Treatment of Tinnitus: A Scoping Review

Abstract

Background: Tinnitus is a perception of an auditory sensation without the presence of an external sound. It has devastating impact on the quality of life and psychosocial aspect of the sufferer. Mechanisms of tinnitus not clear; however, its management include counselling, hearing aids, tinnitus masking, relaxation therapy, cognitive behaviour therapy and tinnitus retraining therapy. Objective: To conduct a scoping review to explore the role of counselling, hearing aids, tinnitus masking, relaxation therapy, cognitive-behavioural therapy and tinnitus retraining therapy in India. To also provide an overview of efficacy of these approaches in tinnitus management. Research Design: Scoping review. Study Sample: Experimental studies, follow-up assessments, and reviews assessing tinnitus treatment approaches were identified as a result of an electronic database met search. Results: The evidence suggests that all tinnitus management programs have their unique benefits in the treatment of tinnitus. Given the confounding variables that include length of therapy, tinnitus severity and subject population, the overall level of evidence is equivocal. Nonetheless, the efficacy of CBT appears reasonably established and combined approach (masking + counselling + attention diversion) appears to be most promising for audiologists for future tinnitus management. A common ground of therapeutic elements was established and evidence was found to be robust enough to guide clinical practice. Conclusion: The use of more robust methodology with well-defined control groups, as well as randomization of clinical trials in future studies would increase the quality of evidence in the study of tinnitus management. Clinical recommendation: Combined therapies (masking + counselling + attention diversion) appear more appropriate in the treatment of tinnitus as the evidence is not sufficient to support a specific treatment method.

The Characteristic and Short-Term Prognosis of Tinnitus Associated with Sudden Sensorineural Hearing Loss

“…Many useful methods have been studied to protect the cochlea from damage [ 40 , 41 ], and several effective methods have been researched to protect the cochlea in vitro [ 42 – 46 ]. However, there were limited methods to treat tinnitus [ 47 ]. Generally, sensorineural hearing loss tends to be stable within 3 months of onset, whereas there can be a spontaneous decrease in tinnitus within 5 years of onset.…”

Baseline Functional Connectivity Features of Neural Network Nodes Can Predict Improvement After Sound Therapy Through Adjusted Narrow Band Noise in Tinnitus Patients

“…Current therapeutic approaches include tinnitus retraining therapy (Scherer et al, 2014; Kim et al, 2016), counseling, cognitive behavior therapy (Conrad et al, 2015; Weise et al, 2016), transcranial magnetic stimulation (Kreuzer et al, 2017; Formanek et al, 2018), hearing aids (Searchfield et al, 2010), pharmacological treatments (von Boetticher, 2011), and several innovative sound-based treatments (e.g., Heidelberg Neuro-Music Therapy) (Krick et al, 2015, 2017a,b), Cochleural Alternating Acoustic Beam Therapy (CAABT) (Liu et al, 2018), and Tailor-Made Notched Music Training (TMNMT) (Okamoto et al, 2010; Kim et al, 2017; Lee et al, 2017). Sound therapy is considered as a cost-effective management for tinnitus (Tunkel et al, 2014; Walker et al, 2016; Makar et al, 2017) and is one of the most commonly used first-line therapy interventions for decades (Henry et al, 2002). An adjusted narrow band noise was commonly used in sound therapy.…”

Effects of sound therapy on resting‐state functional brain networks in patients with tinnitus: A graph‐theoretical‐based study

“…Tinnitus is considered to be triggered by aberrant neural activity in the brain. Sound therapy is an effective way to promote habituation to the tinnitus sensation . We hypothesized that the relief of tinnitus might be related to the FC alteration of brain areas.…”

“…Sound therapy is an effective way to promote habituation to the tinnitus sensation. 32 We hypothesized that the relief of tinnitus might be related to the FC alteration of brain areas. It is of importance to analyze the possible effects of sound therapy on resting-state functional brain networks in patients with tinnitus, adding to our understanding of the neurological mechanism of tinnitus and sound therapy.…”