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Semin Hear 2014; 35(02): 092-104
DOI: 10.1055/s-0034-1372526
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Approaches to Tinnitus Management and Treatment

Marc Fagelson
1   Department of Audiology and Speech-Language Pathology, East Tennessee State University, Johnson City, Tennessee
2   James H. Quillen Veterans Affairs Medical Center, Mountain Home, Tennessee
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Publication History

Publication Date:
29 April 2014 (online)

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Abstract

Tinnitus continues to challenge patients from all walks of life and clinicians from a variety of disciplines. The lack of an evidence base to support a specific treatment confounds efforts to provide consistent benefit to patients and in many instances creates in the patient the impression that nothing can be done to improve their situation. Part of the problem is that although patients rarely experience complete elimination of a tinnitus signal, they often experience relief when receiving effective counseling, specific coping strategies, and sound therapy. Although in most clinical activities the tinnitus remains (i.e., it is not cured), its influence may wane as the patient learns to manage their environment, activities, and ultimately their response to tinnitus. At the same time, several medical interventions target reduction of the tinnitus sound, an approach more consistent with what patients expect as a cure. Therefore, the majority of clinical activity directed at care for patients with tinnitus typically targets either elimination of the tinnitus sound (tinnitus treatment) or modification of the patient's response to the sound (tinnitus management). This review distinguishes and offers examples of both treatment and management programs employed clinically for patients with tinnitus.

Keywords

Tinnitus - sound therapy - auditory training - cognitive behavioral therapy - neuromodulation
 

