Dr. Tobias Kleinjung is an otolaryngologist based at the University Hospital of Zurich, where among his patients are those who suffer from tinnitus. Dr. Kleinjung recently participated in Ida’s Tinnitus Challenge, where he helped to bring a medical perspective to the discussion. He answered a few questions for Ida via email about strategies for dealing with tinnitus, what general practitioners should know about the condition, and the challenges of managing tinnitus.
What does your daily work as an otolaryngologist involve?
My present professional work includes the organization of the largest ENT outpatient department in Switzerland. This comprises all aspects of our profession like emergency cases, patients with otological, rhinological problems and head and neck tumors. The treatment spectrum ranges from conservative approaches to surgical interventions.
How did you first get involved with tinnitus?
My first intense professional involvement with tinnitus started during my ENT residency in 1997. At this time, I was asked to overtake the organization of a tinnitus special clinic at my former affiliation (University of Regensburg, Germany). Since this time, I have seen tinnitus patients of all kinds regularly during my work.
How does your work relate to tinnitus?
Tinnitus is a clinical and a research focus of my work. Two times per week we run a special clinic for tinnitus patients. This clinic is dedicated to patients who have a chronic tinnitus problem and suffer quite a lot. In this clinic, we cultivate a multidisciplinary approach involving specialists from other disciplines like psychiatry, psychology, physiotherapy or dentistry. In our general clinic tinnitus is also an issue. This general clinic runs 365 days and 24 hours/day. Here we are confronted with subjects with acute onset tinnitus. The main issue here is to provide some general diagnostic investigations and counselling.
In my research group, we investigate new strategies for tinnitus therapy (e.g. neuro-feedback) and tinnitus subtyping (electroencephalography, questionnaires).
What do you think is most important for general practitioners to know about tinnitus?
I think that it is of utmost importance to provide some general knowledge about tinnitus to GPs. GPs are often in first contact with the patient which gives them an important position in handling tinnitus cases. First of all, they should have some information on tinnitus etiology and diagnosis. This should enable them to assess their patients properly and provide an adequate management for acute onset tinnitus. This contains mainly counselling and the organization of further diagnostic steps if necessary (audiology, ENT).
What do you see as the greatest challenge to managing tinnitus?
The greatest challenge in the management of tinnitus patients is that we cannot provide a solution in terms of tinnitus elimination to most of our patients. This means that in most situations we can only support our patients in helping them to accept and habituate to the condition. However, there still remain subjects which are not satisfied by our routine approaches. This is an incentive for me in continuing our research efforts developing treatment modalities, which focus more on direct tinnitus modulation than on habituation aspects.