Underlying Mechanisms of Tinnitus: Review and Clinical Implications

Abstract

Background The study of tinnitus mechanisms has increased tenfold in the last decade. The common denominator for all of these studies is the goal of elucidating the underlying neural mechanisms of tinnitus with the ultimate purpose of finding a cure. While these basic science findings may not be immediately applicable to the clinician who works directly with patients to assist them in managing their reactions to tinnitus, a clear understanding of these findings is needed to develop the most effective procedures for alleviating tinnitus. Purpose The goal of this review is to provide audiologists and other health-care professionals with a basic understanding of the neurophysiological changes in the auditory system likely to be responsible for tinnitus. Results It is increasingly clear that tinnitus is a pathology involving neuroplastic changes in central auditory structures that take place when the brain is deprived of its normal input by pathology in the cochlea. Cochlear pathology is not always expressed in the audiogram but may be detected by more sensitive measures. Neural changes can occur at the level of synapses between inner hair cells and the auditory nerve and within multiple levels of the central auditory pathway. Long-term maintenance of tinnitus is likely a function of a complex network of structures involving central auditory and nonauditory systems. Conclusions Patients often have expectations that a treatment exists to cure their tinnitus. They should be made aware that research is increasing to discover such a cure and that their reactions to tinnitus can be mitigated through the use of evidence-based behavioral interventions.

Prevalence and Determinants of Tinnitus in the Italian Adult Population

“…prevalence, aetiology, and potential treatments). This is, at least in part, a consequence of the subjective nature of tinnitus assessment, the heterogeneity of the question used to define the presence of tinnitus, and the large variety of tinnitus characteristics [3] and associated disorders [4]. …”

Aplicabilidade da orientação fonoaudiológica associada ao uso de aparelho de amplificação sonora individual na redução do zumbido

“…In this context, both the orientation and the application of questionnaires are of great importance at this moment, since they make possible the knowledge of patients' fragilities, as well as the effects of tinnitus on their social activities, their emotions, their work performance and their communicative abilities (25) . Although some authors have linked increased tinnitus perception to external acoustic meatus occlusion, one study (26) evaluated 50 individuals with bilateral hearing loss and tinnitus, who were fitted with HAs with open cast and cast with relief ventilation (1 mm) and observed that in only 24% of the cases, there was a difference in performance between the two molds, with 12% improved only with the open mold and 12% improved with the mold with relief ventilation.…”

“…However, the great majority of cases of tinnitus are of auditory origin, and there are, in these cases, greater difficulties in attendance (4,5) . Intervention for tinnitus has been actively investigated, however, there is still no proven means to guarantee the elimination of this symptom (6) . Its clinical evaluation mainly depends on the self-report of the individual, which may hinder objective interpretations and definition of a better intervention (7) .…”

Correlação entre percepção de fala e zumbido antes e após o uso de amplificação

“…Although the cure for tinnitus is being actively investigated, currently, there are no proven ways to eliminate this symptom (28) .…”