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Front Psychol. 2017 Feb 22;8:206. doi: 10.3389/fpsyg.2017.00206. eCollection 2017.

Different Teams, Same Conclusions? A Systematic Review of Existing Clinical Guidelines for the Assessment and Treatment of Tinnitus in Adults.

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Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht UniversityMaastricht, Netherlands; Adelante, Centre of Expertise in Rehabilitation and AudiologyHoensbroek, Netherlands.
ENT Department of Hospital, Cuf Infante Santo - Nova Medical School Lisbon, Portugal.
Department of Otorhinolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Hippocrateion General Hospital Athens, Greece.
ENT Specialist, Institute of Health Care, Mater Dei Hospital Malta, Malta.
Tinnitus Center, Charite University Hospital Berlin, Germany.
Laboratory of Adaptive and Integrative Neuroscience, Centre National de la Recherche Scientifique, Fédération de Recherche, Aix-Marseille Université Marseille, France.
Faculty of Medicine and Health Sciences, Campus Drie Eiken, University of Antwerp Antwerp, Belgium.
Adelante, Centre of Expertise in Rehabilitation and Audiology Hoensbroek, Netherlands.
Department of Physiology and Pharmacology, Karolinska Institutet Stockholm, Sweden.
Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark Odense, Denmark.
Department of Nordic Studies and Linguistics, Copenhagen University Denmark.
NIHR Nottingham Hearing Biomedical Research Unit, Division of Clinical Neuroscience, School of Medicine, University of Nottingham Nottingham, UK.


Background: Though clinical guidelines for assessment and treatment of chronic subjective tinnitus do exist, a comprehensive review of those guidelines has not been performed. The objective of this review was to identify current clinical guidelines, and compare their recommendations for the assessment and treatment of subjective tinnitus in adults. Method: We systematically searched a range of sources for clinical guidelines (as defined by the Institute of Medicine, United States) for the assessment and/or treatment of subjective tinnitus in adults. No restrictions on language or year of publication were applied to guidelines. Results: Clinical guidelines from Denmark, Germany, Sweden, The Netherlands, and the United States were included in the review. There was a high level of consistency across the guidelines with regard to recommendations for audiometric assessment, physical examination, use of a validated questionnaire(s) to assess tinnitus related distress, and referral to a psychologist when required. Cognitive behavioral treatment for tinnitus related distress, use of hearing aids in instances of hearing loss and recommendations against the use of medicines were consistent across the included guidelines. Differences between the guidelines centered on the use of imaging in assessment procedures and sound therapy as a form of treatment for tinnitus distress respectively. Conclusion: Given the level of commonality across tinnitus guidelines from different countries the development of a European guideline for the assessment and treatment of subjective tinnitus in adults seems feasible. This guideline would have the potential to benefit the large number of clinicians in countries where clinical guidelines do not yet exist, and would support standardization of treatment for patients across Europe.


assessment; clinical guidelines; systematic review; tinnitus; treatment

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