Subjective tinnitus assessment and treatment in clinical practice: the necessity of personalized medicine.
OBJECTIVE
Subjective tinnitus can be triggered by a variety of causes, and therefore tinnitus patients constitute a very heterogeneous population difficult to manage. In this article, we reviewed the current literature to present our conceptual model of the conscious auditory percept and tinnitus - based on experimental research - in order to explain the clinical approach to the individual tinnitus patient.


RESULTS
Fundamental research has provided evidence to support the neurophysiological model of tinnitus developed by Jastreboff. By manipulating the limbic, autonomic and auditory systems, tinnitus retraining therapy (TRT) aims to reduce the response to the abnormal stimulus. Evidence has confirmed the effectiveness of TRT and cognitive behavioral therapy in reducing the negative impact of subjective tinnitus on the patients' quality of life.


CONCLUSIONS
Every patient with subjective tinnitus has its unique 'tinnitus profile' which provides a guide to the necessary combination of therapeutic actions. Evidence suggests the multidisciplinary approach combining etiological therapy as well as TRT, and cognitive behavioral therapy in specialized clinics is not only effective in reducing the patient's quality of life but also cost-effective from a healthcare and societal point of view.
aUniversity Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital (UZA), Edegem bFaculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Paul
P
Van de Heyning
Annick
A
Gilles
Sarah
S
Rabau
Vincent
V
Van Rompaey
D001307:Auditory Perception / Q000502:physiology; D006801:Humans; D057285:Precision Medicine; D063189:Symptom Assessment; D014012:Tinnitus / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*