Somatic or somatosensory tinnitus is a subtype of subjective tinnitus, in which tinnitus perception is caused by an alteration in somatosensory afference from the cervical spine or temporo-mandibular area which changes patient’s tinnitus perception in terms of loudness, pitch and localization. A 30-year-old female reported with the complaint of tinnitus, vertigo and reduced hearing sensitivity in the left ear for 7 months. Enduring low frequency annoying tinnitus flare ups with vertigo, vomiting and speech understanding difficulty every 48-72hours. Successive audiological investigations and THI score revealed mild sensorineural hearing loss in the left ear with grade 5 catastrophic handicap. Tinnitus retraining Therapy (TRT) along with pranayama (yogic exercise) was used as a treatment protocol. Nadi Shodhana (Alternate-Nostril Breath- one of the most efficient strategies for calming nerves and settling mind fluctuations) was practised twice daily and during the treatment sessions. Effectiveness of TRT combined with Yoga on a patient with severe tinnitus & accompanying issues was investigated. This treatment strategy proved to be highly effective in lowering tinnitus severity and reducing the accompanying issues with long term effectiveness. As a result, present study enlightens the possible success rate of this treatment protocol for somatosensory tinnitus and its impact on tinnitus recurrence. Key words: Somatosensory tinnitus, TMJ, Pranayama, TRT, Catastrophic handicap.
Objectives: Association of high frequency hearing loss/minor damage in peripheral auditory system in continuous chronic tinnitus with normal PTA is well established.The purpose of the study was to verify whether this finding is true for intermittent unilateral or bilateral tinnitus patients with normal PTA using EHF audiometry and conventional DPOAEs. Materials and method:This study was conducted on 45 normal hearing adults between the age ranges of 18-30 years. Among them 30 adults comprised of study group with intermittent tinnitus which varies in laterality.Tinnitus evaluation was done on these population followed by THI administration. DPOAE and EHF audiometry was completed on all subjects after conventional hearing assessment program. Result and Discussion:Kruskal Wallis H test & Wilcoxon signed rank test was used to compare OAE amplitude & EHF thresholds.Spearman's correlation was used to evaluate the correlation between DPOAE amplitude with EHF threshold. Reduced hearing sensitivity in the extended high frequency region may be early predictor of outer hair cell dysfunction in the most basal area.Findings of this study suggest that intermittent tinnitus may also lead to subtle lesion at the basal region of cochlea which would result in a significant hearing loss with continuous tinnitus in future. Conclusion:Intermittent tinnitus may increase the fragility of peripheral auditory system which may lead to permanent lesions and would be evident as elevated thresholds in conventional PTA.
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