Prophylaxis
Since the cause of tinnitus is largely unknown, the only real recommendation for prophylaxis is to avoid atherosclerosis of the blood vessels (risk of circulatory disorders of the ear) and to reduce stress and postural deformities.
Prognosis
In some cases, even without treatment, there is a spontaneous disappearance of the ear noises. In case of acute tinnitus, healing processes are recorded in 60%-80%. In chronic or subacute tinnitus, healing is often much rarer. Even if there are different evaluations of an acute therapy and its effectiveness, according to the current guidelines a quick treatment should still be started with an acute tinnitus and thus the chances of a cure should be influenced positively under certain circumstances.In subacute and chronic cases, the absolute disappearance of ringing in the ears occurs less frequently, but with appropriate behavioral therapy, the pressure of suffering can be reduced and a more normal life with ringing in the ears can be made possible.
Celebrities with tinnitus
The fact that tinnitus is a very old disease is also shown by various accounts of historical celebrities who also suffered from tinnitus. Among them count: Martin Luther, Beethoven, Rousseau, Smetana and GoyaThe clinical picture of tinnitus or unknown noises in the ear has been described very early. The first records were found on ancient Egyptian papyri, on Babylonian clay tablets and in Ayur Veda, the book of Indian medicine.
In Babylonian medicine in the 17th century B.C. the opinion prevailed that tinnitus was a hidden message of spirits and gods whispered to patients. The clinical picture was attempted to treat the disease by introducing various mixtures into the ear.
Also the pronouncing of various spells should bring improvement of the symptoms. Hippocrates found that most of the ear noises disappeared when the patient approached a louder noise source. He suspected that the tinnitus was caused exclusively by pulsation of vessels.
Pliny 23-79 A.D. first coined the term tinnitus and recommended a brew of rose oil, honey and pomegranate bark for treatment. Tinnitus is generally understood to be the presence of ringing in the ears that cannot come from the patient’s immediate surroundings. The complaints are painless but are usually associated with a wading hearing or hearing disorders and sometimes dizziness.
The reason is the unusual single ear hearing, which upsets the balance system. The causes of tinnitus are largely unexplained. The various theories focus on neuronal factors, circulatory disorders and psychogenic factors.
The ear noises are usually described by the patients as permanent and sometimes of increasing volume. The type of ear noises can be caused by different frequencies and can be perceived by the patient as whistling, humming, hissing or squeaking sounds. Tinniti can be classified into 4 degrees according to the place of origin (objective= pulsating vessel or pressure exerting nerve; subjective= place is unknown), the duration of the disease (acute= in the last three months, subacute= between 3 months and one year; chronic= longer than one year) and the condition of the patient, whereby degree 1 can hardly be perceived by the patient and is more likely to be overheard, whereas degree 4 is so severe that the patient’s everyday life is severely impaired.
These impairments can manifest themselves in concentration disorders, irritability, sleep disorders, anxiety and depression. In very extreme cases, suicidal thoughts or completed suicides may also occur. The diagnosis must be adapted to the individual patient.
For reasons of cost and effort, the full program of diagnostics should only be performed in patients who could not be treated after the basic diagnostics. An important diagnostic criterion is the patient survey, in which the duration of the illness, type of complaints and impairment in daily life should be asked. The diagnosis of tinnitus patients is a multidisciplinary diagnostic procedure in which ENT physicians, neurologists, internists and, if necessary, psychologists should be involved.
The treatment of patients with acute tinnitus should be carried out quickly in order to increase the prognosis of a cure accordingly. Blood-thinning medication, local anesthetics or anti-inflammatory cortisone are used. For patients with chronic tinnitus, attention must be paid more to psychogenic treatment, which focuses on behavioral therapy and autogenic training.
These patients must be made aware that the ringing in the ears will probably not disappear completely, but that appropriate cognitive training will regulate the perception of the tinnitus downwards. The treatment of acute tinnitus and its subacute form is a mixed treatment of acute and chronic tinnitus. Some partially promising therapies are currently still undergoing clinical trials, such asB.
the hyperbaric oxygen treatment, in which the patient is supplied with oxygen in a hyperbaric chamber, or a form of treatment in which the patient is permanently additionally supplied with the same sound that he hears through a small hearing aid. Despite promising results, these treatments are not yet covered by health insurance and have to be financed by the patient himself. The acute tinnitus disappears by itself in 60%-80%. The prognosis of the subacute and chronic forms is much worse and may have to be endured throughout life.
