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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

Does cognitive behavioral therapy help people to cope better with tinnitus?

Cognitive behavioral therapy (CBT) can help people cope better with tinnitus and reduce accompanying depression symptoms. But it doesn't reduce the tinnitus sounds.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 20, 2016

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

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

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

Chronic tinnitus: What helps – and what doesn’t?

Although a wide range of treatments for chronic tinnitus are offered and used, none of them have been proven to reduce the symptoms. Cognitive behavioral therapy can help people cope better with the tinnitus sounds and improve their quality of life.If tinnitus lasts longer than six months, it is considered to be chronic tinnitus. In many cases the cause remains unknown. This makes it harder to treat effectively. A lot of treatments have been tried out and some have been tested in scientific studies. But most of the studies weren't conclusive enough. So more research is needed in order to be able to say whether any treatments can effectively reduce tinnitus sounds.This doesn't mean that you just have to put up with tinnitus. But because all treatments can have side effects, it isn't a good idea to try out every last one of them. It often makes more sense to try to accept the sounds and find a way to keep them from becoming too distressing in everyday life. Cognitive behavioral therapy (CBT) can help people to do this, as research has shown.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 20, 2016

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

Transcranial magnetic stimulation 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. The exact cause of tinnitus remains unknown. At present no particular treatment has been found effective in all patients. Recently, researchers have been able to image the brain using specialised techniques (such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET)). This has led us to believe that high spontaneous neuronal activity in the central auditory system and associated areas may responsible for the perception of tinnitus. Repetitive transcranial magnetic stimulation (rTMS) is a non‐invasive means of inducing electrical currents in the brain and can decrease this neuronal activity. The purpose of this Cochrane Review was to assess the effectiveness and safety of rTMS for the treatment of tinnitus.

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

Version: 2011

Sound therapy (masking) in the management of tinnitus in adults

Tinnitus can be described as a perception of sound that is not related to an external acoustic source. Subjective tinnitus is not heard by anyone else but the sufferer. 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: 2012

Tinnitus: Overview

Most people experience ringing in their ears every now and then, for instance after a loud concert. But some people constantly hear sounds such as a whistling noise for no apparent reason. Tinnitus can seriously affect your everyday life. Read what has been shown to help – and what hasn't.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 20, 2016

Hearing aids for tinnitus in people with hearing loss

Tinnitus describes 'ringing', 'whooshing' or 'hissing' sounds that are heard in the absence of any corresponding external sound. About 10% of people experience tinnitus and for some it has a significant negative impact on their quality of life. Tinnitus is commonly associated with some form of hearing loss and is possibly the result of hearing loss‐related changes in brain activity. It is logical to think, therefore, that providing people who have hearing loss and tinnitus with a hearing aid will not only improve their ability to hear sound but will also reduce their tinnitus symptoms. Hearing aids increase the volume at which people hear external sounds so this may help mask or cover up the tinnitus sound. They also improve communication, which may reduce the symptoms often associated with tinnitus such as stress or anxiety. Hearing aids may also improve tinnitus symptoms by reducing or reversing abnormal types of nerve cell activity that are thought to be related to tinnitus. The purpose of this review is to evaluate the evidence from high‐quality clinical trials that try to work out the effects hearing aids have on people's tinnitus. We particularly wanted to look at how bothersome their tinnitus is, how depressed or anxious tinnitus patients are and whether hearing aid use has an effect on patterns of brain activity thought to be associated with tinnitus.

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

Version: 2014

Zinc supplements for tinnitus

Tinnitus is the perceived sensation of sound in the ear or head. Severe tinnitus affects 1% to 2% of the population. People with severe tinnitus frequently have psychological changes and a decrease in their quality of life. Tinnitus is difficult to control and many doctors are testing new treatments to improve the quality of life of people who suffer from this problem. This review looked for high‐quality studies in the literature that involved zinc supplements as a possible treatment for tinnitus in adults. The aim was to evaluate whether oral zinc is effective in the treatment of tinnitus.

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

Version: 2016

Diuretics for the treatment of Ménière's disease or syndrome

Diuretics (drugs which reduce fluid accumulation in the body) are commonly used in the management of the symptoms of vertigo, hearing loss, tinnitus or aural fullness in patients with Ménière's disease. 'Endolymphatic hydrops' is an increase in the pressure of the fluids in the chambers of the inner ear and is thought to be the underlying cause of Ménière's disease. Diuretics are believed to work by reducing the volume (and therefore also the pressure) of these fluids. The authors of this systematic review carried out an extensive search but could not identify any randomised controlled trials of sufficient quality to include in the review. There is no good evidence about the effect of diuretics on the symptoms of Ménière's disease and further research is needed.

