Search Results (84)

Objectives: Muscular dysfunction of the cervical spine is the most likely cause of somatosensory tinnitus and dizziness. Some patients can modulate their tinnitus through movement or palpation. This study aimed to investigate the effect of manual therapy on muscle pressure pain, range of motion in the cervical spine, and tinnitus and dizziness. Methods: A pilot randomized controlled trial with a waiting-group design was conducted in a university hospital setting. Participants in the intervention group received manual therapy to the head and neck region combined with stretching exercises and muscle relaxation techniques such as releasing tense muscles and myofascial trigger point therapy involving muscle and connective tissue techniques. The primary and secondary outcome measures were pressure pain, tinnitus modulation by head and neck muscles, and range of motion of the cervical spine. Tinnitus and dizziness were assessed before and after the intervention using the Tinnitus Handicap Inventory and the Dizziness Handicap Inventory. Results: After the intervention, significant differences were observed in pressure pain, tinnitus modulation, and range of motion as well as the Tinnitus Handicap Inventory (U = 644; p < 0.001) and the Dizziness Handicap Inventory (U = 133.5; p = 0.010), favoring the intervention group. Conclusions: The results demonstrate that manual therapy significantly altered pressure pain in the head and neck muscles as well as symptoms such as tinnitus and dizziness in the intervention group. Manual therapy may be beneficial in treating cervicogenic somatosensory tinnitus, provided that other potential causes such as otorhinolaryngological pathology have been ruled out. Full article

Background/Objectives:Tinnitus, the perception of sound without an external source, is a prevalent and often distressing condition with complex neurobiological and psychological underpinnings. A growing body of literature suggests a frequent co-occurrence between tinnitus and psychiatric symptoms such as anxiety, depression, and sleep disturbances. However, the extent to which these conditions are associated, and whether treatments targeting one domain impact the other, remains unclear. This scoping review aimed to (1) identify associations between tinnitus and mental health comorbidities, (2) evaluate whether tinnitus treatments affect psychiatric outcomes, and (3) explore whether psychiatric treatments influence tinnitus symptoms. Methods: A comprehensive search of PubMed, MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews, and Google Scholar was conducted for articles published between January 2014 and May 2025. Eligible studies were written in English, French, or Spanish, focused primarily on tinnitus, included at least one co-occurring psychiatric condition, and described how tinnitus was evaluated. A total of 30 studies were included. Data were extracted and synthesized thematically. Study quality was assessed using the Mixed Methods Appraisal Tool and relevant Joanna Briggs Institute checklists. Results: Most studies reported significant associations between tinnitus and psychiatric symptoms, particularly anxiety, depression, stress, insomnia, and, in some cases, psychosis. Treatments aimed at tinnitus, such as eye movement desensitization and reprocessing and cognitive behavioral therapy, were sometimes associated with secondary improvements in mental health. Conversely, limited evidence suggested that psychiatric treatment, including antipsychotic medication and psychotherapy, may reduce tinnitus severity in selected cases. Conclusions: Tinnitus and psychiatric comorbidities frequently co-occur, and early evidence suggests that addressing one may benefit the other. Given the specific inclusion criteria, this review presents a selected subset of the broader literature, focusing only on studies that evaluated tinnitus alongside clinically measured psychiatric symptoms. Future research should prioritize integrated, longitudinal interventions to better understand these complex interactions. Full article

