Article
Ergebnisse zur Optimierung der Leidensdruckreduzierung durch Tinnitusdifferenzialdiagnostik
Results to the improvement of reduction of psychological strain through Tinnitus differential diagnostic
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Authors
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Helmut Lebisch
- Tinnituszentrum Detmold, Detmold, Germany
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Manfred Pilgramm
- Tinnituszentrum Detmold, Detmold, Germany
| Published: | September 7, 2006 |
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Outline
Text
Does the Tinnitus healing eventually exist?
A question, which has stirred up the minds for years and which has lead to a number of untrustworthy excrescences in the Tinnitus therapy.
For the record: The emphasis of the psychological strain does not always derive from the ringing in the ears, but also originates from hardness of hearing, hyperacusis or ear pressure. To differentiate this from the ringing in the ears, an aid (ABI questionnaire) has been developed [Ref. 1]. This questionnaire helps to define focal points for the therapy and accumulates psycho-audio logical data.
In the following this should be clarified by 3 examples:
Example 1: Male patient, 31 years, normal hearing, distinctive hyperacusis, strong subjective psychological strain.
Pre-therapeutic values: ABI questionnaire: hyperacusis 40, Tinnitus 45
Tinnitus questionnaire (Göbel/Hiller): 24
Therapy: Attempt of problem solving: partnership, superior. Consequent hyperacusis training [Ref. 2]. Use of the telephone hotline.
Post-therapeutic values: ABI questionnaire: hyperacusis 5, Tinnitus 0
Tinnitus questionnaire (Göbel/Hiller): 1
The patient subjectively feels healed.
Example 2: Female patient, 41 years, hearing loss right, pan-cochlear inner ear hardness of hearing right at 50 dB, normal hearing left, increased UCL values, high muscular tension
Pre-therapeutic values: ABI questionnaire: hearing loss 25, hyperacusis 35, Tinnitus 55, ear pressure 62
Tinnitus questionnaire (Göbel/Hiller): 32
Therapy: Consequent problem solving: divorce, hearing aid right, hyperacusis training, learning and performing relaxation exercises.
Post-therapeutic values: ABI questionnaire: hearing loss 15, hyperacusis 10, Tinnitus 5, ear pressure 0
Tinnitus questionnaire (Göbel/Hiller): 1
The patient subjectively feels healed.
Example 3: Female patient, 58 years, normal hearing according to age, slightly increased hyperacusis, strong subjective psychological strain.
Pre-therapeutic values: ABI questionnaire: hearing loss 20, hyperacusis 40, Tinnitus 65, ear pressure 37
Tinnitus questionnaire (Göbel/Hiller): 42
Therapy: Despite intensive efforts, the patient still searches for causal therapy methods (laser, oxygen, gingko biloba) at continuing medical tourism.
Post-therapeutic values: ABI questionnaire: hearing loss 15, hyperacusis 25, Tinnitus 15, ear pressure 25
Tinnitus questionnaire (Göbel/Hiller): 31
The patient subjectively feels no therapeutic success.
Discussion and conclusion: These examples impressively show that it is always advisable to define focal points for the psychological strain. If the patient is willing to follow, the individual therapy of the focal points can reduce the psychological strain significantly.
Supposed there will never be an objective tune out of the ringing in the ears, but an intensive and individual anamnesis and differential diagnostic comprises a high probability to reach the target: to reduce the perception of Tinnitus in an increasing number of cases.
References
- 1.
- Pilgramm M, Lebisch H, Pehle W. Ein neues Frageninventar zur Schwerpunktsbestimmung des Leidensdruckes bei chronischen Tinnituspatienten. Z Audiol 2001 suppl IV Seite 191-192
- 2.
- Goebel G, Hiller W. Verhaltensmedizinische Diagnostik bei chronischem Tinnitus mit Hilfe des Tinnitusfragebogens (TF). Diagnostika 2, 1994, 155-167
- 3.
- Lebisch H, Pilgramm M. Hyperakusis/ Diagnostik und Therapie CD 6. DGA-Tagung Würzburg 2003
