Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program or program for underweight.
Review of permanent medication due topossible effect on the existing disease.
Avoidance of psychosocial stress:
Psychological stresses
Stress
Avoidance of environmental stress:
Explosion trauma, blast trauma.
Conventional non-surgical therapy methods
Tinnitus retraining therapy (TRT) is a scientifically based approach to the therapy of chronic decompensated tinnitus. The goal of the therapy is habituation (getting used to) the tinnitus TRT is a long-term therapy (from 12 to 24 months) and aims at a long-term improvement of the individual’s condition. It consists of a four-pillar concept:
Device supply (see below under “Complementary treatment methods / tinnitus masker”).
In the current S3 guideline, TRT is no longer recommended[1].
Hearing aid provision (HG) i. S. of hearing therapy for tinnitus and hearing loss; for low and medium tinnitus frequencies (up to 6 KHz), the benefit is higher than for high-frequency tinnitus.
Hyperbaric oxygenation (HBO; synonyms: hyperbaric oxygentherapy, HBO therapy; English : hyperbaric oxygen therapy; HBO2, HBOT); therapy in which medically pure oxygen is applied under an increased ambient pressure.
Regular check-ups
Regular medical checkups
Nutritional medicine
Nutritional counseling based on nutritional analysis
Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
Detailed information on sports medicine you will receive from us.
Physical therapy (including physiotherapy)
Manual therapy (manipulation and mobilization of joints) can provide relief, especially for cervical spine disorders.
Note: There are currently no sufficiently large controlled studies on cervical spine therapy.
TMJ distraction therapy: in the so-called craniomandibular dysfunction (CMD), there is a loss of the correct bite height due to, among other things, a congenital misalignment of the teeth, one-sided chewing and teeth grinding. This leads to the fact that the lower jaw is no longer sufficiently stabilized and the temporomandibular joint head shifts. This is how the temporomandibular joint noises typical of CMD occur. As the temporomandibular joint head is pushed far back towards the middle ear when closing the mouth, and the pressure on the nerves in between increases strongly. Tinnitus or headaches – especially in the temporal region – can be the result of this nerve stimulus.Dentists treat this problem with the help of a wafer-thin splint made of crystal-clear plastic, which returns the joint heads to their original position. The patient must wear the so-called pivot splint in the upper jaw, which is slightly raised at the back to compensate for the malocclusion, day and night for at least four weeks. This should lead to an improvement in the symptoms of tinnitus.If the influence of TMJ distraction therapy over a period of up to 6 months is assured, this measure is useful.
Hyperbaric oxygen: the benefit of therapy for chronic tinnitus is not proven.
Psychotherapy
Behavioral therapy (e.g., cognitive behavioral therapy, KVT; cognitive behavioral therapy, CBT) for de-focusing and stress management); results in significant improvements in quality of life. The effectiveness of KVT is considered proven according to the guideline.
Psychoeducation: the affected person is provided with information about his disease through these measures. Psychoeducation can be conducted in individual sessions, group sessions or as family support. The involvement of family members is an important factor.Indication: tinnitus with severity I and IICounseling: professional psychosocial counseling of individuals or groups with the aim of problem-solving or change processes; good evidence base.
A tinnitus masker (synonyms: tinnitus noiser, “noiser”) is also called a “noise generator” because it continuously generates a noise that the patient constantly perceives but does not find unpleasant. This noise distracts the patient from his tinnitus or masks it. At the same time, the auditory pathway is “calmed down”. The patient thus learns to ignore the unpleasant noise. The tinnitus masker is individually fitted for each tinnitus patient. Like a hearing aid, it can be worn either in the ear or behind it. It is used for subacute tinnitus, i.e., after the acute measures have been implemented. Note: Experimental pathophysiological evidence shows that treatment with a noise generator can increase tinnitus symptoms; the current S3 guideline “Chronic Tinnitus” also does not recommend noise generators.
Neuromodulatory therapy:
Auditory stimulation – e.g., music modified in the frequency spectrum to compensate for the hearing disorder on an individual basis.
“Coordinated Reset Stimulation” – a form of auditory stimulation, short tones are offered above and below the individual tinnitus frequency.
Neurofeedback in tinnitus treatment shows a significant reduction in tinnitus intensity.
Repetitive transcranial magnetic stimulation (rTMS) – procedure that uses strong magnetic fields to both stimulate and inhibit superficially localized brain regions; results available to date show strong interindividual variability in the effects achieved. Repetitive transcranial magnetic stimulation (TMS; stimulation occurs at a pulse rate of one heart, delivering over 2,000 pulses via the coil placed on the auditory cortex on the left or in time) – In a placebo-controlled study, a benefit could be confirmed with multiple repeated TMSThe U.S. tinnitus guideline (Clinical Practise Guideline) makes no recommendation for TMS.
Another therapy is the music therapy of the German Center for Music Therapy Research e. V. in Heidelberg (DZM).Note: For the so-called tinnitus-centered music therapy, in which the applied music is changed in relation to the tinnitus frequency, there are no studies that would be sufficient for an evidence-based recommendation. For active music therapy can currently be spoken of a moderately validated therapy program.
