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Author: admin | 04.10.2014 | Category: Ringing In The Ears Causes

This therapy is a form of habituation therapy that uses a combination of counseling and sound enrichment to reduce or eliminate the reaction to the sound and gradually ease perception of it to nothing. Most tinnitus retraining therapy functions on the idea that tinnitus is a neurophysiological condition. Again, successful tinnitus retraining therapy relies on counseling and sound enrichment therapy. Widex Zen Therapy (WZT) combines the use of counseling, amplification, fractal tones, relaxation strategies, sleep management, and many elements associated with Tinnitus Retraining Therapy (TRT) and Cognitive Behavioral Therapy (CBT) for an individualized comprehensive tinnitus management program.
The distress associated with tinnitus has complex roots that are characterized by a diverse activation of neural structures. In this paper, we describe a new integrated approach to tinnitus patient management that incorporates not only the optimal segments of existing therapies, but novel acoustical stimuli and relaxation exercises, as well. Counseling contributes greatly to the reduction of distress related to tinnitus and to the facilitation of habituation. The concept of masking thus has largely been replaced by the use of low-level broadband noise. A recent investigation15 concluded that, while noise exposure and stress were both important contributors to tinnitus, stress was the more important factor for the transition from mild to severe distress. A recent survey21 indicated that, of nine tinnitus treatment methods assessed (hearing aids, music, medication, relaxation exercises, counseling, non-wearable sound generators, herbs and dietary supplements, wearable sound generators, and psychological counseling), the most substantial tinnitus amelioration was achieved with hearing aids (34%), followed closely by the use of music (30%). A more detailed rationale and description of how each element of WZT is applied is presented below. How the limbic system affects the tinnitus perception and how the patient’s reaction impacts the ability to cope with or habituate to the tinnitus. Adjustment-based counseling expands these concepts and is designed to help the patient recognize aspects about how the tinnitus is affecting him or her, as well as the cognitive and behavioral ramifications. Foster understanding of the relationship between tinnitus, stress, worry, behaviors, negative thoughts, and quality of life.
For some patients, instructional and general adjustment-based counseling might not be sufficient. Second, they help the patient identify and challenge irrational and maladaptive thoughts, beliefs, attitudes, and behaviors that contribute to, and maintain, distress and fear of tinnitus.
While most well-fitted, high-quality hearing aids can help tinnitus patients with hearing loss, Widex hearing aids are particularly effective because of their low compression thresholds, broad bandwidth, precision in fitting procedure (Sensogram), and in situ verification (Sound Tracker). An alternate approach to pre-recorded music that incorporates the benefits and rules of music but avoids these potential limitations is the use of fractal tones.
The tones (which sound somewhat like wind chimes) are thus pleasant, but are not associated with music that the listener holds in memory.
Results indicated that fractal tones were effective in promoting relaxation and reducing annoyance from tinnitus.
It is believed that the likely cause for this finding was that the steady-state noise provided more masking because of the complete lack of inter-stimulus intervals. Thus, the combination of both tinnitus annoyance reduction and increased relaxation may be an important factor in long-term acceptance for sound-based tinnitus treatments.
It should be noted that, while the majority of subjects selected slower fractal tone tempos for relaxation and long-term wear, this choice was not unanimous. Each Zen setting is programmed in accordance with the hearing loss (Sensogram) to assure audibility of the tones without the possibility of interference with speech perception or full masking of the tinnitus. Slot C: Zen noise + microphone (which might be found effective in reducing tinnitus awareness early in therapy).
For the more complex patient, or for the practitioner who specializes in tinnitus, there is also a flexible protocol for the Advanced WZT Fitting, which allows for more individualization of the settings.
Hearing loss alone is not the only factor accounting for the distress encountered by patients with tinnitus.
While the Zen tones can provide the listener with a relaxing background, if the patient is going to truly break the vicious cycle of tinnitus and stress, proven relaxation exercises should be used. Therefore, WZT suggests that each patient who has a negative reaction to tinnitus, or who demonstrates a need for stress reduction, be prescribed and taught three straightforward but effective relaxation methods: deep breathing, progressive relaxation, and guided imagery. The other component of the relaxation strategies considered vital for comprehensive tinnitus patient care is sleep management.
Some treatment plans, such as TRT, are based on a classification of the patient’s auditory problems (such as hearing loss versus no hearing loss, hyperacusis versus tinnitus alone, etc).
