Abstract
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.
Highlights
Tinnitus is essentially made up of two components, the phantom perception of a sound in the ears or head, and the degree of emotional reaction to that percept
As researchers from around the world are collecting and making efforts to better understand the heterogeneity of subjective tinnitus in adults and systematically evaluate assessment and treatment options, we have, for the first time, described the major similarities and differences between existing clinical guidelines for subjective tinnitus in adults
The results reveal true guidelines from only five countries and highlight a need to develop guidelines that are endorsed by the range of professionals involved in assessing and treating tinnitus
Summary
Tinnitus is essentially made up of two components, the phantom perception of a sound in the ears or head, and the degree of emotional reaction to that percept. In 1–3% of cases tinnitus causes severe health problems, with a wide range of effects on daily life functioning (Davis and Refaie, 2000; Fujii et al, 2011; Kim et al, 2015). Evidence corroborates that the aversive psychological reactions, such as cognitive problems, negative emotions, and dysfunctional attentional processes are of main importance in leading to a severe tinnitus condition (Erlandsson and Hallberg, 2000; Andersson et al, 2006; Cima et al, 2011; Kleinstauber et al, 2013; McKenna et al, 2014; Handscomb et al, 2017). 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
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