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Tinnitus > Final Exam > Flashcards

Final Exam Flashcards

1
Q

How hearing aids help with tinnitus

A
  • Improves hearing related quality of life
  • Reduces attention to tinnitus
  • Reduces stress & fatigue
  • Enables masking by ambient sound
  • Provides stimulation to aduitory system that is deprived of input from HL
  • Prevent maladaptive neuroplastic changes in auditory system
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2
Q

Hearing aids work best for managing tinnitus when…

A
  • Good low frequency hearing
  • Strong reaction to tinnitus
  • Tinnitus pitch within the fitting range of the hearing aids (8k)
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3
Q

How does Tinnitus managment work if tinnitus is above 8k?

A

If Tinnitus is above 8k hz it will not be beneficial because amplifcation does not help extended high frequency hearing loss.

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4
Q

____ prescriptive procedure reccomeneded as a ____ point for ____.; _ _ _ _ targets for _____ intensity evels

A

DSL V.5 prescriptive procedures recommended as a starting point for amplfication; higher targets for low intensity levels

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5
Q

____verfication of output to ensure ____of quiet sounds

A

Real Ear verifcartion of output to ensure audibity of quiet sounds

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6
Q

Main instrument selection and fitting (3)

A

Hearing aids work best for managing tinnitus when.
* Good low frequency hearing
* Strong reaction to tinnitus
* Tinnitus pitch within the fitting range of the hearing aids (8k)

DSL V.5 prescriptive procedures recommended as a starting point for amplfication; higher targets fo low intensity levels

Real Ear verifcartion of output to ensure audibity of quiet sounds

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7
Q

Reccommended Tinnitus Hearing aid features

A
  • Binaural fitting for bilateral HL
  • Open fit when possible to avoid LF occlusion
  • Low compreesion Kneepoint to ensure audibility of low intensity sounds
  • Omnidirectional microphones
  • Expansion Turned off
  • Noise reduction tunred off
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8
Q

Tinnitus HA’s features

Do you want open or closed fit?

A

Open fit when possible to avoid LF occlusion

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9
Q

Tinnitus HA’s features

What kneepoint and why

A

Low compression kneepoint to ensure audibility to low intensity sounds

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10
Q

Tinnitus HA’s features

What type of expanion?

A

None, expansion should be turned off
* you don’t want to turn on expansion on those low level sounds. It can function as a type of tinnitus masker.

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11
Q

Tinnitus HA’s features

what type of directaionality

A

Omnidirectional microphone
* incraeses the range of sounds from the enviorment to help mask the tinnitus

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12
Q

Tinnitus HA’s features

What type of Noise reduction?

A

None, noise reduction should be turned off
* Noise reduction helps clean the signal
* when off it will help mask the tinnitus

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13
Q

Overview

Sound therapy rational

A

Sound therapy uses sound to decraese the loudness or prominence of tinnitus.

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14
Q

The types of sound to me used in sound therapy

A
  • Music
  • Noise (pink,white etc)
  • Relaxation type sounds or enviormental sounds
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15
Q

Why is music an option for sound therapy?

A

Music is used widely for it’s calming and health effects.

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16
Q

Is music therapy helpful? why or why not?

A

Music therapy reduces tinnitus severity, pitch loudness, allevites depression, and improves cortical reorganiztion and increasing gray matter volume in the brain areas involved in sound.

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17
Q

Type of Relaxation - type sounds or enviomental sounds

A

Sound apps
any sound app like resound sound app we used

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18
Q

reasons for the use of sound therapy?

A
  • reduces the audibility of tinnitus by replacing tinnitus with a pleasent sound
  • provdes constant stimulation of auditory pathways replacing spontaous activity lost w/HL to faciliate adaptation.
  • Aid relaxtion. can change a persons reaction to the tinnitus.
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19
Q

what should be included in education and counceling?

A
  • Basic info expalining tinnitus
  • Reassurance tinnitus is not dangerous or life threatening
  • Link between HL and tinnitus and audio assessment
  • expalin no cure but managment is availible
  • Referral to resources
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20
Q

Counceling strategies

A
  • Help people recgonize how their beliefs impact their reactions
  • Provide coping/mangement strategies
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21
Q

Lifestyle modifcations

Name some factors that can exacerbate tinnitus symptoms

A
  • stress and fatigue
  • consistent noise exposure
  • Asprin in high doses
  • Alcohol & caffine
  • Tobacco
  • High Sodium intake
    Lifestyle modifcations can help minimize tinnitus
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22
Q

What is mindfullness?

A
  • mindfullness teaches people to be more present and accepting of their experince
    **Mindfullness has shown results in managment of tinnitus **
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23
Q

What does MBCT stand for?

A

Mindfulness-based Cognitive Therapy

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24
Q

What is MBCT?

A

Mindfulness-based Cognitive Therapy is a theraputic approach that combines minfulness parctice with elements of cognitive therapy to help manage psychological conditions

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25
Q

how long is MBCT for?