WZT treatment plans consider the patient’s reaction to be the principal factor in determining the course of action. For Widex Zen Therapy, it is recommended that the newly released Tinnitus Functional Index (TFI)33 be employed as a subjective measure. The manual also describes how to establish realistic, time-based expectations, provides methods of assessing progress, and discusses how to create a follow-up schedule. WZT has been designed to incorporate the optimal parts of existing approaches to tinnitus patient management. WZT emphasizes a collaborative counseling approach that promotes the concept of habituation and also integrates cognitive-behavioral interventions to correct maladaptive thoughts and behaviors and create coping strategies. Widex Zen Therapy is unique because it is an integrated program addressing all three major components of tinnitus distress: auditory, attention, and emotion. It can occur through loud sound exposure, certain drug side effects, fluid in the ear, wax buildup, and even using in-ear earphones over a certain volume.
Counseling functions to explain how and why the sound enrichment works and provides verbal support for continuing the treatment when the effects plateau. Counseling helps reclassify the phantom sounds as neural signals and the sound therapy weakens those signals and related neuronal activity.
By mentally working with the person who is suffering, a counselor can help them change the way they perceive the noise and ready them to make the most of the sound therapy. I’m looking into finding a solution for myself, but most of the ones advertised, especially those involving a visit to a clinic are expensive.
Want to know how to stop ringing in the ears?The perception of noise or sounds in your ears when no external sound is present is called Tinnitus. The components comprising tinnitus distress include the phantom auditory perception, the hyper-vigilance and excessive attention paid to the tinnitus, and the negative emotional element.
Sweetow, PhD, is a professor in the Dept of Otolaryngology at the University of California, San Francisco and was Director of Audiology at the UCSF Medical Center Audiology Clinic for 20 years (1991-2011).


While each of these approaches has been reported to be beneficial for certain patients, none are universally effective, and only a few have survived the test of time. The overall objective of Widex Zen Therapy (WZT) is to ensure that the tinnitus does not negatively impact the patient’s quality of life. This is both instructional and adjustment based,to educate the patient and assist the limbic system to alter or reclassify the negative interpretation of the tinnitus.
This stimulates the ears and brain in order to minimize increases in central activity (overcompensation) and maladaptive cortical reorganization. A novel, proven acoustic stimulus—filtered in accordance with the hearing loss and delivered dichotically in a discreet, inconspicuous, and convenient manner—designed to both relax and provide acoustic stimulation. A different focus is used in CBT, which teaches the patient coping strategies, distraction techniques, and methods of identifying and correcting maladaptive thoughts and behaviors.
Masking might provide a degree of immediate relief, but in the long term may be perceived as being little more than the substitution of one annoying sound for another. But these steady-state signals may not foster stress reduction and relaxation, and, like masking, do not address the long-term emotional issues related to tinnitus.
However, TRT does not directly address emotional issues or teach coping strategies, despite the fact that anxiety and depression are extremely common in tinnitus patients. In these cases, Widex Zen Therapy recommends the use of cognitive behavioral intervention to help the patient identify barriers to achieving natural habituation. First, they help the hearing care professional understand the patient’s perspective and thereby what the patient brings in terms of experiences, knowledge, opinions, feelings, and prejudices toward the tinnitus. The goal is to help the patient recognize that it is not the tinnitus itself that is producing anguish and negative emotions, rather it is the patient’s maladaptive thoughts that lead to an emotion that leads to the reaction (and all reactions are subject to modification). Specific recommendations with regard to fitting considerations are described in the WZT Manual, including binaural use, earmold coupling, expansion, noise reduction, multiple programs, maximum output, feedback management, acclimatization, and use of data logging.
Research has shown that the use of previously recorded music may have restrictions on stress reduction because familiar music can evoke memories, potentially leading to negative emotions and creating unwanted distraction. Fractal tones utilize harmonic relationships, and are generated by a recursive process where an algorithm is applied multiple times to its previous output24 and ensure that no sudden changes appear in tonality, intensity, or tempo. Instead, fractal tones incorporate the properties of music that have been proven to be most relaxing.
Both fractal tones and broadband noise reduced tinnitus annoyance, but the fractal tones were preferred by subjects for longer term use. However, only two of the participants opted to have the noise-only as a program during the 6-month wearing of the hearing aids, and none of them selected the noise-only condition as their preferred setting. Therefore, the Zen options also contain a broadband noise that can be mixed together with the fractal tones or played by its own.
The nature of this programming algorithm thus ensures that the intensity level of the sound-based tool is in accordance with other tinnitus treatment methods that have habituation as their goal.
