SS02: TINNITUS: MECHANISMS AND TREATMENT

PHARMACOLOGY FOR TINNITUS MANAGEMENT. AN UPDATE.

Carol Bauer

Southern Illinois University School of Medicine. USA.

The important development of tinnitus research in the last years has improved the knowledge on tinnitus mechanisms, its diagnosis and treatment. From a peripheral point of view, tinnitus is considered today as a brain reaction to erroneous input activity from the auditory or somatosensorial systems. In this round table we will review different aspects on diagnosis and management. The mechanisms of tinnitus, focused on the role of cortical plasticity will be a topic of discussion. An accurate diagnosis is crucial to design the best therapeutic options. Stimulation of the somatosensory pathways can help us to control somatic modulated tinnitus and it could be done through muscular training, electro-stimulation or pharmaceutical approaches. The concept of somatosensorial tinnitus will be presented and discussed.

Treatment should be based on tinnitus aetiology as our first step. Medical counselling is a very effective tool, and it should be mandatory in all the patients. Drug treatment could develop a step forward in the next years. NMDA-antagonists or GABA-agonists are some of the targets of the research. A review of clinical trials on pharmacotherapy for tinnitus will be presented in the round table. Auditory management is based in the fact that acoustic deprivation is the most powerful engine for tinnitus generation. Patients can be treated through passive training therapies as hearing aids, retraining therapies (TRT) or filtered music approaches. Active acoustic training through auditory discrimination is a new promising approach and so is the repetitive transcranial magnetic stimulation over the auditory cortex.  A review on acoustic treatment for tinnitus will also be presented. Lastly, we will present the mechanisms and results of repetitive transcranial magnetic stimulation for tinnitus management.