Treatment
The acute tinnitus disappears in about 70-80% of cases by treating the cause or disappears on its own. In 20-30% of cases of acute tinnitus, the ringing in the ears remains. It is important to have the tinnitus diagnosed by an ENT physician and possibly other physicians, e.g. orthopedists or internists, depending on the cause of the tinnitus.
The chronic tinnitus does not disappear, but there are now various ways in which sufferers can cope with it. Due to insufficient or faulty education and information, as well as resignation or fear, the tinnitus can take on the character of a disease. This can result in further diseases and restrictions in coping with and participating in everyday life.
It is therefore important that the affected person informs himself/herself, takes responsibility for his/her own well-being and uses support services. One possibility is to visit a self-help group in order to exchange information with those affected. Some affected persons need (additional) therapeutic support from a specialist.
Addresses and information are available from the German Tinnitus League. There are no special medications against tinnitus. Research is still underway, but there are currently no special preparations against the tinnitus.
There are, however, various psychotropic drugs that act on the brain and reduce the tinnitus emanating from it and soften the ringing in the ears. At the same time they work against sleep disorders and can also have an indirect effect on the state of relaxation through improved sleep. With chronic tinnitus, problems falling asleep and sleeping through the night are very common.
Insufficient or restricted sleep can have a negative influence on the state of relaxation and manifest itself as distress. This in turn can intensify the tinnitus. In acute tinnitus it can be beneficial to support the blood circulation and the transport of nutrients in the inner ear and in the brain.
This can be achieved by taking Tebonin®, for example. Blood cell components are made more elastic, so that oxygen and nutrients can be transported more easily into the inner ear and brain. In chronic tinnitus, Tebonin® can influence the cooperation of nerve cells in the brain.
It can improve the brain’s ability to adapt and thus reduce the perception of disturbing ear noises. In chronic, subjective tinnitus, this can contribute to the success of further measures such as targeted “listening away”. The fact that the tinnitus is perceived more quietly can lead to stress relief, better sleep and an increased sense of well-being and thus to an improvement in the quality of life.
In its guideline “Tinnitus”, the German Society for Otolaryngology recommends treatment with cortisone for acute and sub-acute tinnitus. When the phase of a possible self-healing (1-2 days) after an acute tinnitus is over, the guideline recommends to consider a cortisone treatment. Cortisone is not a specific medication for tinnitus.
However, an improvement in blood circulation and positive effects on the immune system as well as an anti-inflammatory effect have been observed. It has also been observed to contribute to a reduction of swelling in the ear canal and in the inner ear. The exact effect of cortisone in tinnitus is still under scientific investigation.
It is believed that cortisone acts on the receptors in the cochlea. In order to achieve the best possible effect of cortisone, it is administered by injection or drip treatment. Usually the cortisone is administered in high doses over 3 days.
After that it is slowly reduced. Cortisone treatment for acute or subacute tinnitus usually takes about 10 days. In the case of tinnitus caused by cervical spine disease, physiotherapeutic treatment sometimes has a supportive effect.
The contents of the treatment should be individually coordinated. A physiotherapist with additional training in manual therapy is often recommended. Some patients have had positive experiences with approaches from osteopathy or kinesology.
Contents such as the manual treatment of tendons, ligaments, muscles, skin and subcutaneous tissue, as well as active movement exercises were found to be supportive.Learning a favorable posture, learning and performing individual exercises, learning a balance between sporting activity and physical rest, as well as improving body perception also had positive effects on the person concerned. Cold treatments to stimulate blood circulation and thus promote relaxation, alleviate pain and improve the stretching of muscles were also found to be effective in some patients. Specialist medical authors describe a possible, supportive homeopathic treatment for tinnitus.
The treatment requires a detailed interview with the person affected and extensive knowledge of the person treating the tinnitus. As different as the causes of tinnitus and its individual manifestation can be, so different can the application of homeopathic remedies be. Globules are used, which are often taken by children.
Examples are Phosphorus, Petroleum, Rectificatum, Cocculus, Nux vomica and Arnica. As a rule, an application in the potency D12 is made and as a dosage 5 globules 3x daily are usually recommended. Which globules are used depends on the character of the tinnitus, additional complaints and the patient’s medical history.
Phosphorus is sometimes used in patients who are sensitive to faint noises and other stimuli and who complain quickly or frequently of mental and physical exhaustion. Affected people who complain of hearing loss and a “dull” sound, as well as itching, knocking and burning in the ear, are sometimes treated with Phosphorus. Petroleum is used, for example, for knocking noises in the ear, sometimes in connection with dizziness and itching in the throat and external auditory canal, as well as nausea.
Another example is arnica, which is used in acute noise trauma. Noise trauma can cause swelling, on which arnica can have a decongesting effect. It is important that the cause of the tinnitus is clarified by a specialist before a homeopathic (self) treatment.
In the case of chronic tinnutis, a “noise generator”, a so-called noiser, can provide relief in some cases. A noiser can be placed behind or in the ear. However, it is important to ensure that the external auditory canal remains clear so that everything can still be heard.
A noiser must be selected and fitted very individually. If a tinnitus lasts longer than 3 months, it is usually a chronic tinnitus. More than half of those affected suffer from hearing loss at the same time.
Often a built-in noiser, in a hearing aid, has a supporting effect. This so-called tinnitus noiser can easily be built into various hearing aid models. The noiser produces a soothing, quiet noise.
This noise is often perceived as pleasant by the affected person. This noiser soothes the auditory pathway in the brain. At best, the brain’s filter system reacts after a while in such a way that it classifies both the tinnitus and the tinnitus noiser as unimportant and filters them out and thus “eliminates” them.
When this happens, the tinnitus is no longer perceived. A noiser forms the basis for a retraining therapy. Here the affected person should learn to no longer perceive the ringing in the ears as disturbing and tormenting, as well as to learn how to “listen away”.
This form of treatment is designed for long-term success. It can take about 6 months until the first successes are noticeable for the affected person. In addition to various hearing aid models that allow the installation of a tinnitus noiser, there is also a smartphone tinnitus balance app. Here one can get access to a kind of library of sounds and music that can be used in case of tinnitus.
