Clinical Practice Guideline: Tinnitus

Tunkel, David E.; Bauer, Carol A.; Sun, Gordon H.; Rosenfeld, Richard M.; Chandrasekhar, Sujana S.; Cunningham, Eugene R.; Archer, Sanford M.; Blakley, Brian W.; Carter, John M.; Granieri, Evelyn; Henry, James A.; Hollingsworth, Deena B; Khan, Fawad; Mitchell, Scott G.; Monfared, Ashkan; Newman, Craig W.; Omole, Folashade; Phillips, C. Douglas; Robinson, Shannon K.; Taw, Malcolm B.; Tyler, Richard S.; Waguespack, Richard W.; Whamond, Elizabeth J.

doi:10.1177/0194599814545325

Cited by 522 publications

(451 citation statements)

References 233 publications

(474 reference statements)

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“…In the absence of a medical cure for distressing tinnitus, clinical management typically consists of audiological management of hearing loss by sound-masking systems or hearing aids and reducing tinnitus distress by education and cognitive behavioural therapy (CBT) (Tunkel et al, 2014). The latter treatment is directed at the tinnitus-related cognitions and behaviours that are thought to cause and prolong tinnitus-related distress (McKenna et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

A trauma-focused approach for patients with tinnitus: the effectiveness of eye movement desensitization and reprocessing – a multicentre pilot trial

Rikkert

Rood

Roos

et al. 2018

European Journal of Psychotraumatology

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Background: While normal tinnitus is a short-term sensation of limited duration, in 10–15% of the general population it develops into a chronic condition. For 3–6% it seriously interferes with many aspects of life. Objective: The aim of this trial was to assess effectiveness of a trauma-focused approach, eye movement desensitization and reprocessing (EMDR), in reducing tinnitus distress. Methods: The sample consisted of 35 adults with high levels of chronic tinnitus distress from five general hospitals in the Netherlands. Participants served as their own controls. After pre-assessment (T1), participants waited for a period of 3 months, after which they were assessed again (T2) before they received six 90 min manualized EMDR treatment sessions in which tinnitus-related traumatic or stressful events were the focus of treatment. Standardized self-report measures, the Tinnitus Functional Index (TFI), Mini-Tinnitus Questionnaire (Mini-TQ), Symptom Checklist-90 (SCL-90) and the Self-Rating Inventory List for Post-traumatic Stress Disorder (SRIP), were completed again halfway through treatment (T3), post-treatment (T4) and at 3 months’ follow-up (T5). Results: Repeated measures analysis of variance revealed significant improvement after EMDR treatment on the primary outcome, TFI. Compared to the waiting-list condition, scores significantly decreased in EMDR treatment [t(34) = −4.25, p < .001, Cohen’s dz = .72]. Secondary outcomes, Mini-TQ and SCL-90, also decreased significantly. The treatment effects remained stable at 3 months’ follow-up. No adverse events or side effects were noted in this trial. Conclusions: This is the first study to suggest that EMDR is effective in reducing tinnitus distress. Randomized controlled trials are warranted.

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Section: Introductionmentioning

confidence: 99%

A trauma-focused approach for patients with tinnitus: the effectiveness of eye movement desensitization and reprocessing – a multicentre pilot trial

Rikkert

Rood

Roos

et al. 2018

European Journal of Psychotraumatology

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“…According to the most recent trends of thought, tinnitus is not considered a disease, but a symptom, which may have multiple causes, sometimes even in a single patient [11,12]. Noise exposure, metabolic and cardiovascular disease, presbycusis, ototoxicity and cranial and cervical trauma are the most frequently considered causes of tinnitus [12,13].…”

Section: Current Trends Of Thoughts Concerning Tinnitus Pathophysiologymentioning

confidence: 99%

“…Noise exposure, metabolic and cardiovascular disease, presbycusis, ototoxicity and cranial and cervical trauma are the most frequently considered causes of tinnitus [12,13]. Cafeine abuse, dietary factors, temporomandibular joint and cervical diseases have also been described as contributing factors [14][15][16].…”

