耳鸣的防治重点讲述.pptVIP

掩蔽疗法-音乐枕 * 掩蔽疗法-助听器（禅 Zen） 丹麦（唯听）助听器中基于碎型算法的音乐。该音乐是根据使人放松的原则制作 (Robb et al.,1995) 1、每一个禅程序，都能调整响度，音调和模式 2、确保禅音（或噪音）听到，但声音相对柔和 3、不应妨碍会话言语 4、耳鸣烦恼级应该开始减少（耳鸣可以仍被听见） 人工耳蜗是极重度感应神经性聋伴有严重耳鸣患者的选择之一 人工耳蜗植入术后，耳鸣的厌烦程度、耳鸣的响度均有改善 术后超过半数患者对耳鸣抑制感到满意 掩蔽疗法-耳蜗电极植入 Kalcioglu MT, Cokkeser Y, Kizilay A, et al. Follow-up of 366 ears after tympanostomy tube insertion. Otolarynogol Head Neck Surg, 2003,128;560-564. Daly KA, Hunter LL,Lindgren BR,et al. Chronic otitis media with effusion sequelae in children treated with tubes. Arch Otolaryngol Head Neck Surg, 2003,126;517-522. Vagus nerve stimulation Electrical stimulation of the DCN Transcranial direct current stimulation Deep brain stimulation 电刺激治疗 电刺激治疗 对耳鸣的电刺激抑制首先于1855年被报道，共包含两种电刺激方式 深部脑电刺激 Electrical stimulation of the DCN Previous studies indicate that the dorsal cochlear nucleus (DCN) may serve as a generator and/or modulator of noise-induced tinnitus. This prompted an interest to investigate the modulatory role of the DCN in tinnitus suppression. In this study, we chronically implanted the DCN of rats with behavioral evidence of intense tone-induced tinnitus. Behavioral evidence of tinnitus was measured using a gap detection acoustic startle reflex paradigm. Our results demonstrated that electrical stimulation of the DCN suppressed behavioral evidence of tinnitus, especially at high frequencies. The data suggest that the DCN may be used as a target to suppress tinnitus through a bottom-up neuromodulation approach. The underlying mechanism of DCN-stimulation-induced tinnitus suppression was discussed by comparing it with other stimulation modalities. Luo H, Zhang X, Nation J, et al.Tinnitus suppression by electrical stimulation of the rat dorsal cochlear nucleus.Neuroscience Letters 522 (2012) 16– 20 DCN植入电极刺激治疗耳鸣的机制 First, noise-induced DCN hyperactivity is believed to result from a lack of peripheral auditory input to the central auditory system that leads to disinhibition [12]. DCN stimulation may have compensated for the to