RU2726923C9 - Method of active tinnitus suppression - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to methods of treating tinnitus. Sound exposure is combined with translingual neurostimulation. Treatment involves two stages. At the first stage, audibility thresholds of the patient are determined, and a frequency region of ear noise generation is evaluated. At the second stage, ear noise is suppressed by sound exposure combined with translingual neurostimulation. At the second stage, signals are presented through a device for personal listening to sound in the area of ear auricle generation based on data obtained at the first stage. For this purpose noise is used with bandwidth of 1 or 2 kHz, central noise frequency within range of 0.5 to 15 kHz. Patient notifies whether he hears his own ear noise against the background of the audio signal or not, by means of signals supplied from the panel in his hand. In a special case, at the first stage, tones and white noise are presented through the device for personal listening of sound with monaural or binaural signal intensity from 0 to 140 dB. In a particular case sound tones from 0.1 kHz to 16 kHz are presented, white noise is band-pass with width of 1 and 2 kHz, central frequency of noise varies from 0.5 to 15 kHz, duration of signals is 500 msec, period of presentation is 1 s. In a particular case, the patient either independently chooses the sound that is maximally similar in sound and volume with its own ear noise, or such selection is carried out according to the patient's reactions or instructions. In the special case at the second stage signals are white noise with duration of 5 sec. In the particular case, the noise is separated by pause of 5 s. In a particular case, translingual neurostimulation is carried out with a pulse frequency of 50–200 Hz with length of 20–35 min using a non-invasive neurostimulator.

EFFECT: method enables treating any type of tinnitus by using noise with central frequencies of 0_5 to 15 kHz and width of 1 and 2 kHz, and reducing the length of treatment.

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Description

The invention relates to medicine, namely to methods of treating tinnitus.

At present, there are known techniques described in patents RU 2611909 C from 01.03.2017 and RU2614220 C1 from 23.03.2017, in which the patient's hearing threshold is determined using sound. Despite the fact that already at this stage, positive dynamics can be observed, this method of treatment will be long and may not achieve the desired result.

The claimed group of inventions is aimed at increasing the efficiency and reducing the duration of treatment.

This is achieved by a method of active suppression of tinnitus, which includes exposure to sound in combination with translingual neurostimulation.

This method includes two stages:

- the first stage - determination of the patient's hearing thresholds and assessment of the frequency domain of ear noise generation;

- the second stage - suppression of ear noise due to sound effects in combination with translingual neurostimulation.

At the first stage, 3 types of signals are presented to the patient through a device for personal listening to sound, monaurally (on the right or left ear) or binaurally (on both ears): tones, white noises, and signal intensity from 0 to 140 dB, and the patient either independently chooses a sound that is as similar as possible in sound and volume to its own ear noise, or such a choice is made according to the patient's reactions or instructions.

Audio bandwidth tones from 0.1 kHz to 16 kHz, white noise - band pass, with 1 and 2 kHz bandwidth, center frequency of noise varies from 0.5 to 15 kHz.

The duration of the signals is 500 msec, the presentation period is 1 sec.

The patient either independently chooses a sound that is as similar as possible in sound and volume to his own ear noise, using signals supplied from the remote control in his hand, or such a choice is made according to the patient's reactions or instructions.

The received data is recorded and stored in the patient's file.

At the second stage, based on the data obtained at the first stage, which determine the patient's hearing area, sound signals are presented through the device for personal listening to the sound to the ear noise generation area

Additionally, sound signals are presented to the perfocal zone.

The signals are 5-sec white noise segments, the noise bandwidth is 1 or 2 kHz, and the center frequency of the noise is set within the range of 0.5 to 15 kHz. The signals are presented in the form of a continuous sound row, in which the noises are separated by a pause of 5 seconds, for 20 minutes, and the patient notifies whether he hears his own ear noise (against the background of the sound signal) or not, and if the ear noise persists, then in the next presentation, the signal intensity increases, if the ear noise disappears (suppressed by the sound signal), then the signal intensity decreases, the signal intensity changes.

The signal intensity changes with a step of 2-4 dB, the initial signal intensity is selected within 10-20 dB above the audibility threshold set when determining the patient's audiogram, while simultaneously giving a continuous sound signal for 10-35 minutes. continuous translingual neurostimulation is performed.

