WO2002042986A1 - Procede et systeme pour le diagnostic et la reeducation des patients souffrant d'acouphenes - Google Patents

Procede et systeme pour le diagnostic et la reeducation des patients souffrant d'acouphenes Download PDF

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Publication number
WO2002042986A1
WO2002042986A1 PCT/PL2000/000085 PL0000085W WO0242986A1 WO 2002042986 A1 WO2002042986 A1 WO 2002042986A1 PL 0000085 W PL0000085 W PL 0000085W WO 0242986 A1 WO0242986 A1 WO 0242986A1
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WO
WIPO (PCT)
Prior art keywords
patient
tinnitus
noise
sounds
ear
Prior art date
Application number
PCT/PL2000/000085
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English (en)
Inventor
Andrzej Czyzewski
Henryk Skarzynski
Bozena Kostek-Czyzewska
Original Assignee
Andrzej Czyzewski
Henryk Skarzynski
Kostek Czyzewska Bozena
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Andrzej Czyzewski, Henryk Skarzynski, Kostek Czyzewska Bozena filed Critical Andrzej Czyzewski
Priority to AU2001214231A priority Critical patent/AU2001214231A1/en
Priority to PCT/PL2000/000085 priority patent/WO2002042986A1/fr
Publication of WO2002042986A1 publication Critical patent/WO2002042986A1/fr

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Classifications

    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/20—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for electronic clinical trials or questionnaires
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/30—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems

