[Unmet medical needs in otorhinolaryngology].

Unfulfilled medical wishes and the resulting disappointments often have infrastructural causes and are the result of inadequate services or limited available resources in a medical practice. As annoying as these might be, they can hardly be influenced by the individual therapeutic competence of the ENT physician. The situation is different in the case of unfulfilled medical wishes of patients who cannot be adequately helped for a variety of reasons, whether because of the severity of their illness or because of the particular, predominantly psychosomatic constellations.

[S3-Guideline Chronic Tinnitus - Update].

Chronic tinnitus is a symptom of disturbed auditory perception. More than 90% of tinnitus patients suffer from hearing loss. Many people experience tinnitus and seek for treatment, but suffering and actual burden of tinnitus is individually very different, sometimes it disappears after a certain time even without treatment.

[Psychosomatic medicine for patients with Meniere's disease].

Background: Unpredictable attacks of vertigo with or without emesis, unilateral hearing loss, and tinnitus characterize the inner ear disorder that is classified as part of Meniere's disease (MD). While the pathological final stage with cochleovestibular hydrops seems to be certain as a component of MD, there are many uncertainties with respect to the multifactorial pathogenesis. It is certain that the disease can have effects in addition to the attack, which questions the treatment of things that were previously taken for granted.

[Stress and suffering from tinnitus-a psychosomatic approach].

The development and processing of tinnitus is often associated with stress. There are many publications on this subject that have investigated possible connections between stress perception and tinnitus symptoms using different concepts and different test inventories. In this review, we present the development of Selye's concept of stress using the transactional stress model of Lazarus and its transfer to patients suffering from tinnitus.

[Tinnitus counseling in a specialized ambulanz and a attempt to identify relevant "interactional" factors for outcome].

One aim of our large-scale catamnesis was to prove that neuro-otological diagnostics and knowledge are a fundamental prerequisite in counseling, but also that the counterpart, the patient, has to be reached in his or her distress. For this purpose, we had developed an own 6-part scaled questionnaire on the understanding of the counseled and on the feeling of being understood as a patient. Through its evaluation we had hoped to obtain reliable findings with regard to individual effect factors.

[Often not considered during Expert opinion: Patients after accidents or noise traumata - A patient-focused, complementary perspective].

Patients who have acquired tinnitus in the context of an accident, a noise trauma or other external influences have important distinctive features in treatment. Although their suffering was in general caused by external circumstances or other people and mostly without own fault, they suffer from a permanent damage, difficult to be realized externally. Additionally they must concentrate their remaining resources to deal adequately with their suffering from tinnitus and very often permanent hearing loss.

[Catamnesis after a single intervention for tinnitus patients in a specialized clinic].

Background: Patients suffering from tinnitus require individualized clarification (counseling), sometimes going beyond the scope of the field of ENT and the initiation of specific interventions.

Aim: To investigate if patients who had a specific neurotological assessment including a psychosomatic medical history follow the recommendations provided to them. In addition, it should be examined whether compliance with the treatment suggestions has led to any psychological improvement in the suffering from tinnitus, evaluated by psychological tests.

[Neuro-otology counseling for patients with chronic tinnitus].

The diagnosis and treatment of tinnitus requires professional competence in neuro-otology and also an appropriate and comprehensible clarification for the individual patient.According to the Tinnitus-Guidelines of 2015 the counselling by the physician in charge is essential regarding the individual aetiopathogenesis, as well as the patient's individual coping mechanism with tinnitus, the prognosis, exacerbating factors and also as to the damaging impact on the ear.Therefore the therapeutic aim is to depathologize the symptom tinnitus and to provide an explanation and a context in the contemporary approved and scientific conception.

Treatment of tinnitus needs a combined neurootological and psychosomatic approach.

In this study the results of the examination of 100 successive patients with Tinnitus, M. Menière or vertigo, who were referred to a specialised neurootological and psychosomatic centre, are presented. The study focuses on the results of the audiological tests and the question of the related hearing impairment as well as on psychological diagnosis and the possible connection between biographical details and symptom development.

Specific findings in distortion product otoacoustic emissions and growth functions with chronic tinnitus.

Chronic tinnitus has a very high prevalence in industrialized countries. Latest studies found chronic tinnitus in 4% of the German population, with almost 2% suffering severely in their daily life. Because no curative therapeutic approach is available--neither pharmacological nor surgical--the main focus lies in treatments that enhance the habituation of tinnitus.