Tinnitus: Clinical Updates from Diagnosis to Treatment

Dear Colleagues,

Tinnitus—a perceived ringing or buzzing without an external acoustic source—occurs in approximately 12–14% of adults, and in severe cases the symptoms become disabling enough to prompt medical consultation. Despite its considerable economic and psychological burden, no medications have yet received FDA approval for tinnitus management. Ongoing clinical investigations are assessing agents such as N-methyl-D-aspartate (NMDA) receptor antagonists, dopamine D2 receptor antagonists, selective serotonin reuptake inhibitors (SSRIs), γ-aminobutyric acid (GABA) agonists, and zinc supplementation. Earlier off-label clinical observations, although inconclusive, indicate that patients with marked depressive symptoms may experience tinnitus relief following treatment with antidepressants, including nortriptyline or sertraline. Initial studies have also suggested potential efficacy of misoprostol, a prostaglandin E1 analog, and sulpiride, a dopamine D2 antagonist. Experimental animal models further indicate that inhibitors of GABA transaminase and modulators of potassium channels may reduce tinnitus perception. Improvements have additionally been reported in patients using melatonin for associated sleep disturbances. As with many complex neurologic conditions, a single universal medication is unlikely to be effective; treatments directed toward specific patient subgroups are expected to produce better outcomes.

Acceptance and commitment therapy emphasizes mindfulness and behavior guided by personal values to mitigate emotional consequences. Tinnitus retraining therapy integrates counseling with sound enrichment to promote habituation. Individually notched music therapy delivers personalized auditory stimulation aimed at symptom reduction. Cochlear implants (CIs) and implantable hearing aids (like middle ear implants) can significantly reduce tinnitus for individuals with severe-to-profound hearing loss by restoring sound input, which helps the brain recalibrate and suppress internal noise. While CIs are not typically FDA-approved solely for tinnitus treatment, studies show up to 90% of recipients experience reduced tinnitus severity after surgery. t. Neuromodulation and neurofeedback techniques also show potential benefit. Emerging options such as virtual reality platforms, mobile applications, and photobiomodulation are being explored as innovative treatments. Despite these encouraging approaches, robust evidence is still required to establish the efficacy and durability of outcomes.

This Special Issue aims to present and disseminate the most recent advances related to the treatment of tinnitus.

Prof. Dr. Chul Ho Jang
Guest Editor

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• tinnitus related research
• drug
• cochlear implant or middle ear implant related tinnitus reduction