Consultation des notices

It is estimated that approximately 10% of adult population in developed countries is affected by subjective tinnitus. Physiopathology of subjective tinnitus remains incompletely explained. Nevertheless, subjective tinnitus is thought to result from hyperactivity and neuroplastic reorganization of cortical and sub cortical networks following acoustic deafferentation induced by cochlear or auditory nerve damage. Involvement of both auditory and non-auditory central nervous pathways explains the conscious perception of tinnitus, and also the potentially incapacitating discomfort experienced by some patients (sound hypersensitivity, sleep disorders, attention deficit, anxiety or depression). These clinical patterns are similar to those observed in chronic pain following amputation where conditioning techniques using virtual reality have been shown both to be theoretically interesting and effectively useful. This analogy led us to develop an innovative set-up with dedicated auditory and visual 3D virtual reality environments in which unilateral subjective tinnitus sufferers are given the possibility to voluntarily manipulate an auditory image of their tinnitus (tinnitus avatar). This paper describes the theoretical framework and set-up adjustments required by this very first attempt to adapt virtual reality techniques to subjective tinnitus treatment. Therapeutic usefulness will be validated by a further controlled clinical trial.