[Neurootologic and psychosomatic habituation therapy. Treatment approaches in chronic tinnitus]

Modern tinnitus therapy, especially for chronic tinnitus accompanied by psychosomatic disturbances, is based on an understanding of the controlled network of auditory perception. The symptom of tinnitus derives from damage or defective coding in this system, mainly the inner ear. It becomes an independent disease as a result of disturbed auditory perception with pathologic evaluation and emotional association in the cortex. We present different therapeutic approaches based on these models. The therapy aims to eliminate or diminish the symptom of tinnitus through retraining, cognitive restructuring, or enhancement of efferent filter mechanisms in the auditory pathway. Psychosomatic stabilization of patients is an important preliminary condition for effective habituation; therefore, an integrative neurootologic and psychosomatic therapy is proposed that requires an interdisciplinary therapeutic team and can be mostly carried out in an outpatient setting.