The natural history of subjective tinnitus in adults: A systematic review and meta‐analysis of no‐intervention periods in controlled trials

Abstract

Objectives: Tinnitus is a prevalent condition, but little has been published regarding the natural history of the condition. One technique for evaluating the long-term progression of the disease is to examine what happens to participants in the nointervention control arm of a clinical trial. The aim of this study was to examine no-intervention or waiting-list data reported in trials, in which participants on the active arm received any form of tinnitus intervention.Data Sources: CINAHL, PsychINFO, EMBASE, ASSIA, PubMed, Web of Science, Science Direct, EBSCO Host, and Cochrane. Methods: Inclusion criteria followed the PICOS principles: Participants, adults with tinnitus; Intervention, none; Control, any intervention for alleviating tinnitus; Outcomes, a measure assessing tinnitus symptoms using a multi-item patientreported tinnitus questionnaire. Secondary outcome measures included multi-item patient-reported questionnaires of mood and health-related quality of life and measures that quantified change in tinnitus loudness; Study design, randomized controlled trials or observational studies utilizing a no-intervention or waiting-list control group. Data were extracted and standardized mean difference was calculated for each study to enable meta-analysis.Results: The evidence strongly favored a statistically significant decrease in the impact of tinnitus over time, though there was significant heterogeneity and clinical significance cannot be interpreted. Outcome data regarding secondary measures did not demonstrate any clinically significant change.Conclusions: Participants allocated to the no-intervention or waiting-list control arm of clinical trials for a tinnitus intervention show a small but significant improvement in self-reported measures of tinnitus with time; the clinical significance of this finding is unknown. There is, however, considerable variation across individuals. These findings support previous work and can cautiously be used when counseling patients.

A multidisciplinary European guideline for tinnitus: diagnostics, assessment, and treatment

“…It should be explained that tinnitus can be affected by life situations that make it more bothersome in time. In general, the severity of tinnitus decreases over time [207] Hearing aids will make the tinnitus louder…”

“…Most people find that their tinnitus seems to settle down over time as they notice it less. There is good evidence from clinical trials that in general tinnitus becomes less bothersome over time, even without doing anything [193,207].…”

Tinnitus as a comorbidity to temporomandibular disorders—A systematic review

“…However, since only one study included a control group, it cannot be excluded that a placebo effect may have affected the results. In a recent systematic review on the natural course of tinnitus in adults, Phillips et al reported that in tinnitus populations not receiving any intervention, an improvement is seen over time, indicating that some of the results reported by the primary studies in the present systematic review may be an effect of time rather than treatment, especially in the light of the lack of control groups.…”

A Retrospective Analysis of Haemotologic Parameters in Patients with Bilateral Tinnitus

“…Many aetiologic factors and mechanisms of pathology were hypothesized (14). However, there are not any certain pathophysiological explanations about tinnitus (15)(16)(17). This clinical problem can occur at older ages and decrease hearing caused by any ear diseases like otosclerosis, Meniere etc.…”

“…As a blood marker MPV shows platelet volume and gives information about platelet function. Highly MPV values were associated with more platelet aggregation and increased risk of ischemic injury (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)21). There are many studies on MPV and tinnitus relationship.…”