Friday 17 May 2013

Bshaa 17/05/13 AM

Dr.Sweetow: Tinnitus...
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.

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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