The beeping is immediately annoying. Exactly 8786 Hertz come from the two small black loudspeakers on Prof. Hans Volker Bolay’s desk. “That’s him,” says his patient Jens Schweighöfer and nods. “That’s my tinnitus.” He’s been hearing it for seven years. He has two rehab stays behind him. He even took part in a study at the University Hospital in Regensburg. It did not help. “You have to learn to live with it,” says Schweighöfer, not sounding like he wants to do it a second longer.
He drove almost four hours to present himself at the German Center for Music Therapy Research (DZM) in Heidelberg – the only institution in Germany that offers scientifically based music therapy for chronic tinnitus. Schweighöfer is sitting in Prof. Bolay’s outpatient clinic, housed on the ground floor of an office building in the Wieblingen district, between the tax office and the supermarket. After Prof. Bolay has determined his tinnitus frequency, he puts on disposable gloves and examines the pressure sensitivity of the paranasal sinuses, the jaw joints and the cervical spine. “I’ve been chewing mainly on the right side for a long time,” admits Schweighöfer.
Bolay nods, sits down and says: “You know that we cannot help all patients? Our therapy doesn’t work for 20 percent.” Schweighöfer nods. He seems like a man for whom the glass is always half full. And at the DZM, his chances are better than fifty-fifty: in 80 out of 100 patients, the ringing in the ears decreases significantly or disappears as a result of the treatment – regardless of how long it existed beforehand. This is confirmed by a current long-term study. But Prof. Bolay mentions these figures rather casually.
The brain begins to produce sounds itself
“As researchers, we are of course very satisfied with these numbers,” says the 60-year-old after handing over Schweighöfer to a colleague for further tests. “But I always ask patients if they’re happy with a plumber who can’t fix every fifth faucet.” He does this because he knows how many dubious providers of tinnitus therapy brag about their supposed successes. “It’s a big market,” confirms Prof. Peter Plinkert, Director of the ENT University Clinic Heidelberg, who came to the DZM especially for the interview. Ginkgo, lasers, ear candles, neurostimulators – the list of alleged saviors is long. “When Mr. Bolay presented his method to us, I must have known 50 others that didn’t work. At the time I thought: Forget it,” admits Plinkert. Today the two work closely together. “I had to relearn. His results surprised and convinced me.”
Bolay smiles. “You need strong nerves among conventional medicine. We had to submit our first studies three times before a specialist journal published them.” For too long music therapy in Germany was considered half-baked. “Rightly so,” Bolay concedes. “There were almost no scientific studies. That’s why we had to proceed step by step.” He starts a short animation on his PC. It shows recordings of a functional magnetic resonance tomography on test subjects who were either listening to music or tinnitus. Not only the so-called auditory cortex is visibly active. Parts of the brain that are responsible for feelings and memory also light up red-orange. “Interestingly, the activity in listening to music and listening to tinnitus was almost identical. So tinnitus is a neurological problem,” explains Bolay.
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The tinnitus is a phantom sound
Prof. Bolay draws an invisible curve on the table with his left index finger. “With every noise in the ear, we observe a hearing loss in a certain frequency range, the so-called tinnitus sink.” The result: some nerve cells no longer receive input from the outside, become overexcitable and start firing signals spontaneously. Those affected perceive it as tinnitus. The brain can also silence this phantom sound. “We’re doing a kind of intensive language course here.” In a language that everyone understands: music. Bolay is also an expert there: the trained church musician plays the piano, organ and double bass. “I financed my studies with that,” he says on the way to one of the treatment rooms. In the bright room there is a white grand piano, next to it a gong, on the shelf a sine wave generator, which can reproduce the different sounds in the ears of the patients. They play them on the gong or on a vibraphone. A therapist prescribes tone sequences on the grand piano that lie outside or within the frequency range affected by the tinnitus. The patients should recognize them and sing after them. “There are also resonance exercises,” Bolay continues. To do this, the participants learn overtone singing, in which the voice sounds like a didgeridoo, and sing their tinnitus with an “octave”, i.e. doubled or halved pitch. Several times a day. “That also creates a slight high blood pressure in the head.” Not everyone can stand it. outside or inside the frequency range affected by the tinnitus. The patients should recognize them and sing after them. “There are also resonance exercises,” Bolay continues. To do this, the participants learn overtone singing, in which the voice sounds like a didgeridoo, and sing their tinnitus with an “octave”, i.e. doubled or halved pitch. Several times a day. “That also creates a slight high blood pressure in the head.” Not everyone can stand it. outside or inside the frequency range affected by the tinnitus. The patients should recognize them and sing after them. “There are also resonance exercises,” Bolay continues. To do this, the participants learn overtone singing, in which the voice sounds like a didgeridoo, and sing their tinnitus with an “octave”, i.e. doubled or halved pitch. Several times a day. “That also creates a slight high blood pressure in the head.” Not everyone can stand it.
That’s why Claudia Krüger has to stare at colorful balls, cubes and pyramids in the room opposite. A computer presents them in increasingly rapid succession. The 37-year-old elementary school teacher is supposed to say what shape and color she sees with a click of the mouse. What she doesn’t know is that within three minutes it will be almost impossible. The game is a stress test that records your heart rate and skin conductivity. Then she should rest on a comfortable couch.
