Zur interdisziplinären S3-Leitlinie für die Therapie des chronisch-idiopathischen Tinnitus

Zenner, Hans‐Peter; Delb, W.; Kröner‐Herwig, Birgit; Jäger, Bürkard; Peroz, Ingrid; Hesse, Gerhard; Mazurek, Birgit; Goebel, Gerhard; Gerloff, Christian; Trollmann, Regina; Biesinger, E.; Seidler, Harald; Langguth, Berthold

doi:10.1007/s00106-015-0011-z

Cited by 28 publications

(14 citation statements)

References 59 publications

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“…The time course of transition from the acute to the chronic condition is not entirely clear. Whereas, some define duration of up to 3 months as subacute and a tinnitus lasting at least 6 months as being chronic ( 12 ), others assume the chronic condition is reached already after 3 months ( 19 ). Assessments in the present study were chosen to investigate these time intervals and together with studies on spontaneous remission after sudden HL ( 7 ) indicate that chronification of the tinnitus is taking place during the first days or weeks after onset.…”

Section: Discussionmentioning

confidence: 99%

“…We set out to investigate the development of acute tinnitus within the 6 months after its first appearance, i.e., during transition from the acute to the chronic condition ( 19 ). As tinnitus is a phenomenon associated with the ears, patients experiencing it for the first time are likely to seek help by an otolaryngologist, at least in a country where the general health system allows them to do so without extra cost.…”

Section: Introductionmentioning

confidence: 99%

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Transition from Acute to Chronic Tinnitus: Predictors for the Development of Chronic Distressing Tinnitus

et al. 2017

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BackgroundAcute tinnitus and its transition to chronic tinnitus are poorly investigated, and factors associated with amelioration versus exacerbation are largely unknown. Aims of this study were to identify early predictors for the future development of tinnitus severity.MethodPatients with tinnitus of no longer than 4 weeks presenting at an otolaryngologist filled out questionnaires at inclusion (T1), as well as 3 (T3), and 6 months (T4) after tinnitus onset. 6 weeks after onset, an interview was conducted over the phone (T2). An audiogram was taken at T1, perceived tinnitus loudness, and tinnitus-related distress were assessed separately and repeatedly together with oversensitivity to external sounds and the levels of depression and anxiety. Furthermore, coping strategies with illness were recorded.ResultsComplete remission until T4 was observed in 11% of the 47 participants, while voiced complaints at onset were stable in the majority. In the subgroup with a relevant level of depression at T1, tinnitus-related distress worsened in 30% until T4. For unilateral tinnitus, perceived loudness in the chronic condition correlated strongly with hearing loss at 2 kHz on the tinnitus ear, while a similar correlation was not found for tinnitus located to both ears or within the head.ConclusionResults suggest early manifestation of tinnitus complaints, and stress the importance of screening all patients presenting with acute tinnitus for levels of depression and tinnitus-related distress. Furthermore, hearing levels should be monitored, and use of hearing aids should be considered to reduce tinnitus loudness after having ascertained that sound sensitivity is within normal range.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Transition from Acute to Chronic Tinnitus: Predictors for the Development of Chronic Distressing Tinnitus

et al. 2017

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“…Therefore, the treatment was conducted within 4 modules, which will be described below. The selection of the modules is based on the “Algorithm for the Diagnostic & Therapeutic Management of Tinnitus” (Tinnitus Research Initiative: Biesinger et al, 2008) and the German S3 guideline for chronic tinnitus, in accordance with the recommendations from Zenner et al (2015). …”

Section: Methodsmentioning

confidence: 99%

Results of an Interdisciplinary Day Care Approach for Chronic Tinnitus Treatment: A Prospective Study Introducing the Jena Interdisciplinary Treatment for Tinnitus

Ivanšić

Dobel

Volk

et al. 2017

Front. Aging Neurosci.

