From the Guidelines
Treatment for tinnitus should prioritize a multidisciplinary approach, including sound therapy, cognitive behavioral therapy (CBT), and addressing underlying causes, as recommended by the most recent guidelines 1. The management of tinnitus involves a comprehensive evaluation to identify potential underlying causes and to determine the most appropriate interventions to improve symptoms and quality of life for tinnitus sufferers, as outlined in the clinical practice guideline: tinnitus executive summary 1.
Key Treatment Options
- Sound therapy, which includes using white noise machines, fans, or smartphone apps to mask the tinnitus, is a recommended approach 1.
- Cognitive behavioral therapy (CBT) is strongly recommended for patients with persistent, bothersome tinnitus, as it helps patients develop coping strategies and change negative thought patterns about tinnitus 1.
- Hearing aids can be beneficial for those with hearing loss, as they amplify external sounds and reduce the perception of tinnitus 1.
- Relaxation techniques, such as meditation, deep breathing exercises, and yoga, may provide relief for stress-related tinnitus.
- Avoiding triggers like loud noises, caffeine, alcohol, and nicotine can prevent worsening of symptoms.
Medical Therapy
Some medications, such as tricyclic antidepressants, anticonvulsants, and benzodiazepines, may be considered, but their use should be cautious due to side effects and dependency risks, and they are not FDA-approved specifically for tinnitus 1.
Recent Guidelines
The most recent guidelines, such as the ACR Appropriateness Criteria® Tinnitus: 2023 update 1, emphasize the importance of a targeted history and clinical examination, as well as a prompt and comprehensive audiological examination in patients with hearing problems or with unilateral persistent tinnitus.
Conclusion Not Applicable
Instead, the focus should be on providing evidence-based recommendations for the treatment of tinnitus, prioritizing the most recent and highest-quality studies, such as the 2023 update of the ACR Appropriateness Criteria® Tinnitus 1.
From the Research
Treatment Options for Tinnitus
- The treatment options for tinnitus are based on the severity of the condition and any associated problems 2.
- Nutritional supplements, such as Ginkgo biloba and B-complex vitamins, may have an impact on selected patients with mild-to-moderate tinnitus 2.
- Cognitive behavior therapy (CBT) is a highly effective treatment option for tinnitus, as it helps to reduce the distress associated with the condition 2, 3, 4, 5, 6.
- CBT can help patients to manage their tinnitus by changing their negative thoughts and behaviors associated with the condition 3, 4, 6.
- Other treatment options for tinnitus include sound therapy, tinnitus retraining therapy, and melatonin, although the evidence for these treatments is inconclusive 5.
- Surgical treatment options, such as cochlear implant, repetitive transcranial magnetic stimulation, and vagal stimulator, may be effective in reducing tinnitus in certain patients 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 5.
Effectiveness of Different Treatments
- CBT has been shown to be more effective in decreasing tinnitus-related distress, while notched sound therapy (NST) may be more helpful in reducing tinnitus loudness 4.
- A comparison of CBT and NST found that both treatments were effective in managing chronic subjective tinnitus, but CBT was more effective in improving quality of life 4.
- Melatonin, antidepressants, and cognitive training may help with sleep disturbance, mood disorders, and cognitive impairments associated with tinnitus 5.
Importance of Comprehensive Care
- Providing information about the natural progression of tinnitus and being familiar with the causes that warrant additional evaluation, imaging, and specialist involvement are essential to comprehensive care 5.
- A standard workup for tinnitus should include a targeted history and physical examination to identify treatable causes and associated symptoms that may improve with treatment 5.