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What is the evidence that 1Hz rTMS positively affects chronic tinnitus?

Bibliographic details: Phillips N, El Refaie A.  What is the evidence that 1Hz rTMS positively affects chronic tinnitus? Audiological Medicine 2012; 10(2): 76-82

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Evaluation and treatment of tinnitus: comparative effectiveness

Bibliographic details: Pichora-Fuller MK, Santaguida P, Hammill A, Oremus M, Westerberg B, Ali U, Patterson C, Raina P.  Evaluation and treatment of tinnitus: comparative effectiveness. Rockville, MD, USA: Agency for Healthcare Research and Quality. Comparative Effectivenss Review No. 122. 2013 Available from: http://effectivehealthcare.ahrq.gov/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=1649

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Ginkgo biloba extract in the treatment of tinnitus: a systematic review

Tinnitus is a symptom frequently encountered by ear, nose, and throat practitioners. A causal treatment is rarely possible, and drug and nondrug treatment options are limited. One of the frequently prescribed treatments is Ginkgo biloba extract. Therefore, randomized, placebo-controlled clinical trials of Ginkgo biloba extract preparations were searched for and reviewed systematically. There is evidence of efficacy for the standardized extract, EGb 761(®) (Dr Willmar Schwabe GmbH & Co KG Pharmaceuticals, Karlsruhe, Germany), in the treatment of tinnitus from three trials in patients in whom tinnitus was the primary complaint. Supportive evidence comes from a further five trials in patients with age-associated cognitive impairment or dementia in whom tinnitus was present as a concomitant symptom. As yet, the efficacy of other ginkgo preparations has not been proven, which does not necessarily indicate ineffectiveness, but may be due to flawed clinical trials. In conclusion, EGb 761(®), a standardized Ginkgo biloba extract, is an evidence-based treatment option in tinnitus.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

The efficacy of auditory perceptual training for tinnitus: a systematic review

Auditory perceptual training affects neural plasticity and so represents a potential strategy for tinnitus management. We assessed the effects of auditory perceptual training on tinnitus perception and/or its intrusiveness via a systematic review of published literature. An electronic database search using the keywords 'tinnitus and learning' or 'tinnitus and training' was conducted, updated by a hand search. The ten studies identified were reviewed independently by two reviewers, data were extracted, study quality was assessed according to a number of specific criteria and the information was synthesised using a narrative approach. Nine out of the ten studies reported some significant change in either self-reported or psychoacoustic outcome measures after auditory training. However, all studies were quality rated as providing low or moderate levels of evidence for an effect. We identify a need for appropriately randomised and controlled studies that will generate high-quality unbiased and generalisable evidence to ascertain whether or not auditory perceptual training has a clinically relevant effect on tinnitus.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Systematic review and meta-analyses of randomized controlled trials examining tinnitus management

OBJECTIVES/HYPOTHESIS: To evaluate the existing level of evidence for tinnitus management strategies identified in the UK Department of Health's Good Practice Guideline.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

The effect of waiting: a meta-analysis of wait-list control groups in trials for tinnitus distress

OBJECTIVE: The response rates and effects of being placed on a wait-list control condition are well documented in psychiatric populations. Despite the usefulness of such estimates and the frequent use of no-treatment controls in clinical trials for tinnitus, the effect of waiting in a tinnitus trial has not been investigated systematically. The aim of the present study was to quantify the overall effect of wait-list control groups on tinnitus distress.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

A review of alternative treatments for tinnitus

This review evaluated the effectiveness of alternative treatments for tinnitus. The authors concluded that hypnotherapy improved some subjective measures. Some of the methods used to conduct the review were not reported and the conclusions were based on evidence from two small, apparently methodologically flawed, studies. Consequently, the evidence was very limited.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

A systematic review and meta-analysis of randomized controlled trials of cognitive-behavioral therapy for tinnitus distress

This review found evidence that suggested cognitive behavioural therapy was an effective treatment for adults with tinnitus distress. The authors noted that caution was warranted given that few large-scale well-controlled trials were identified. These cautious conclusions reflected the limitations of the evidence presented and are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Gabapentin for tinnitus: a systematic review

PURPOSE: The main aim of this study was to assess the effect of gabapentin on tinnitus via a systematic review.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

A systematic review and meta-analysis on the efficacy of self-help interventions in tinnitus

This study is a review and meta-analysis on the efficacy of cognitive-behavioural therapy (CBT) self-help interventions for tinnitus. Randomized controlled trials were identified by searching in databases (e.g. ISI Web of Knowledge, PubMed, Cochrane Library, and PSYNDEX) and by manual search. Ten studies with 1188 participants in total were included in the meta-analysis. Participants were 49.2 years old and had tinnitus for 5.2 years. Self-help interventions significantly reduced tinnitus distress (d = 0.48) and depressiveness (d = 0.25) when compared with a passive control (e.g. information only and discussion forums) at post-assessment. There was no difference to the face-to-face controls (group treatment). The presence of therapists and the methodological quality of the studies did not influence the results. Sensitivity analysis revealed that there might be a publication bias regarding the comparison to the face-to-face control. However, the results suggest that CBT self-help interventions are an effective treatment for tinnitus distress. Since few studies were identified, this conclusion must be supported by future meta-analyses.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Tinnitus Retraining Therapy (TRT) for tinnitus

