Tinnitus ist ein weit verbreitetes Symptom und ein häufiger Grund für die Vorstellung
beim Hals-Nasen-Ohren-Arzt. Wichtig ist die Abklärung eines möglichen Hörverlusts.
Es gibt bislang keine Akuttherapie, die nachweislich zur Heilung führt; bei chronischem
Tinnitus kommt die kognitive Verhaltenstherapie zum Einsatz. Der vorliegende Beitrag
liefert eine Übersicht über den Tinnitus, gibt Empfehlungen und geht auf aktuelle
Erkenntnisse ein.
Abstract
Tinnitus is a highly prevalent symptom and a common reason for seeing an otolaryngologist.
Since tinnitus can go hand in hand with hearing loss, the step-by-step clarification
of hearing loss is one of the essential ENT examinations for tinnitus sufferers. The
anamnesis and medical history are relevant, since a multidimensional interaction with
the tinnitus can be important for the treatment, especially in the case of a psychological
comorbidity. In the vast majority of patients, no causal factor can be found. In the
absence of external stimuli, phantom perceptions of tones or noises are held responsible
for subjective tinnitus, which probably arises from pathological changes of the auditory
pathway, but also in non-auditory cortical structures. In the case of acute tinnitus,
a comprehensive audiological assessment is needed, and if the hearing threshold is
normal, counseling is the priority. The patient must be informed about the nature
of these benign symptoms. So far, there is no acute therapy that has been proven to
increase the probability of healing, i.e. the disappearance of the acute tinnitus.
Only if the hearing threshold descended, for instance in case of sudden idiopathic
hearing loss, therapy of the underlying disease can also lead to improvement or healing
of the acute tinnitus. Counseling for chronic tinnitus with high burden is also about
reducing exaggerated expectations of healing that cannot be fulfilled. The training
of habituation strategies is important. The standard of therapy for chronic tinnitus
with psychological strain represents cognitive behavioral therapy for dealing with
the tinnitus in a beneficial way. Tinnitus is a symptom of a very heterogeneous group
of patients. In the future, it is to be hoped that digital applications and interventions
in particular will be evaluated in quality-controlled clinical studies in order to
be able to further personalize patient therapy.
Schlüsselwörter
Ohrgeräusche - Leidensdruck - Psychotherapie - Phantomschmerz
Keywords
ear noise - suffering - psychotherapy - phantom pain
