A Critical Review on the Management of Tinnitus - Report Example

HEALTH SCIENCES AND MEDICINE By Location Health Sciences and Medicine Section Introduction and background to include the aims and objectives of the review Tinnitus is a medical condition that can result from a number of underlying causes, but the most significant cause of this hearing loss is as a result of exposure to noise (Moller et 2010, p. 213). Other possible causes of this hearing loss can be an ear infection, multiple sclerosis, neurological damage, and emotional stress. Sanchez and Rocha discuss on the age in which tinnitus affects a person that is relatively above the age of 55. Neri et al (2009, p. 86) also tries to illustrate the difficulties that have resulted from the having clear causes that tend to influence the occurrence of tinnitus as much as 10-15% of the population according to the article suffers from this condition. Another article that discusses this condition is by Sweetow (2013) begins by giving theories associated with the origin of tinnitus and also highlighting the key facts surrounding this condition that many audiologists deal with on a day-to-day basis. The percentage of those that seek treatment for hearing loss tends to few than that of those that do not seek medical intervention while those that detect the onset of this condition are able to adjust and live with it. Another article that focuses on this medical condition is by Greenemeir (2012) where he begins by illustrating the effects associated with the exposure to blasts and loud noises, especially for those in battlefields as they tend to hear the noises as much as they may be in quiet surroundings. This explains the ‘ringing in the ears’ aspect associated with tinnitus in which many audiologists are not able to treat in their practice because the author asserts that there is no direct way of issuing medication to the inner ear, which tends to be affected by this problem. Like Sweetow’s article, Powers and Ramirez (2014) support the idea that tinnitus results from multiple causes that can be up to two hundred, but these authors assert that minimal focus has been on external factors that influence the occurrence of tinnitus. Other than this, Sanchez and Rocha (2011, p. 1090) give the various treatment options that may include audio pathway by including evaluation for patients in order to make the treatment plan to be effective. The authors also review several articles that also focus on the treatment of tinnitus as much as the condition may not have a known cure. In addition, the article by Sanchez and Rocha also seeks to explain the reason as to why many patients suffering from tinnitus may have partial pain in the side of the body that is less painful and vice versa. Further, a book by Snow Brown gives a diversionary approach to the cause of tinnitus in which the author asserts that it affects more men than women and also in people that have certain medical conditions such as arthritis. Many of those affected by tinnitus go about their business as normal because they feel as though this chronic condition do not mind it, which tends to generate into a serious case of deafness (Snow 2004, p. 1). A book by Bradley draws the association between tinnitus and Meniere’s disease in which this may be a roaring sound as compared to the conventional loud sound characterised in tinnitus. However, the book asserts that some medication such as salicylates, propranolol, aminophyline, and quinidine among a list of other drugs tend to influence the tinnitus without necessarily causing hearing impairment (Bradley 2004, p. 255). In one of the chapters of the book by Warrell, Timothy and Firth (2003) discuss hearing challenges that are clinically recognized in which tinnitus is one of them. Part of the definition given in this chapter about this condition is that it tends to have roots in the brain in that it may not necessarily result from external noises meaning that the sound tends to be in the head of the sufferer. In this article, Benson & Meyer intimate that the use of philosophy can be a therapeutic option of approaching the issue of chronic tinnitus. The focus of the article is also in influencing patients to cope with this condition rather than promising them that there is a cure because this is one of the key aspects that patients grapple with. Section 2: Discussion of the guideline in light of this literature According to this article, most of those that exhibit signs of having tinnitus do not feel the need of going for treatment as per a research study conducted. The article also examines the relationship between melatonin and tinnitus as the treatment of both of these conditions was more effective than treating one of them as this tends to reduce the quality of tinnitus in a patient (Neri et al 2009, p. 88). The authors also give the findings of a study conducted in 2006 on one hundred and six patients that had symptoms of hearing loss and part of the treatment plan was treating both melatonin and tinnitus, while others only received treatment for tinnitus. Contrary to other researches on tinnitus, Sweetow (2013) focuses case reports that help in explaining the fact that this condition may last for a long while before a proper diagnosis is made or it may disappear as a result of the body experiencing trauma. Further, the author asserts that stress is more likely to influence the occurrence of tinnitus as compared to noise as the latter aggravates tinnitus from mild to severe. Additionally, Sweetow (2013) gives the various treatment therapies that are auditory-striatal-limbic therapy, auditory modality and the auditory therapy and explaining the application and effectiveness of each. Greenemeir (2012) explains that tinnitus condition is a common hearing disability in Afghanistan and in the Middle East nations that have experienced war in recent years. Contrary to other texts, Greenemeir (2012) focuses on the development of hearing delivery devices by the Draper Laboratory located in Cambridge in which the device separates the middle and the inner ear. Other treatment plans such as injecting medicine into the eardrum are also discussed by Greenemeier. Essentially, Powers and Ramirez (2014) seek to illustrate the types of discomfort caused by tinnitus that range from disruption in sleeping patterns to difficulty in concentrating. According to the authors, these effects tend to affect the well being of a patient with tinnitus as others may withdraw from active social life because this condition may be impeding their concentration levels. The article by Powers and Ramirez also explains how 15% of those informed of them suffering from tinnitus may not move on because they believe that this condition would create a lot of disruption and discomfort in the normal running of their lives. Further, Snow asserts that those affected by tinnitus tend to develop intolerance towards loud sounds and continued exposure to this is likely to cause deafness in the future if not addressed (Snow 2004, p. 