Catastrophic / severe (THI) level of category 4 tinnitus with low sound tolerance and very high level of anxiety caused by the tinnitus. Treatment program is based on up to two years long intervention with visits in our clinic scheduled on average once every three to four months with a specialized schedule for distant patients available. Program starts with the first part of the treatment designed to eliminate hyperacusis (low sound tolerance). Significant change in the awareness and annoyance generated by the tinnitus presence occurs on average after two months following the initiation of the treatment.
An introduction to the Tinnitus Treatment offered by Metro Hearing and Tinnitus Treatment Clinic
Working with the Neurophysiological Model of Tinnitus proposed by P J. Jastreboff and C.J.Hazell has proven to be a very effective way of helping tinnitus patients around the world. Neurophysiological Model of Tinnitus helps to find some answers to a number of tinnitus related questions including the most common ones such us:
- Why does the tinnitus induce distress in only 20% of the tinnitus population?
- Why the psychoacustical description of tinnitus is not related to tinnitus severity and treatment outcome?
Using this model, we can conclude that auditory system only plays a secondary role in clinically- relevant tinnitus and other system in the brain are dominant.
Stages of tinnitus emergence:
- Generation – typically in the periphery
- Detection ( including pattern recognition ) – subcortical centers
- Perception and evaluation – cortical areas
- Sustained activation of emotional ( limbic ) and autonomic nervous
One of the possible mechanisms of generation of tinnitus – related neuronal activity is Discordant Dysfunction Theory. Based on Professor Jastreboff model it seems that the critical role for chronic tinnitus is played by the connections between the auditory, limbic and autonomic nervous system. As clinicians we can confirm a very strong connection between the level of the limbic system activation and severity of tinnitus present in the awareness of the patient. Some symptoms generated by the autonomic system involvement can be greatly increased in strength as well indicating autonomic system response. This is why is so important to include a very solid and comprehensive addition of specialized but standard tools from psychology. Individual approach with one to one sessions is of the upmost importance in the successful treatment of tinnitus. Understanding that auditory system plays only a secondary role in chronic tinnitus and other systems in the brain are dominant, helps to recognize that (activated by tinnitus presence) connections are also governed by the principles of conditioning reflexes. Once the conditioned reflex is created, the sensory stimulus will generate reactions without need for continuous reinforcement. Also, the interaction between the limbic system, the auditory system and autonomic nervous system is going to determine the extent of tinnitus annoyance. This is why our treatment is based on the “ European school ” model- which is designed with much greater and deeper involvement of modern psychology.
This is a much more time consuming and labour intensive approach. With the specialized (and based on Tinnitus Retraining Therapy) sound therapy (using a much more active approach which addresses possible problems with low sound tolerance or presence of hyperacusis ), counselling patients are provided with, designed to have a very strong effect on their levels of stress and anxiety they experience. Eliminating tinnitus caused annoyance is also allowing us to address any other issues which could make tinnitus treatment progression much slower or not possible. This way our treatment is known and described by our past patients as a life changing experience, with the benefits of much lower stress levels and ability of being in charge of their own emotions for the rest of their lives.