Release: Embargoed until September 24, 2000Contact: Kenneth Satterfield202-371-4517 (9/23-27)703-519-1563[email protected]
TREATMENT STRATEGIES FOR CHRONIC PAIN RECOMMENDED FOR TINNITUS PATIENTS
A new study suggests that when traditional treatment fails to alleviate tinnitus, pain management techniques could be effective
Washington, DC -- A research finding from the Oregon Hearing Research Center calls for a new standard of care for patients with severe tinnitus. The study concludes that patients with tinnitus incur a "vicious cycle" of symptoms often found in those suffering from chronic pain. Accordingly, those with chronic tinnitus should be treated with the same strategies that are effective with patients suffering from constant pain.
The author of the study, "Chronic Tinnitus as Phantom Auditory Pain," is Robert L. Folmer, PhD, from the Tinnitus Clinic, Oregon Hearing Research Center, Department of Otolaryngology, Oregon Health Sciences University, Portland, OR. His findings will be presented Wednesday, September 27, 2000, before the American Academy of Otolaryngology--Head and Neck Surgery Foundation Annual Meeting/Oto Expo, to be held at the Washington, DC, Convention Center.
Methodology: Detailed questionnaires were sent to patients prior to their initial appointment at the Oregon Health Sciences University Tinnitus Clinic. Information requested included patients' medical, hearing, and tinnitus histories.
At the patient's initial appointment:
(1) Staff met with each patient for an in-depth interview and review of their medical and tinnitus history. Each patient received information and counseling regarding factors that could exacerbate or improve their condition.
(2) Patients were given audiological evaluations that included pure tone air and bone conduction thresholds, speech perception in quiet and noise, and tympanometry.
(3) Evaluations were conducted by matching tinnitus with sounds played through headphones, determination of minimum masking levels, and measurements of residual inhibition.
(4) Assessment of acoustic therapies which could include hearing aids, in-the-ear sound generators, tapes or compact discs.
(5) Evaluations were reviewed; presentation of treatment plan and other recommendations were made.
Results: Data was taken from 160 patients (112 males, 48 females, mean age 50.9 +12.8 years; age range 17-87 years). Significant findings from the evaluation included:
There were no significant differences between the male and female patients in the study; Fifty patients (31 percent) reported they had current depression; 59 (37 percent) reported a history of depression; A direct correlation could be found between the reported tinnitus severity and sleep interference.
Results from this study and other similar research demonstrated that the severity of chronic tinnitus is often correlated with insomnia, anxiety, and depression. These symptoms can form a vicious cycle, and often exacerbate each other. The author states that the word "pain" can be substituted for tinnitus, and the relationships and symptoms will remain the same.
Conclusions: Because tinnitus patients share many similarities with chronic pain patients, Dr. Folmer recommends that otolaryngologist--head and neck surgeons are to incorporate some or all of the following strategies in their treatment:
1. Treat depression using medications and/or psychotherapy. Previous literature suggests that successful treatment for depression can reduce the severity of tinnitus for patients experiencing both maladies. Some antidepressant medications will also improve sleep patterns and reduce anxiety.
2. Use acoustic therapies to promote relaxation, improve sleep patterns, and to alleviate patient frustration by reducing their perception of tinnitus.
3. Address patient anxiety with medications, relaxation therapy, psychotherapy, biofeedback, hypnosis, massage, or any other appropriate stress management techniques.
4. Assess and treat any neurosis, psychosis, or other maladaptive behaviors during a series of psychotherapy/counseling sessions.
Dr. Folmer states that if a clinician has assessed and treated every medical cause for a patient's tinnitus, and the patient reports little improvement in tinnitus severity, the clinician should spend time necessary to effectively treat the patient with pain management procedures; or refer the patient to a comprehensive chronic pain or tinnitus treatment center.
-end --
For additional information regarding this study or an interview with Dr. Folmer, contact Ken Satterfield at 202-371-4517 (9/23-9/27), or email [email protected].
RSS