Cognitive behavioural therapy (CBT) is an evidence-based intervention for managing distress associated with tinnitus, hyperacusis, and misophonia. This paper summarises key points from the 2025 Tonndorf Lecture presented at the third World Tinnitus Congress and the 14th International Tinnitus Seminar in Poland. The lecture addressed (1) the theoretical foundations of CBT for these conditions, (2) clinical evidence on CBT delivered by psychologists, audiologists, and digital self-help, and (3) the proportion of patients who may benefit from CBT. Research demonstrates that CBT can effectively reduce distress related to tinnitus, hyperacusis, and misophonia. Both psychologist- and audiologist-delivered CBT approaches have demonstrated significant improvements in reducing the impact of tinnitus, hyperacusis, and misophonia on patients’ quality of life, while guided internet-based CBT also demonstrates positive outcomes. Unguided internet-based CBT is also effective, though it faces challenges such as higher dropout rates. Despite these promising results, not all patients experience the same level of benefit. Some continue to experience distress even after completing CBT, highlighting the need for alternative or complementary interventions and ongoing support. This paper estimates that approximately 1 in 52 individuals with tinnitus require CBT, indicating that while tinnitus is relatively common, the need for intensive therapy is comparatively small. To enhance treatment outcomes, future research should compare the effectiveness of psychologist- and audiologist-delivered CBT, explore hybrid models that combine face-to-face and digital interventions, and address challenges with internet-based CBT, particularly for hyperacusis and misophonia. Furthermore, incorporating neuroimaging and physiological measures in future randomised controlled trials could provide objective insights into the neural mechanisms underlying symptom improvement, ultimately helping to refine CBT interventions. Identifying characteristics of non-responders to CBT may also guide the development of more tailored therapeutic approaches. Full article

Background: To examine the changes in perceived tinnitus sound qualities following internet-based cognitive behavioral therapy (ICBT) for tinnitus. Method: This study was embedded within several clinical trials evaluating the efficacy of ICBT and used a quasi-experimental design (N = 152). Participants completed a series of online questionnaires, including measures of tinnitus sound qualities (Tinnitus Qualities and Impact Questionnaire; TQIQ), tinnitus severity (Tinnitus Functional Index; TFI), anxiety (Generalized Anxiety Disorder-7; GAD-7), depression (Patient Health Questionnaire-9; PHQ-9), insomnia (Insomnia Severity Index; ISI), and health-related quality of life (EQ-5D-5L Visual Analog Scale; VAS). Data were analyzed using a range of parametric and non-parametric statistics, and Cohen’s d effect sizes were reported. Results: There were no significant differences between the intervention and control groups in sociodemographic and clinical variables at baseline except for anxiety and depression symptoms, which were higher in the intervention group. A statistically significant reduction in tinnitus severity, anxiety, depression, and insomnia was noted post-intervention, with small-to-moderate effect sizes. Statistically significant improvements were also noted for the TQIQ (overall and all subscales) following ICBT compared to the no-intervention group (p ≤ 0.028), all with small-to-large effect sizes, except for the loud sounds subscale and for participants with a TQIQ < 38 at baseline, or “mild” perceived qualities of tinnitus (p ≥ 0.136). A significantly greater proportion of participants in the intervention group had minimum clinically important differences (38%) on the TQIQ compared to the no-intervention group (9%). Conclusions: ICBT can lead to changes in the perceived qualities of tinnitus sound in addition to reducing tinnitus severity and other aspects, such as anxiety, depression, and insomnia. While these findings are preliminary, they highlight that tinnitus distress and perception may be related. However, the study has several limitations including a lack of audiological variables and objective measures. For this reason, the study results must be viewed with caution and must be treated as preliminary. Full article

Background/Objectives: This study evaluated the feasibility and effectiveness of three sound therapies—enriched acoustic environment with random noise (EAERR), enriched acoustic environment with gamma tones (EAEGT), and white noise (WN)—in alleviating tinnitus distress and enhancing emotional well-being. Methods: A total of 125 individuals with tinnitus were recruited, with 92 completing the four-month intervention. Following counseling, participants selected a therapy and listened daily for one hour for four-months at the mixing point intensity. Tinnitus severity and emotional state were assessed at the baseline and post-treatment using the Tinnitus Handicap Inventory (THI), Tinnitus Functional Index (TFI), and Hospital Anxiety and Depression Scale (HADS). Results: All therapies significantly reduced tinnitus distress and improved emotional well-being, with 80.4% of participants reporting benefits. Conclusions: These findings suggest that sound therapies are effective for tinnitus management, though further research with larger and more homogeneous samples is needed to refine their application and optimize treatment for diverse tinnitus profiles. Full article