Tinnitus is described as the perception of sound or noise in the absence of real acoustic stimulation. Tinnitus may be perceived in one or both ears, within the head or outside the body. Although various theories have been suggested, the cause is not fully understood. A wide range of treatments have been used, but none has been found effective in all patients.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Acupuncture for the treatment of tinnitus: a systematic review of randomized clinical trials

BACKGROUND: Complementary and alternative medicine (CAM) has frequently been used to treat tinnitus, and acupuncture is a particularly popular option. The objective of this review was to assess the evidence concerning the effectiveness of acupuncture as a treatment for tinnitus.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Effectiveness of repetitive transcranial magnetic stimulation for chronic tinnitus: a systematic review

OBJECTIVE: This systematic review aimed to assess the effectiveness of repetitive transcranial magnetic stimulation (rTMS) treatment for chronic tinnitus. Data Sources Relevant electronic databases and a reference list of articles published up to January 2012 were searched. Randomized controlled clinical trials of all types of rTMS treatment for patients with chronic tinnitus were included.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Cochlear implantation in unilateral sudden deafness improves tinnitus and speech comprehension: meta-analysis and systematic review

OBJECTIVE: In recent years, otologists have begun to place cochlear implants into nonfunctioning ears after sudden unilateral hearing loss. Patients in these trials demonstrate differing degrees of hearing loss in the unimplanted ear. Few studies have examined the role of implantation in patients with normal hearing in the unimplanted ear. To understand if this practice benefits these patients in terms of tinnitus, sound localization, and speech understanding, the available world literature is reviewed.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Ginkgo biloba for tinnitus

People with tinnitus hear sounds such as crackling or whistling in the absence of external noise. Noises appear to arise in the ears or inside the head and may be experienced all of the time, or only intermittently. The causes of tinnitus are not yet fully understood and a variety of treatments are offered including medication, psychotherapy, noise 'maskers' and tinnitus retraining therapy. The review of trials assessed the effectiveness of extract of Ginkgo biloba. Few good‐quality trials were found. Four studies were included in the review, with a total of 1543 participants. The included studies were overall at low risk of bias. There was no evidence that Ginkgo biloba is effective for tinnitus when this is the primary complaint.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Evaluation and Treatment of Tinnitus: Comparative Effectiveness [Internet]

A review was undertaken to evaluate the peer-reviewed literature on three areas of tinnitus management for the following Key Questions (KQs): (1) measures used to assess patients for management needs (KQ1); (2) effectiveness of treatments (KQ2); and (3) identification of prognostic factors (KQ3).

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: August 2013
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Antidepressants for patients with tinnitus

Tinnitus is described as the perception of sound or noise in the absence of real acoustic stimulation, and it is frequently associated with depression or depressive symptoms. Six studies involving a total of 610 patients matched the inclusion criteria for this review. Four evaluated three tricyclic antidepressant agents (amitriptyline, nortriptyline and trimipramine) for the treatment of tinnitus. These studies did not find enough evidence to prove the efficacy of these agents in the management of tinnitus. One study evaluated paroxetine, a selective serotonin reuptake inhibitor antidepressant, and one evaluated trazodone, an atypical antidepressant. Neither of these studies showed benefit of paroxetine or trazodone in the treatment of tinnitus. Side effects, though relatively minor, were common in all groups of antidepressants. Further research is required.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Anticonvulsants for tinnitus

Tinnitus is the perception of sound or noise in the absence of external acoustic stimulation. It is a common and potentially distressing symptom for which no adequate therapy exists. The pathophysiology of tinnitus has been compared to phantom limb pain therefore anticonvulsant drugs have been proposed as a possible therapy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Cognitive behavioural therapy for tinnitus

Tinnitus can be described as the experience of sound in the ear or in the head. Subjective tinnitus is not heard by anyone else. At present no particular treatment for tinnitus has been found effective in all patients.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Hyperbaric oxygen for sudden hearing loss and tinnitus (ringing in the ears) of unknown cause

Idiopathic sudden sensorineural hearing loss (ISSHL) is common and often results in permanent hearing loss. It therefore has a high impact on the well‐being of those affected. Tinnitus (abnormal persistent noises or ringing in the ear) is similarly common and often accompanies the hearing loss. Although the cause of these complaints is not clear, they may be related to a lack of oxygen secondary to a vascular problem not yet identified. Hyperbaric oxygen therapy (HBOT) involves breathing pure oxygen in a specially designed chamber and it is sometimes used as a treatment to increase the supply of oxygen to the ear and brain in an attempt to reduce the severity of hearing loss and tinnitus.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

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