Dysfunction of the temporomandibular joint , z. B. Acoustic neuroma
Only rarely can a single cause be identified and proven. For the development of tinnitus are often complex interconnections decisive, which exist between hearing and brain. A distinction is made between:
Subjective tinnitus: The subjective tinnitus occurs most frequently. It is heard exclusively by the affected person, it can be
not audible to others Make.
Objective tinnitus: Objective tinnitus is extremely rare. It is caused by a measurable sound source at the ear. With the help of special devices, the doctor can make the patient's ear noises audible.
Examinations – Diagnostics
In the case of acute ringing in the ears, your ENT – doctor first contact person. He examines the ears, the entire hearing and other organs. During the consultation, the patient's previous medical history is. It asks about the onset, any triggers such as noise exposure or stress, and any pre-existing conditions. He will also let you describe the ear noises in detail.
Subsequently, the following examinations, among others, are applied:
– Hearing test (audiometry) – tinnitus matching to detect the volume and frequency of the sound – ear microscopy – examination (mirroring) of the nasopharynx – examination of the auditory nerve function – supplementary examinations can be: Balance check, check for dental or jaw malocclusions, clarification of high blood prere or changes in the cervical spine/shoulder-neck musculature
Therapy of Tinnitus
The treatment depends strongly on the individual case. There is no general, clearly effective therapy. Different methods are used.
If there is a new onset of tinnitus (acute tinnitus) with hearing loss, often a hearing loss is present. Then, if possible, the examination by the ENT doctor should take place within 2 working days. Presumably, the doctor will then o. g. examinations, but the therapy is initially approx. 1 week back. If the hearing loss does not recover within this period, a short-term (ca. 1 week) cortisone therapy can be carried out. If the hearing is normalized within this period, but the tinnitus remains, cortisone therapy is not considered, since cortisone can only influence the hearing. The doctor will then discuss the further course of action with you individually, but infusion treatment is no longer indicated today. Incidentally, according to the 2019 European Tinnitus Guideline, even a subjectively significant increase in loudness in a pre-existing tinnitus without hearing loss is not treated with infusions or cortisone.
If the ringing in the ears lasts more than three months, the medical experts speak of a Chronic tinnitus. Here the relief of symptoms is the primary therapeutic goal. Targeted treatment is difficult. Certain learnable behavioral techniques can help to change the subjective unpleasant sensations.
A strong recommendation is made by the 2019 European Tinnitus Guideline for tinnitus-related behavioral therapy. The patient should learn strategies to cope better with the persistent tinnitus by means of behavioral therapy. Stress usually intensifies the tinnitus. Therefore, relaxation techniques such as autogenic training or yoga are also helpful. It is also important to fully educate the patient that the tinnitus is not threatening, especially to avoid futile attempts at therapy. Just an unreflective research on the Internet (ca. 20M. Left) can lead to a multiplicity of senseless measures as well as over a more intensive occupation with the tinnitus to a complaint increase.
If the tinnitus is accompanied by a hearing disorder, hearing aids are useful. In many cases, tinnitus diminishes as hearing normalizes.