Definitions

  • the invention is an electronic diagnostic and rehabilitation system for people suffering from internal ear noise, i.e. tinnitus patients and people with an abnormally high hearing sensitivity, i.e. hyperacusis patients.
  • Tinnitus Diagnosis/Treatment, Abraham Shulman Ed. 1991 pp. 41-49.
  • a newer design of a tinnitus masker is provided by the US patent No. 4,222,393, wherein a tinnitus patient is subjected to external sounds of different pitch, one after another, to enable the patient to identify the particular external sound having the same pitch as the subjective tinnitus sound perceived by the patient. Then the patient is provided with a power operated sound generator producing a range of frequencies extending above and below the perceived pitch to mask the tinnitus sound.
  • the sound generator may be worn in the same manner as a hearing aid and may be combined with a hearing aid, if necessary.
  • the primary energy of the sound generator is produced between the frequencies of 1000 Hz, 5000 Hz and 10000 Hz.
  • the PCT Application WO 90/07251 discloses a tinnitus masking device having an electronic circuit arranged in a housing and an earphone for generating a sound spectrum that can mask the patient's tinnitus. It comes with a volume control for setting the sound intensity.
  • the electronic circuit is designed in a such a way that the sound spectrum generated by the earphone contains a line spectrum with a fundamental tone while the frequency of the fundamental tone can be set by the user.
  • a disadvantage of known tinnitus instruments is that the frequency range and the level of the masking noise cannot be set with sufficient flexibility.
  • the relatively new US patent No. 5,403,262 defines a tinnitus masking device and method for producing a masking signal with a selected centre frequency, selected bandwidth, and selected volume provided.
  • a random noise generator and a clock circuit are employed in conjunction with a switched capacitance filter bank to produce a masking signal with the selected centre frequency and selected bandwidth.
  • the masking signal is then received by a volume control unit and then amplified for delivery to the tinnitus sufferer's ear or ears by speakers or headphones.
  • the tinnitus masking device may include a timer and fade out unit.
  • US patent No. 5,788,656 which is an electronic stimulation system for treating patients suffering from a tinnitus disorder in which the patient hears ringing or other sounds originating in the ear.
  • the system includes an electronically actuated probe to which a complex signal in the auditory range is applied to cause the probe to vibrate in accordance with the signal.
  • the probe is placed on the patient in proximity of the cochlea of the inner ear. The probe vibrations are transmitted to the cochlea to stimulate this organ and thereby alleviate the tinnitus disorder.
  • 5,795,287 stimulates hearing by vibrating the structure to which it is coupled.
  • the user may select the frequency, intensity and phase of the tone generated. Additionally, a second tone or a background sound may be selected.
  • Another vibrating device for diagnosing and treating hearing disorders including a supersonic transducer which has a resonance frequency in the supersonic range is described in the US patent application No. 6,068,590.
  • the methods of stimulation proposed in the cited patents are not directly related to the present invention which uses a different concept of acoustic therapy of tinnitus.
  • the European Patent No. 9611047 concerning the problem of tinnitus has a priority date of 1996 while its American version dated April 2000 bears the number of 6,047,074. It defines a programmable hearing aid that can be used in a tinnitus therapy mode and correct other hearing impairments of the hearing aid user.
  • the hearing aid contains a signal processing chain, between the hearing aid input and output, which is responsible for producing a useful signal by modifying the input signal in order to correct the hearing impairment of the hearing aid user.
  • the signal processing chain also includes an arrangement for generating a tinnitus therapy signal, which is combined in the signal processing chain with the useful signal, depending on the selected or pre-set mode of operation.
  • the tone of the patient's tinnitus can be exactly identified and the corresponding frequency can be covered with a narrow band noise. It is also possible to select a signal by generating melodic sound sequences or other tones to mask the tinnitus which eliminates the limitation of the generated noise.
  • This patent is relatively closest to the present invention, because in the description of the preferred embodiments it says that the masking signals can be generated outside the hearing aid and can be made available to the patient in an arbitrary processed form for tinnitus therapy. However, it does not define any ways of making co-ordinated tinnitus diagnosis neither does it provide a description of the mentioned externally delivered masking sounds. It leaves out the problem of fitting masking sounds to patients and gives no information about the means of recording, shaping and transmitting external signals to the hearing aid in its role as a tinnitus masking device.
  • the invention provides a method for developing a new type of interactive information, diagnostic and rehabilitation services for people suffering from noise in the ear (tinnitus) and excessive sensitivity to sound (hyperacusis).
  • the new type of service uses the possibilities offered by state-of-the-art computer technology and telecommunications.
  • a multimedia computer software using the concept covered by the invention, installed locally or on a network computer, makes screening tests of ear noise possible. Thanks to its unique method of fitting masking sounds to the patient's needs, tinnitus patients can be rehabilitated using the masking or habituation method.
  • the system can easily deliver information to tinnitus patients, as well.
  • the system in the invention is explained using figures and an explanation, provided in detail in the next section.
  • the essence of the system lies in the fact that it enables automatic diagnostic examination.
  • the patient In the course of the examination the patient is asked to complete an on-screen questionnaire and hear out a set of sounds whose tone resembles the typical noises subjectively perceived by the patients.
  • the subject is asked to answer detailed questions in the electronic questionnaire and next to identify those sounds which most strongly resemble those they perceive as ear noise.
  • the computer diagnoses the patient as free from ear noise or classifies them into a risk group.
  • the patient is informed about the result and can then read about the causes of the ailment and the recommended treatment. At this stage, contacting a specialist is advisable.
  • the system in the invention upon diagnosing the patient can assign them a Personal Identification Number. Coupled with the diagnostic tool is also a rehabilitation tool which is a programmable ear noise masker. To use it, the patient can try out various masking sounds played back by the system from a sound card through the attached earphones and then download those sounds to a miniaturised personal digital player for further use during therapy. In this way, the system in the invention uses the modern multimedia computer to effectively provide information about the ear noise and diagnose the problem. It also suggests a therapy which uses optimised ear noise masking provided externally using a filtered noise or synthetic sounds or natural sounds.
  • the system in the invention can be used on a typical multimedia personal computer equipped with a sound card, earphones and a communication port for sending sound samples to miniaturised digital recorders.
  • the software for diagnostics and rehabilitation of ear noise can be installed on a local or network computer with which the user's computer will communicate.
  • the system in the invention can be implemented as mass use service, e.g. by making it available on the Internet.
  • the electronic questionnaire used in the diagnostic and rehabilitation system in the invention can consist of about 10-30 questions elaborated by specialists.
  • the questions can be about the results of hearing tests, genetic background, hearing disease record, dizziness, duration and frequency of the ear noise, exposure to noise in everyday life, consumption of stimulants, arterial hypertension, etc.
  • the sound material used for a comparative examination of the nature of the ear noise subjectively perceived by the patient can include sound files, with band filtered white noise, simple tones of various frequencies, multi-tones, both harmonic and non-harmonic and different types of synthetic and natural sounds which resemble e.g. low frequency thumps, murmur, rustle, twitter of birds, sounds made by the cicada, dripping of water, whistling and many others.
  • the preferred number of sounds to which the subject should be exposed for further comparison with the ear noise they hear ranges between 10 to 20.
  • the results of the questionnaire are analysed in an algorithmic analysis followed by an analysis of the selection of sounds made by the patient. Based on these, the computer diagnoses the subject as free from ear noise or classifies them into a risk group.
  • the decision-making algorithm can use expert knowledge on ear noise diagnostics which gives it the deterministic function. It can also be a learning algorithm, like a neural network for example, which learns to make automatic diagnoses after it has been trained on sets of data obtained from a sufficiently large group of patients.
  • the computer system in the invention can have a software which supports the treatment through a programmable training of the patient's hearing controlled by the computer.
  • the role of the computer system in the invention is to save in its memory the schedule of playback sessions, types of sounds to be played back by the patient and the level of their loudness.
  • the computer programme can be set to not only store the recommendations as to the frequency and duration of the training but can also automatically remind the patient that they have to begin training.
  • the training sounds can either be played back from the computer or sent to the miniature sound file player.
  • the patient's ear can be exposed to ultrasounds which are signals of frequencies that are inaudible to the human ear.
  • an ultrasound generator can be used which can receive its settings from the computer through an interface, in particular a serial interface operating in the USB standard or through an infrared communication port.
  • the role of the miniature ultrasound generator is to generate noise or tonal signals whose energy is typically concentrated between 20 kHz to 100 kHz or even higher.
  • a miniature ultrasound probe is connected to the output of the ultrasound generator. The probe is placed inside the patient's ear canal, preferably in a position that enables the propagation of the acoustic wave through the tissue near the middle ear.
  • the problem of ear noise masking is analogous to the problem of reducing the noise made by the analogue-to-digital converter in the range of low signals and the so called digital deafness.
  • These phenomena are known in digital signal acquisition. They originate when signals on the input of a digital channel are particularly low.
  • self originating internal noises occur, of varying nature, which resemble certain cases of tinnitus.
  • dither noise linearises the threshold characteristics of the analogue-to-digital converter's sensitivity.
  • the parasitic noise, originating inside the channel is reduced.
  • noise or a high frequency signal are used more and more often as the dither noise.
  • the dither technique can be used in which the spontaneous noise is masked by a noise or signal, especially a high frequency one, fed externally. For this reason, in the system in the invention it is postulated that a noise or signal whose spectrum is within the ultrasound frequencies be used as tinnitus masker acting as the dither noise.
  • Sounds from the audio band that the patient (preferably after additional consultation with a specialist) will select for use in everyday life as maskers or in habituation therapy, in the system in the invention can be downloaded from the computer to a digital sound file player, equipped with miniature earphones. It is important to note though, that patients who complain of ear noise should not have their ears blocked. Therefore, open earphones should be used.
  • the basic advantage of this method of sound generation is that the sounds can be used directly and can be coded in the mp3 format.
  • a modern digital player is very small, light weight, battery powered, has no rotating mechanical elements of the medium which makes it a very convenient portable tool for playing back a fitted tinnitus masker.
  • FIG. 1 A block diagram of the system for fitting masking signals and how they are generated for therapy is given in Fig. 1.
  • the acoustic signal fitted to mask the ear noise of the patient or recommended for habituation purposes is sent from the computer 1 through its sound signal input 2 to earphones 3 or to the ultrasound probe 7 or through a serial interface 4 is then downloaded to the miniature sound file player 5 which can come as a stand alone file player in the mp3 format or as mobile phone acting as player or a watch that can perform this function.
  • the sound level can be adjusted in the computer 1 in the programme or in the device 5 using a gain control 6 to match the patient's needs.
  • the computer 1 uses the software to diagnose and rehabilitate ear noise which is installed on a local or network computer with which the local computer is connected via a computer network.
  • the device 5 assumes the role of a programmable ultrasound generator whose settings can be sent from the computer 1 through the serial interface 4 and delivered near the tympanic membrane of the patient's ear through a miniaturised vibrational ultrasound probe 7.
  • the earphones can also be used for talking on the phone. It can be connected to the computer using the USB interface's cable or another serial interface, e.g. an infrared port.
  • Fig. 1 presents a block diagram of the computer system used in tinnitus therapy.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Primary Health Care (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biophysics (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Biomedical Technology (AREA)
  • Data Mining & Analysis (AREA)
  • Databases & Information Systems (AREA)
  • Pathology (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Abstract

