Tinnitus – Klinik und Therapie

Zusammenfassung

Tinnitus ist ein Phantomgeräusch, das ein Symptom verschiedener Störungen sein kann, z. B. durch Hörverlust, kardiovaskuläre oder neurologische Erkrankungen, Diabetes oder Tumoren. Bei dekompensiertem Tinnitus leiden die Patienten aufgrund ihrer Unfähigkeit, die auditive Aufmerksamkeit vom Tinnitus-Ton abzulenken, an Schlaflosigkeit, Konzentrationsproblemen und anderen psychologischen Störungen. In extremen Fällen kann es zu Symptomen einer manifesten Depression kommen. Der auditorische Charakter des Tinnitus veranlasst die Patienten überwiegend, Hilfe bei HNO-Ärzten zu suchen. Das erste Ziel der Behandler besteht darin, die Ursache des Tinnitus zu bestimmen und seine audiologischen Eigenschaften zu messen. Das zweite Ziel ist es, die tinnitusinduzierte Belastung einzuschätzen, den Schweregrad zu bewerten und u. U. weiterführende Therapien einzuleiten. Der Artikel beschreibt die audiologischen und psychologischen Eigenschaften des Tinnitus, derzeitige Klassifikationsmodelle und die therapeutischen Ansätze auf diesem Gebiet.

Abstract

Tinnitus is a phantom sound that can be a symptom of various disorders such as hearing loss, cardiovascular diseases, neurological disorders, diabetes or tumors. Because of the inability to divert the auditory attention from tinnitus sound, patients suffer with insomnia, problems with concentration and other psychological conditions, in some extreme cases including major depression symptoms. The auditory character of tinnitus induces the patients to seek help predominantly at the otolaryngologist practice. The first aim of a physician is to establish the cause of tinnitus and to measure its audiological properties. The second aim is to estimate the tinnitus-induced distress and to grade its psychological severity. This manuscript is dedicated to describe the audiological as well as psychological properties of tinnitus, its contemporary classification and the therapeutic methods used in the field.

Schlüsselwörter

auditorisches System - Hörbahn - Hörverlust - Depression - Stress - psychometrische Instrumente - Tinnitustherapien

Key words

auditory system - auditory pathway - hearing loss - depression - stress - psychometric instruments - tinnitus therapies