Background and Objectives: The management of chronic tinnitus in patients with otosclerosis presents a considerable clinical challenge, particularly as to those who are either ineligible for or reluctant to undergo surgical interventions. Surgical interventions improve hearing levels and may provide relief from tinnitus; however, medical research is also focused on alternative non-surgical treatments aimed at symptomatic improvement. This is particularly relevant, considering that otosclerosis currently has no definitive cure, despite the existence of various surgical techniques and oral therapies. This study evaluates the effects of oral calcium and fluoride supplementation on tinnitus severity in otosclerosis patients who opted for non-surgical management. Materials and Methods: A total of 128 otosclerosis patients with tinnitus were included in this study, which was conducted over a five-year period. Patients were categorized into three groups based on the severity of their tinnitus (mild, moderate and severe), as assessed by the Tinnitus Handicap Inventory (THI). Patients in all three groups received Florical (Mericon Industries, Inc., Peoria, IL, USA), a calcium and fluoride supplement, and were monitored over three months. The severity of tinnitus was reassessed following supplementation. Statistical analyses were conducted to further investigate patient scores. Results: Evaluating patients based on the severity of their tinnitus, we consistently observed clinically significant reductions in THI scores, specifically a decrease of 10 points or more, among those with mild tinnitus. The moderate group exhibited a lower degree of reduction in their THI scores, while the severe group appeared to be unaffected. Statistical analyses reveal a significant correlation between the reduction of tinnitus and the supplementation of Florical, as the severity of tinnitus decreases. Conclusions: The present study suggests that oral calcium and fluoride supplementation may serve as a promising non-surgical approach for tinnitus management in otosclerosis (particularly in patients with mild symptoms), in addition to its marketing-indicated role, supporting the preservation of hearing levels in otosclerosis. Its efficacy seems to diminish as tinnitus severity increases, further pointing out a potential preventative role of this supplementation. Full article

Background: Meniere’s disease (MD) is a set of rare disorders that affects >4 million people worldwide. Individuals with MD suffer from episodes of vertigo associated with fluctuating sensorineural hearing loss and tinnitus. Hearing loss can involve one or both ears. Over 10% of the reported cases are observed in families, suggesting its significant genetic contribution. The condition is polygenic with >20 genes, and several patterns of inheritance have been reported, including autosomal dominant, autosomal recessive, and digenic inheritance across multiple MD families. Preclinical research using animal models has been an indispensable tool for studying the neurophysiology of the auditory and vestibular systems and to get a better understanding of the functional role of genes that are involved in the hearing and vestibular dysfunction. While mouse models are the most used preclinical model, this review analyzes alternative animal and non-animal models that can be used to study MD genes. Methods: A literature search of the 21 genes reported for familial MD and the preclinical models used to investigate their functional role was performed. Results: Comparing the homology of proteins encoded by these genes to other model organisms revealed Drosophila and zebrafish as cost-effective models to screen multiple genes and study the pathophysiology of MD. Conclusions: Murine models are preferred for a quantitative neurophysiological assessment of hearing and vestibular functions to develop drug or gene therapy. Full article

Background: Jugular foramen syndrome (JFS) is a rare condition characterized by the compression or impairment of one or more terminal cranial nerves passing through the jugular foramen. Although malignancies are the primary cause of JFS. Methods: In this report, we present the first documented case of JFS caused by acute otitis media in an adult patient. Results: A 74-year-old woman presented with ear pain, hoarseness, dysphagia, dizziness, tinnitus, and hearing loss. A physical examination revealed a reddish-bulging tympanic membrane, left-sided hearing loss, right uvula deviation, and cranial nerve palsies affecting the ninth and tenth nerves. Imaging studies confirmed temporal bone inflammation, thrombosis of the sigmoid sinus extending into the internal jugular vein, and signs of thrombophlebitis of the jugular vein. The patient underwent a cortical mastoidectomy, sigmoid sinus decompression, and ventilation tube insertion, along with antibiotic, steroid, and anticoagulant therapy. Postoperatively, the patient’s condition improved significantly. Conclusions: This case highlights the importance of considering complicated acute otitis media in the differential diagnosis of neurological abnormalities associated with JFS. A thorough evaluation of the patient’s medical history and radiological imaging can assist in identifying the cause of the symptoms and guide appropriate surgical or conservative treatment. Further research is essential to gain more comprehensive insights into the pathophysiology and therapeutic interventions of JFS affecting the ears. Full article

