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Tinnitus & Hyperacusis REFERENCE Tinnitus & Hyperacusis GlossarY The American Tinnitus Association (ATA) is pleased to provide our readers with a glossary of terms pertaining to tinnitus and hyperacusis. It has been adapted with permission from a document published with the Progressive Tinnitus Management program developed by researchers and clinicians at the Veterans Health Administration. The ATA Tinnitus & Hyperacusis Glossary was edited by members of the Tinnitus Today Editorial Advisory Panel. The terminology used to describe any condition is of vital importance to diagnosis and treatment of the condition. Without a commonly understood set of terms, we could not effectively communicate a diagnosis, direct treatment for conditions, or expect patients to understand and follow those treatments accurately. www.ATA.org TINNITUS TODay WIntER 2017 33 REFERENCE Acceptance and Commitment aminoglycoside antibiotics: Any by neural networks that respond to Therapy (ACT): A psychotherapeutic of a group of antibiotics derived from different levels of sound. approach similar to Cognitive Behav- various species of Streptomyces that auditory hallucinations: Usually ioral Therapy (CBT), and sometimes is inhibit bacterial protein synthesis and perceived as voices or music (and referenced as part of the third wave of are active against gram-negative bac- sometimes as environmental sounds, CBT approaches. ACT involves mind- teria, in particular. Aminoglycosides e.g., a barking dog), and have been fulness, which is aimed at reducing include streptomycin, gentamicin, studied primarily in the context of psychological distress, depressive amikacin, kanamycin, tobramycin, and mental health. Some individuals who symptoms, and anxiety by focusing on neomycin, among others. All can be experience auditory hallucinations do the present moment. Effects of ACT highly toxic and should require moni- not have discernible mental illness. have been investigated in different toring for early signs of toxicity—par- The prevalence of auditory halluci- populations, including patients with ticularly ototoxicity and nephrotoxicity. nations is unknown, although small different psychological disorders (e.g., annoyance: An unpleasant nuisance studies have reported rates of 2- to anxiety and depression), and chronic that causes irritation and word that 32-percent. Auditory hallucinations health conditions (e.g., chronic fatigue often is used to describe negative without mental illness are more com- and chronic pain), as well as with oth- emotional reactions to tinnitus. An- mon in women than men and increase erwise healthy individuals. Third-wave noyance level can be rated on a scale with age and with hearing loss. The CBT approaches have been making of, e.g., 1-10, where one represents most common manifestation is hear- their way into tinnitus intervention no annoyance and 10 represents the ing repetitive musical patterns, with or research as well. most annoyance imaginable. without lyrics (musical hallucinations). acute tinnitus: Also referred to as audiobook: Audio recording of a auditory imagery: A normal phe- “recent-onset” or “new-onset” tinni- book or magazine that can be lis- nomenon that occurs for all people tus, acute tinnitus has been exper- tened to as an alternative to visual that generally refers to the imagination ienced either persistently or recur- reading. Audiobooks can be used of sound, such as repeating a phone rently for less than six months. Most as sound-based therapy for tinnitus number in one’s head or recalling a clinicians and researchers identify six management, especially for distract- musical song or passage. months as the point in time when ing attention away from the tinnitus. acute tinnitus becomes chronic augmentative sound: Any sound Audiobooks may be accessed as CDs, tinnitus, although there is a used therapeutically for tinnitus MP3 files, or downloaded from vari- range of opinion regarding management, exclusive of sound from ous subscription services. the point at which tinni- ear-level devices. tus becomes chronic, auditory gain: The auditory sys- augmentative sound device: Any from three to 24 tem has “gain control,” similar to the device (other than ear-level device) that months. volume control on a stereo, and the produces sound that can be used ther- level of gain determines the degree apeutically for tinnitus management. to which environmental sounds are These can include TV, radio, MP3 amplified, or enhanced. The level of player, fan, satellite radio, smartphone, gain changes automatically to adjust and tabletop sound generators. to the level of sound. As the sound level decreases, the gain increases, autonomic nervous system: and vice versa. Gain is controlled Controls basic bodily functions, such partially by the