From the Guidelines
Tinnitus management should prioritize cognitive behavioral therapy (CBT) and sound therapy to improve symptoms and quality of life, as recommended by the most recent guidelines 1. Tinnitus is a condition characterized by hearing sounds like ringing, buzzing, or hissing when no external sound is present. Unfortunately, there is no single cure for tinnitus, but several management strategies can help reduce its impact.
- Sound therapy using white noise machines, fans, or smartphone apps can mask the tinnitus sounds and provide relief.
- Hearing aids may help if tinnitus is associated with hearing loss.
- Cognitive behavioral therapy (CBT) has proven effective for managing the psychological impact of tinnitus by changing how you respond to the sounds, as supported by the American Academy of Otolaryngology-Head and Neck Surgery Foundation guidelines 1.
- Certain medications like low-dose antidepressants might help in some cases, though no medication is specifically FDA-approved for tinnitus.
- Lifestyle modifications can also make a difference:
- Avoid loud noises
- Limit caffeine and alcohol consumption
- Manage stress through relaxation techniques
- Ensure adequate sleep Tinnitus often results from damage to the tiny hair cells in the inner ear that transmit sound signals to the brain, causing the brain to generate phantom sounds in response to this altered input. While tinnitus can be frustrating, these approaches can significantly improve quality of life for many sufferers, as emphasized by the ACR Appropriateness Criteria 1. The most effective management strategy is a multidisciplinary approach that includes education, counseling, and individualized treatment plans, as outlined in the clinical practice guideline: tinnitus executive summary 1.
From the Research
Definition and Prevalence of Tinnitus
- Tinnitus is the sensation of hearing a sound in the absence of an internal or external source, and it is a common problem encountered in primary care 2.
- It affects up to 21% of the adult population, with an estimated 1% to 3% experiencing severe problems 3.
Diagnosis and Management of Tinnitus
- A standard workup for tinnitus begins with a targeted history and physical examination to identify treatable causes and associated symptoms that may improve with treatment 2.
- A comprehensive audiologic evaluation should be performed for patients who experience unilateral tinnitus, tinnitus that has been present for six months or longer, or that is accompanied by hearing problems 2.
- Cognitive behavior therapy (CBT) is the only treatment that has been shown to improve quality of life in patients with tinnitus 2.
- Sound therapy and tinnitus retraining therapy are treatment options, but evidence is inconclusive 2.
Treatment Options for Tinnitus
- CBT may reduce the impact of tinnitus on quality of life, and it is probably effective in reducing symptoms of depression 3.
- Notched sound therapy (NST) is also effective in reducing tinnitus severity and loudness, and it may be more helpful in reducing tinnitus loudness than CBT 4.
- Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) have shown potential for the treatment of tinnitus, but further research is needed before these techniques can be recommended for routine clinical use 5.
Effectiveness of Cognitive Behavioral Therapy
- CBT has been shown to be effective in reducing the negative impact of tinnitus on quality of life, and it may have small additional benefits in reducing symptoms of depression and anxiety 3, 6.
- The evidence suggests that CBT is a useful treatment option for tinnitus, and it may be effective in reducing tinnitus-related distress and improving quality of life 2, 3, 6.