The physical consequences of stress are manifested in responses from the limbic system that either are caused by a malfunctioning inhibitory gating system30,31 or are based on negative emotional reactions, rendering habituation to this benign, but annoying auditory perception, exceedingly difficult. Teaching the patient how to quickly recognize changes in muscle tension, and how to implement immediate methods of relaxing those muscle groups, is quite easy and can be extremely helpful. Mastering these simple methods can provide immediate and noticeable physical changes for the tinnitus patient. However, since tinnitus is such a complex and diverse problem, not all patients require the same treatment even if they have similar hearing or phantom auditory perceptions.
Tinnitus patients with minimal or no negative reaction may be helped adequately with simple counseling and education. This scale, which was designed and tested by several of the world’s most respected authorities on tinnitus, is highly recommended because of the manner in which it is subdivided, the comprehensive nature of the questions, and its proven responsive to treatment-related changes.
The application of WZT is demonstrated with the use of illustrative and realistic case examples. This simplified approach also provides recommendations for which components of WZT should be applied to a given individual based on the score of the subjective scales. It provides professionals with an evidence-based comprehensive program comprised of amplification with flexible sound-based tools along with an extensive counseling and relaxation program. It does not consider one or the other to be the correct approach, rather it emphasizes the important role of each method in dealing with the plethora of problems that accompany tinnitus. While many patients will be adequately served by counseling and sound therapy (hearing aids with the fractal tone and noise options), those patients who have increasingly significant negative reactions to their tinnitus will be best treated with a comprehensive program that includes cognitive-behavioral concepts, relaxation exercises, and sleep management, along with counseling and acoustic tools. Could an underlying hearing loss be a significant factor in the handicap caused by tinnitus?
Tinnitus as a plastic phenomenon and its possible neural underpinnings in the dorsal cochlear nucleus.
Tinnitus treatment and the effectiveness of hearing aids: hearing care professional perceptions. Enriched acoustic environment after noise trauma reduces hearing loss and prevents cortical map reorganization.
Perceived and physiological indicators of relaxation: as different as Mozart and Alice in Chains.
MarkeTrak VIII: The prevalence of tinnitus in the United States and the self-reported efficacy of various treatments. Treatment of tinnitus with a customized acoustic neural stimulus: a controlled clinical study. The Tinnitus Functional Index: Development of a new clinical measure for chronic, intrusive tinnitus.
It is often accompanied by hearing loss at least in the perceived range of the ringing or other noise (some sufferers hear high-pitched whining, electric buzzing, hissing, humming, tinging or whistling sounds).
Sound enrichment aids in reducing the overall reaction to the sound causing the problem and following that, the combined treatment can lower the perception of tinnitus to levels before it became a problem. While there are other methods this particular form of therapy has proven more effective for a wide range of cases. Individuals who successfully complete the therapy usually only have to go for checkups twice a year and many times this can be done over the phone. It is believed that this method successfully disrupts the neural activity that caused the phantom sounds and can even stop it. These noises can range from a high pitched ringing, hissing, whistling or buzzing, to a low roaring, humming, clicking or pulsing sound.


This treatment doesn't actually reduce the intensity of tinnitus symptoms or get rid of them. In addition, major issues contributing to the anguish experienced by tinnitus patients include hearing loss, sleep deprivation, maladaptive thoughts and behaviors, and excessive stress.
Furthermore, none of the existing tinnitus therapies directly address all of the problems listed above that contribute to the distress experienced by tinnitus patients. For patients with high tinnitus distress levels, the use of Cognitive Behavioral Intervention (CBI) is recommended. Combining the two approaches, however, has the advantage of addressing all three primary aspects of tinnitus distress (auditory, attentional, and emotional). Also, some sound therapies require headphones, and thus may be intrusive, uncomfortable, or impractical for use during the work day. A potential shortcoming of CBT is that it is commonly administered by psychologists who may not have an understanding of the auditory mechanism or the relationship between tinnitus, hearing loss, and sound enrichment.
The objectives are to provide the patient with an understanding of the habituation process and to help the patient reclassify the tinnitus.
This intervention utilizes segments of the programs and tools used by psychologists who provide comprehensive therapy (CBT). This provides the clinician with important information regarding who the person is and what treatment plan should be created for that individual. Following the rules of the algorithm, they repeat enough to sound familiar but vary enough to be unpredictable.
