TINNITUS MODELS FOR COUNSELING PATIENTS W ITH CHRONIC TINNITUS

Tinnitus models are an integral part of tinnitus counselling. In cases with compensated tinnitus, counselling represents the only therapeuti c measure necessary. In contrast, patients with uncompensated tinnitus require further therapy in the form of medication, tinnitus-maskers o r psychotherapy. Sound processing along the peripheral and central aud itory pathways is achieved by functional loops that direct mechanical, electrical or chemical information to various points in the pathway. Minor damage to a loop can cause destabilization of this finely balanc ed system and can induce tinnitus. Current peripheral tinnitus models are reviewed and discussed with respect to in vitro data from isolated outer hair cells of the guinea pig cochlea. Audiological findings of a patient with central tinnitus after brainstem surgery are discussed in view central tinnitus models. Specific models for common hearing di sorders, such as tinnitus with normal hearing, noise trauma, sudden he aring loss, toxic cochlear lesions, presbyacusis, acoustic neurinoma a nd Meniere's disease are presented for the ENT-surgeon involved with t innitus-counselling.