• Literatur

• 1 Seydel C, Zirke N, Haupt H et al. Psychometric instruments for the diagnosis of tinnitus. HNO 2012; 60: 732-742
• 2 Adoga AA, Adoga AS, Obindo JT. Tinnitus and the prevalence of co-morbid psychological stress. Nigerian J of Med 2008; 17: 95-97
• 3 Maes IH, Cima RF, Vlaeyen JW et al. Tinnitus: a cost study. Ear Hear 2013; 34: 508-514
• 4 Kreuzer PM, Vielsmeier V, Langguth B. Chronic tinnitus: an interdisciplinary challenge. Dt Ärztebl Int 2013; 110: 278-284
• 5 Knipper M, Van Dijk P, Nunes I et al. Advances in the neurobiology of hearing disorder: recent developments regarding the basis of tinnitus and hyperacusis. Prog Neurobiol 2013; 111: 17-33
• 6 AWMF . Chronischer Tinnitus. S3-Leitlinie. 2015
• 7 AWMF . Chronischer Tinnitus. S1-Leitlinie. 2010
• 8 Elgoyhen AB, Langguth B, De Ridder D et al. Tinnitus: perspectives from human neuroimaging. Nature Rev Neurosc 2015; 16: 632-642
• 9 van Dijk P, Langers DR. Mapping tonotopy in human auditory cortex. Adv in exp Med and Biol 2013; 787: 419-425
• 10 Eggermont JJ, Roberts LE. Tinnitus: animal models and findings in humans. Cell and tissue research 2015; 361: 311-336
• 11 Zirke N, Seydel C, Arsoy D et al. Analysis of mental disorders in tinnitus patients performed with Composite International Diagnostic Interview. Qual Life Res 2013; 22: 2095-2104
• 12 Zirke N, Seydel C, Szczepek AJ et al. Psychological comorbidity in patients with chronic tinnitus: analysis and comparison with chronic pain, asthma or atopic dermatitis patients. Qual Life Res 2013; 22: 263-272
• 13 Hebert S, Canlon B, Hasson D. Emotional exhaustion as a predictor of tinnitus. Psychotherapy and psychosomatics 2012; 81: 324-326
• 14 Hebert S, Lupien SJ. The sound of stress: blunted cortisol reactivity to psychosocial stress in tinnitus sufferers. Neurosci Lett 2007; 411: 138-142
• 15 Hebert S, Lupien SJ. Salivary cortisol levels, subjective stress, and tinnitus intensity in tinnitus sufferers during noise exposure in the laboratory. Int J of Hyg and env Health 2009; 212: 37-44
• 16 Hesse G. Evidence and Lack of Evidence in the Treatment of Tinnitus. LRO 2016; 95: 155-191
• 17 Zenner HP. Systematics for mechanisms of tinnitus development. HNO 1998; 46: 699-704
• 18 Biesinger E, Heiden C, Greimel V et al. Strategies in ambulatory treatment of tinnitus. HNO 1998; 46: 157-169
• 19 Schaaf H, Hesse G. Pre- and posttreatment results of an inpatient neurotologic and psychosomatic tinnitus therapy. HNO 2015; 63: 577-582
• 20 Lenarz T. Tinnitus guideline. Germ Soc of Otorhinolary, Head and Neck Surg 1998; 77: 351-535
• 21 Lenarz T. Diagnosis and therapy of tinnitus. LRO 1998; 77: 54-60
• 22 Bruggemann P, Szczepek AJ, Rose M et al. Impact of multiple factors on the degree of tinnitus distress. Front Hum Neurosci 2016; 10: 341
• 23 Langenbach M, Olderog M, Michel O et al. Psychosocial and personality predictors of tinnitus-related distress. Gen Hosp Psy 2005; 27: 73-77
• 24 Langguth B, Kleinjung T, Fischer B et al. Tinnitus severity, depression, and the big five personality traits. Prog Brain Res 2007; 166: 221-225
• 25 Weber JH, Jagsch R, Hallas B. The relationship between tinnitus, personality, and depression. Z Psychosom Med Psychother 2008; 54: 227-240
• 26 Zirke N, Goebel G, Mazurek B. Tinnitus and psychological comorbidities. HNO 2010; 58: 726-732
• 27 Zenner HP, Delb W, Kroner-Herwig B et al. On the interdisciplinary S3 guidelines for the treatment of chronic idiopathic tinnitus. HNO 2015; 63: 419-427
• 28 Folmer RL, Griest SL, Meikle MB et al. Tinnitus severity, loudness, and depression. Otolary Head and Neck Surg 1999; 121: 48-51
• 29 Heinecke K, Weise C, Schwarz K et al. Physiological and psychological stress reactivity in chronic tinnitus. J Behav Med 2008; 31: 179-188
• 30 Hoare DJ, Kowalkowski VL, Kang S et al. Systematic review and meta-analyses of randomized controlled trials examining tinnitus management. Laryngoscope 2011; 121: 1555-1564
• 31 Hoare DJ, Hall DA. Clinical guidelines and practice: a commentary on the complexity of tinnitus management. Eval and Health Prof 2011; 34: 413-420
• 32 Jastreboff PJ. Tinnitus retraining therapy. Br J of Aud 1999; 33: 68-70
• 33 Bauer CA, Brozoski TJ. Effect of tinnitus retraining therapy on the loudness and annoyance of tinnitus: a controlled trial. Ear Hear 2011; 32: 145-155
• 34 Hoekstra CE, Rynja SP, van Zanten GA et al. Anticonvulsants for tinnitusThe Cochrane database of systematic reviews. 2011
• 35 Phillips JS, McFerran D. Tinnitus Retraining Therapy (TRT) for tinnitusThe Cochrane database of systematic reviews. 2010
• 36 Martinez-Devesa P, Perera R, Theodoulou M et al. Cognitive behavioural therapy for tinnitus. The Cochrane database of systematic reviews 2010
• 37 Cima RF, Maes IH, Joore MA et al. Specialised treatment based on cognitive behaviour therapy versus usual care for tinnitus: a randomised controlled trial. Lancet 2012; 379: 1951-1959
• 38 Mazurek B, Georgiewa P, Seydel C et al. Integrated intensive treatment of tinnitus: method and initial results. Gesundheitswesen 2005; 67: 485-491
