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Review
. 2022 Apr 1;119(13):219-225.
doi: 10.3238/arztebl.m2022.0135.

Chronic Tinnitus

Birgit Mazurek  1 , Gerhard Hesse, Christian Dobel, Volker Kratzsch, Claas Lahmann, Heribert Sattel; Guideline group
Collaborators, Affiliations
Review

Chronic Tinnitus

Birgit Mazurek et al. Dtsch Arztebl Int. .

Abstract

Background: Chronic tinnitus is a commonly occurring symptom of the auditory system. Epidemiological studies assume a lifetime prevalence in men and women of 3.5% for chronic tinnitus requiring treatment. Almost 25% of all Germans have experienced at least one episode of tinnitus. No causal therapy is yet available, but numerous treatment strategies are being pursued. Rigorous scientific assessment of these procedures is essential.

Methods: For this exhaustive revision of the German clinical practice guideline, the literature in the medical databases PubMed and Cochrane Library, including existing guidelines from various countries, was systematically searched using keywords on the topic of chronic tinnitus. On the basis of the revised guideline, a separate guideline was written in language accessible to patients.

Results: Chronic tinnitus is often associated with hearing loss, but the mental distress caused by the ear noise is another crucial element. Apart from expert counseling, the recommended treatment comprises psychotherapeutic interventions, particularly cognitive behavioral therapy (with effect sizes of 0.54 to 0.91 for reduction of the tinnitus-related distress), and measures to improve the hearing. There is insufficient evidence regarding the effects of drug treatment, sound and music therapy, and neuromodulation (magnetic stimulation or electrostimulation).

Conclusion: Alongside thorough and sound diagnosis and counseling, the principal treatment options for chronic tinnitus are specific cognitive behavioral therapy and expert psychotherapeutic interventions on an individual or group basis. Future-preferably interdisciplinary-research should evaluate the long-term effects of the treatment options, with particular attention to psychosomatic comorbidity.

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Figures

Figure
Figure
Flowchart for treatment of chronic tinnitus
See this image and copyright information in PMC

Comment in

  • In Reply.
    Hesse G. Hesse G. Dtsch Arztebl Int. 2022 Oct 7;119(40):683-684. doi: 10.3238/arztebl.m2022.0234. Dtsch Arztebl Int. 2022. PMID: 36594340 Free PMC article. No abstract available.

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