Dr.Sweetow: Tinnitus...
Theories:
Disruption of Auditory Input
Decrease of inhibtory function: efferent
Other inputs - collateral inputs from touch/feel/sight/TMJ function
Neuron acivity
Fear and Threat - limbic function
Other brain function.
Possible cure through gating function in lower brain areas/basal ganglia - hypothalamus area. Deals with phantom perception.
Ability to relax impaired through whole brain: px brain waves altered.
Stress - major factor - Empirical evidence.
BRAIN function - Cut auditory nerve Tx still present.
Tx Px have - ABNORMAL GATING.....(inability to ignore or filter)
historical approaches: Adjustment via auditory input: hearing aids, masker, ipod etc. Neuromonics, Soundcure. Zen tones.
Limbic approaches: CBT etc,TRT. Instructional approaches. Antidepressants.
New stuff: Cortical intervention etc.
Not all strategies effective: Px has to believe delivery.
Tx closely aligned with sleep issues/stress/attention/emotion etc.
Treatment:
Counselling: give px Widex questionnaire.
Review - with spouse.
Instructional Counselling - Phys/Anat, NORMAL for hearing loss, difficulties: define when where how.
Habituation: process of "Ignoring" - somatosensory cortex analysis - hippocampus: identify, Amygdala - limbic threat or not = cerabellum - move on depending on risk.
Tinnitus px = chronic state of anxiety, stress etc.
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