What is sound therapy for tinnitus

Everything about tinnitus

What is tinnitus?

Tinnitus (noises in the ear) is an acoustic perception without an external sound source. One differentiates:

  • acute tinnitus - ringing in the ears up to 3 months and
  • chronic tinnitus - ringing in the ears is present for more than 3 months

How does hearing work?

Hearing means the recording, processing and recognition of sound signals. This process begins in our ears.

Outer ear and middle ear

All tones and noises in the environment hit our ears as sound waves. They make the eardrum vibrate. The ossicles connected to the eardrum vibrate, amplify the sound and transmit it to the inner ear, the so-called snail.

Electron microscope image of a rodent (rat) snail.
With 3 coils and 22mm length it is comparable to the human snail.

Source: Image by Marc Lenoir from “Promenade around the cochlea”
by R. Pujol, S. Blatrix, T. Pujol and V. Reclar-Enjalbert, CRIC,
University of Montpellier 1 -Inserm

Inner ear

Inside the cochlea there is a membrane with sensory cells (“hair cells”). The membrane lies in a liquid. If the sound waves hit the liquid, the membrane also begins to vibrate: with high notes at the beginning of the snail, and with low notes at the end of the snail.

These vibrations now stimulate the outer hair cells. They amplify the signal and pass it on to the inner hair cells, the actual auditory cells, which transmit it as an electrical stimulus to the auditory nerve beginning in the cochlea.

Without any sound stimulus, there is an intrinsic activity in the sensory cells - the background noise.


The electrical signal is sent from the snail to the hearing center via three to four relay stations.

In humans, the hearing center is (1)
in the area of ​​the temporal lobe (2).

Source: Image by Marc Lenoir from “Promenade around the cochlea”
by R. Pujol, S. Blatrix, T. Pujol and V. Reclar-Enjalbert, CRIC,
University of Montpellier 1 -Inserm

Only when the signal has reached the hearing center do we perceive a tone or noise. We “hear” it.

The signal has already passed through the aforementioned relay stations - the hearing filters. The filters amplify a signal, weaken it or even prevent it from being passed on to the hearing center. Signals that are important to us (such as the crying of one's own child for a mother) are amplified, but also sounds that seem threatening or so strange that our acoustic memory cannot classify them.

We hardly or not at all notice other noises, e.g. the rustling of a refrigerator or a computer.
We know them, they are unimportant.

How does tinnitus develop and what causes it?

Tinnitus is an acoustic perception without an external sound source.

  • The causes of the subjective noises in the ears are still unknown.
  • They probably arise after damage to hair cells in the inner ear.
  • The hearing center receives faulty or weakened signals.
  • In order to understand the signal, the background noise of the nerve cell is amplified in the hearing center.
  • Suddenly the previously imperceptible self-noise occurs in consciousness. We hear tinnitus.

"Is tinnitus heralding a stroke or am I going insane?"


Can noises in the ears be caused by stress?

  • Stress means an increase in the basic potential in the entire nervous system. We are “electrically charged”.
  • As with damage to the inner ear cells, the basic activity of our hearing center increases.
  • We perceive our own noise, a tinnitus.
  • This means that tinnitus can also occur in people with good hearing.

Why does a noise in the ear not go away again?

Almost everyone hears a buzz in their ears for a few seconds every now and then. However, if we perceive this new, unknown sound for a longer period of time, it is evaluated unconsciously by the brain (since the hearing center is connected to the feeling center, the limbic system).

We cannot identify the source of the sound or classify the noise, the tinnitus. We perceive it as a threat, it disturbs us. We are helpless, insecure: is it perhaps the harbinger of a stroke, is it a brain tumor? How long does the noise in the ear last, does it even get louder?

We try with all our might to assign the new noise; we pay all our attention to it. This creates a vicious circle: the more attentively we listen to a sound, whether coming from outside or inside, the more the hearing center is activated.

We think the tinnitus is getting louder. After all, it dominates our entire hearing.

Silence? There is no longer.

The tinnitus signal circles the hearing center like a virus in a computer. Even if the auditory nerve is severed, the noise in the ear can therefore still be heard. Tinnitus can become the dominant perception. We do not come to rest. The entire organism is in a constant state of stress, which can lead to sleep and concentration disorders or even depression. In this case, doctors speak of decompensated tinnitus.

Can the tinnitus get louder over time?

No. The loudness of tinnitus is always between 5 and 15 decibels above the hearing threshold of the person affected. Certain amplifiers can make the noise in the ear appear louder to the subjective perception. This includes:

  • Negative stress
  • fatigue
  • noise
  • Pain
  • Shoulder and neck tension
  • TMJ discomfort.

Is tinnitus curable?

Acute tinnitus can resolve on its own. If treatment is started in a short period of time, the chance of recovery is increased by around 20%. Long-term healing of chronic tinnitus has not yet been possible - neither with medication, nor with an operation or alternative healing methods, e.g. acupuncture.

How do you treat acute tinnitus?

According to the current state of knowledge, acute tinnitus should be treated like a sudden hearing loss within the first 24 hours. This includes high-dose, short-term administration of cortisone and medication to improve the flowability of the blood. These drugs are given as an intravenous infusion. Infusion treatment lasts a maximum of eight days. This can be followed by acupuncture treatment, which often leads to a reduction in the intensity of the tinnitus.