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

Version: 2010

Betahistine for Ménière's disease or syndrome

Ménière's disease is a disorder of the inner ear which results in a spinning form of dizziness (vertigo), hearing loss and ringing in the ear (tinnitus), and can be disabling. It has no known cause. When it is secondary to a known inner ear disorder, it is called Ménière's syndrome. Both can be difficult to diagnose. The drug betahistine hydrochloride (Serc®, Betaserc®) has been used to reduce the frequency and severity of the attacks. While the drug is very acceptable to those who use it, the review of trials did not find enough evidence to show whether it is helpful. Further research is needed.

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

Version: 2011

Intratympanic steroids for Ménière's disease or syndrome

Ménière's disease is a disorder of the inner ear which results in a spinning form of dizziness (vertigo), hearing loss and ringing in the ear (tinnitus); this can be very disabling. The cause of Ménière's disease is unknown. There has been some support in the medical literature for a course of treatment that involves the injection of steroids through the eardrum and into the middle ear to reduce the frequency and severity of these symptoms.

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

Version: 2011

Different infusion durations for preventing platinum‐induced hearing loss in children with cancer

We reviewed the evidence of the effects of different durations of platinum infusion to prevent hearing loss or tinnitus, or both, in children with cancer. We also looked at anti‐tumour efficacy, adverse effects other than hearing loss and quality of life.

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

Version: 2016

Intratympanic gentamicin for Ménière's disease or syndrome

Ménière's disease is characterised by three major symptoms: rotational dizziness (vertigo), hearing loss and ringing in the ears (tinnitus), sometimes accompanied by aural fullness. Intratympanic gentamicin is a relatively new therapy with promising results. Gentamicin is an antibiotic which damages the inner ear and the balance organ when it is applied behind the ear drum. This treatment may decrease the spells of vertigo in Ménière's disease. In this review we assess the effectiveness of this kind of treatment for Ménière's disease. Two randomised controlled trials, including a total of 50 patients, were identified which fulfilled the review inclusion criteria. Both of these found a beneficial effect of intratympanic gentamicin therapy for Ménière's disease, although the size of the effect differed between the two trials. Based on these findings, we conclude that intratympanic gentamicin may be an effective treatment for vertigo complaints in Ménière's disease, but it carries a risk of increasing hearing loss. Further research is needed to clarify the effect of intratympanic gentamicin on vertigo in Ménière's disease and the risk of inducing or increasing hearing loss.

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

Version: 2011

Positive pressure therapy for Ménière's disease or syndrome

Ménière's disease is a disorder of the inner ear, which results in vertigo, hearing loss and tinnitus. When it is secondary to another known inner ear disorder, it is called Ménière's syndrome. A number of different treatments have been used for patients with this disease, ranging from dietary measures (e.g. a low‐salt diet) and medication (e.g. betahistine or diuretics) to extensive surgery. However, Ménière's disease has a fluctuating natural course with remissions and exacerbations, which makes the evaluation of treatments difficult.

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

Version: 2015

Surgery for Ménière's disease

Ménière's disease is characterised by recurrent attacks of three major symptoms: vertigo (rotational dizziness), deafness and tinnitus (ringing of the ears), and/or aural fullness, all of which are discontinuous and variable in intensity. The symptoms of Ménière's disease are thought to be caused by excess pressure in the fluids of the inner ear which leads to sudden attacks of vertigo and hearing loss. A number of surgical procedures, of varying levels of invasiveness, have been developed to reduce the symptoms of Ménière's disease, but it is not clear whether or not these are effective. The surgical interventions can be categorised as two types: one type of surgical intervention aims to affect the natural history of the disease, with conservation of vestibular function. The other type aims to relieve symptoms by abolishing vestibular function. Both types of surgical intervention are considered in this review. Despite an extensive search the review authors only found two randomised controlled trials studying surgical interventions for Ménière's disease. Both of these trials, involving a total of 59 patients, studied endolymphatic sac surgery; one comparing it to placebo surgery and the other to a different type of surgery. Neither trial detected a significant difference between the treatment and control group.

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

Version: 2013

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