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A multidisciplinary systematic review of the treatment for chronic idiopathic tinnitus

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  • Published:
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Abstract

The majority of tinnitus patients are affected by chronic idiopathic tinnitus, and almost 60 different treatment modalities have been reported. The present study is a multidisciplinary systematic analysis of the evidence for the different forms of treatment for chronic tinnitus. The results are used to form the basis of an S3 guideline. A systematic search was carried out in PubMed and the Cochrane Library. The basis for presenting the level of evidence was the evidence classification of the Oxford Centre of Evidence-based Medicine. Whenever available, randomised controlled trials were given preference for discussing therapeutic issues. All systematic reviews and meta-analyses were assessed for their methodological quality, and effect size was taken into account. As the need for patient counselling is self-evident, specific tinnitus counselling should be performed. Due to the high level of evidence, validated tinnitus-specific, cognitive behavioural therapy is strongly recommended. In addition, auditory therapeutic measures can be recommended for the treatment of concomitant hearing loss and comorbidities; those should also be treated with drugs whenever appropriate. In particular, depression should be treated, with pharmacological support if necessary. If needed, psychiatric treatment should also be given on a case-by-case basis. With simultaneous deafness or hearing loss bordering on deafness, a CI can also be indicated. For auditory therapeutic measures, transcranial magnetic or direct current stimulation and specific forms of acoustic stimulation (noiser/masker, retraining therapy, music, and coordinated reset) for the treatment of chronic tinnitus the currently available evidence is not yet sufficient for supporting their recommendation.

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Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076, Tübingen, Germany

    Hans-Peter Zenner

  2. Otorhinolaryngology Centre, Kaiserslautern, Germany

    Wolfgang Delb

  3. Department of Psychology, Georg-August University of Göttingen, Göttingen, Germany

    Birgit Kröner-Herwig

  4. Mental Health Centre, Clinic for Psychosomatics and Psychotherapy, Medical University of Hannover, Hannover, Germany

    Burkhard Jäger

  5. Department for Dental Prosthetics, Geriatric Dentistry and Function, Charité Hospital, Medical School Berlin, Berlin, Germany

    Ingrid Peroz

  6. Tinnitus Clinic, Bad Arolsen Hospital, Arolsen, Germany

    Gerhard Hesse

  7. Charité Hospital, Medical School Berlin, University Otorhinolaryngology Clinic, Berlin, Germany

    Birgit Mazurek

  8. Department of Behavioural Medicine, Psychosomatics, Psychiatry and Psychotherapy, Schön Clinic in Roseneck, Prien am Chiemsee, Germany

    Gerhard Goebel

  9. Clinic and Outpatient Clinic for Neurology, University Hospital of Hamburg-Eppendorf, Hamburg, Germany

    Christian Gerloff

  10. Social Paediatric Centre, Neuropaediatrics and Epileptology, University Paediatric Clinic, Erlangen, Germany

    Regina Trollmann

  11. Otorhinolaryngology Centre, Traunstein, Germany

    Eberhard Biesinger

  12. MedClin Bosenberg Clinics, Saint Wendel, Germany

    Harald Seidler

  13. Department for Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany

    Berthold Langguth

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Hans-Peter Zenner declares that there is no conflict of interest. Wolfgang Delb declares that there is no conflict of interest. Birgit Kröner-Herwig declares that there is no conflict of interest. Burkhard Jäger declares that there is no conflict of interest. Ingrid Peroz declares that there is no conflict of interest. Gerhard Hesse declares that there is no conflict of interest. Birgit Mazurek declares that there is no conflict of interest. Gerhard Goebel declares that there is no conflict of interest. Christian Gerloff declares that there is no conflict of interest. Regina Trollmann declares that there is no conflict of interest. Eberhard Biesinger declares that there is no conflict of interest. Harald Seidler declares that there is no conflict of interest. Berthold Langguth declares that there is no conflict of interest.

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Zenner, HP., Delb, W., Kröner-Herwig, B. et al. A multidisciplinary systematic review of the treatment for chronic idiopathic tinnitus. Eur Arch Otorhinolaryngol 274, 2079–2091 (2017). https://doi.org/10.1007/s00405-016-4401-y

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