Tinnitus is a widespread disease: medical professionals estimate the number of patients requiring treatment at more than one million. The causes of this disorder often associated with great suffering for patients are manifold. Only a few have a clear trigger, for example, a change in the blood vessels, which generates a sound that can also be heard from the outside. Much more common, however, is the so-called subjective tinnitus that only the patient hears. Therefore, to dismiss the ear noise as pure imagination is still wrong: The nerve cells responsible for hearing in the brain receive a signal from the fine auditory cells in the inner ear via the auditory nerve in these patients. In the perception, the tinnitus does not initially differ fundamentally from the hearing of real sounds.
Such false signals in the auditory cells can have many causes, and many of the mechanisms are not yet understood in detail. The triggers include damage caused by noise, infections in the inner ear or side effects of medication or metabolic diseases. Frequently, however, the causes are also in tension and disorders of the cervical spine and the temporomandibular joint.
In many patients, such subjective tinnitus becomes chronic. That is, the ear noise may change its volume, but never disappears completely. Often the ear noise then already became independent: The brain has then stored the sound as an earwig, even if the original cause of tinnitus in the ear has long since disappeared and from the inner ear no corresponding sound signal more comes. display
The aim of the therapy concept developed by Heike Argstatter and Hans Volker Bolay of the DZM in Heidelberg is to break through this fixation of the brain on the ear noise and to steer the perception again into other paths. It can treat patients who hear a tone of clearly defined frequency and not, for example, a noise or hum.
The first component of the therapy is to recreate the tone of tinnitus in pitch and volume with the aid of an electronic tone generator. This sound then forms the new basis for listening to music. Thus, the therapist sounds relaxation music with the tinnitus tone or one of its octaves as the root note. "The patients integrate this sound into the hearing process and for the first time no longer perceive it as negative, " explains psychologist Heike Argstatter in an interview with wissenschaft.de.
"In the second step, the patients sing specifically the tinnitus tone and learn to control it, " says Argstatter. Through targeted listening and exercises such as the singing of prescribed melodies, they also learn to control their attention and thereby actively influence the tinnitus. Further elements of the therapy concept are to better control the influence of stress on tinnitus and to focus on positive things. In addition, the patients train to put these techniques into practice in everyday life and to assign a positive function to tinnitus - as a warning signal for stress, for example.
Sixty patients have already completed and completed the Heidelberg therapy concept consisting of twelve sessions - with great success, as Argstatter reports: "At seventy percent, there was a clear improvement, " says the psychologist. The stress index of the so-called tinnitus questionnaire, which indicates how strongly a patient suffers from his ear noises, declined permanently in these patients, as shown in the interview with M, in which the ear noises are no longer a heavy burden that determine the whole life.
In a new study with other patients, which begins in September, the Heidelberg researchers now want to further test the effectiveness of the therapy. The twelve units can be completed either as a block within eight days or distributed over twelve weeks. There is a waiting list for compact therapy, while places are still available for long-term therapy. Also in the coming year, places will be offered for the treatment. The costs are not yet taken over by the health insurance companies.ddp / science.de Ulrich Dewald