The noise in the ear often has an organic cause
Only if her body deals normally with tension and relaxation is she eligible for therapy at the DZM. Prof. Bolay explains it like this: “In every second case of tinnitus noise, there is an organic cause.” High blood pressure, diabetes, narrowed vessels, heart problems, a crooked jaw joint or an undetected hearing loss can trigger the noise. “That always has to be treated first, otherwise our therapy can’t help. And sometimes it is no longer necessary after that.” However, if the therapy here only revolved around the musical work on the tinnitus, it would probably not be so successful. “The psyche plays a major role,” says Prof. Bolay. “There is an arrangement between the tinnitus and the sufferer: He eliminates as many periods of rest and recovery as possible, so that he is conscious of the ringing in his ears as little as possible.” It is particularly common for teachers, factory workers, hunters and marksmen. “And those managers who believe that their health account is as good as their salary.” Between ringing in the ear andStress creates a dangerous reciprocal effect: If you are overworked, the tinnitus gets worse – and vice versa. “We have to cut this connection,” says Bolay. That is why the patients create their “tinnitus map” at the beginning of their therapy week. “We ask them: What are the worst and the best situations with the tinnitus?” says Bolay. The most beautiful? “If they are treated with particular care at work because of their ringing in their ears, for example, they experience this positively – as an important benefit from the illness.”
Addresses & Tips
Therapy & Study: German Center for Music Therapy Research, Maassstr. 32/1, 69123 Heidelberg, Tel. 0 62 21/83 38 60, dzm-heidelberg.de.
Tip: The DZM therapy should also be used in the context of a study for acute tinnitus (lasting a maximum of eight weeks). We are still looking for test persons!
Advice & help: German Tinnitus League, Am Lohsiepen 18, 42369 Wuppertal, Tel. 02 02/24 65 20, tinnitus-liga.de
Every patient longs for silence – until it is there
Claudia Krüger would also have to unfold her map when she comes back. Could talk about the noise in physical education, which she can hardly stand. About children whom she cannot locate acoustically in class because the constant beeping in their ears disturbs everything. In Heidelberg, she could learn to eliminate stress with her personal “feel-good picture” in her head and a music-therapeutic relaxation training. But: “When the patients feel that their tinnitus is changing, wandering in their heads, getting higher, deeper and more and more quiet, they are frightened.” One of Bolay’s patients then let water run from the shower into her ear canal.
And then – silence. No sound. “We totally underestimated that,” says outpatient clinic manager Boley in retrospect. “The participants want nothing more than that. But when the time comes, many have the feeling of losing a loyal companion. That’s why we’re talking much more intensively today about this moment and about the silence. ”Whether Claudia Krüger will get involved remains open when she says goodbye.
A black and white postcard hangs not far from the front door. A little boy with headphones asks: “Where is the music once it’s heard?” In the head is the answer. There she can do a lot.
Hearing protection: nasty noises in the ears don’t stand a chance
- Our ears never sleep. It is all the more important to give them regular breaks. For example, listening to the rustling of leaves in the forest or listening to soft music.
- Rock concerts, open-air parties, anti-nuclear demonstrations or drilling 90 holes for the new veranda – after such experiences, your ears often ring. The following applies here: wear hearing protection! Brightly colored earplugs and headphones are available in pharmacies and hardware stores.
- Long-term stress also makes hearing more vulnerable. Conscious relaxation, for example with yoga or meditation, helps to relieve the pressure. If it beeps, the inner peace prevents the attention from “sticking” to the noise in the ear – this increases the chance of healing.
- Go for a hearing test every two years. It is not uncommon for an undetected hearing loss to be behind the tinnitus. The sooner it is discovered, the better countermeasures can be taken.
Test
How much does the noise bother you?
1. I am constantly aware from morning to night that I have a ringing in my ears.
2. If the tinnitus continues like this, I no longer find my life worth living.
3. Since I’ve had the ringing in my ears, I’ve been irritated and annoyed more often and faster.
4. I am afraid that the tinnitus may cause physical harm.
5. Ever since the ringing in my ears started, I can’t really switch off and relax.
6. The tinnitus is often so loud that I can no longer ignore it.
7. I often cannot fall asleep at night because of the ringing in my ears and lie awake.
8. I notice that the tinnitus makes me feel depressed more easily and more often.
9. I wonder if the ringing in my ears will ever go away.
10. I feel helpless, exposed and a victim of my ringing in the ears.
11. I can’t concentrate as well since I got the tinnitus.
12. I’m concerned that my ringing in the ears might be caused by a serious physical problem.
- Yes (2 Points)
- Partial (1 point)
- No (0 points)
Resolution:
IMPORTANT: If the tinnitus is only a few days old (max. eight weeks), you should consult an ENT doctor immediately. At this stage, a 3- to 5-day cortisone therapy can help. Have your hearing tested and clarified whether there are any organic triggers (e.g. high blood pressure or diabetes).
0 to 7 points: You live with your tinnitus without any problems, do not let it bother you and do not pay any special attention to it. Good! A relaxation technique helps to get through particularly stressful situations.
8 to 16 points: Tinnitus is increasingly becoming a problem for you. “Not listening” still works, but setbacks are increasing. For example, contact a tinnitus outpatient clinic in your area or get support from a self-help group of the German Tinnitus League.
17 to 24 points: The tinnitus dominates your feelings and thoughts and your everyday life. An appointment with the ENT doctor is no longer enough. The soul needs help too. The best thing for you would be inpatient tinnitus treatment.