By filtering these sounds in accordance with an individual’s hearing loss and delivering them in an inconspicuous manner via high fidelity hearing aids, both hearing needs and stress management can be addressed.
This may be related to the belief that noise lacks the inherent stress-reducing and relaxation-inducing characteristics of music. Therefore, a variety of flexible Zen programs are available that differ in terms of tempo, pitch, dynamic range, and chord (Table 1). Also, the connection between somatic influences, such as tightening the jaw, grinding the teeth, or contracting neck muscles, can lead to increased tinnitus perception. More than two-thirds require in excess of 30 minutes to fall asleep, and it has been reported that tinnitus severity increases with sleep problems.32 The relaxation techniques and dozens of sleep suggestions are detailed in the WZT Manual. Others may require counseling and amplification, whereas patients whose reaction to the tinnitus is severe and negative will require an integrated program incorporating all WZT components. Moreover, it is doubtful that any single tinnitus therapy will work for all patients or that a single sound-based tool (noise, tone, music, etc) will be acceptable to all patients.
Noise generators often are used to provide the correct background noise, but are only fully effective when the patient is willing to learn to use the generator correctly to pinpoint the exact frequencies that their tinnitus is manifesting at.
While there are many different forms of treatment for this condition, most all of them focus on habituation to the sound.
Other therapies employ a limited number of pre-recorded stimuli that can become predictable or boring, or promote active, rather than passive, listening.
Additionally, both approaches may not satisfy the patient’s immediate need for gratification.
However, it does not require the same intensive therapeutic approach, which would be beyond the expertise of many hearing care professionals and would require a greater time commitment than can be reasonably expected. Because stress decreases the ability of a patient to successfully cope with tinnitus, and since stress is often manifested as a tightening of muscles, a variety of approaches designed to help a patient relax have been used for tinnitus patients.
The ultimate decision on how to design Widex Zen Therapy for a given individual should be based on the information gleaned from the WZT Intake Questionnaire, the personal interview of the patient, and the use of one or more subjective tinnitus scales.
While the effect of Tinnitus might be intermittent, those who suffer from it on a continuous basis may experience irritability, depression, and the inability to rest effectively.
Once successful with the habituation part of the therapy, perception of the phantom sounds typically is reduced in intensity and notability allowing the resumption disrupted activities.
Furthermore, unless the sound therapy provides a correction for any existing hearing loss, the increase in central auditory gain is not being addressed. For example, patients may become frustrated or reject the concept when informed that habituation via TRT may require as long as 18-24 months.
For these individuals tinnitus retraining therapy can be a huge help in restoring their normal lives. If one form of treatment does not work, the patient should consider trying another to see if that one helps. This type of tinnitus can lead to elevated stress levels, anxiety and even depression. People who are negatively affected by this condition often become desperate to learn how to stop ringing in the ears.
This is called tinnitus retraining therapy, and it is as intensive and extensive as it sounds. This method, tinnitus retraining therapy (TRT), uses a combination of low level, broad-band noise and counseling to achieve the habituation. Our reviews are based on product popularity, positive customer feedback and value for money. Whether it be by the use of antibiotics and maskers to tinnitus retraining therapy to natural products which have caught the medical world off guard due to their success there is a way now to stop the ringing in your ears. Pinpointing the exact cause of the problem is not always straightforward, and in many cases it is never found.Regardless of the cause, there are certain things that can aggravate tinnitus and make the symptoms worse.
The main culprits include noisy environments, excessive stress, certain medications, caffeine and alcohol; so you’ll need to reduce or eliminate these while learning how to get rid of tinnitus. These include increasing the amount of exercise you do each day, getting regular quality sleep, eating more fruit and vegetables and taking specific supplements and vitamins for tinnitus.
Whether it be maskers or tinnitus retraining therapy or one of the holistic approaches that have quickly become the number one treatment choice. All of these can be very beneficial and will also boost your immune system, lower stress levels and get your body in better general health which is ideal for the healing process.Studies have shown that tinnitus sufferers are often lacking in specific vitamins and minerals, and by increasing the intake of these their symptoms have been significantly reduced. It’s important to note however that simply taking vitamins in an attempt to stop ringing ears is unlikely to eliminate tinnitus completely, but can be used as a means to provide relief as part of a complete solution. TRT involves the use of counseling combined with sound therapy and relaxation techniques as a way to retrain the brain and help break the negative reaction to the sounds that tinnitus makes.



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  5. Effects in 9% of sufferers researchers mentioned, contained too who have hearing.


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