  • References

  • 1 Davis A, El Rafaie A. Epidemiology of tinnitus. In: Tyler R, , ed. Tinnitus Handbook. Clifton Park, NY: Thomson Delmar Learnings; 2000: 1-24
    Google Scholar
  • 2 Hazell JWP. Support for a neurophysiological model of tinnitus. In: Reich GE, Vernon JA, , eds. Proceedings of the Fifth International Tinnitus Seminar. Portland, OR: American Tinnitus Association; 1996: 51-57
    Google Scholar
  • 3 Zöger S, Svedlund J, Holgers KM. Relationship between tinnitus severity and psychiatric disorders. Psychosomatics 2006; 47 (4) 282-288
    Google Scholar
  • 4 Harrop-Griffiths J, Katon W, Dobie R, Sakai C, Russo J. Chronic tinnitus: association with psychiatric diagnoses. J Psychosom Res 1987; 31 (5) 613-621
    CrossrefPubMedGoogle Scholar
  • 5 Tyler RS. Neurophysiological models, psychological models, and treatments for tinnitus. In: Tyler R, , ed. Tinnitus Treatments: Clinical Protocols. New York, NY: Thieme; 2005: 1-22
    Google Scholar
  • 6 Higgins JPT, Green S (Eds.). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2 [updated September 2009]. The Cochrane Collaboration. Available at: http://www.cochrane.org/search/site/tinnitus . Accessed on April 8, 2014
    PubMedGoogle Scholar
  • 7 Kleinjung T. Surgical treatments: introduction. In: Moller A, Langguth B, DeRidder D, Kleinjung T, , eds. Textbook of Tinnitus. New York, NY: Springer; 2011: 661-662
    CrossrefGoogle Scholar
  • 8 Kleinjung T. Surgical treatment: the ear. In: Moller A, Langguth B, DeRidder D, Kleinjung T, , eds. Textbook of Tinnitus. New York, NY: Springer; 2011: 663-668
    CrossrefGoogle Scholar
  • 9 Quaranta N, Wagstaff S, Baguley DM. Tinnitus and cochlear implantation. Int J Audiol 2004; 43 (5) 245-251
    Google Scholar
  • 10 House JW, Brackmann DE. Tinnitus: surgical treatment. Ciba Found Symp 1981; 85: 204-216
    PubMedGoogle Scholar
  • 11 Granjeiro RC, Kehrle HM, de Oliveira TS, Sampaio AL, de Oliveira CA. Is the degree of discomfort caused by tinnitus in normal-hearing individuals correlated with psychiatric disorders?. Otolaryngol Head Neck Surg 2013; 148 (4) 658-663
    CrossrefPubMedGoogle Scholar
  • 12 Henry JA, Zaugg TL, Myers PJ, Schechter MA. The role of audiologic evaluation in progressive audiologic tinnitus management. Trends Amplif 2008; 12 (3) 170-187
    CrossrefPubMedGoogle Scholar
  • 13 Møller MB, Møller AR, Jannetta PJ, Jho HD. Vascular decompression surgery for severe tinnitus: selection criteria and results. Laryngoscope 1993; 103 (4 Pt 1) 421-427
    CrossrefPubMedGoogle Scholar
  • 14 Silverstein H. Transmeatal labyrinthectomy with and without cochleovestibular neurectomy. Laryngoscope 1976; 86 (12) 1777-1791
    CrossrefPubMedGoogle Scholar
  • 15 Magnan J, Lafont B, Rameh C. Long-term follow-up of microvascular decompression for tinnitus. In: Moller A, Langguth B, DeRidder D, Kleinjung T, , eds. Textbook of Tinnitus. New York, NY: Springer; 2011: 669-679
    CrossrefGoogle Scholar
  • 16 Baguley DM, Atlas MD. Cochlear implants and tinnitus. Prog Brain Res 2007; 166: 347-355
    PubMedGoogle Scholar
  • 17 Yonehara E, Mezzalira R, Porto PR , et al. Can cochlear implants decrease tinnitus?. Int Tinnitus J 2006; 12 (2) 172-174
    PubMedGoogle Scholar
  • 18 De Ridder D, Vanneste S. Auditory cortex stimulation for tinnitus. In: Moller A, Langguth B, DeRidder D, Kleinjung T, , eds. Textbook of Tinnitus. New York, NY: Springer; 2011: 717-726
    CrossrefGoogle Scholar
  • 19 Seidman MD, Ridder DD, Elisevich K , et al. Direct electrical stimulation of Heschl's gyrus for tinnitus treatment. Laryngoscope 2008; 118 (3) 491-500
    CrossrefPubMedGoogle Scholar
  • 20 Noreña AJ, Eggermont JJ. Changes in spontaneous neural activity immediately after an acoustic trauma: implications for neural correlates of tinnitus. Hear Res 2003; 183 (1–2) 137-153
    CrossrefPubMedGoogle Scholar
