Tinnitus Treatment

After a diagnosis carried out by a specialist, numerous treatment options are available for tinnitus patients. These often differ not only in their shape, but are based on very different approaches. The spectrum ranges from drug treatments and behavioral therapies to acoustic stimulation.

The aim of the tinnitus treatments is to reduce the noise in the ear or to put the perception of the noise in the background, i.e. to “ignore” it. Although there are repeated reports that a new treatment could cure a person with tinnitus, it should be noted that, according to the current state of science, no universal method is known that reliably cures all tinnitus in all patients.

Even if the range of treatment options is diverse, a lack of evidence of the effectiveness of the therapies is often criticized. In many cases there are no indications for the tinnitus patient regarding the effectiveness of the respective therapy. Such proof of effectiveness can be provided, for example, by testing the therapy on several test groups.

If all groups assume that a certain therapy (or drug) is being used in such an attempt, even if this is only the case with a certain group, it is called a placebo-controlled study. However, no corresponding studies are available for the majority of the treatments offered. In the following you can find detailed information about the different treatment options for tinnitus.

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Acute and Chronic Tinnitus

With regard to the different treatment methods, a distinction must first be made between two types of tinnitus. These can be differentiated from one another by the duration for which the ear noise is present. If the noise persists for one to three months, one speaks of acute tinnitus. For many of those affected, the unpleasant noise in the ear disappears after just 20 minutes. The chance of a so-called spontaneous healing of an acute tinnitus is basically there.

However, if the ringing in the ear persists for longer than three months, then it is a chronic tinnitus, which affects millions of people all over the world.

Different treatments are used depending on whether it is acute or chronic tinnitus. An acute ringing in the ear is mainly treated with medication with the aim of avoiding the development of chronic tinnitus. With chronic tinnitus, there are more far-reaching methods of use.

With both types of tinnitus, however, it is important that the person concerned actively relaxes and avoids stress. In addition, an ENT doctor should be consulted as a first measure as soon as the ringing in the ear lasts longer than a day.

Tinnitus Therapy Options at a Glance

Therapy Options for Objective Tinnitus (acute):

  • Calming or removing the source of sound in the patient’s body
  • Tinnitus counseling (coping training and education)
  • Drug treatment (e.g. with cortisone, vasodilators)

Therapy Options for Objective Tinnitus (chronic):

  • Calming or removing the source of sound in the patient’s body
  • Tinnitus counseling (coping training and education)
  • Behavioral approaches
  • Physical therapy
  • Body therapies (e.g. tai chi, biofeedback, or hydrotherapy)

Therapy Options for Subjective Tinnitus (acute):

  • Tinnitus counseling (coping training and education)
  • Drug treatment (e.g. with cortisone, vasodilators)

Therapy Options for Subjective Tinnitus (chronic):

  • Body therapies (e.g. tai chi, biofeedback, or hydrotherapy)
  • Tinnitus counseling (coping training and education)
  • Behavioral approaches
  • Combined therapy approaches
  • Drug therapy methods
  • Physical therapy
  • Brain stimulation methods (magnetic and electrical)
  • Hearing aid acoustics
  • Body therapies (e.g. tai chi, biofeedback, or hydrotherapy)

Ways to Treat Tinnitus

These existing treatment strategies for tinnitus fall into two categories. On the one hand, strategies are pursued that are intended to directly influence tinnitus by reducing its volume or curing it. On the other hand, an attempt is made to influence the patient’s reactions to his tinnitus.

Even if the treatment options for tinnitus offered are diverse, patients suffering from chronic tinnitus in particular gradually despair. It is up to them which type of therapy they choose, but it is important not to be discouraged. There are many options available, from the use of acoustic stimulation, to coping training and behavior therapy.

Coping Training (Tinnitus Counseling):

Tinnitus coping training can already be of great benefit to the patient in the acute stage, but is mainly used once the tinnitus has reached the chronic stage. The content of such training is to provide comprehensive information about the meaning of tinnitus and how to deal with the noise in the ear correctly.

In medicine, this advice is called tinnitus counseling and is usually carried out by an ENT doctor. It is important that the patient is informed about the development of the tinnitus and also about its importance for the body and how to deal with the noise in the ear in everyday life. The aim of the coping training is to reduce fears on the part of the patient and in this way to enable the correct handling of the tinnitus.

Behavioral Therapeutic Approaches:

A well-known behavioral therapeutic approach is what is known as cognitive behavioral therapy, which deals with the attitudes, thoughts, as well as the evaluations and beliefs of the patients with regard to their illness. The therapy, which originated in the 1960s, is based on the assumption that our well-being depends on the way we think and the body reacts accordingly.

The focus of such a therapy is the targeted processing, checking and evaluation of facts that should ultimately lead to a positive change in concrete behavior.

Neuro-Scientifically Approaches:

There is a consensus in the scientific community that although tinnitus is preceded in most cases by hearing impairment, the processes involved in the development and maintenance of the perception of tinnitus are to be located centrally in the auditory centers of the brain.

Hearing damage not only leads to the injured party hearing less well in certain frequency ranges, but also to the fact that the brain receives reduced input. The altered stimulation causes misdirected neuro-plastic processes to set in, which lead to an abnormal neural activation pattern in the auditory networks and the perception of the tinnitus.

Therapies used up to now did not take these findings into account and therefore do not offer a causal treatment concept. Patients can be offered music therapy that treats the above-mentioned cause of the disease in a targeted and therefore effective way.

This is based on neuroscientific studies in which it has been shown that both the perceived volume of the tinnitus and the associated neural activity in the auditory cortex are statistically significantly reduced by training with music specially prepared for the patient.

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