Psychotherapy to treat tinnitus

Psychotherapy can help treat tinnitus. In Germany around 10 to 20 percent suffer from ear noises.

(23.09.2010) In Germany, about 10 to 20 percent of the population suffer permanently from tinnitus aurium (Latin for "ringing the ears") or short tinnitus. 40 percent have heard this kind of ear noise at least once in their lives, with around a third of older people being affected by constant tinnitus. There is no standard therapy that promises success. However, good results have already been achieved in the past with individually adapted forms of treatment, so that many patients can be helped.

The Professional Association of German Neurologists (BVDN) currently points out that tinnitus retraining, a type of habituation and adaptation therapy, has recently had positive treatment results and that psychotherapy should also be used to combat the nerve-consuming ear noise. The therapist and the patient try to find out the causes of the disease and jointly develop methods to minimize the noise. Psychotherapy can be very helpful in chronic tinnitus patients. Accompanying relaxation methods are also considered useful in this context. Because stress is the most common cause of tinnitus. In particular, if chronic tinnitus occurs together with other mental illnesses such as depression, according to BVDN chairman Frank Bergmann, psychotherapy offers a good alternative treatment. In these cases, the psychotherapeutic approach can treat not only tinnitus, but the entire clinical picture.

In the case of tinnitus caused by sudden noise, also called sudden hearing loss, another treatment is required. Medications that promote blood circulation are the first choice here to prevent the one-off occurrence from becoming chronic tinnitus. Because the longer the tinnitus persists, the higher the likelihood that it will persist. While in most cases the sounds perceived by the patient have no external source that can be perceived by other people, there is also objective tinnitus. This relatively rare form of tinnitus is based on an externally perceptible or at least measurable body's own sound source. For example, objective tinnitus can be linked to the pulse, which experts call pulse-synchronous ear noises. “The sound is real. The doctor can often hear it when he puts his stethoscope on his neck or behind his ear, ”explains Professor Dr. med. Erich Hofmann, Director of the Clinic for Diagnostic and Interventional Neuroradiology at the Fulda Clinic. This is a transmitted noise from the blood vessels, the expert continues.

Surgical interventions are usually required here, but they also promise a relatively great success in treatment. For example, patients in whom calcification of the vessels (arteriosclerosis) leads to constrictions in the carotid artery can be helped with a stent. If a connection between the carotid artery and the adjacent vein is the cause of objective tinnitus, the doctors can “glue the affected vessels via a catheter (…) in such a way that the short circuit between artery and vein is eliminated,” explains Prof. Hofmann . According to the expert, certain tumors that cause ear noises can also be treated relatively well. But there are also cases of objective tinnitus in which no treatment methods are known. This is more often the case, for example, if the carotid artery runs through the middle ear in patients from birth and this causes objective tinnitus. The causes of pulse-synchronous ear noises as well as diagnosis and therapy with the help of imaging methods will be a focus of the annual conference of the German Society for Neuroradiology (DGNR) “neuroRad 2010” in Cologne.

The classification of tinnitus as an independent disease is also considered problematic among experts. Because the ringing in the ears is usually a symptom of another disease. If the therapy focuses only on the removal of tinnitus, but not on the treatment of the cause, the patients can hardly be helped. It is therefore hardly surprising that none of the numerous treatment methods has so far been able to establish itself as scientifically sound and promising. Depending on the cause of tinnitus, a different treatment is required. However, the psychotherapeutic approach offers a good alternative in this regard, since the probability of the cause of the tinnitus is relatively high. (fp)

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