  • 21 Chen GD, Jastreboff PJ. Salicylate-induced abnormal activity in the inferior colliculus of rats. Hear Res 1995; 82 (2) 158-178
    CrossrefPubMedGoogle Scholar
  • 22 Kaltenbach JA. Neurophysiologic mechanisms of tinnitus. J Am Acad Audiol 2000; 11 (3) 125-137
    PubMedGoogle Scholar
  • 23 Langguth B, De Ridder D. Neuromodulation: introduction. In: Moller A, Langguth B, DeRidder D, Kleinjung T, , eds. Textbook of Tinnitus. New York, NY: Springer; 2011: 687-689
    CrossrefGoogle Scholar
  • 24 Plewnia C, Bartels M, Gerloff C. Transient suppression of tinnitus by transcranial magnetic stimulation. Ann Neurol 2003; 53 (2) 263-266
    CrossrefPubMedGoogle Scholar
  • 25 Hallett M. Transcranial magnetic stimulation and the human brain. Nature 2000; 406 (6792) 147-150
    CrossrefPubMedGoogle Scholar
  • 26 Vanneste S, De Ridder D. Transcranial direct current stimulation (tDCS): a new tool for the treatment of tinnitus?. In: Moller A, Langguth B, DeRidder D, Kleinjung T, , eds. Textbook of Tinnitus. New York, NY: Springer; 2011: 711-715
    CrossrefGoogle Scholar
  • 27 Post A, Keck ME. Transcranial magnetic stimulation as a therapeutic tool in psychiatry: what do we know about the neurobiological mechanisms?. J Psychiatr Res 2001; 35 (4) 193-215
    CrossrefPubMedGoogle Scholar
  • 28 De Ridder D, Verstraeten E, Van der Kelen K , et al. Transcranial magnetic stimulation for tinnitus: influence of tinnitus duration on stimulation parameter choice and maximal tinnitus suppression. Otol Neurotol 2005; 26 (4) 616-619
    CrossrefPubMedGoogle Scholar
  • 29 Meng Z, Liu S, Zheng Y, Phillips JS. Repetitive transcranial magnetic stimulation for tinnitus. Cochrane Database Syst Rev 2011; (10) CD007946
    PubMedGoogle Scholar
  • 30 Dobie RA. A review of randomized clinical trials in tinnitus. Laryngoscope 1999; 109 (8) 1202-1211
    CrossrefPubMedGoogle Scholar
  • 31 Baldo P, Doree C, Lazzarini R, Molin P, McFerran DJ. Antidepressants for patients with tinnitus. Cochrane Database Syst Rev 2006; 4 (4) CD003853
    PubMedGoogle Scholar
  • 32 Mardini MK. Ear-clicking “tinnitus” responding to carbamazepine. N Engl J Med 1987; 317 (24) 1542
    PubMedGoogle Scholar
  • 33 Elgoyhen AB, Langguth B. Pharmacological approaches to tinnitus treatment. In: Moller A, Langguth B, DeRidder D, Kleinjung T, , eds. Textbook of Tinnitus. New York, NY: Springer; 2011: 625-637
    CrossrefGoogle Scholar
  • 34 Doyle KJ, Bauch C, Battista R , et al. Intratympanic steroid treatment: a review. Otol Neurotol 2004; 25 (6) 1034-1039
    CrossrefPubMedGoogle Scholar
  • 35 Noreña AJ, Eggermont JJ. Enriched acoustic environment after noise trauma reduces hearing loss and prevents cortical map reorganization. J Neurosci 2005; 25 (3) 699-705
    CrossrefPubMedGoogle Scholar
  • 36 Vernon J, Schleuning A. Tinnitus: a new management. Laryngoscope 1978; 88 (3) 413-419
    CrossrefPubMedGoogle Scholar
  • 37 Sweetow RW. Cognitive aspects of tinnitus patient management. Ear Hear 1986; 7 (6) 390-396
    CrossrefPubMedGoogle Scholar
  • 38 Cima RFF, Maes IH, Joore MA , et al. Specialised treatment based on cognitive behaviour therapy versus usual care for tinnitus: a randomised controlled trial. Lancet 2012; 379 (9830) 1951-1959
    CrossrefPubMedGoogle Scholar
  • 39 Smith SL, Fagelson M. Development of the self-efficacy for tinnitus management questionnaire. J Am Acad Audiol 2011; 22 (7) 424-440
    Article in Thieme ConnectPubMedGoogle Scholar
  • 40 Mohr AM, Hedelund U. Tinnitus patient-centered therapy. In: Tyler R, , ed. Tinnitus Treatments: Clinical Protocols. New York, NY: Thieme; 2005: 198-216
    Google Scholar
  • 41 Jastreboff PJ, Hazell JWP. Treatment of tinnitus based on a neurophysiological model. In: Vernon J, , ed. Tinnitus: Treatment and Relief. Boston, MA: Allyn & Bacon; 1998: 201-216
    Google Scholar
  • 42 Davis PB, Paki B, Hanley PJ. Neuromonics Tinnitus Treatment: third clinical trial. Ear Hear 2007; 28 (2) 242-259