A

MBCT for tinnitus involves structed 8-week programs where patients engage in weekly sessions taht teach and reinforce mindfullness practices.

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26
Q
A
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26
Q

What does rTMS stand for?

A

Repetitive Trancranial Magnetic Stimulation (rTMS)

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27
Q
A
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28
Q

what is rTMS?

A
  • rTMS is a device that delivers short magnetic pulses though a magnetic coil placed near teh scalp to modulate brain activity in areas assoicited with mood
  • aims to allevaite symtoms of mental health conditions
29
Q

How does rTMS work?

A

rTMS using strong electromagnetic signals to reduce neural hyperactivity in the brains cortex, beleived to be associated with tinnitus

30
Q

Sucess of rTMS is based on what

A

success depends on the correct application of treatment protocols, including coil placement, stimulation frequency & intensity

31
Q

Are medications a managemnt option for tinnitus? why or why not?

A
  • No FDA approved drugs to treat tinnitus
  • However drugs are commonly used off label
  • those treatmenst often have severe side effects and are ineffective for tinnitus
32
Q

Are supplements a managemnt option for tinnitus? why or why not?

A
  • they are used to help with associated symptoms not tinnitus
  • Melatonin has been shown to improve tinnitus symptoms and particualy improve sleep
33
Q

What are the challenegs in tinnitus drug discovery?

A
  • Tinnitus is a very heterogeneous disorder; symptoms and underlying pathologies vary widely. making it hard to develop a one size fits all treatment
  • Tinnitus involves complex & overlapping brain netowrks that are difficult to study and target
  • animal studies dont fully mimic human tinnitus
34
Q

Define CBT

A

CBT is a problem focused and action oriented psychological intervetion that combines principles from behavioral & cognitive psychology.

35
Q

What does CBT do?

A

CBT uses a variety of cognitive and behvaioral techniques to help individuals identify and modify the realtionships between their thoughts, behviors and emotions

36
Q

What is the purpose of CBT?

A

Reduces negative responses to tinnitus by transforming negative thoughts into positive realistic ones,

37
Q

CBT aims too…

A

aims to decraese anxiety and depression, enhancing overall quality of life.

38
Q

CBT challenges

A

Time commitment & expectations can impact the success of these treatments.

39
Q

CBT principles

A

What we think, how we feel and how we behave are all connected and each factors has an influence on well-being

40
Q

CBT Goals

A
  • Monitor their negative automatic thoughts
  • recognize relationships between thoughts,emotions and behaviors
  • assess validity of distorted automatic thoughts
  • Replace baised thoughts w/ reality oriented interpretations
  • Identity & Modify dysfucntional beliefs that lead to distorted experinces
41
Q

What are the components to CBT and how are they benefical?

A
  1. Cognitive restructuring
  2. Behavioral Modification

This combined approach helps patients identify & correct maladaptive behaviors, distorted conceptions and irrational beliefs

42
Q

Name the elements of CBT

A

Relaxation Therapy
Cognitive Restucturing
Attention control Techniques
Imagery Techniques
Sleep Mangement

43
Q

Relaxation Trainning

A
  • Teaches tension reduction through muscle relaxation exercises
  • Coping with tension and anxiety related to tinnitus
  • Limited effectiveness alone; better w/comprehensive mangement program
44
Q

Cognitive restructuring

A

is the identification of dysfunctional beliefs and negtive thoughts; that are a response of life events or distress

45
Q

Attention Control Techniques

A
  • redirect attention from tinnitus to other enviormental details
  • Encourages engaging other senses (smell, taste) to distract
  • Sound masking or amplifying background noises helps manage tinnitus more effectively
46
Q

Imagery Techniques

A
  • Modify negative associations w/tinnitus by “masking” or imagining positive scenes
  • Masking: Imagine their tinnitus beging masked by a waterfall,ocean waves etc. without using actual sounds
  • Pleasent scenes: Imagining scenariors such as walking in natures w/birds singing
47
Q

Sleep management

A

SM techniques
* sleep hygiene
* bedtime restriction
* relaxation
* cognitive restructuring

48
Q

what is involved in relapse prevention?

A
  • this involves discussing potential risk factors for worsesning tinnitus and hearing loss
  • creating a proactive plan for managing any escilation in symptoms
49
Q

true or false

When doing tinnitus treatment, your tinnitus will get constiatnt downward trajectory.

A

False
* is it excpected to have flucutuations.
* Patienst should be notifed of this so they dont stop treatment

50
Q

What is the most important aspect of tinnitus treatment?

A

Consistency is the most important

51
Q

Techniques to prevent relapse?

