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Tinnitus-Hyperakusis-Center Frankfurt

Tinnitus-Hyperakusis-Center Frankfurt. Analysis of failures of TRT June 17 , 2008 Dr. med. Christian Hellweg Gabriele Lux-Wellenhof Tinnitus-Hyperacusis Center Frankfurt am Main Germany. 613 patients were evaluated 2 years after treatment withTRT:

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Tinnitus-Hyperakusis-Center Frankfurt

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  1. Tinnitus-Hyperakusis-Center Frankfurt

  2. Analysis of failures of TRTJune 17 , 2008Dr. med. Christian HellwegGabriele Lux-WellenhofTinnitus-Hyperacusis CenterFrankfurt am MainGermany

  3. 613 patients were evaluated 2 years after treatment withTRT: 491 successful cases (at least 30% improvement in at least 3 main documented parameters of tinnitus ) 122 cases resistant to this kind of improvement

  4. Analysis of failures of TRT is useful because: 1)It allowes improvement of treatment strategies of TRT 2)It allowes some prognosis of treatment outcome 3)It leads to a better understanding of tinnitus mechanisms and neurophysiological model 4)It is a valuable feedback for the treatment provider to be aware of his performance

  5. Groups of non-responders: • 42 patients with low suffering level from the beginning • 17 patients with pending law suits • 4 patients category IV • 6 patients with psychotic symptoms • 19 patients with menieres desease • 12 patients having mechanical and technical problems with the devices etc. • 22 patients with miscellaneous reasons, or unknown

  6. What follows from our analysis? • Tinnitus is not equal to tinnitus, it makes a difference: • if there are psychotic elements involved • if the tinnitus is triggered again and again by inner ear structures (i.e.morbus meniere) • if the tinnitus is permanently enhanced by external sounds (category IV patients)

  7. What follows from our analysis? 2) TRT may also have prophylactic effects and benefits: - councelling may prevent worsening of tinnitus - the right sound environment may prevent tinnitus - it may also be called a success if the patient after councelling is not afraid anymore that he may eventually get tinnitus

  8. What follows from our analysis? 3) Patients attitude is important for treatment outcome: - what gain does he have from tinnitus? - what is his state of treatment expectation? - is his thinking based on scientific, religious, homeopathic, esoteric or other background? - what was his history of treatment experience before TRT?

  9. What follows from our analysis? 4) We should offer only easy, aggreable and pleasant tools, devices and exercises: - if anything scratches, hurts or pricks: no success! - if TRT exerts another form of stress, if patient feels that he has to perform: no success! - if patient doesn´t like sounds of sound therapy: no success!

  10. What tells this analysis to the TRT provider: • He should be competent as a human beeing as well as a tinnitus specialist • He should avoid to show dominance or superiority.He should meet with the patient on an equel eye to eye level • He should try to participate…. • apply active attentive listening….. • and create an atmosphere in which the patient feels that he is the most important member of the TRT team… • and all members of the team are together trying to reach the common goal : getting rid of the problem • He should check all technical aspects throughout the treatment

  11. Dr.Christian Hellwegf.c.hellweg@online.de Gabriele Lux-Wellenhof www. Ohrensausen.de

  12. Question 1:What are the main reasons for todays increasing incidence of tinnitus in western countries ?

  13. Question 2: • What are the reasons for the increased incidence of low tone hearing loss? • what are the underlying biochemical mechanisms?

  14. Question 3: • What is the first documented incidence of true hyperacusis ?

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