Background: Tinnitus can significantly impact a patient’s quality of life. As no evidence-based curative treatments exist, therapies such as cognitive behavioral therapy, tinnitus retraining therapy, acceptance and commitment therapy, and mindfulness-based interventions aim to minimize tinnitus severity and have been shown effective. Since traditional delivery can be costly and time-consuming and often has limited accessibility, therapies might also be provided via eHealth. This study investigates the change in tinnitus severity measured by the Tinnitus Functional Index (TFI) score after participation in an online self-paced tinnitus (“Still Tinnitus”) course. The secondary aim was to identify predictors for the clinically relevant improvement after participation in this course. Methods: This retrospective record study included patients from Still Tinnitus course between March 2023 and July 2024. Patients were recruited via the Still Tinnitus website. Differences in the TFI scores from baseline and after completing the fifth (last) module of the course were calculated to investigate the change in tinnitus over time. Multivariate logistic analyses were performed to identify the possible predictors for the clinically relevant improvement after completion of the Still Tinnitus course. Results: In total, 122 patients were included in the study. The analysis revealed a clinically relevant reduction in the TFI score of 27.2 points. Multiple regression analyses showed that the “duration of the tinnitus” (OR 5.0; 95%CI: 1.537–16.240; p = 0.007) and “female sex” (OR 1.9; 95%CI 0.111–7.637; p = 0.030) are predictors for a clinically relevant improvement. Conclusions: In a convenience sample of tinnitus patients, the Still Tinnitus course may contribute to a clinically relevant reduction in tinnitus severity. A shorter duration of tinnitus and female sex were identified as significant predictors. Full article

Background/Objectives: Tinnitus, often described as a ringing in the ears, affects a significant portion of the population, varying in perception and severity. Methods: This systematic review investigates the correlation between tinnitus and temporomandibular joint disorders (TMDs) within a PRISMA-compliant framework, ensuring methodological transparency and rigor. Using databases, such as PubMed, Scopus, and Web of Science, we analyzed studies from the past decade to evaluate clinical and observational evidence. Results: A significant association between TMD and tinnitus was found, with somatosensory and neuroplastic mechanisms contributing to this relationship. Key therapeutic approaches identified include manual therapy and multidisciplinary treatments, demonstrating potential clinical efficacy. Conclusions: However, the available evidence remains inconsistent, emphasizing the need for further research with standardized methodologies to improve understanding and refine therapeutic strategies. This review provides a foundation for future studies aiming to enhance tinnitus management by addressing underlying TMD-related mechanisms. Full article

Post/Long COVID (syndrome) is defined as a condition with symptoms persisting for more than 12 weeks after the onset of SARS-CoV-2 infection that cannot be explained otherwise. The prevalence of self-reported otorhinolaryngological Post/Long COVID symptoms is high. The aim of this review was to analyze the current literature regarding the actual prevalence, knowledge of the etiopathology, and evidence-based treatment recommendations of otorhinolaryngology-related Post/Long COVID symptoms. A systematic literature search of articles published since 2019 in PubMed and ScienceDirect was performed and resulted in 108 articles. These were the basis for this review and formed a comprehensive series of consented therapy statements on the most important of otorhinolaryngology-related Post/Long COVID symptoms. Otorhinolaryngological symptoms did not appear isolated but as part of a multi-organ syndrome. Self-reported otorhinolaryngology-related Post/Long COVID symptoms were often not confirmed by objective testing. The confirmed prevalence estimated for anosmia, dysgeusia, cough, facial palsy, hoarseness/dysphonia, acute hearing loss, tinnitus, and vertigo/dizziness was about 4%, 2%, 4–19%, 0%, 17–20%, 8%, 20%, and 5–26%, respectively. There are manifold theoretical concepts of the etiopathology of different symptoms, but there is no clear evidence-based proof. This certainly contributes to the fact that there is no effective specific treatment option for any of the symptoms mentioned. Healthcare pathways must be established so that otorhinolaryngological Post/Long COVID symptoms can be recognized and evaluated and otorhinolaryngologists can provide counseling. This would also help to establish and selectively include patients in clinical trials investigating specific therapeutic concepts. Full article