    CrossrefPubMedGoogle Scholar
  • 43 Stephens D. A history of tinnitus. In: Tyler R, , ed. Tinnitus Handbook. Clifton Park, NY: Thomson Delmar Learning; 2000: 437-448
    Google Scholar
  • 44 McKenna L, Irwin R. Sound therapy for tinnitus—sacred cow or idol worship? An investigation of the evidence. Audiological Medicine 2008; 6 (1) 16-24
    CrossrefPubMedGoogle Scholar
  • 45 Roberts LE, Bosnyak DJ. Auditory training in tinnitus. In: Moller A, Langguth B, DeRidder D, Kleinjung T, , eds. Textbook of Tinnitus. New York, NY: Springer; 2011: 563-573
    CrossrefGoogle Scholar
  • 46 Henry JA, Zaugg TL, Schechter MA. Clinical guide for audiologic tinnitus management II: treatment. Am J Audiol 2005; 14 (1) 49-70
    CrossrefPubMedGoogle Scholar
  • 47 Von Korff M, Moore JC. Stepped care for back pain: activating approaches for primary care. Ann Intern Med 2001; 134 (9 Pt 2) 911-917
    CrossrefPubMedGoogle Scholar
  • 48 Searchfield G. Hearing aids and tinnitus. In: Tyler R, , ed. Tinnitus Treatments: Clinical Protocols. New York, NY: Thieme; 2005: 161-175
    Google Scholar
  • 49 Hanley PJ, Davis PB. Treatment of tinnitus with a customized, dynamic acoustic neural stimulus: underlying principles and clinical efficacy. Trends Amplif 2008; 12 (3) 210-222
    CrossrefPubMedGoogle Scholar
  • 50 Seidman MD, Babu S. Alternative medications and other treatments for tinnitus: facts from fiction. Otolaryngol Clin North Am 2003; 36 (2) 359-381
    CrossrefPubMedGoogle Scholar
  • 51 Mazzoli M. Complementary tinnitus treatments. In: Moller A, Langguth B, DeRidder D, Kleinjung T, , eds. Textbook of Tinnitus. New York, NY: Springer; 2011: 733-747
    CrossrefGoogle Scholar
  • 52 Person OC, Puga MES, da Silva EMK, Torloni MR. Zinc supplementation for tinnitus. Cochrane Database Syst Rev 2012; (5) CD009832
    PubMedGoogle Scholar
  • 53 Shambaugh Jr GE. Zinc for tinnitus, imbalance, and hearing loss in the elderly. Am J Otol 1986; 7 (6) 476-477
    PubMedGoogle Scholar
  • 54 Hilton M, Stuart E. Ginkgo biloba for tinnitus. Cochrane Database Syst Rev 2004; (2) CD003852
    PubMedGoogle Scholar
  • 55 Meehan T, Eisenhut M, Stephens D. A review of alternative treatments for tinnitus. Audiological Medicine 2004; 2: 74-82
    CrossrefPubMedGoogle Scholar
  • 56 Campbell KCM, Meech RP, Klemens JJ , et al. Prevention of noise- and drug-induced hearing loss with D-methionine. Hear Res 2007; 226 (1–2) 92-103
    CrossrefPubMedGoogle Scholar
  • 57 Martinez-Devesa P, Perera R, Theodoulou M, Waddell A. Cognitive behavioural therapy for tinnitus. Cochrane Database Syst Rev 2010; (9) CD005233
    PubMedGoogle Scholar
  • 58 Evans S, Ferrando S, Findler M, Stowell C, Smart C, Haglin D. Mindfulness-based cognitive therapy for generalized anxiety disorder. J Anxiety Disord 2008; 22 (4) 716-721
    CrossrefPubMedGoogle Scholar
  • 59 Wu SD, Lo PC. Inward-attention meditation increases parasympathetic activity: a study based on heart rate variability. Biomed Res 2008; 29 (5) 245-250
    CrossrefPubMedGoogle Scholar
  • 60 Jastreboff PJ, Jastreboff MM. Tinnitus Retraining Therapy (TRT) as a method for treatment of tinnitus and hyperacusis patients. J Am Acad Audiol 2000; 11 (3) 162-177
    PubMedGoogle Scholar
  • 61 Jastreboff PJ. The neurophysiological model of tinnitus and hyperacusis. In: Hazell JWP, , ed. Proceedings of the Sixth International Tinnitus Seminar. Cambridge, UK: THC; 1999: 32-38
    Google Scholar
  • 62 Jastreboff PJ. Tinnitus retraining therapy. In: Moller A, Langguth B, DeRidder D, Kleinjung T, , eds. Textbook of Tinnitus. New York, NY: Springer; 2011: 575-596
    CrossrefGoogle Scholar
  • 63 Bandura A. Self-Efficacy: The Exercise of Control. New York, NY: W. H. Freeman and Company; 1997
    Google Scholar
  • 64 Mohr AM. Reflections on tinnitus by an existential psychologist. Audiological Medicine 2008; 6: 73-77
    CrossrefPubMedGoogle Scholar