Evidence and evidence gaps in tinnitus therapy

Hesse, Gerhard

doi:10.3205/cto000131

Cited by 16 publications

(3 citation statements)

References 195 publications

(201 reference statements)

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“…Therapeutic approaches such as intratympanic steroid treatment do not affect chronic tinnitus [ 218 , 219 ] if it does not occur in conjunction with acute hearing loss. A temporary increase in tinnitus intensity and tinnitus distress is not considered new-onset tinnitus but should be considered and treated as a fluctuation in the subjective perception of chronic tinnitus [ 220 ].…”

Section: Therapy Of Chronic Tinnitusmentioning

confidence: 99%

S3 Guideline: Chronic Tinnitus

Mazurek

Hesse

Sattel

et al. 2022

HNO

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Section: Therapy Of Chronic Tinnitusmentioning

confidence: 99%

S3 Guideline: Chronic Tinnitus

Mazurek

Hesse

Sattel

et al. 2022

HNO

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“…While hearing aids are recommended for patients with hearing loss and concurrent tinnitus in all guidelines [67][68][69], hearing aids for tinnitus alone is given a weak recommendation due to the lack of high-quality, robust data in the literature [69]. Several systemic reviews investigating the efficacy of hearing aids for tinnitus have found a lack of high-quality RCTs in the literature and noted equivocal results with a need for further studies [79,80].…”

Section: Hearing Aidsmentioning

confidence: 99%

Current and Emerging Therapies for Chronic Subjective Tinnitus

Park,

Kullar,

Malhotra

et al. 2023

JCM

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Importance: Chronic subjective tinnitus, the perception of sound without an external source for longer than six months, may be a greatly debilitating condition for some people, and is associated with psychiatric comorbidities and high healthcare costs. Current treatments are not beneficial for all patients and there is a large need for new therapies for tinnitus. Observations: Unlike rarer cases of objective tinnitus, chronic subjective tinnitus often has no obvious etiology and a diverse pathophysiology. In the absence of objective testing, diagnosis is heavily based on clinical assessment. Management strategies include hearing aids, sound masking, tinnitus retraining therapy, cognitive behavioral therapy, and emerging therapies including transcranial magnetic stimulation and electrical stimulation. Conclusions and relevance: Although current treatments are limited, emerging diagnostics and treatments provide promising avenues for the management of tinnitus symptoms.

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“…Considering that due to this heterogeneity in tinnitus manifestations and treatment responses for all treatment approaches—not only rTMS—there is up until now no common valid treatment for every single patient or a cure for tinnitus available [ 26 , 27 ]. A potential way to minimize the variability in treatment responses might be the personalization of interventions [ 23 , 28 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

Personalization of Repetitive Transcranial Magnetic Stimulation for the Treatment of Chronic Subjective Tinnitus

et al. 2022

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Background: Personalization of repetitive transcranial magnetic stimulation (rTMS) for tinnitus might be capable to overcome the heterogeneity of treatment responses. The assessment of loudness changes after short rTMS protocols in test sessions has been proposed as a strategy to identify the best protocol for the daily treatment application. However, the therapeutic advantages of this approach are currently not clear. The present study was designed to further investigate the feasibility and clinical efficacy of personalized rTMS as compared to a standardized rTMS protocol used for tinnitus. Methods: RTMS personalization was conducted via test sessions and reliable, sham-superior responses respectively short-term reductions in tinnitus loudness following active rTMS protocols (1, 10, 20 Hz, each 200 pulses) applied over the left and right temporal cortex. Twenty pulses at a frequency of 0.1 Hz served as a control condition (sham). In case of a response, patients were randomly allocated to ten treatment sessions of either personalized rTMS (2000 pulses with the site and frequency producing the most pronounced loudness reduction during test sessions) or standard rTMS (1 Hz, 2000 pulses left temporal cortex). Those participants who did not show a response during the test sessions received the standard protocol as well. Results: The study was terminated prematurely after 22 patients (instead of 50 planned) as the number of test session responders was much lower than expected (27% instead of 50%). Statistical evaluation of changes in metric tinnitus variables and treatment responses indicated only numerical, but not statistical superiority for personalized rTMS compared to standard treatment. Conclusions: The current stage of investigation does not allow for a clear conclusion about the therapeutic advantages of personalized rTMS for tinnitus based on test session responses. The feasibility of this approach is primarily limited by the low test session response rate.

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Evidence and evidence gaps in tinnitus therapy

Cited by 16 publications

References 195 publications

S3 Guideline: Chronic Tinnitus

S3 Guideline: Chronic Tinnitus

Current and Emerging Therapies for Chronic Subjective Tinnitus

Personalization of Repetitive Transcranial Magnetic Stimulation for the Treatment of Chronic Subjective Tinnitus

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