Abstract
The current management in tinnitus of sensorineural origin is reviewed. Epidemiological data demonstrates that 90% of patients with hearing loss experience some tinnitus. Approximately 1% of the population suffer from a chronic tinnitus that causes severe distress and requires some type of management intervention. Present non-surgical therapies include masking techniques, psychological counseling, and biofeedback. There are also a number of drugs that have been applied, the most common being antidepressants. These have had the most success in managing patients with tinnitus, although it is currently felt that antidepressants treat underlying psychological problems rather than directly affect the tinnitus. The other large class of drugs include benzodiazopans, in addition to a new synthetic analog of a natural prostaglandin E1, misoprostol. Despite the many drugs now available,none has been approved by the United States Food and Drug Administration for the treatment of tinnitus. Many surgical therapies have been advocated but are directed towards the treatment of concurrent vertigo or for tumors of the cerebellopontine angle, with tinnitus sometimes being relieved by the operation. Specific surgical procedures such as cochlear resection and microvascular decompressions lack clear-cut efficacy. Despite author bias and a myriad of treatment modalities at present, there is still no specific therapy that definitively relieves tinnitus clinically.
Similar content being viewed by others
References
Attias J, Shemesh Z, Bleich A, Solomon Z, Bar-Or G, Alster J, Sohmer H (1995) Psychological profile of help-seeking and non-help-seeking tinnitus patients. Scand Audiol 24:13–18
Berliner K, Shelton C, Hitseberger W, Luxford W (1992) Acoustic tumors: effect of surgical removal on tinnitus. Am J Otol 13:13–17
Blakany T, Bantil H (1987) Workshop: direct electrical stimulation of the inner ear for the relief of tinnitus. Am J Otol 8:207–212
Briner W, House J, O'Leary M (1993) Synthetic prosta-gland in E1 Misoprostol as a treatment for tinnitus. Arch Otolaryngol Head Neck Surg 119:62–64
Brusis T, Loenneckeni R (1985) Treatment of tinnitus with lontophoresis and local anesthesia. Laryngorhinootologie 64:355–358
Carman R, Sbihovec D (1984) Relaxation biofeedback in the treatment of tinnitus. Am J Otol 5:376–381
Crinnion CL, McCart G (1995) Misoprostol for tinnitus. Ann Pharmacother 29:782–784
Dobie R, Sullivan M, Katon W, Sakai C, Russo J (1992) Antidepressant treatment for tinnitus patients. Acta Otolaryngol (Stockh) 112:242–247
Dobie R, Sakai C, Sullivan M, Katon W, Russo J (1993) Anti-depressant treatment of tinnitus patients: report of randomized clinical trail and clinical prediction of benefit. Am J Otol 14:18–23
Emmet J, Shea J (1984) Medical treatment of tinnitus. J Laryngol Otol [Suppl 9] 98:264–270
Fucci M, Sataloff R, Myers D (1994) Vestibular nerve section. Am J Otolaryngol 15:180–189
Goel A, Sekhar L, Langheinrich W, Kamerer D, Hirsch B (1992) Late course of preserved hearing and tinnitus after acoustic neurilemoma surgery. J Neurosurg 77:685–689
Henrich D, McCabe B, Gantz B (1995) Tinnitus and acoustic neuromas; analysis of the effect of surgical excision on postoperative tinnitus. Ear Nose Throat J 74:462–466
Huynh L, Fields S (1995) Alprazolam for tinnitus. Ann Pharmocother 29:311–312
Jannetta P (1977) Observations on the etiology of trigeminal neuralgia, hemifacial spasm, acoustic nerve dysfunction and glossopharyngeal neuralgia. Definitive microsurgical treatment and results in 117 patients. Neurochirurgia 20: 145–154
Kane N, Kazanas S, Maw A, Coakham HB, Torrens MJ, Morgan MH, Stranjalis G, Butler SR (1995) Functional outcome in patients after excision of intracanalicular acoustic neuromas using the suboccipital approach. Ann R Coll Surg Engl 77:210–216
Kirsch C, Blanchard E, Pames S (1989) Psychological characteristics of individuals high and low in their ability to cope with tinnitus. Psychom Med 51:209–217
Kroner-Herwig B, Herbing G, Van Rijn-Kalkmann U, Frenzel A, Schilkowsky G, Esser G (1995) The management of chronic tinnitus-comparison of a cognitive-behavioural group training with yoga. J Psychosom Res 39:153–165
Kubo T, Doi K, Takeda N, Sugiyama N, Yamada K, Kohmura E, Hayakawa T (1995) Assessment of auditory and vestibular functions after vestibular neurectomy for Meniere's disease. Acta Otolaryngol (Stockh) 115:149–153
Mason J, Rogerson D (1995) Client-centered hypnotherapy for tinnitus: who is likely to benefit? Amer J Clin Hypn Apr 37:294–299
Plath P, Oliver J (1995) Results of combined low-power laser therapy and extracts of Ginkgo biloba in cases of sensorineural hearing loss and tinnitus. Adv Otorhinolaryngol 49:101–104
Pulec J (1995) Cochlear nerve section for intractable tinnitus. Ear Nose Throat J 174:468, 470–476
Salah RS, DeQuardo JR, Jibson MD, Carli T, Tandon R (1995) Tinnitus and ECT. Convuls Ther 11:122–125
Scott B, Lindberg P, Lyttkens L, Mellin L (1985) Psychological treatment of tinnitus in experimental groups study. Scandinavia Audiologic 14:223–230
Shouard CH, Meyer B, Maridat D (1981) Transcutaneous electrical therapy for severe tinnitus. Acta Otolaryngol 91:415–422
Silverstein H, Haberkamp T, Smouha E (1986) The state of tinnitus after inner ear surgery. Otolaryngol Head Neck Surg 95:438–441
Soderman A, Ahlner K, Bagger-Sjoback D (1996) Surgical treatment of vertigo — the Karolinska Hospital policy. Am J Otol 17:93–98
Tyler R (1995) Tinnitus in the profoundly hearing-impaired and the effects of cochlear implants. Ann Otol Rhinol Laryngol Suppl 165:25–30
Van Leewen J, Braspenning J, Meijer H, Cremers CW (1996) Quality of life after acoustic neuroma surgery. Ann Otol Rhinol Laryngol 105:423–430
Vernon J (1977) Attempts to relieve tinnitus. Am Audiolog Soc 2:124
Von Wedel H, Calero L, Walger M, Hoenen S, Ruwalt D (1995) Soft-laser/Ginkgo therapy in chronic tinnitus. A placebocontrolled study. Adv Otorhinolaryngol 49:105–108
Zhang K, Shun Z (1995) Microvascular decompression by the retrosigmoid approach for idiopathic hemifacial spasm: experience with 300 cases. Ann Otol Rhinol Laryngol 104:610–612
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Parnes, S.M. Current concepts in the clinical management of patients with tinnitus. Eur Arch Otorhinolaryngol 254, 406–409 (1997). https://doi.org/10.1007/BF02439968
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02439968