Medical conditions

Otological, infectious

Otitis media, labyrinthitis, mastoiditis

Otological, neoplastic

Vestibular schwannoma, meningioma

Otological, labyrinthine

Sensorineural hearing loss, Ménière’s disease, vestibular vertigo

Otological, other

Impacted cerumen, otosclerosis, presbycusis, noise exposure


Meningitis, migraine, multiple sclerosis, epilepsy


Head or neck injury, loss of consciousness


Temporomandibular joint disorder




Rheumatoid arthritis

Immune mediated

Systemic lupus erythematosus, systemic sclerosis

Genetically mediated

Paget’s disease, Alport’s syndrome

Infectious diseases mediated

Mumps, Rickettsia, Leishmania

Mitochondrial dysfunction

Nonsyndromic mitochondrial hearing loss, MELAS syndrome

Endocrine and metabolic

Diabetes mellitus, hyperinsulinemia, hypothyroidism, hormonal changes during pregnancy


Anxiety, depression, emotional trauma

Ototoxic medications

Analgesics, antibiotics, antineoplastic drugs, corticosteroids, diuretics, immunosuppressive drugs, nonsteroidal anti-inflammatory drugs, steroidal anti-inflammatory drugs, phosphodiesterase 5D inhibitors, methadone, pegylated interferons, inhibitors of viral reverse transcriptase

Tinnitus is a phantom sound perceived only by the affected person and can be a symptom of a variety of diseases and conditions.

Stress is a physiological reaction of the organism to the environmental changes that helps in adaptation to new, unknown circumstances. This reaction is possible because of stress hormones. How, when, and where these hormones are produced and what kind of consequences their presence may have are presented by Ron de Kloet and Agnieszka Szczepek in Chap. 2.

Clinical experience continuously teaches us that the interface between tinnitus and stress can change the course of treatment and of convalescence. Patients themselves refer to the emotional or social stress as a major factor influencing the onset and progression of their tinnitus. Further, the already existing tinnitus may act as stressor, thus leading to therapeutic impasse (see Chap. 3 written by Sylvie Hébert, Birgit Mazurek, and Agnieszka Szczepek). Therefore, it is important to recognize stress and to deal with it and stress-induced conditions that may worsen tinnitus. Similarly, tinnitus-related stress may worsen both—tinnitus itself and comorbid psychological conditions.

The interface between tinnitus and stress can change the course of treatment and of convalescence.

A recent study recognized the diversity of medical specialists treating tinnitus (see Fig. 1.1) (Baguley et al. 2013). In practice, this means that in various countries, patients with tinnitus may be seen by practitioners with different medical backgrounds. It is common knowledge that not all health practitioners are by default trained in recognizing and treating the consequences of stress, present in form of depressiveness, generalized anxiety, tinnitus-related distress, and other symptoms. We are fully aware of the fact that the uniform and universal medical treatment of tinnitus all over the world is not possible, at least not yet. However, what is possible would be the additional knowledge sharing—and with this in mind, we wrote this book for you.
Oct 20, 2017 | Posted by in OTOLARYNGOLOGY | Comments Off on Introduction

Full access? Get Clinical Tree

Get Clinical Tree app for offline access