[Hearing aids, implantable hearing aids and cochlear implants in chronic tinnitus therapy]

Chronic tinnitus can be influenced positively by plastic cortical changes of tinnitus assignment and auditory perception. Acoustic stimulation plays an important role, either through active hearing therapy or through a hearing device. The positive effect of hearing aids regarding tinnitus loudness and severity has been shown in many studies with large numbers of patients and amounts to up to 70%. Implantable hearing systems and their effect on tinnitus have not been examined sufficiently yet; there are reports about positive as well as negative effects on tinnitus perception. There is a strong indication, however, when pathological processes in the middle ear need direct coupling of the implantable hearing aid with the stapes or the round window and there is no possibility of providing a conventional hearing aid due to high-grade combined hearing loss. Cochlear implants (CI) for profoundly deaf patients influence tinnitus loudness and severity in 34-93% of the patients; the large deviation is due to inhomogeneous parameters in the studies that are not always based on validated questionnaires. Existing tinnitus, however, influences the outcome of CI patients. There are studies and discussions about the effect of CI for unilateral deafness with tinnitus.