Private or professional stress must be avoided. Relaxation is the most important thing now. Anxiety can turn tinnitus into a vicious circle. A good education of the person concerned about the phenomenon of â € œtinnitusâ € often causes him to go out of his mind again. If the person concerned is well informed, the tinnitus often comes out of the perception again.

How do you treat chronic tinnitus?

The ideas about the development of tinnitus were summarized at the beginning of the nineties by Prof. Pavel Jastreboff (Baltimore) into a “neurophysiological model”. From this he developed the tinnitus retraining therapy (TRT) in collaboration with Prof. Jonathan Hazell (London). It is currently the most promising therapy for annoying noises in the ear. The tinnitus retraining therapy does not always make a noise in the ear disappear permanently.

With this treatment, however, you will learn to perceive your tinnitus less loudly. Often you don't even notice it - like the glasses on your nose or the clothes that cover your most sensitive organ, the skin, day and night. It is impossible NOT to think about tinnitus. But you have the option to think of something else!

What does tinnitus retraining therapy mean?

The treatment we carry out consists of four sub-areas:

1. Tinnitus coping therapy: Counseling = intensive advice on dealing with tinnitus

We understand counseling to provide information about the phenomenon of tinnitus. Only when you lose the fear of ringing in your ears, no longer perceive it as threatening, is the way to get used to it. Counseling is therefore the basis of tinnitus coping therapy.

2. Sound therapy: Noise and / or hearing aids and intensive listening training

Noise devices and hearing aids passively support active tinnitus coping training. If possible, the hearing aids / noiseers are adjusted at the place of residence. Tinnitus is a disturbance of your hearing with fixation on a certain, unpleasant sound. In listening training we try together to break this fixation by consciously directing your attention to other acoustic stimuli. In this way you learn to enjoy pleasant sounds, such as music, again despite tinnitus. We want to restore the joy of hearing to you.

3. Psychological support

Sometimes the ringing in the ear is just the first sign of unsolved problems that the patient is not even aware of.
These relationships can be recognized in a psychological conversation and, if necessary, treated. You will also learn techniques for relaxation. Relaxation techniques help relieve the stress of everyday life, get over sleep disorders, and promote general wellbeing. Suitable psychotherapists are selected at the place of residence of the person concerned.

4. Acupuncture

Acupuncture treatment cannot eliminate tinnitus. However, chronic tinnitus often increases the intensity of the tinnitus for various reasons. Then acupuncture can help to reduce the loudness of the tinnitus so that the noise in the ear is easier to bear. A total of around 10 acupuncture sessions are necessary.

How long does tinnitus retraining therapy last?

  • Getting used to tinnitus can take one to two years.
  • The only requirement for treatment is your active participation.
  • Regardless of the cause of the tinnitus, it leads to success in 70 to 80 percent of all cases.

What are noisers?

Tinnitus occupies your entire hearing center. A soft noise created by so-called “noisers” has a distracting effect. Modern devices can be programmed in such a way that they emit a noise that is pleasant for you, which you will no longer perceive after a short time.

Do noisers affect hearing?

  • Noisers neither reduce nor improve hearing.
  • In contrast to methods previously used, the noise should not cover up your tinnitus.
  • Only then will the noise in your ears be subconsciously integrated into the harmless noise.
  • The auditory perception of the entire brain should be trained.
  • It therefore makes sense to supply both ears with noisers. Recommended wearing time: six to eight hours a day.
  • The individual adjustment is carried out by our hearing aid acoustician.

When does it make sense to wear hearing aids?

A ringing in the ear often occurs with hearing loss. Tinnitus almost always has the frequency that is worst perceived. If you compensate for the hearing loss at this pitch, the brain receives more external information. The result: the tinnitus becomes quieter. This is why hearing aids are fitted to tinnitus even if the hearing loss is minor.

Can hearing aids be combined with noisers?

A hearing aid can also be combined with a noiser. The decision is made by the doctor and hearing aid acoustician individually. Only one thing is important: to improve the quality of your hearing.

Do hearing aids or noisers always belong to tinnitus treatment?

Hearing aids and noisers are part of the TRT. It makes sense to use it, but it is not absolutely necessary. However, if the use of the devices is not combined with other treatment steps, it does not lead to getting used to the noise in the ear.

Psychological care

Sometimes the ringing in the ear is just the first sign of unsolved problems that the patient is not even aware of. These relationships can be recognized in a psychological conversation and, if necessary, treated. You will also learn techniques for relaxation.

Relaxation techniques help relieve the stress of everyday life, get over sleep disorders, and promote general well-being.

What does hyperacusis mean?

If someone reacts too sensitively to relatively quiet noises, one speaks of hyperacusis. Like tinnitus, it arises from disturbances in the central processing of sound signals. The noises that are perceived as too loud cause vegetative symptoms: racing heart, sweating, panic, fear. Any noises in the ears can be amplified for a short time. People with hyperacusis only live with earplugs and withdraw completely from the community.

How is hyperacusis treated?

Treatment is carried out according to the TRT - with one difference: noises, for example when setting the noiser or during hearing therapy, are dosed much more carefully. However, the patient should only use hearing protection when it is noisy. After just a few months, most of those affected can expose themselves to normal environmental noises and even attend a concert.