WO2001070110A1 - Method and apparatus for treating tinnitus - Google Patents
Method and apparatus for treating tinnitus Download PDFInfo
- Publication number
- WO2001070110A1 WO2001070110A1 PCT/AU2001/000332 AU0100332W WO0170110A1 WO 2001070110 A1 WO2001070110 A1 WO 2001070110A1 AU 0100332 W AU0100332 W AU 0100332W WO 0170110 A1 WO0170110 A1 WO 0170110A1
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- WO
- WIPO (PCT)
- Prior art keywords
- sound
- frequency
- patient
- tinnitus
- frequencies
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F11/00—Methods or devices for treatment of the ears or hearing sense; Non-electric hearing aids; Methods or devices for enabling ear patients to achieve auditory perception through physiological senses other than hearing sense; Protective devices for the ears, carried on the body or in the hand
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/41—Detecting, measuring or recording for evaluating the immune or lymphatic systems
- A61B5/411—Detecting or monitoring allergy or intolerance reactions to an allergenic agent or substance
-
- H—ELECTRICITY
- H04—ELECTRIC COMMUNICATION TECHNIQUE
- H04R—LOUDSPEAKERS, MICROPHONES, GRAMOPHONE PICK-UPS OR LIKE ACOUSTIC ELECTROMECHANICAL TRANSDUCERS; DEAF-AID SETS; PUBLIC ADDRESS SYSTEMS
- H04R25/00—Deaf-aid sets, i.e. electro-acoustic or electro-mechanical hearing aids; Electric tinnitus maskers providing an auditory perception
- H04R25/75—Electric tinnitus maskers providing an auditory perception
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/12—Audiometering
- A61B5/121—Audiometering evaluating hearing capacity
Definitions
- the present invention is directed to a method for treating tinnitus or alleviating the symptoms of tinnitus as well as an apparatus for use in such treatment and therapy.
- Tinnitus is the perception of sound when no external sound is present and is colloquially referred to as "ringing in the ears".
- the sound heard by tinnitus sufferers is not limited to ringing but may also take other forms including hissing, roaring, whistling, chirping or clicking. It is an extremely common disease with an estimated 1 in 5 people experiencing some degree of tinnitus. In extreme cases sufferers are seriously debilitated.
- Physiological causes include exposure to loud noise over an extended period of time, injury to the head or whiplash and medical conditions such as otosclerosis and Meniere's disease.
- Biochemical causes include reactions to certain medications such as ototoxic drugs and allergies. In many patients the cause of tinnitus is not known.
- the present inventor has surprisingly found that if a sufferer of tinnitus is exposed to sound of certain frequencies within the normal human auditory spectrum and certain intensities, said sound being inaudible to the sufferer, for a period of time, the sufferer's tinnitus can be treated or at least the symptoms of the disease can be alleviated.
- the present invention is directed to a method for treating tinnitus or ameliorating the symptoms of tinnitus in a patient including the step of:
- - presenting to the patient a sound having a predetermined frequency or frequencies within the spectrum of about 20 hertz to 20,000 hertz and having a predetermined intensity, said sound being inaudible to the patient.
- the sound presented to the patient in the method described above shall be referred to as the "suppression signal”.
- the method is carried out by exposing the patient to an artificially generated suppression signal.
- the treatment can be achieved by selectively amplifying sounds already present in the environment and received by the patient.
- the present invention is directed to a method of treating tinnitus or ameliorating the symptoms of tinnitus in a patient including the step of:
- a hearing aid device may be used in the method of the present invention to selectively amplify external sounds.
- the sound that is amplified has a centre frequency in the range of 100 hertz and up to 20,000 hertz, more preferably 3000 hertz to 16,000 hertz.
- the method includes a combination of presenting both, an artificially generated suppression signal and a suppression signal which is a selectively amplified external sound to the patient.
- tinnitus may be the expression of hypersensitivity of the inner hair cells.
- Inner hair cells are under the regulatory control of outer hair cells.
- this inhibitory system is lost with the result that inner hair cells may fire randomly giving rise to a perception of noise by the sufferer.
- outer hair cells responsive to neighbouring frequencies are stimulated. These neighbouring outer hair cells can then take over the function of defective outer hair cells thereby restoring the inhibitory system.
- the present invention involves sensitivity modulation of inner hair cells for tinnitus control using sounds inaudible to the patient.
