Tinnitus: causes and clinical management.
Tinnitus is the perception of sound in the absence of a corresponding external acoustic stimulus. With prevalence ranging from 10% to 15%, tinnitus is a common disorder. Many people habituate to the phantom sound, but tinnitus severely impairs quality of life of about 1-2% of all people. Tinnitus has traditionally been regarded as an otological disorder, but advances in neuroimaging methods and development of animal models have increasingly shifted the perspective towards its neuronal correlates. Increased neuronal firing rate, enhanced neuronal synchrony, and changes in the tonotopic organisation are recorded in central auditory pathways in reaction to deprived auditory input and represent--together with changes in non-auditory brain areas--the neuronal correlate of tinnitus. Assessment of patients includes a detailed case history, measurement of hearing function, quantification of tinnitus severity, and identification of causal factors, associated symptoms, and comorbidities. Most widely used treatments for tinnitus involve counselling, and best evidence is available for cognitive behavioural therapy. New pathophysiological insights have prompted the development of innovative brain-based treatment approaches to directly target the neuronal correlates of tinnitus.
Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany; Interdisciplinary Tinnitus Center, University of Regensburg, Regensburg, Germany. Electronic address: berthold.langguth@medbo.de.
Berthold
B
Langguth
Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany; Interdisciplinary Tinnitus Center, University of Regensburg, Regensburg, Germany.
Peter M
PM
Kreuzer
Interdisciplinary Tinnitus Center, University of Regensburg, Regensburg, Germany; Department of Otolaryngology, University of Zurich, Zurich, Switzerland.
Tobias
T
Kleinjung
Unit of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; BRAI(2)N, Sint Augustinus Hospital, Antwerp, Belgium.
Dirk
D
De Ridder
D000818:Animals; D006801:Humans; D014012:Tinnitus / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*