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Objective: Considering the heterogeneity of the symptoms shown by patients suffering from chronic tinnitus, there are surprisingly few interdisciplinary treatments available, and mostly available only for inpatients. In order to provide an interdisciplinary treatment, we developed a day care concept in which each patient was treated by an ENT doctor, a cognitive behavioral therapist, a specialist for medical rehabilitation and an audiologist (Jena Interdisciplinary Treatment for Tinnitus, JITT). The aim of this study was to observe the changes of tinnitus related distress due to interdisciplinary day care treatment and to determine which factors mediate this change.Subjects and Methods: Tinnitus annoyance was measured using the Tinnitus Questionnaire on 308 patients with chronic tinnitus. They were treated in the day care unit over five consecutive days between July 2013 and December 2014. Data were collected before treatment when screened (T0), at the beginning (T1) and at the end of the 5 day treatment (T2), as well as 20 days (T3) and 6 months after treatment (T4).Results: Overall, tinnitus annoyance improved significantly from the screening day to the beginning of treatment, and to a much larger degree from the beginning to the end of treatment. The treatment outcome remained stable 6 months after treatment. Patients with the following symptoms displayed higher tinnitus annoyance at T0: dizziness at tinnitus onset, tinnitus sound could not be masked with background noise, tinnitus worsening during physical stress, comorbid psychiatric diagnosis, higher age and higher hearing loss. Loudness of tinnitus perceived in the right ear correlated with tinnitus annoyance significantly. Demographic, tinnitus and strain variables could only explain 12.8% of the variance of the change in tinnitus annoyance from T0 to T4. Out of 39 predictors, the only significant ones were “sick leave 6 months before treatment” and “tinnitus annoyance at T0.”Conclusion: The newly developed JITT represents a valuable treatment for chronic tinnitus patients with improvement remaining stable for at least 6 months after treatment. Using a large number of variables did not allow predicting treatment outcome which underlines the heterogeneity of tinnitus.

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“…A meta-analysis of anticonvulsant treatment with carbamazepine, gabapentin and lamotrigine did not reveal additional benefits compared to placebo in controlled studies [146]. For benzodiazepines beneficial effects on tinnitus distress were reported [147], but long-term data are missing and in light of the dependency risk of regular benzodiazepine intake their routine use cannot be recommended [148, 149]. New approaches currently under study include potassium channel modulators [62, 93] and the intra-tympanic application of the NMDA receptor antagonist s-ketamine [150].…”

Section: Treatment Of Tinnitusmentioning

confidence: 99%

Maladaptive plasticity in tinnitus — triggers, mechanisms and treatment

2016

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Tinnitus is a phantom auditory sensation that reduces quality of life for millions worldwide and for which there is no medical cure. Most cases are associated with hearing loss caused by the aging process or noise exposure. Because exposure to loud recreational sound is common among youthful populations, young persons are at increasing risk. Head or neck injuries can also trigger the development of tinnitus, as altered somatosensory input can affect auditory pathways and lead to tinnitus or modulate its intensity. Emotional and attentional state may play a role in tinnitus development and maintenance via top-down mechanisms. Thus, military in combat are particularly at risk due to combined hearing loss, somatosensory system disturbances and emotional stress. Neuroscience research has identified neural changes related to tinnitus that commence at the cochlear nucleus and extend to the auditory cortex and brain regions beyond. Maladaptive neural plasticity appears to underlie these neural changes, as it results in increased spontaneous firing rates and synchrony among neurons in central auditory structures that may generate the phantom percept. This review highlights the links between animal and human studies, including several therapeutic approaches that have been developed, which aim to target the neuroplastic changes underlying tinnitus.

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Zur interdisziplinären S3-Leitlinie für die Therapie des chronisch-idiopathischen Tinnitus

Cited by 28 publications

References 59 publications

Transition from Acute to Chronic Tinnitus: Predictors for the Development of Chronic Distressing Tinnitus

Transition from Acute to Chronic Tinnitus: Predictors for the Development of Chronic Distressing Tinnitus

Results of an Interdisciplinary Day Care Approach for Chronic Tinnitus Treatment: A Prospective Study Introducing the Jena Interdisciplinary Treatment for Tinnitus

Maladaptive plasticity in tinnitus — triggers, mechanisms and treatment

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