants only remembered modest amounts, only one brochure was adequate for patient education, and the RGL of both brochures were higher than recommended. There is a great need for more studies examining suitability, readability, and patient recall not only in tinnitus, but in all areas of healthcare.
|
236 |
Simultaneous hearing problems: health conditions in tinnitus, sound sensitivity and both diagnosesNordin, Josefin January 2014 (has links)
Little research has been conducted on simultaneous hearing problems. The aim of this study was to investigate health conditions (stress, sleep quality, depression, anxiety, and burnout) in individuals with 1) tinnitus, 2) sound sensitivity, and 3) both tinnitus and sound sensitivity, compared to a reference group without these diagnoses. Data from a Swedish population-based sample, stratified for age and gender, was collected through a mail survey. The participation rate was 40 %, and 3406 individuals participated. The results showed that the sample with sound sensitivity was in poorest health condition, raising the notion of different underlying mechanisms of the sound sensitivity in the samples with sound sensitivity versus double diagnoses. More research is needed to further explore the effects of living with simultaneous hearing problems, and subgroups within the phenomena of sensitivity to sound. / Lite forskning har hittills undersökt simultana hörselproblem. Syftet med denna studie var att undersöka hälsotillstånd (stress, sömnkvalitet, depression, ångest och utbrändhet) hos individer med 1) tinnitus, 2) ljudkänslighet, och 3) tinnitus och ljudkänslighet, jämfört med en referensgrupp utan dessa diagnoser. Data från en svensk populationsbaserad grupp, stratifierat för ålder och kön, samlades in via en brevenkät. Deltagandet var 40 % och 3406 individer deltog. Resultatet visade att gruppen med ljudkänslighet var i sämst hälsotillstånd, vilket väcker funderingar om olika underliggande mekanismer för ljudkänsligheten i grupperna med ljudkänslighet jämfört med dubbeldiagnos. Mer forskning behövs för att vidare utforska följderna av att leva med simultana hörselproblem, och subgrupper inom fenomenet för ljudkänslighet.
|
237 |
Sensitised audiological measures of auditory dysfunction in tinnitus patients with normal hearing thresholdsIshak, Wan Syafira January 2011 (has links)
Substantial evidences show that tinnitus is associated with hearing loss. However, approximately 10% of tinnitus patients attending an ENT/Audiology clinic for their problems have hearing within normal audiometric thresholds. The general consensus on the roles of hearing loss in triggering tinnitus seems not applicable in this minority group. The absence of any grossly abnormal audiometric findings to explain their tinnitus leaves the clinician with a diagnostic dilemma and presents difficulties in dealing with the patients. The aim of this study was therefore to scrutinize auditory functioning in a sample of tinnitus subjects with normal hearing thresholds and non-tinnitus normally hearing control participants. Five tests were applied: Audioscan, Transient Evoked Otoacoustic Emission (TEOAE), Distortion Product Otoacoustic Emission (DPOAE), Threshold Equalising Noise (TEN) test and Contralateral Suppression of TEOAE (CSTEOAE). Optimal parameters for these tests have been defined and subsequently used to detect subtle auditory deficit in tinnitus patients with normal hearing thresholds. Twenty-seven tinnitus patients with hearing thresholds within normal limit participated in this study. A total of 27 non-tinnitus volunteers with similar thresholds were recruited as controls. Significant more Audioscan notches were found in tinnitus patients than in controls, particularly at 3001 to 8000 Hz region. Moreover, abnormal TEOAE was significantly more in tinnitus patients than in controls. No significant difference was observed in DPOAE, TEN and CSTEOAE test. Only one patient was found with abnormal TEN test and no TEOAE suppression, which led to the discovery of a large vestibular schwannoma. VI In summary, these results confirm the possible existence of subtle auditory deficit in tinnitus patients with normal hearing thresholds. However, combination of cochlear and retrocochlear abnormality may also possible. The presence of tinnitus without concomitant hearing loss in this group suggests that it may be an early sign of diseases that are only diagnosed after the onset of hearing loss.
|
238 |
Illness representations, acceptance, coping and psychological distress in chronic tinnitusMoreland, Jessica Elizabeth Natanya January 2007 (has links)
Tinnitus is a prevalent condition which is associated with significant distress and disability in a substantial proportion of the population. The variance in distress is not adequately explained by audiological characteristics of the symptom and it has been widely accepted that other variables are influential in determining the relationship between the stimulus and distress. A review of the literature highlights significant relationships between many psychosocial variables and tinnitus severity (impact on life). However, conclusions based on existing research are limited due to methodological weaknesses and widespread neglect of coherent theoretical foundations. The review identifies a need for further research with comprehensive theoretical underpinning to provide a greater understanding of adaptation to chronic tinnitus. One theoretical framework which has been applied extensively to explore the process of adaptation to chronic conditions is Leventhal's Self Regulation Model (SRM). This model has not yet been applied to the study of chronic tinnitus with sufficient methodological rigour to draw firm conclusions on its utility for this patient group. Existing research on tinnitus suggests that coping efforts (integral to the SRM) are often associated with increased distress with the notable exception of strategies indicative of acceptance. Recent research into chronic pain has indicated a role for acceptance in predicting adaptation, however it has not been investigated in the context of tinnitus to date. Therefore, research was undertaken to investigate the relationships between cognitive illness representations, coping, acceptance and psychological distress in patients with chronic tinnitus. The findings suggest that cognitive illness representations predict variance in psychological distress and that coping and acceptance variables enhance the explanatory power of the models. The clinical implications of the findings and the limitations of the study are discussed. Finally, an account of the process of undertaking the research and reflections on this experience is presented.
|
239 |
Tinnitus related hyperactivity through homeostatic plasticity in the auditory pathwaySchaette, Roland. Unknown Date (has links) (PDF)
Berlin, Humboldt-University, Diss., 2007.
|
240 |
An empirical investigation into the relationship between emotional processing and tinnitus distressMcCormack, Susan January 2017 (has links)
For many people, living with tinnitus is a highly distressing experience. Theoretical models have identified a number of factors to explain why some individuals experience distress while others do not. However, there is no agreement on the psychological processes involved. This study has introduced emotional processing as an explanatory concept for the experience of persistent tinnitus distress. Emotional processing involves active engagement with and expression of emotions in order to cope successfully with life events. The Emotional Processing Model (EPM) identifies a range of emotional behaviours or emotional processing styles which promote or inhibit emotional processing. The survey study measured emotional processing using the Emotional Processing Scale (EPS-25) with 47 adult participants referred to an NHS Trust’s Audiology Outpatient Clinics for tinnitus assessment. The data collected were analysed to assess the extent of the relationship between specific emotional processing deficits and tinnitus distress and to determine if the age and gender of participants and the duration of their tinnitus were contributory factors to tinnitus distress. The results indicated that individuals who are distressed by their tinnitus process their emotions less effectively than those who are not distressed and that, of the contributory variables examined, poor emotional processing was found to be the single significant explanatory factor for their tinnitus distress. Interviews were subsequently held with a small sample of other people who experienced tinnitus distress to explore their experiences and the relationship between emotional processing and tinnitus distress. The findings supported the results of the survey study. Taken together, the study has contributed to the understanding of tinnitus distress with the introduction of the EPM and the EPS-25 and has generated new knowledge to inform future therapeutic interventions and the research agenda.
|
Page generated in 0.0337 seconds