L'invention concerne un procédé permettant de développer un nouveau type de services d'information interactifs, de diagnostic et de rééducation pour les personnes souffrant de bruit dans l'oreille (acouphènes) et de sensibilité excessive aux sons (hyperacousie). Ce nouveau type de service exploite les possibilités qu'offre la technologie de pointe dans le domaine de l'informatique et des télécommunications. En particulier, un logiciel informatique multimédia utilisant le concept couvert par l'invention, installé de manière locale ou sur un réseau informatique, permet d'effectuer des tests de dépistage concernant les acouphènes. Ce logiciel utilise un questionnaire électronique et présente au sujet des exemples de sons qui ressemblent à des acouphènes. Grâce à son unique procédé permettant d'adapter des sons masquants aux besoins du patient, les patients souffrant d'acouphènes peuvent être rééduqués au moyen dudit procédé d'effet de masque ou d'accoutumance. Les sons sélectionnés pour combattre le bruit dans l'oreille du patient peuvent être reproduits selon un planning établi par un programme informatique ou téléchargés dans un lecteur de fichiers musicaux miniaturisé comportant des écouteurs, portés par le patient. En variante, les sons peuvent se présenter sous forme de bruit vibratoire haute fréquence généré dans un générateur d'ultrasons externe et transmis à l'oreille du patient au moyen d'une sonde vibratoire à ultrasons miniature.
PCT/PL2000/000085 2000-11-24 2000-11-24 Procede et systeme pour le diagnostic et la reeducation des patients souffrant d'acouphenes WO2002042986A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
AU2001214231A AU2001214231A1 (en) 2000-11-24 2000-11-24 Method and system for the diagnostics and rehabilitation of tinnitus patients
PCT/PL2000/000085 WO2002042986A1 (fr) 2000-11-24 2000-11-24 Procede et systeme pour le diagnostic et la reeducation des patients souffrant d'acouphenes