• 39 Mazurek B, Fischer F, Haupt H et al. A modified version of tinnitus retraining therapy: observing long-term outcome and predictors. Audiol & Neuro-Otol 2006; 11: 276-286
• 40 Mazurek B, Hesse G. Current status of tinnitus research and treatment. HNO 2010; 58: 971-972
• 41 Mazurek B. Tinnitus: from basic principles to therapy. HNO 2015; 63: 253-257
• 42 Seydel C, Haupt H, Szczepek AJ et al. Long-term improvement in tinnitus after modified tinnitus retraining therapy enhanced by a variety of psychological approaches. Audiol & Neuro-Otol 2010; 15: 69-80
• 43 Hobson J, Chisholm E, El Refaie A. Sound therapy (masking) in the management of tinnitus in adults. The Cochrane database of systematic reviews 2012; 11: CD006371
• 44 Hoare DJ, Searchfield GD, El Refaie A et al. Sound therapy for tinnitus management: practicable options. J Am Acad of Audiol 2014; 25: 62-75
• 45 Shekhawat GS, Searchfield GD, Kobayashi K et al. Prescription of hearing-aid output for tinnitus relief. Int J Audiol 2013; 52: 617-625
• 46 Searchfield GD, Kaur M, Martin WH. Hearing aids as an adjunct to counseling: tinnitus patients who choose amplification do better than those that don’t. Int J Audiol 2010; 49: 574-579
• 47 Tunkel DE, Bauer CA, Sun GH et al. Clinical practice guideline: tinnitus. Otolary Head Neck Surg 2014; 151: 1-40
• 48 McNeill C, Tavora-Vieira D, Alnafjan F et al. Tinnitus pitch, masking, and the effectiveness of hearing aids for tinnitus therapy. Int J Audiol 2012; 51: 914-919
• 49 Lin HW, Bhattacharyya N. Otologic diagnoses in the elderly: current utilization and predicted workload increase. Laryngoscope 2011; 121: 1504-1507
• 50 Hesse G. Neurootologic and psychosomatic habituation therapy. Treatment approaches in chronic tinnitus . HNO 2008; 56: 686-693
• 51 Schaaf H, Eichenberg C, Kastellis G et al. Treatment of tinnitus needs a combined neurootological and psychosomatic approach. Otolary polska 2010; 64: 78-82
• 52 Ptok M, Meyer S, Ptok A. Hearing training, hearing therapy and auditory rehabilitation in hearing impaired individuals during the last few centuries. HNO 2012; 60: 913-918
• 53 Hoare DJ, Stacey PC, Hall DA. The efficacy of auditory perceptual training for tinnitus: a systematic review. Annals of behavioral medicine: a publication of the Society of Behavioral Medicine 2010; 40: 313-324
• 54 Herraiz C, Diges I, Cobo P et al. Auditory discrimination training for tinnitus treatment: the effect of different paradigms. Europ Arch of Otorhinolary 2010; 267: 1067-1074
• 55 Herraiz C, Hernandez FJ, Toledano A et al. Tinnitus retraining therapy: prognosis factors. Am J Otolary 2007; 28: 225-229
• 56 Herraiz C, Diges I, Cobo P et al. Auditory discrimination therapy (ADT) for tinnitus managment: preliminary results . Acta Otolary Suppl 2006; 80-83
• 57 Punte AK, Vermeire K, Hofkens A et al. Cochlear implantation as a durable tinnitus treatment in single-sided deafness. Cochl Impl Int 2011; 12: 26-29
• 58 Olze H, Szczepek AJ, Haupt H et al. The impact of cochlear implantation on tinnitus, stress and quality of life in postlingually deafened patients. Audiol & Neuro-Otol 2012; 17: 2-11
• 59 Olze H, Szczepek AJ, Haupt H et al. Cochlear implantation has a positive influence on quality of life, tinnitus, and psychological comorbidity. Laryngoscope 2011; 121: 2220-2227
• 60 Blasco MA, Redleaf MI. Cochlear implantation in unilateral sudden deafness improves tinnitus and speech comprehension: meta-analysis and systematic review. Otol Neurotol 2014; 35: 1426-1432
• 61 Langguth B, Elgoyhen AB. Current pharmacological treatments for tinnitus . Exp Op Pharmacother 2012; 13: 2495-2509
• 62 Goebel G, Kahl M, Arnold W et al. 15-year prospective follow-up study of behavioral therapy in a large sample of inpatients with chronic tinnitus. Acta Otolary Suppl 2006; 70-79
• 63 Schaaf H, Dolberg D, Seling B et al. Comorbidity of tinnitus and psychiatric disorders. Nervenarzt 2003; 74: 72-75
• 64 Konzag TA, Rubler D, Bandemer-Greulich U et al. Psychological comorbidity in subacute and chronic tinnitus outpatients. Z Psychosom Med Psychother 2005; 51: 247-260
• 65 Hofmann E, Behr R, Neumann-Haefelin T et al. Pulsatile tinnitus: imaging and differential diagnosis. Dt Ärztebl Int 2013; 110: 451-458
• 66 Soyka MB, Schuknecht B, Huber AM. Aberrant internal carotid artery as a cause of pulsatile tinnitus: a difficult diagnosis in MRI?. HNO 2010; 58: 151-154
• 67 Stoll W. Pulsatile tinnitus caused by ectopic blood vessels in the middle ear area. Contribution to the differential diagnosis of glomus jugulare tumor. LRO 1987; 66: 381-385
• 68 Biesinger E, Groth A, Hoing R et al. Somatosensoric tinnitus. HNO 2015; 63: 266-271
• 69 Reisshauer A, Mathiske-Schmidt K, Kuchler I et al. Functional disturbances of the cervical spine in tinnitus. HNO 2006; 54: 125-131
• 70 Biesinger E, Reisshauer A, Mazurek B. The role of the cervical spine and the craniomandibular system in the pathogenesis of tinnitus. Somatosensory tinnitus. HNO 2008; 56: 673-677