Wagenaar Olav, Wieringa Marjan, Verschuure Hans
Erasmus Medical Center, Department of Otorhinolaryngology, Rotterdam, The Netherlands.
Int Tinnitus J. 2010;16(1):66-72.
Tinnitus and hyperacusis are both aggravating audiological symptoms. Their underlying mechanisms are not fully understood, but the pathophysiology involves a central mechanism rather than a peripheral one. There is no curative treatment. A review of the available research on tinnitus and auditory processing was conducted to connect insights gained from different approaches to the subject; this resulted in the development of a holistic view of both conditions. In this view, the chronic course of the symptoms is pathological and attributed to a stress-related lack of habituation. This article adds to the literature on tinnitus and hyperacusis by presenting a schematic model of the cognitive mechanisms which can be used clinically in patient information sessions which are geared towards provide reassurance and encouraging the development of coping skills. In cooperation with the patient, the model can also help in the identification of underlying pathology. Future aims of study are suggested, elaborating on the role of tinnitus and hyperacusis in normal auditory processing and on the value of insight. Finally, parallels are drawn between tinnitus and positive symptom syndromes in neuropsychiatry and some of its modern visions on their treatment.
耳鸣和听觉过敏都是加重的听力学症状。其潜在机制尚未完全了解，但病理生理学涉及中枢机制而非外周机制。目前尚无治愈性治疗方法。对耳鸣和听觉处理方面的现有研究进行了综述，以将从不同方法中获得的见解联系起来；这促成了对这两种情况的整体看法的形成。按照这种观点，症状的慢性病程是病理性的，且归因于与压力相关的习惯化缺失。本文通过呈现认知机制的示意图模型，为耳鸣和听觉过敏的文献增添了内容，该模型可在旨在提供安心并鼓励应对技能发展的患者信息咨询会上临床使用。与患者合作时，该模型还可帮助识别潜在病理。文章提出了未来的研究目标，阐述了耳鸣和听觉过敏在正常听觉处理中的作用以及洞察力的价值。最后，文章对耳鸣与神经精神病学中的阳性症状综合征及其一些现代治疗观点进行了比较。