Section: Current Trends Of Thoughts Concerning Tinnitus Pathophysiologymentioning

confidence: 99%

Ménière’s Disease and Tinnitus

Figueiredo¹,

Azevedo²,

Penido³

2017

Up to Date on Meniere's Disease

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Tinnitus is one of the Ménière's disease clue symptoms, but by far less studied than vertigo or other types of dizziness. The typical Ménière's tinnitus is a low pitched luctuating one. Although controversial, cochlear Ménière's disease may account for a tinnitus subtype, a fact that may impact on tinnitus diagnosis and treatment. Further studies focused on tinnitus are necessary to clarify at which extent Ménière's disease may have a role in some types of chronic tinnitus.

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“…Evidence-based guidelines have, however, emerged elsewhere. Tunkel et al [10] produced an American Academy of Otolaryngology evidence-based clinical practice guideline for tinnitus. This guideline makes strong recommendations for the use of validated questionnaires of tinnitus severity and for the use of education and psychological therapy.…”

Section: Introductionmentioning

confidence: 99%

“…Is further work needed in these areas? The current service evaluation also affords us the opportunity to make a baseline comparison of current day audiology practices in the UK and the recent evidence-based recommendations of the American Academy of Otolaryngology [10].…”

Section: Introductionmentioning

confidence: 99%

Equity and person-centeredness in provision of tinnitus services in UK National Health Service audiology departments

Hoare

Broomhead

Stockdale

et al. 2015

EJPCH

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Rationale, aim and objective: Chronic tinnitus is a prevalent condition broadly managed using individualised sound-based interventions, individualised or group education, counselling, or cognitive therapies. In the UK, therapy is largely delivered by audiologists or hearing therapists and, where available, clinical psychologists and physicians. Changes in the structure of the health service necessitate ongoing evaluation to monitor equity and person-centeredness of care. The purpose of the current evaluation was to describe provision and explore diversities in the services provided for tinnitus patients across the four countries of the UK and consider these relative to current commissioning and clinical practice guidelines. Method: A 37 item questionnaire was devised and distributed via email and social media to reach audiology departments in the UK and 147 valid responses were acquired during the 3 month period of the evaluation. Results: The structure and provision of tinnitus services varies widely across the four countries of the United Kingdom in terms of which clinicians provide the services. Outside of England there was no report of clinical psychology or audiovestibular physician involvement in services. There is also variability in access to psychological therapy or support (little training in CBT in Scotland and none in Northern Ireland), self-help groups (little involvement but interest from clinicians) and devices (e.g., one quarter of departments do not currently offer combination hearing aid devices for tinnitus). Clinicians are increasingly using validated questionnaires to evaluate the effectiveness of tinnitus management in their departments. Conclusions: Training in and the provision of psychological support for tinnitus patients by audiologists is particularly a concern for Scotland and Northern Ireland and has implications for the person-centeredness of audiology services. Capacity and need for research in paediatric tinnitus, combination devices, non-ear level sound devices and audiologist-delivered psychological therapy, are noted.

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Clinical Practice Guideline: Tinnitus

Abstract: Guideline S2Otolaryngology- Head and Neck Surgery 151(2S) and (b) recommend sound therapy to patients with persistent, bothersome tinnitus. The development group provided no recommendation regarding the effect of acupuncture in patients with persistent, bothersome tinnitus.

Cited by 522 publications

References 233 publications

A trauma-focused approach for patients with tinnitus: the effectiveness of eye movement desensitization and reprocessing – a multicentre pilot trial

A trauma-focused approach for patients with tinnitus: the effectiveness of eye movement desensitization and reprocessing – a multicentre pilot trial

Ménière’s Disease and Tinnitus

Equity and person-centeredness in provision of tinnitus services in UK National Health Service audiology departments

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