Interventions against hearing loss as an integral component of successful tinnitus therapy.

Tinnitus very often develops from acute or chronic hearing loss, mainly inner ear deafness. The frequency of the tinnitus mostly corresponds to the frequency range of the hearing loss and is enhanced by down-regulation of inhibition in the central auditory pathway for these frequencies, in addition to focused attention and enhanced arousal for the disturbing sound. Therefore, interventions to improve hearing such as mid-ear surgery or-more often-electronic devices including hearing aids or cochlear implants (CI) are important for the treatment of tinnitus. In this review, the current German S3 guideline "Chronic tinnitus" and recent literature are discussed.

[Interventions against hearing loss are an integral component of successful tinnitus therapy. German version]. / Hörverbessernde Maßnahmen als integraler Bestandteil einer erfolgreichen Tinnitusbehandlung.

Tinnitus very often develops from acute or chronic hearing loss, mainly inner ear deafness. The frequency of the tinnitus mostly corresponds to the frequency range of the hearing loss and is enhanced by down-regulation of inhibition in the central auditory pathway for these frequencies, in addition to focused attention and enhanced arousal for the disturbing sound. Therefore, interventions to improve hearing such as mid-ear surgery or-more often-electronic devices including hearing aids or cochlear implants (CI) are important for the treatment of tinnitus. In this review, the current German S3 guideline "Chronic tinnitus" and recent literature are discussed.

[Tinnitus counseling in a specialized ambulanz and a attempt to identify relevant "interactional" factors for outcome]. / Tinnitus Counselling in einer Spezialambulanz und ein (gescheiterer) Versuch, relevante "interaktionelle" Faktoren für den Erfolg zu identifizieren.

One aim of our large-scale catamnesis was to prove that neuro-otological diagnostics and knowledge are a fundamental prerequisite in counseling, but also that the counterpart, the patient, has to be reached in his or her distress. For this purpose, we had developed an own 6-part scaled questionnaire on the understanding of the counseled and on the feeling of being understood as a patient. Through its evaluation we had hoped to obtain reliable findings with regard to individual effect factors.Therefore we had mailed to 699 outpatients who had been counseled by us. In 295, the hearing findings, the Mini-Tinnitus Questionnaire (TF 12) and the Hospitality Anxiety and Depression Scores (HADS) could be compared at two measurement points at least 6 months apart.While counseling was found to be sustainable in symptom reduction and compliance to implement recommended interventions, no significant single interactional factor in counseling was detected by our examiation after proper statistics were obtained.In the article, the steps taken and corrections made are also pointed out with regard to the appropriate statistical approach, also to point out that primarily clinicians often need the support of trained statisticians.

[Catamnesis after a single intervention for tinnitus patients in a specialized clinic]. / Katamnese nach einmaliger Intervention bei Tinnituspatienten in einer Spezialambulanz.

BACKGROUND: Patients suffering from tinnitus require individualized clarification (counseling), sometimes going beyond the scope of the field of ENT and the initiation of specific interventions. AIM: To investigate if patients who had a specific neurotological assessment including a psychosomatic medical history follow the recommendations provided to them. In addition, it should be examined whether compliance with the treatment suggestions has led to any psychological improvement in the suffering from tinnitus, evaluated by psychological tests. MATERIAL AND METHOD: In295 out of 699 patients audiological tests were evaluated using the mini-questionnaire (TF 12) according to Hiller and Goebel and the German language version of the Hospitality Anxiety and Depression Scale (HADS) at 2 points in time with an interval of a least 6 months. The group of those who followed the recommendations were compared to the group of those who did not follow the recommendations. RESULTS: A total of 180 patients (64.5%) followed at least 1 of the recommendations made to them. Patients who followed at least one recommendation benefited significantly more than the whole group in the TF 12 and in both HADS categories compared to the group that did not follow the recommendations. CONCLUSION: In addition to counseling it was shown that the implementation of a specific measure has a positive effect, detectable for the Progressive Muscle Relaxation (PMR). Specific for ENT, a hearing aid can initiate an improvement even if no statistically significant difference to the comparison group was found.