We help you to focus your attention back on other things

Living with annoying tinnitus can be a challenge that can push you to the very limits of your patience. Just like you, there are just under four million adults in Germany with this condition, and two-thirds of them have it permanently. When the "ringing in the ear" drowns out other sounds, it can affect your concentration at work just as much as your recovery as you sleep at night.

With tried-and-tested treatments, at Schoen Clinic we can help you regain more quality of life. Our experts show you how you can deliberately deflect your attention so that the dreadful noise loses its impact and fades increasingly into the background of your consciousness.

Causes & symptoms

Tinnitus: Causes of this condition

There are many different causes of tinnitus. In most cases, it occurs in conjunction with hearing problems. If the ear is not sending enough sounds to the auditory centre, the brain tries to compensate for the inadequate information. It turns up and amplifies disruptive sounds in the nerve cells that are normally suppressed and you do not notice. Tinnitus is therefore not a condition in its own right, but rather an expression of dysregulation. Additional stress, strain, but also depression and anxiety can trigger awareness of the noises in the ear. If the noises in the ear are suddenly there, emotions play a crucial role. The more negative the emotions and the more intense the anxiety, the more acute the perception of tinnitus and the suffering it causes.

Tinnitus: Other causes
There are also many other causes for noises in the ear. They can range from harmless to serious. Therefore a comprehensive examination is strongly recommended. The following possible causes of tinnitus need to be explored - especially if there are any indicators of them:
  • Ear wax
  • Eustachian tube dysfunction
  • Middle ear conditions (such as otosclerosis)
  • Inner ear conditions (such as age-related deafness)
  • Sudden loss of hearing
  • Sound trauma
  • Menière's disease
  • Auditory nerve conditions (such as acoustic neuroma or vestibular schwannoma)
  • Tumours affecting the auditory nerve
  • Dysfunction in the dental / maxillary area
  • Changes to the cervical spine
Your blood pressure should also be checked and if necessary the use of medication considered.

Symptoms: How to recognise tinnitus

Tinnitus patients are constantly hearing noises. In most cases, they hear a whistling in the ear, sometimes a rushing sound, a hissing sound or a buzzing noise. Sometimes it occurs in just one ear, sometimes in both. Many sufferers also perceive the noise in their heads. One thing common to all patients, however, is that only they can hear the tinnitus. Despite this, these sounds in the ear are not imaginary.

The volume, severity and intensity of the tinnitus are perceived very differently by each individual. In extremely rare cases, the tinnitus is found to be "objective". It can be heard by people nearby and requires specific investigation and treatment.

Various degrees of tinnitus
There are a great number of people who do not suffer with noises in the ear, and who do not feel in any way impaired by them. In such cases, the tinnitus is said to be compensated. Many others, however, find it a very burdensome condition and feel that their quality of life is significantly impaired. This form of tinnitus is referred to as uncompensated. There are many stages between these two extremes. This classification of severity is crucial for treatment.

Conditions that occur alongside tinnitus
It is believed that around 60 per cent of tinnitus patients also have hypersensitivity to sound (hyperacusis). This is often perceived as more burdensome than the noises in the ear, and therefore absolutely needs to be treated at the same time.

As further conditions that occur alongside tinnitus, patients primarily suffer anxiety disorders and depression, which in turn can have various causes. Often, the depression is of an exhaustion type. In many cases, this condition is (also) responsible for the development of tinnitus, however often it is also the result of extremely troublesome tinnitus.


Diagnosis: how tinnitus is detected

As part of an examination by an ENT consultant, the clinician will first have an in-depth discussion with you. Time and empathy play an important role in this. The aim is to pick up any possible clues as to why the tinnitus developed. The investigations carried out also include an examination of the ear and comprehensive hearing tests. These are used to investigate the middle and inner ear, as well as the auditory nerve. A detailed discussion of the results then follows, along with advice.