8). According to the Snow, there is no standard application for conducting a clinical evaluation or regarding a patient’s sound tolerance, but when a person develops a deep intolerance to sound then this is a cause of alarm. The author also draws a relationship between hyperacusis and tinnitus, which may as a result of genetic inheritance. The chapter affirms that tinnitus is a common condition, but the number of reported cases world over tends to be rare meaning that it is not possible to gather data surrounding the occurrence of tinnitus in the world. The chapter recommends that surgical intervention can also be an applicable intervention strategy for dealing with this condition though in very rare cases. According to this chapter the clustering of medical intervention of tinnitus is in three, namely prosthetic, pharmacological, and psychological, which the chapter expounds on. In one of the chapters, the Bradley classifies this condition into three classes, namely mild, severe and moderate in which it explains the environments in which this condition may occur. Further, the article discusses the two types of tinnitus that are subjective and objective tinnitus by giving the difference between the two, the treatment options that are effective in each of them and the significance of clinical evaluation (Bradley 2004, p. 254). According to the book, tinnitus can have dire effects in that a sufferer may themselves concentrating on the tinnitus alone rather than any external sounds, which is a serious side effect that experience it may not be aware of this fact. Like the other texts that provide management and treatment of tinnitus, the book recommends masking, counselling, and biofeedback after clinical evaluation. According to (Benson & Meyers 2013), the use of such treatment plans can be effective in treating this condition because it helps a sufferer and a doctor to know how to handle the different levels of tinnitus. The failure of applying this means that a sufferer may be enrolled in a treatment plan that may not be effective because their evaluation suggests that counselling or any other treatment can be applied as per their problem. Section 3: Revised guideline and applied conclusion Sanchez and Rocha conclude that neural plasticity and the effects that it can cause at a later stage after its onset. The article also affirms that the diagnosis of somatosensory tinnitus can draw influence from body injuries that can influence condition to occur on the ear ranging from head trauma to neck and shoulder injuries. The Benson & Meyer suggest that individuals with mild, severe or moderate tinnitus should receive different levels of treatment plans in order for them to manage this condition effectively. The authors imply that tinnitus tends to vary in terms of quantity and volumes in which the measurement of these levels can be through the levels of tone presented to a patient within a sound treatment room and not from a general approach. Bradley concludes that there can be special cases of tinnitus that have been realized through the conducting of clinical evaluation in which these isolated cases where the disease may be non-existent. However, the book by Bradley also suggests that low dosages of antidepressants such as alprazolam can be helpful in managing tinnitus, which is a divergent treatment plan. On the contrary, it discourages the use of destructive surgery as part of the management of tinnitus because there is no existing proof that this application is effective in treating this condition. However, the author of this book suggests that positive reassurance can also be an appropriate way of managing tinnitus because it helps those with this condition to go on with their lives rather than dwell on pity (Warrell 2003). Contrary to other literature, the Snow advises on the ways in which a person that has developed an intolerance to sound may use in order to reduce the level of hearing discomfort. They include the use of ear protection gadgets in which some patients may opt to use ear plugs even in quiet environments, making the auditory system to be highly sensitive to loud noises (Snow 2004, p. 13). Greenemeir (2012) communicates the advantage of using this treatment option for tinnitus, which is that a doctor is able to control the dosage issued to the inner ear. Therefore, Greenemeir (2012) focuses mainly on the medical devices that are relevant in the treatment of tinnitus both at the research and implementation stages and asserts that this device are likely to influence a breakthrough in the future for the treatment of this condition. Essentially, Neri et al conclude by being in agreement that there has not been a cure approved by the Food and Drug Administration that can cure tinnitus in totality, which is a fact that many researchers have proven to be fact. The findings in the article by Sweetow (2013) are that the major effects of tinnitus include insomnia in which the inclusion of integrated tinnitus components can be essential in this treatment plan. The author gives alternative treatment plans that include relaxation exercises as part of the treatment plan for tinnitus and amplification for stimulating the peripheral system. Like the other articles discussing the treatment of tinnitus, Powers and Ramirez (2014) agree that a clinical evaluation of a patient that reports hearing loss should be the first step in ensuring that this condition does not progress, in which many do not view this is a matter of importance. Bibliography Benson, GA and Meyers, AD 2013, Introduction, Philosophy and Classification, Medscape Available: http://emedicine.medscape.com/article/856916-overview [14 April 2014] Bradley, GW 2004, Neurology in clinical practice: Principles of diagnosis and management, Oxford, Taylor & Francis. Greenemeir, L 2012, Buzz Kill: Self-Dissolving Tinnitus Treatment Gives New Hope, Scientific American, Available from: http://www.scientificamerican.com/article/tinnitus-treatment/ [14 April 2014] Moller, RA , Berthold, L, DeRidder and Kleinjung T 2010, Textbook of Tinnitus, London, Springer. Neri, G (2009), ‘Treatment of central and sensorineural tinnitus with orally administered Melatonin and Sulodexide: personal experience from a randomized controlled study’ National Journal of Medicine, vol. 29, no. 2, April, pp. 86-91. Powers, L & Ramirez, T 2014, Clinical Management of Tinnutus, Available from: http://www.audiologyonline.com/articles/clinical-management-of-tinnitus-12558 [14 April 2014] Sanchez, TG & Rocha CB (2011), ‘Diagnosis and management of somatosensory tinnitus: review article’, National Journal of Medicine, vol. 66, no. 6, June, pp. 1089-1094. Snow, J B 2004. Tinnitus: theory and management. Hamilton, Ont, BC Decker. Sweetow, RW 2013, An Integrated Approach to Tinnitus Management, AudiologyOnline, Available from: http://www.audiologyonline.com/articles/integrated-approach-to-tinnitus-management-11598 [14 April 2014] Warrell, DA 2003, Oxford textbook of medicine. Oxford, Oxford University Press. Read More