Tinnitus
Tinnitus is the perception of sound in the ears or head when no external sound is present. It can manifest as ringing, buzzing, hissing, or other sounds, and can vary in intensity and duration.
What is Tinnitus?
Perception of sound, without direct auditory stimulus
-> beep, noise, hum
Causes
Causes (classical):
- Hearing disorders
- Middle ear irritation: acoustic trauma, certain infectious diseases, high emotional tension (stress)
- Medication & other causes
- Antibiotics (especially aminoglycides & vancomycin)
- NSAIDs Chemotherapy
- Diuretics
Causes:
- poor sound processing
- kidney problems (lymph: Na+ & K+)
- jaw problems
- neck problems
- shoulder complaints
Types
Mechanical tinnitus
- vascular, jaw, tension neck, etc
- pulsating, humming, pressure sensation on ear
- medical cause of the body
- 5%
Sensory tinnitus
= continuous sound (beeping, hissing) amplified by stress, emotions, etc & improved by quietness, background noise, etc
- hyperactivity central auditory system
- damage hair cells
- 95%
But: Not everyone with hearing damage has Tinnitus!
Treatment
- Cognitive Behavioural Therapy
- Multidisciplinary approach
Mesology
looking at physiological parameters (infection, virus, kidneys, lymph, etc)
Osteopathy
looking at mechanical parameters (TMJ, neck, shoulder, fascia, etc)
Physiotherapy
looking at tension & posture
Breathing & relaxation
becoming aware of the body, breathing techniques
Psychology & cognitive behavioural therapy
stress, thoughts, breaking vicious circle
- Importance of heterogenicity
Tinnitus handicap inventory (THI)
The Tinnitus Handicap Inventory (THI) is a self-reporting questionnaire designed to assess the impact of tinnitus on an individual's daily life, measuring the degree of distress and disability caused by tinnitus across multiple domains.
The THI typically consists of 25 to 30 questions that cover various aspects of tinnitus-related difficulties, including emotional, functional, and catastrophic reactions. The inventory provides a quantitative measure of the impact of tinnitus, with higher scores indicating greater perceived handicap.
The THI can be helpful in several ways:
1) Assessment of Tinnitus Severity:
The inventory provides a systematic way to evaluate the severity of tinnitus symptoms. By quantifying the impact across different domains of life, clinicians can better understand the extent to which tinnitus affects an individual's well-being.
2) Treatment Planning:
Understanding the specific ways in which tinnitus affects a person's life can guide treatment planning. For instance, if a patient reports significant emotional distress due to tinnitus, interventions targeting anxiety or stress management may be prioritized. The THI helps clinicians tailor treatment strategies to address the most pressing concerns of the individual.
3) Monitoring Progress:
The THI can be administered at different points during treatment to monitor changes in tinnitus-related distress over time. Comparing scores before and after interventions allows clinicians to assess the effectiveness of treatments and make adjustments as needed.
4) Communication:
Tinnitus can be challenging to describe accurately, as it is a subjective experience. The THI provides a standardized language for patients to communicate their tinnitus-related difficulties to healthcare providers. This facilitates more effective communication between patients and clinicians, leading to better-informed treatment decisions.
Self-management
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