- the inventor has found that the method described above is most effective if the frequency or frequencies of the suppression signal presented to the patient is basal to, (ie greater than) the frequency or frequencies of tinnitus perceived by the patient.
- the method is effective if the predetermined frequency or frequencies of the suppression signal are the same or approximately the same as the frequency or frequencies of tinnitus experienced by the patient, or lower than the frequency or frequencies of tinnitus experienced by the patient.
- the inventor has realised that tinnitus sound is often associated with hearing loss and the frequency of tinnitus sound is often lower than the frequency at which maximum hearing loss occurs.
- the suppression signal should be at an intensity below the threshold of hearing of the patient for the frequency or frequencies of sound presented to the patient as this does not interfere with the patient in their day-to-day activities. It is preferred that in the method of this invention the suppression signal presented to the patient is a pulsed pure tone, or pulsed narrow band. When using a pulsed narrow band signal its frequencies should vary by no more than 25% of the centre frequency, and preferably no more than 5% of the centre frequency.
- the same or "ipsilateral" ear may be stimulated in the present method.
- stimulation of the opposite or “contralateral” ear is more effective in the method of this invention.
- the human ear can function as a loudspeaker and emit sound. Such sounds are commonly referred to as spontaneous emissions.
- spontaneous emissions Such sounds are commonly referred to as spontaneous emissions.
- the present inventor has recognised that if spontaneous emissions from one ear are absent or diminished, this may be an indication that the inhibitory system for that ear is not working properly.
- the favoured ear to stimulate in the method of this invention may be the ear that is measured as having the highest level of spontaneous emissions.
- any hearing loss resides. Where there is a hearing loss in one ear of the tinnitus sufferer and a hearing aid is used to amplify external sounds, it may be advantageous to fit the hearing aid to that ear and select a level of amplification that also helps to partially or fully restore the hearing of the ear as well as treat the tinnitus symptoms. Alternatively, if stimulating the ear that has hearing loss would cause further damage to the hearing of that ear, it may be preferable to stimulate the ear that is not damaged. Thus, when determining which ear should be stimulated in the method of this invention, a number of factors need to be taken into consideration.
- the present invention is directed to a hearing aid for use in a method of treating tinnitus or ameliorating the symptoms of tinnitus in a patient, wherein the hearing aid is capable of amplifying a single frequency or a narrow band sound having frequencies no greater than 25% of a centre frequency, preferably no greater than 5%.
- tinnitus noises are often perceived by sufferers to have a frequency above 6000 hertz.
- 6000 hertz is the upper limit of sound that currently available hearing aids are designed to amplify. This is because one of the main functions of hearing aids used in the treatment of partial deafness is to assist the speech of the sufferer, the frequency of speech sounds being usually up to 6000 hertz. Accordingly, currently available hearing aids may not be suitable to treat all forms of tinnitus according to the present invention and the inventor has perceived the need to develop a hearing aid that can amplify sound having a frequency above 6000 hertz. To the knowledge of the present inventor, such a hearing aid having this capability is new.
- the present invention is directed to a hearing aid for treating tinnitus or ameliorating the symptoms of tinnitus, said hearing aid having the ability to amplify sound having a frequency in the range of 6000 hertz to 20,000 hertz.
- the hearing aid can function to amplify sound having a frequency in a range of up to 12,000 hertz, more preferably up to 20,000 hertz.
- the hearing aids of this invention have the same features of known hearing aids which will be known to the skilled addressee.
- novel hearing aids of this invention are programmable, digital and frequency specific hearing aids.
- an external sound is presented to the patient.
- This can be done using a portable sound reproduction device.
- the device be capable of producing a sound of a single frequency or narrow bandwidth and having a range from 100 to 20,000 hertz.
- the sound may be a pulsed pure tone or pulsed narrow band.
- a pulsed narrow band signal its frequencies should vary by no more than 25% of the centre frequency, and preferably no more than 5% of the centre frequency.
- the device is capable of reproducing sound having an intensity not exceeding the threshold of normal speech of the patient being treated.
- the intensity of speech measured at a distance of 1 metre is around 65dBSPL.
- the present invention is directed to a portable sound reproduction device for use in a method of treating tinnitus or ameliorating the symptoms of tinnitus, said device capable of producing sound having:
- the device has the further feature of; (iv) a fine sound level control at low intensities of approximately 1dB resolution.
- the device has a storage medium, the storage medium having stored thereon the suppression signal.