outer hair cells as heartbeat, blood pressure, breath- of the inner ear, which ing, body temperature, sweating, etc. mechanically amplify These are automatic functions that we sounds, and partially cannot normally control; to an extent, 34 TINNITUS TODay WIntER 2017 www.ATA.org REFERENCE these functions can be modified by clinical research. Its earliest use was to exercising or relaxing; also, techniques treat mood disorders, such as depres- such as biofeedback and hypnosis can sion and anxiety. CBT for tinnitus was provide a certain amount of control first described by an audiologist who over the autonomic nervous system; adapted CBT, as used for pain manage- complete the method of Tinnitus Retraining ment. Since then, numerous studies of masking of Therapy (TRT) describes the autonom- CBT for tinnitus have been published, tinnitus: Use ic nervous system as part of the neu- as well as a detailed text outlining the of sound to com- rophysiologic model of tinnitus, which components and relevant exercises for pletely suppress the is essential to TRT counseling. implementing CBT for tinnitus. CBT perception of tinnitus. now is viewed as a psychotherapy Although complete masking Baroque music: Style of classical offered only by mental health clinicians was originally the intent of Dr. music composed between 1600 and specifically trained to provide this Jack Vernon’s method of Tinnitus 1750. A commercial wearable device particular intervention. The primary Masking, it soon became clear that uses Baroque music configured spe- components of CBT for tinnitus include partial masking also was effective for cifically for tinnitus management. education, cognitive restructuring, at- patients. Bluetooth: Utilization of shortwave tention control, and training in the use coping skills: Any strategy, such radio frequencies to permit wireless of imagery and relaxation techniques. as using soothing sound, designed communication between computers, chronic tinnitus: Tinnitus experi- to benefit a person with respect to cell phones, printers, audio devices, enced either persistently or recurrent- reducing reactions to tinnitus; coping and a variety of other applications. It ly over a long duration of time is con- skills that are taught in CBT include enables wireless streaming of audio sidered chronic. The VA and numerous stress management, distraction, and signals from Bluetooth-enabled devic- entities define chronic as lasting more cognitive restructuring (changing es to some hearing aids. than six months, although the transi- thoughts and feelings). broadband noise: Wide band of tional time point from acute to chronic decreased sound tolerance: sound, configured such that each fre- tinnitus lacks consensus. See acute Inability to tolerate everyday sounds quency within the band produces com- tinnitus. that most people tolerate easily. See parable output. It often is referred to as cisplatin: A chemotherapeutic drug related terms hyperacusis, misopho- masking noise for purposes of deliver- used to treat a variety of cancers, nia, and phonophobia. ing sound-based therapy for tinnitus. which has the highest ototoxic poten- distraction: General approach of brown noise: A broadband noise tial of all the platinum compounds in directing one’s attention away from a where the sound pressure level drops clinical use. See ototoxic drug. disturbing symptom or problem and as the frequency rises; with brown combination instrument: An is a technique that can be helpful in noise the sound pressure level drops ear-level device, either custom in-the- managing reactions to tinnitus. faster than it does with pink noise. ear or behind-the-ear, containing both Brown noise is perceived by a normal ear-level device: In-the-ear or behind- an amplification circuit and a separate human ear to have more low-frequency the-ear instrument used for amplifica- circuit for production of a generally than high-frequency energy and some- tion and/or tinnitus management. An broadband or filtered noise. These times is used to manage reactions to ear-level device may be a hearing aid, instruments are used when patients tinnitus. masker, or combination instrument. require amplification for hearing loss Cognitive Behavioral Therapy and also experience tinnitus. The fight-or-flight response: The (CBT): Method of psychotherapy noise may usually be shaped and can autonomic nervous system be- that has undergone three decades of be beneficial to patients for tinnitus comes strongly activated when there development based on theoretical and management. is danger or fear; specifically, the www.ATA.org TINNITUS TODay WIntER 2017 35 REFERENCE sympathetic part of the autonomic structures, common to all mammals, perceived loudness of their tinnitus. nervous system induces changes in and involved
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