Translingual neurostimulation is carried out with a pulse frequency of 50-200 Hz with a duration of 20-35 minutes. using a non-invasive neurostimulator.

After the end of two stages, with an interval of 5-10 minutes, a test of the level of suppression of ear noise is carried out, the test is carried out without translingual neurostimulation, during testing, the threshold noise intensity at which the ear noise disappears is determined, the threshold value is determined for all noises used in the basic procedure for noise reduction, the measured thresholds are a quantitative indicator of the achieved level of subjective ear noise reduction.

The received data is recorded and stored in the patient's file.

During one day, the procedure is repeated 2-3 times with intervals of 3-4 hours, taking into account the change in the patient's hearing area.

To implement the claimed method, it is possible to use a system for active suppression of tinnitus, which includes a device for determining the hearing threshold, including a device for generating sound signals and a device for presenting sound signals to a patient, a device for recording and storing data obtained during treatment, and a device for translingual neurostimulation.

The device for determining the hearing threshold is an electronic computer that provides the ability to connect a device for presenting sound signals to the patient, which in turn provides the ability to connect it to the device for determining the hearing threshold, as well as the ability to record, store and visualize data obtained in the process treatment.

The system can be provided with the ability to connect the device for translingual neurostimulation to the device for determining the hearing threshold and control the device for translingual neurostimulation through the device for determining the hearing threshold.

A device that provides the ability to generate audio signals provides the ability to generate audio signals of three types: audio band tones from 0.1 kHz to 16 kHz, white noise - band pass, with a bandwidth of 1 and 2 kHz, and signal intensity from 0 to 140 dB in steps of 2 -4 dB, signal duration 500 msec, and presentation period 1 sec.

A device for presenting sound signals to a patient is a device for personal listening to sound, monaurally (on the right or left ear) or binaurally (on both ears).

The device for recording and storing data obtained during treatment is an electronic computer with the ability to record and store data.

A device for translingual neurostimulation, which provides a frequency of 50-200 Hz impulses with a duration of 20-35 minutes.

The translingual neurostimulation device is a non-invasive neurostimulator.

The system can additionally include a device for notifying the patient about reaching the hearing threshold, which is a remote control associated with the device for determining the hearing threshold.

The device for determining the hearing threshold provides automatic delivery of sound signals to the device for presenting sound signals to the patient and / or automatic delivery of signals to control the operation of the device for translational neurostimulation, based on data obtained during treatment and stored in the device for recording and storing data.

In addition, in order to achieve the declared effects, an integral part of both the system and the method should be a component of the system for active suppression of tinnitus, which is a device for translingual neurostimulation that provides a pulse frequency of 50-200 Hz with a duration of 20-35 minutes.

The translingual neurostimulation device is a non-invasive neurostimulator.

It may also be possible to control the device for translingual neurostimulation through the device for determining the hearing threshold and / or provide the ability to automatically control the device for translingual neurostimulation by the device for determining the hearing threshold based on data obtained during treatment.

FIG. 1 - a special case of the implementation of the system, including the computer system unit 1, monitor 2, headphones 3, non-invasive translational neurostimulator 4 with electrodes 5, notification panel 6.

FIG. 2 is an example of a sequence of operations when implementing the method.

FIG. 3-8 are examples of graphs of audiograms in the process of active suppression of tinnitus using translingual neurostimulation.

Examples of achieving these effects when using the claimed group of inventions.

Patient # 1.

The clinical picture.

Complaints about ringing in the left ear. Acute left-sided sensorineural hearing loss of unspecified etiology. Complaints about a significant hearing loss on the left in the low frequency region, hearing at high frequencies (above 1000 Hz) near the norm. On the part of ENT organs without visible pathology.

Concomitant diseases: chronic trigeminal neuralgia - neuropathy of 2,3 branches of the trigeminal nerve on the right, chronic herpetic infection, stage 2 discirculatory encephalopathy, cervical osteochonrosis.

Audiogram, fig. 3, where R is the right ear, L is the left ear.

Hearing loss in the left ear by 42 dB in the frequency range 125-1000 Hz.

A graph of audiograms during active suppression of tinnitus using translingual neurostimulation, FIG. 4.

Audio signal: band-pass white noise (1 kHz bandwidth) with different center frequency. Monaural presentation of noise to the affected left ear.

Effect of the procedure: Decrease in tinnitus level by 46 dB within 7 days when exposed to high-frequency noise (3-7 kHz). Low frequency noise (below 3 kHz) has no effect.

