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THE SEQUENTIAL SOUND THERAPY (SST)
The Sequential Sound Therapy ( SST) is a complete treatment for tinnitus and hyperacousis.
It includes 3 solid bases:
- PHARMACOTHERAPY
- TREATMENT WITH SOUND SEQUENCES
- COGNITIVE BEHAVIORAL THERAPY
1- PHARMACOTHERAPY.
The targeted results are:
- Eliminate stress and anxiety
- Facilitate a satisfactory sleep
- Eliminate hyperacousis
- Decrease the intensity of the tinnitus
- Change the high frequency spectrum to low frequencies
The introduction and the application of the new medicines has increased in a significant way the success of the treatment of tinnitus since 1997.
The medications having a circulatory effect such as trimetazidine and the ginko bilboa ( Tanakan) can be useful. Gabaergic agonists ( neurontin ) and dopaminergics ( piribedil ) act particularly on the efferent hearing system. The inhibitors of the concerned neuronal pathways by decreasing the hyperexcitability of the hearing centres such as carbamazépine ( Tegretol) are also recommended. Tranquillizers or antidepressants which decrease the recapture of the serotonine can be also prescribed. Finally, recent studies showed that the acamprozate (a blocker of NMDA receptors and a Gabaergic agonist) were effective in a certain number of cases.
2- TREATMENT WITH SOUND SEQUENCES
According to the research works of Miguel Angel Lopez Gonzalez and Rocio Lopez Fernandez C' is a method of treatment of tinnitus which is based on the use of a sound generator of a wide band of white noise, the intensity of mask of which can be is superior, or lower than the intensity of the tinnitus, with an intermediate stage or the intensities of mask and that of the tinnitus are equal.
The sequence is to start with a total mask (white noise with intensity superior to the tinnitus); then a limited mask (white noise equal to the intensity of the tinnitus); at the end a partial mask (white noise with intensity lower than the tinnitus). Depending on whether the patient presented with hearing loss or not, a hearing aid with opened tip was added.
It is advised to wear the sounds generator several hours a day and especially at the most quiet moments of the day. If the sleeping process and the sleep of the patient are perturbed, the sound generator will be used all night long. Regarding the hearing aid, it is used 6 hours a day the first month by sequence of 2 hours, then during the 2nd and 3rd month, the use of the hearing aid is left to the discretion of the patient. The successive follow-ups take place every 3 months, then every 6 months and finally annually.
The results are to be evaluated with the THI questionnaire and on a visual scale. The authors report positive results in 100 % of the cases! A comparative study was made with the TRT from which it is strongly inspired, but with a net advantage for the SST.
3-Cognitive behavioral therapy ( CBT)
Facilitate the work on the improvement of the perception of tinnitus and the handicap which is related to it. The CBT leans on the theories of the learning, the behavior and the conditioning. These therapies, called "cognitive", are interested in the progressive modification of the mental plans of interpretation of the reality, to eliminate the disorders, annoyance and the unsuitable behavior (example of the behavior of fold to avoid the exposure to tinnitus. Our psychologists trained in these clinical approaches offer individual meetings and group sessions.
The group work contributes to help the patient to put in perspective its perception of tinnitus and to be inspired by initiatives of others as other potential alternatives.
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