[Diagnosis and therapy of tinnitus].

INTRODUCTION: Tinnitus is still one of the most frequent symptoms encountered by the otorhinolaryngologist. Diagnosis and therapy present high demands due to the complex etiology and secondary symptoms. PATHOPHYSIOLOGY: In contrast to objective ear ringing with a physical sound source near the ear, tinnitus is faulty coding within the auditory system. Damage due to all kinds of causes can lead to a change of spontaneous activity in the auditory system. The result is a subjective auditory impression which is increased by further learning processes. DIAGNOSTICS: The aim of otorhinolaryngologic and especially audiologic diagnostic studies is to find the cause of the tinnitus. Modern methods for the objectivation of tinnitus are still experimental. The psychosomatic diagnostic studies evaluate secondary symptoms. THERAPY: Acute tinnitus is treated like sudden deafness. For chronic forms, the analysis of the causes is particularly important for developing an individual consultation and therapy plan. Providing information of the patient is the first step for a sensible treatment of the symptoms. The retraining therapy represents a learning process to reduce subjective symptoms, inconvenience, and loudness. Supportive therapy includes the use of instrumentation and medication.
CONCLUSION: Acute tinnitus is often curable. However, only palliative treatment is available for chronic tinnitus. The otorhinolaryngologist plays a crucial role in the management of the disorder.