Patient # 2.

The clinical picture.

Right-sided hearing loss and right-sided tinnitus of unknown etiology. Subjectively, tinnitus is tonal in nature with modulations

Vegetovascular dystonia, dizziness.

Audiogram, fig. 5, where R - right ear, L - left ear

Hearing loss in the right ear by 80 dB in the frequency range 2.5-8 kHz.

A graph of audiograms during active suppression of tinnitus using translingual neurostimulation, FIG. 6

Audio signal: white noise with a frequency range of 1-4 kHz, binaural presentation.

The noise bandwidth corresponds to the threshold of hearing impairment (see audiogram).

Effect of the procedure: Decrease in the severity of tinnitus by 45 dB within 1.5 months of testing.

Patient 3

The clinical picture.

Bilateral hearing loss and bilateral tinnitus of unknown etiology. Subjectively, tinnitus is close to tonal in nature with a noisy sound, is highly variable: it increases and decreases arbitrarily.

MRI data: pronounced expansion of the perivascular CSF spaces of Virchow-Robin, mainly in the area of the basal nuclei on both sides.

Audiogram, fig. 7, where R is the right ear, L is the left ear.

Hearing loss in both ears by 60 dB in the frequency range 1.5-8 kHz.

A graph of audiograms during active suppression of tinnitus using translingual neurostimulation, FIG. 8.

Audio signal: white noise with a frequency range of 1-4 kHz, binaural presentation.

The noise bandwidth corresponds to the threshold of hearing impairment (see audiogram). Sound Intensity Threshold (in dB) is the minimum sound intensity that will suppress tinnitus.

Effect of the procedure:

Reducing the severity of tinnitus by 50 dB within 2 months of testing. The appearance of long episodes of the disappearance of ear noise.

Claims (12)

1. A method of active suppression of tinnitus, which includes exposure to sound in combination with translingual neurostimulation, and to suppress ear noise, sound signals are presented to the area of ear noise generation, characterized in that it includes two stages: the first stage - determining the patient's hearing thresholds and assessing the frequency domain generating ear noise; the second stage is the suppression of ear noise due to sound exposure in combination with translingual neurostimulation; at the second stage, signals are presented through a device for personal listening to the sound to the area of ear noise generation based on the data obtained at the first stage, the noise bandwidth is 1 or 2 kHz, the center frequency of the noise is set within the range of 0.5 to 15 kHz, the patient notifies whether he hears his own ear noise against the background of the sound signal or not, using signals from the remote control in his hand. 2. The method according to claim 1, characterized in that at the first stage, tones and white noises are presented to the patient through a device for personal listening to sound, monaurally - to the right or left ear or binaural - to both ears, tones and white noises, signal intensity from 0 to 140 dB. 3. The method according to claim 2, characterized in that the tones of the audio band from 0.1 kHz to 16 kHz are presented, the white noise is band-pass with a bandwidth of 1 and 2 kHz, the center frequency of the noise varies from 0.5 to 15 kHz, the duration signals 500 msec, presentation period 1 sec. 4. The method according to claim 3, characterized in that the duration of the signals is 500 msec, the presentation period is 1 sec. 5. The method according to claim. 2, characterized in that the patient either independently chooses a sound that is maximally similar in sound and loudness to his own ear noise, or such a choice is carried out according to the patient's reactions or instructions. 6. The method according to claim 2, characterized in that the patient either independently chooses a sound that is as similar as possible in sound and volume to his own ear noise using signals supplied from the remote control in his hand, or such a choice is made according to reactions or instructions the patient. 7. The method according to claim 3, characterized in that the received data is recorded and stored in the patient's file. 8. The method according to claim 1, characterized in that at the second stage, the signals are pieces of white noise with a duration of 5 seconds. 9. The method according to claim 1, characterized in that the noises are separated by a pause of 5 seconds. 10. The method according to claim 1, characterized in that the translingual neurostimulation is carried out with a pulse frequency of 50-200 Hz with a duration of 20-35 minutes using a non-invasive neurostimulator. 11. The method according to claim 9, characterized in that the received data is recorded and stored in the patient's file. 12. The method according to claim 1, characterized in that during one day the procedure is repeated 2-3 times with intervals of 3-4 hours, taking into account changes in the patient's hearing area.

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