- Such devices include, for example a personal CD, Mini Disk, MP3 Player, Personal Digital Assistant (PDA), Portable Personal Computer or tape player.
- PDA Personal Digital Assistant
- the portable device is digitally programmable to produce the suppression signal.
- Such devices may include a personal digital assistant (PDA), portable personal computer or programmable mobile telephone.
- the device is capable of producing a pure output of sound. That is, it can produce the desired sound without also producing additional background frequencies.
- the device for use in the method of this invention combines the function of the novel hearing aid and portable apparatus for reproducing the suppression signal as described above.
- the device functions to amplify that sound.
- the device operates to produce a sound having the predetermined characteristics itself.
- the inventor has realised that the effectiveness of the method of this application can be improved if the external sound presented to the patient is a pulse signal or the sound that is amplified is done so in a manner so as to present it as a pulse signal to the patient.
- the sound reproduction device and hearing aid of this invention can function in this manner.
- Another aspect of the present invention is directed to a method of operating a sound reproduction device or hearing aid device to treat tinnitus or ameliorate the symptoms of tinnitus as described earlier. Accordingly, a further aspect of the present invention is directed to a method of operating a sound reproduction device to present to a patient a sound having a predetermined frequency or frequencies within the spectrum of about 20 hertz to 20,000 hertz and a predetermined intensity, said sound being inaudible to said patient, for treating tinnitus suffered by said patient or ameliorating the symptoms of tinnitus experienced by said patient.
- the present invention is directed to a method of operating a hearing aid device to amplify to a predetermined level external sound received by a patient within the spectrum of about 20 hertz to 20,000 hertz and having a predetermined frequency or frequencies, said amplified external sound being inaudible to said patient, for treating tinnitus suffered by said patient or ameliorating the symptoms of tinnitus experienced by said patient.
- the sound reproduction device and hearing aid can be operated in the various preferred manners described earlier.
- the present invention is directed to a method of identifying the frequency or frequencies and intensity of sound to be presented to the patient in the method of treatment discussed above, including the following steps:
- a further optional step in the method that may be carried out before step (ii) is varying the intensity 1 of the identified frequency or frequencies and the identification by the patient of the intensity that matches the tinnitus sound.
- the process may be carried out by increasing the intensity of sound of that specific frequency until there is suppression of tinnitus.
- the process may be carried out by increasing the frequency and simultaneously reducing the intensity of the sound until the lowest intensity at which suppression or amelioration occurs is identified.
- the frequency or frequencies and intensity of this sound are the optimum frequency or frequencies and intensity for use in the method of this invention.
- the bandwidth of the sound is increased and the intensity is simultaneously decreased until sound having the lowest intensity at which suppression or amelioration occurs is identified.
- the frequency or frequencies and intensity of this sound are the optimum for use in the method of this invention.
- a preliminary step in this identification process may be obtaining a description of the type (pitch) and loudness of the tinnitus sound from the patient before presenting sounds to the patient for identification.
- a programmable digital and frequency specific hearing aid may be used in the method of identifying the optimum intensity of amplification for use in the method of treatment. For example, once the hearing aid is fitted, the hearing aid channel which corresponds to the frequency or frequencies of the tinnitus sound is selected and to determine what intensity of amplification is most appropriate the gain of this channel can be increased incrementally until the patient notes that the tinnitus sound is suppressed.
- the present invention is directed to a device for identifying a suppression signal for use in the method described above, the device including:
- a computing device sound generating means: and - a computer storage media containing a computer program having a software component which allows a user operating the computing device to select a frequency and intensity of sound, a software component which allows said user to alter the selected frequency and selected intensity, and a software component which causes the sound generating means to emit sound of any selected frequency and intensity.
- the device has a visual display means for displaying the selected frequency or frequencies and selected intensity or intensities. More preferably, this information is displayed on an audiograph.
- the computer program also has software components which cause an audiograph to be displayed and selected frequencies and intensities to be displayed on the audiograph.
- the frequencies and intensity selected during the process of identifying the suppression signal can be plotted on the audiograph. This forms a tinnitus suppression plot.
- the computer program has a software component which causes an audiogram to be displayed on the audiograph. It is preferred that the computer program also has a software component which causes selected frequencies and intensities to be recorded so that this information can be accessed at a future date.
- the tinnitus suppression plot be superimposed on the audiogram.
- the tinnitus suppression plot should cross over the audiogram so that part of the suppression plot extends above the audiogram and into an area on the audiogram that represents the area of hearing loss for the patient.
