Tinnitus: mechanisms, measures and sound treatments

Abstract

Tinnitus is the auditory perception of sounds in the absence of any external source. Tinnitus that occurs every day for more than five minutes is reported by 10-15% of the population, and for 1 to 2% it is a handicap that interferes significantly with their quality of life (severe tinnitus). Despite the intensive research into therapeutic options, including surgery, pharmacotherapy, and electrical and acoustical stimulation, there is no approved treatment for tinnitus at present. Although the exact origin of tinnitus is still unknown, it seems to be the correlate of maladaptive attempts of the brain at reorganization due to distorted sensory input (brain plasticity). This theory is consistent with the fact that most tinnitus is associated with hearing loss. Acoustical therapies try to take advantage of this plasticity, stimulating properly the auditory system to produce tinnitus relief. Several sound therapies are reviewed in this paper, concluding that the so-called Enriched Acoustic Environment (namely a sequence of gammatones, each one with random frequency and amplitude matched to the hearing loss at this frequency) provides the most refined and selective stimulus for the tinnitus patient. Therefore, the hearing loss curve of the patient is needed to design this sound stimulus.

Efficacy and factors influencing outcomes of customized music therapy combined with a follow-up system in chronic tinnitus patients

“…Tinnitus is one of the most common complaints in otorhinolaryngology and audiology outpatient clinic, and is usually classified as subjective and objective tinnitus. Epidemiological studies have shown that it can affect approximately 10–15% of adults [ 1 , 2 ], leading to serious impact on quality of life [ 2 – 5 ].…”

Relating tinnitus features and audiometric characteristics in a cohort of 34 tinnitus subjects

“…Tinnitus is the conscious perception of sound heard in the absence of physical sound sources external or internal to the body (Eggermont & Tass, 2015). Epidemiological studies report that tinnitus roughly affects 10 % of the adult population (Hall et al, 2015) and severely disturbs the quality of life of about 1-2 % of adults by producing anxiety, annoyance, irritability, disturbed sleep patterns, and depression (Cobo, 2015;Diges, Simón, & Cobo, 2017;Van de Heyning et al, 2007;Vio & Holme, 2005).…”

A multidisplinary approach to tinnitus

“…En el caso auditivo, un déficit de la entrada periférica se puede producir por pérdidas auditivas (hipoacusia) debidas a sobreexposición a ruido, envejecimiento, o cualquier otra causa. Esta pérdida de información auditiva periférica puede originar diferentes mecanismos de compensación plástica a nivel sub-cortical y cortical, incluyendo (Cobo, 2015;Eggermont, 2012):…”

“…Cuando el acúfeno cursa con ansiedad y/o depresión, los ansiolíticos y/o antidepresivos pueden ayudar a reducir los síntomas emocionales. Por suerte, han proliferado muchas terapias que pueden proporcionar alivio del acúfeno (Cobo, 2015). Muchas de ellas combinan alguna terapia sonora para disminuir la señal del acúfeno con el consejo médico para desactivar sus reacciones negativas (Jastreboff, 2015).…”