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/PL2000/000085 WO2002042986A1 (fr) 2000-11-24 2000-11-24 Procede et systeme pour le diagnostic et la reeducation des patients souffrant d'acouphenes

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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8088077B2 (en) 2006-05-16 2012-01-03 Board Of Trustees Of Southern Illinois University Tinnitus testing device and method
US8888712B2 (en) 2006-05-16 2014-11-18 Board Of Trustees Of Southern Illinois University Tinnitus testing device and method
US10842418B2 (en) 2014-09-29 2020-11-24 Starkey Laboratories, Inc. Method and apparatus for tinnitus evaluation with test sound automatically adjusted for loudness
US11419526B2 (en) 2014-09-29 2022-08-23 Starkey Laboratories, Inc. Method and apparatus for characterizing tinnitus using Bayesian minimum-entropy psychometric procedure

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5572421A (en) * 1987-12-09 1996-11-05 Altman; Louis Portable medical questionnaire presentation device
US5876334A (en) * 1997-03-26 1999-03-02 Levy; George S. Lie detector system using reaction time
EP0912074A1 (fr) * 1997-10-24 1999-04-28 Hearing Innovations Incorporated Détermination de la sensibilité individuelle aux signaux ultrasonores
WO1999049822A1 (fr) * 1998-03-31 1999-10-07 Scientific Learning Corporation Procede et dispositif informatise permettant de remedier a la reponse sensorielle exacerbee chez des individus aux fonctions sensorielles reduites

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5572421A (en) * 1987-12-09 1996-11-05 Altman; Louis Portable medical questionnaire presentation device
US5876334A (en) * 1997-03-26 1999-03-02 Levy; George S. Lie detector system using reaction time
EP0912074A1 (fr) * 1997-10-24 1999-04-28 Hearing Innovations Incorporated Détermination de la sensibilité individuelle aux signaux ultrasonores
WO1999049822A1 (fr) * 1998-03-31 1999-10-07 Scientific Learning Corporation Procede et dispositif informatise permettant de remedier a la reponse sensorielle exacerbee chez des individus aux fonctions sensorielles reduites

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
HOLGERS KAJSA-MIA ET AL: "Predictive factors for the severity of tinnitus.", AUDIOLOGY (LONDON), vol. 39, no. 5, September 2000 (2000-09-01), pages 284 - 291, XP001014113, ISSN: 0020-6091 *

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8088077B2 (en) 2006-05-16 2012-01-03 Board Of Trustees Of Southern Illinois University Tinnitus testing device and method
US8888712B2 (en) 2006-05-16 2014-11-18 Board Of Trustees Of Southern Illinois University Tinnitus testing device and method
US10842418B2 (en) 2014-09-29 2020-11-24 Starkey Laboratories, Inc. Method and apparatus for tinnitus evaluation with test sound automatically adjusted for loudness
US11419526B2 (en) 2014-09-29 2022-08-23 Starkey Laboratories, Inc. Method and apparatus for characterizing tinnitus using Bayesian minimum-entropy psychometric procedure

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Publication number Publication date
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