- the suppression signal is preferably located in this section of the tinnitus suppression plot.
- a computer program has a software component which allows the user to select a bandwidth of frequencies and to alter the bandwidth.
- the present invention is directed to the computer program per se that is capable of performing these functions. Accordingly, in this embodiment the invention is directed to a computer program for identifying a suppression signal for use in the method described above, said program having:
- a software component which causes a sound operating device to emit sound of any selected frequencies and intensity.
- the program is capable of performing the additional functions described above with reference to the device for identifying a suppression signal.
- the program has a:
- a software component which causes an audiograph to be displayed on a visual display means; a software component which causes selected frequencies and intensities to be displayed on said audiograph;
- the computing device may be a consumer grade PC or other sound-enabled programmable device.
- the computer program may be delivered via the internet or other electronic media to enable the clinician or patient to load the program onto their own computing device and thereby operate the computing device in the manner described above.
- a suppression signal may also have to be varied over time to most effectively treat the patient's tinnitus.
- a suppression signal may also have to be varied over time to most effectively treat the patient's tinnitus.
- a number of suppression signals may be utilised simultaneously or alternatively to treat the tinnitus.
- a number of tinnitus suppression plots may be recorded.
- the computer program allows a user to record multiple tinnitus suppression plots and suppression signals which the patient may retrieve and utilise depending on current needs.
- the computer program may embody algorithms which automatically adapt to the individual patient's variation in tinnitus frequencies and intensities, providing ongoing, effective suppression for such patients.
- the computer program once operated to identify a suppression signal or signals, is capable of performing the following additional functions:
- a separate programmable sound generating device to generate the suppression signal or signals.
- the program or a version of it may be downloaded onto the programmable sound generating device.
- a programmable device may be a personal digital assistant, portable personal computer, desktop personal computer or network device; and/or
- a portable or fixed storage device such as a personal CD, mini disk, MP3 player, personal digital assistant (PDA) or portable personal computer or tape player.
- PDA personal digital assistant
- Suppression signals or a version of the program configured with the patient's profile may be transferred to other devices via wireless data links, local area networks, Internet, audio connection, or other electronic media.
- the two channel (stereo) capability of consumer electronic devices enables the effective treatment of patients with bilateral tinnitus.
- the repeat functionality of such devices can be utilised to keep the storage requirements to a minimum while producing a continuous suppression signal.
- such devices provide multiple "tracks" which may store multiple suppression signals for the effective suppression of tinnitus in those with tinnitus modalities that vary with time.
- a single "track” is not limited to a single frequency.
- an in-line attenuating device is utilised to provide much lower audio intensity levels and also to provide much finer control at such low levels. This also minimises the risk of misuse of the audio signals output by such devices.
- the attenuator means that the audio device may be operated within its "normal" output levels, thereby minimising artefacts that may arise when operating at the low extreme of the said audio device's output range.
- the attenuating device may incorporate other audio signal conditioning capabilities such as low pass filters and/or high pass filters to further improve the suppression effect of the device's output.
- An application service provider (ASP) distribution model is used in one form of the invention, where the computer program embodied in profile software resides on a server at a location remote from the user, and via a dedicated (e.g. dialup) or generic network connection (e.g. Internet), the user interfaces with the server for the delivery of the suppression signal.
- ASP application service provider
- the ASP means of distribution can be utilized to permit a centralized method of collection of information, including diagnosis and monitoring, leading to the analysis and broad diagnosis and contributing factors affecting tinnitus sufferers.
- the ASP distribution model is used in one form of the invention, where the profile software resides on a server means at a location remote from the clinician user, and via a communications connection the clinician can be connected to the server means.
- the clinician can access data stored in relation to a patient for the time period between visits.
- the clinician can access data stored in relation to a patient even though the patient is not at the clinician's premises for the purposes of monitoring and clinician care.
- the present inventor has found that if the tinnitus sufferer also experiences hearing loss at or around the frequency of tinnitus sound perceived by the sufferer and a hearing aid is used in treating the hearing loss, the tinnitus sound can also be suppressed if the hearing aid is programmed to selectively amplify external sound at or around the same frequency as the tinnitus sound, but in this instance to a level slightly greater than the level of hearing loss for the patient at or around that frequency.
- the method includes the step of selectively amplifying external sound received by said patient in the range of about 20 hertz to 20,000 hertz, said external sound having a frequency or frequencies at or around the frequency of tinnitus sound perceived by the patient and within the range of hearing loss for said patient, said external sound amplified to a level slightly above the threshold of hearing for said patient at said frequency or frequencies.