A
  • Identifying risk factors
  • Importance of Continious practice
  • Managing Temporay fluctuations
  • Generalization of treatment benefits
  • Post- Treatment support
52
Q

CBT candidate selection

A
  • 40 - 70 with or without HL
  • No severe comorbid psychological conditons
  • Had tinnitus &/or suffered from tinnitus for at least 3 months
  • seeking to alleviate impact of tinnitus on quality of life and daily activities
53
Q

TRT

Describe the interaction between the auditory system, limbic system and autonomic nervous system

A
  • When tinnitus becomes associated with negative emotion, it triggers strong reactions in the limbic system and autonomic nervous system
  • Once arousal of limbic and ANS is sufficaently high, the stimulus linked to this activation will dominate all other brain functions
54
Q

TRT

How does the relationship between the auditory system, limbic system and autonomic nervous system lead to tinnitus vicious cycle?

A
  • Auditory system provides the source of the signal
  • Tinnitus through inappropriatly created functional connecetion casues activation of the Limbic and ANS
  • This creates a vicious cycle involving auditoy, limbic and Autonomic nervous systems = distress and annoyance
55
Q

TRT

Auditory system provides the ____ of the —– Tinnitus through —– —– —– —– casues activation of the Limbic and ANS

A

Auditory system provides the source of the signal Tinnitus through inappropriatly created functional connecetion casues activation of the Limbic and ANS

56
Q

TRT

Development and passive extinction of the conditioned reflex in the normal system

A
  • Once tinnitus acquires a negative emotion and starts to induce activation of the ANS
  • Leading to progressively stronger activation of ANS and Limbic system through conditioned reflex arc.
  • once negative assoication is made hard to revmove because apart of conditioned reflex arc.
57
Q

TRT

Mechanism preventing spontaneous extinction of conditioned reflexes in tinnitus patients

A
  • If signal is associated with high levels of emotional distress conditioned reflexes are created
  • Tinnitus (stimulus) will activate limbic system & ANS (reaction)
  • constant state of alertness causes tinnitus patients to be exhausted, lack of sleep, unable to focus on anythign else except the tinnitus.
58
Q

Can the conditioned reflexes be revered? Why or why not?

A

Yes they can be reversed
* body reactions to any stimulus can be reversed & brain is able to learn
* Natural habituation of various stimuli is continlously taking place
* 3/4 of peopple who experinece tinnitus naturally habitaute to it.

59
Q

Name the two types of Habitutaion

A
  1. Habitutaion of reaction
    * retraining counceling
  2. Habitiation of perception
    * sound therapy
60
Q

Habitiutaion of reaction

A

Retraining counceling
* you learn not to react to the tinnitus in a negative way

61
Q

TRT

Habituation of perception

A
  • repeative appearance of a particular sound, the subcortical pathways will block it and the individual will be unaware that the sound is present
  • Habituation of perception prevents the signal from reaching higher cortical areas involved in signal awareness
    * Repated sound - subcortical pathways block - unaware of sound = habituation of perception
62
Q

TRT Overview

A
  • Neurophysiological traetment by Jastreboff
  • TRT is a habituation based treatment uses coucneling to decrease the strength in tinnitus evoked reactoions to decrease the strength of tinnitus signal
63
Q

TRT Goals

A
  • Induce & Facilitate the patients habituation to their tinnitus
  • Eliminate reactions induced by tinnitus
  • Prevent spread of tinnitus signal to other brain systems

Successful Outcome
* Still perceives tinnitus but not bothered by it anymore
* Enhanced quality of life through decreased tinnitus distress

64
Q

What are the TRT components?

A
  1. Retraining Counceling (habituation of reaction)
  2. Sound Therapy ( Habituation of perception)
65
Q

what is the TRT protocol?

A
  • Introductory contact
  • Inital visit: taking history of tinnitus, audiologic & medical assessment, assessing the category. for treatment & TRT counceling
  • Instrument fitting
  • Follow up Visits: Evaluation of the patients status and furtehr counseling
  • Closing the treatment
66
Q

TRT Inital Interview

A
  • Determine TRT treatment category - will determine overall course of treatment best for the patient
  • Assess tinnitus impact & severity
  • Identify sensitivity to sounds & decreased sound tolerance (hyperacusis)
  • Assess subjective hearing difficulties that could impact treatment
67
Q

TRT

Key aspects of treatment to discuss with the patient

A
  • Treatment objectives
  • Schedule of treatment sessions
  • Requirements for using ear-level devices
  • Costs associated with treatment
  • Any other pertinent details of the planned treatment
68
Q

True or False

assigning the patient to the correct category of treatment is essential for successful therapy

A

TRUE
assigning the patient to the correct category of treatment is essential for successful therapy
- becuase inappropriate treatment could make symptoms worse.

69
Q

TRT

Categorization of Patients

A
  • all patients are placed in one of the 5 categories (0-4) may be changed during treatment
  • determined by:
  • Severity & duration
  • Presence and extent of hyperacusis
  • Subjetive significance of hearing loss
  • prolonged exacerbation of symptoms follwing sound exposure

Tinnitus (7 decks)

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