Skip to main content
Log in

Current concepts in the clinical management of patients with tinnitus

  • Clinical Review
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. 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

    PubMed  CAS  Google Scholar 

  2. Berliner K, Shelton C, Hitseberger W, Luxford W (1992) Acoustic tumors: effect of surgical removal on tinnitus. Am J Otol 13:13–17

    PubMed  CAS  Google Scholar 

  3. Blakany T, Bantil H (1987) Workshop: direct electrical stimulation of the inner ear for the relief of tinnitus. Am J Otol 8:207–212

    Google Scholar 

  4. 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

    Google Scholar 

  5. Brusis T, Loenneckeni R (1985) Treatment of tinnitus with lontophoresis and local anesthesia. Laryngorhinootologie 64:355–358

    CAS  Google Scholar 

  6. Carman R, Sbihovec D (1984) Relaxation biofeedback in the treatment of tinnitus. Am J Otol 5:376–381

    Google Scholar 

  7. Crinnion CL, McCart G (1995) Misoprostol for tinnitus. Ann Pharmacother 29:782–784

    PubMed  CAS  Google Scholar 

  8. Dobie R, Sullivan M, Katon W, Sakai C, Russo J (1992) Antidepressant treatment for tinnitus patients. Acta Otolaryngol (Stockh) 112:242–247

    CAS  Google Scholar 

  9. 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

    PubMed  CAS  Google Scholar 

  10. Emmet J, Shea J (1984) Medical treatment of tinnitus. J Laryngol Otol [Suppl 9] 98:264–270

    Google Scholar 

  11. Fucci M, Sataloff R, Myers D (1994) Vestibular nerve section. Am J Otolaryngol 15:180–189

    Article  PubMed  CAS  Google Scholar 

  12. 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

    Article  PubMed  CAS  Google Scholar 

  13. 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

    PubMed  CAS  Google Scholar 

  14. Huynh L, Fields S (1995) Alprazolam for tinnitus. Ann Pharmocother 29:311–312

    CAS  Google Scholar 

  15. 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

    PubMed  CAS  Google Scholar 

  16. 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

    PubMed  CAS  Google Scholar 

  17. 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

    CAS  Google Scholar 

  18. 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

    Article  PubMed  CAS  Google Scholar 

  19. 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

    CAS  Google Scholar 

  20. Mason J, Rogerson D (1995) Client-centered hypnotherapy for tinnitus: who is likely to benefit? Amer J Clin Hypn Apr 37:294–299

    CAS  Google Scholar 

  21. 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

    PubMed  CAS  Google Scholar 

  22. Pulec J (1995) Cochlear nerve section for intractable tinnitus. Ear Nose Throat J 174:468, 470–476

    Google Scholar 

  23. Salah RS, DeQuardo JR, Jibson MD, Carli T, Tandon R (1995) Tinnitus and ECT. Convuls Ther 11:122–125

    PubMed  CAS  Google Scholar 

  24. Scott B, Lindberg P, Lyttkens L, Mellin L (1985) Psychological treatment of tinnitus in experimental groups study. Scandinavia Audiologic 14:223–230

    CAS  Google Scholar 

  25. Shouard CH, Meyer B, Maridat D (1981) Transcutaneous electrical therapy for severe tinnitus. Acta Otolaryngol 91:415–422

    Google Scholar 

  26. Silverstein H, Haberkamp T, Smouha E (1986) The state of tinnitus after inner ear surgery. Otolaryngol Head Neck Surg 95:438–441

    PubMed  CAS  Google Scholar 

  27. Soderman A, Ahlner K, Bagger-Sjoback D (1996) Surgical treatment of vertigo — the Karolinska Hospital policy. Am J Otol 17:93–98

    PubMed  CAS  Google Scholar 

  28. Tyler R (1995) Tinnitus in the profoundly hearing-impaired and the effects of cochlear implants. Ann Otol Rhinol Laryngol Suppl 165:25–30

    PubMed  CAS  Google Scholar 

  29. Van Leewen J, Braspenning J, Meijer H, Cremers CW (1996) Quality of life after acoustic neuroma surgery. Ann Otol Rhinol Laryngol 105:423–430

    Google Scholar 

  30. Vernon J (1977) Attempts to relieve tinnitus. Am Audiolog Soc 2:124

    CAS  Google Scholar 

  31. 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

    Google Scholar 

  32. 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

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints 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

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02439968

Key words

Navigation