- the level of amplification should not exceed 10 dB SPL, more preferably 5 dB SPL above the level to restore the hearing loss at the relevant frequency of frequencies.
- These levels of additional amplification are often not perceived by the patient, so that the patient is only aware that amplification has been carried to treat hearing loss.
- the hearing aid be programmed to perform both functions, that is, amplify certain frequency or frequencies to compensate for hearing loss, and, to amplify a frequency or frequencies at or around the tinnitus frequency to suppress tinnitus.
- Figure 1 is a flowchart of the steps undertaken to identify a suppression signal for use in the method of treatment of this invention.
- Figure 2 is an illustration of the display screen of the computing apparatus described earlier to determine a suppression signal for a specific tinnitus frequency in one ear using the process described in the flowchart of Figure 1.
- the first step in the method is obtaining an audiogram for the patient.
- the frequency of sound that matches the tinnitus sound is obtained.
- the intensity of this sound is increased until the tinnitus is suppressed. Thereafter, the frequency is increased and intensity is decreased until an inaudible suppression signal is identified.
- Figure 2 shows the display screen of the device used in the process illustrated in Figure 1 to obtain a suppression signal.
- the display screen shows an audiograph.
- On the audiograph there is an audiogram (line marked with 'X's) showing sound frequency versus intensity for the patient, representing the hearing threshold level of the patient.
- This line shows that the patient suffers a hearing loss over a band of frequencies and that the severity of the hearing loss reaches a maximum for one particular frequency.
- the present inventor has found that in such patients the frequency of tinnitus sound perceived by the patient is usually but not necessarily apical to the frequency of the maximum hearing loss. This perceived sound is marked with the letter A. Starting from this point, the frequency and intensity of sound presented to the patient is altered. The sounds presented to the patient are marked with a box.
- the inventor has found that in the method of the present invention it is preferred to provide a sound to the patient having a frequency and level of intensity in area below the hearing threshold. A suppression is obtained which is marked B. As there is no hearing in this area, the auditory signal used is not perceived by the patient.
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Abstract
Description
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Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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AU2001242101A AU2001242101A1 (en) | 2000-03-24 | 2001-03-26 | Method and apparatus for treating tinnitus |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AUPQ6451A AUPQ645100A0 (en) | 2000-03-24 | 2000-03-24 | Method and apparatus for treating tinnitus |
AUPQ6451 | 2000-03-24 | ||
AUPR1486 | 2000-11-14 | ||
AUPR1486A AUPR148600A0 (en) | 2000-11-14 | 2000-11-14 | Method and apparatus for treating tinnitus |
Publications (1)
Publication Number | Publication Date |
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WO2001070110A1 true WO2001070110A1 (en) | 2001-09-27 |
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PCT/AU2001/000332 WO2001070110A1 (en) | 2000-03-24 | 2001-03-26 | Method and apparatus for treating tinnitus |
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Cited By (8)
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EP1488618A1 (en) * | 2002-03-12 | 2004-12-22 | Era Centre Pty Ltd | Multifunctional mobile phone for medical diagnosis and rehabilitation |
WO2005053533A1 (en) | 2003-12-04 | 2005-06-16 | Neuromonics Pty Ltd | Tinnitus rehabilitation device and method |
WO2008087157A2 (en) * | 2007-01-18 | 2008-07-24 | Universita' Degli Studi Di Parma | Device for the treatment of tinnitus |
WO2009029040A1 (en) * | 2007-08-31 | 2009-03-05 | Tore Persson | Methods and devices for the treatment of tinnitus, anosmia and nerve injury |
US20110071340A1 (en) * | 2009-09-22 | 2011-03-24 | Mcguire John F | Methods and systems for treating tinnitus |
DE102011001793A1 (en) * | 2011-04-05 | 2012-10-11 | Burmester Audiosysteme Gmbh | Hearing-aid for balancing hearing loss of tinnitus patient, has filter designed as notch filter and high-slope filter for reducing or disabling environment sound signal in predetermined frequency range |
EP2566424B1 (en) | 2011-07-28 | 2016-11-16 | My Tinnitus Has Gone AG | Generating an adapted audio file |
US11778397B2 (en) | 2018-12-21 | 2023-10-03 | My Tinnitus Has Gone Ag | Device for providing an audio signal |
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