Background: Somatic tinnitus (ST) is a type of tinnitus that is influenced by changes in somatosensory input from the cervical spine or temporomandibular area. Although traditional physiotherapy has been shown to reduce ST symptoms, in-clinic treatment is not always available, and adherence to home exercise programs is often low. This study aims to investigate the effectiveness of an app-based physiotherapy program to enhance the compliance and availability of treatment for ST patients. Methods: This pilot randomised controlled trial included 38 adult patients with chronic somatic tinnitus. Participants were randomly assigned to a treatment group receiving a 9-week app-based cervical spine exercise program or a control group. The primary outcome was tinnitus distress measured using the Tinnitus Handicap Inventory (THI). As a secondary outcome we used the Mini-Tinnitus Questionnaire (Mini-TQ). Results: Participants in the treatment group showed significant reductions in tinnitus distress, with a large effect size for both the THI and Mini-TQ groups (Cohen’s d = 1.71 and 1.02, respectively). The control group showed no significant changes. Conclusions: This study provides evidence that an app-based physiotherapy intervention is a feasible and effective treatment for ST. Further research with larger sample sizes and comparisons to traditional in-clinic treatments is needed to confirm these findings. Additional studies on personalised treatment might further improve the treatment. Full article

Background: This study aimed to investigate whether Internet-based cognitive behavioural therapy intervention (ICBT) for individuals with tinnitus had an indirect effect on the third-party disability noticed by significant others (SOs). Methods: Significant Others Questionnaire (CTSOQ). Individuals with tinnitus completed standardized self-reported outcome measures for tinnitus severity, anxiety, depression, insomnia, hearing-related quality of life, tinnitus cognitions, hearing disability, and hyperacusis. Results: In total, 194 pairs of individuals with tinnitus and their SOs participated. The impact of third-party disability experienced by SOs was significantly reduced after individuals with tinnitus undertook the ICBT intervention (d = 0.41). This reduced SOs with severe difficulties from 52% to 35%. The remaining impact was mild for 30% and moderate for 35%. SOs with higher baseline difficulties and SOs who were partners (e.g., spouses) were less likely to notice indirect benefits from intervention undertaken by their family members. There was a moderate positive correlation between the post-intervention CTSOQs and the clinical variables of tinnitus severity and depression. Conclusions: Third-party disability may be reduced as an indirect effect of individuals with tinnitus undertaking ICBT. Including SOs of individuals with tinnitus within the rehabilitation process may add additional benefits, and such involvement should be encouraged. Full article

This study investigates a novel multimodal treatment for chronic tinnitus, a condition that significantly affects quality of life, by combining personalized sound therapy with both low- and high-frequency electromagnetic wave stimulation. Conducted at Tor Vergata University Hospital in Rome, the research involved 55 patients and employed a portable medical device for therapy delivery. Treatment effectiveness was measured through the Tinnitus Functional Index (TFI), Tinnitus Handicap Inventory (THI), Visual Analogue Scale (VAS), Hyperacusis Questionnaire (HQ), and Short Form-36 Health Survey (SF-36), encompassing initial sound therapy and subsequent multimodal treatment phases. Remarkably, 73% of participants experienced notable improvements in TFI scores, with 39% reporting a significant enhancement of 13 points or more. This improvement was mirrored in secondary outcomes like THI, VAS, and HQ scores, along with certain SF-36 domains, indicating enhanced life quality and reduced tinnitus distress. The study underscored high compliance and no adverse effects, suggesting the combined therapy’s promising potential in chronic tinnitus management. The findings advocate for further research to discern the distinct contributions of each treatment modality, positing that this innovative approach could ameliorate tinnitus symptoms and improve patient well-being, confirming its safety and efficacy. Full article

Background: This study aimed to examine whether individuals with chronic tinnitus report more positive experiences following internet-based cognitive behavioral therapy (CBT). Methods: A mixed-methods design was used, nested in clinical trials evaluating internet interventions for tinnitus. Participants (n = 164) completed online questionnaires (both structured and open-ended) providing demographic information as well as health variables (e.g., tinnitus distress, anxiety, depression, insomnia). An open-ended question listing positive effects or outcomes related to having tinnitus was also included. Responses to the open-ended questions were analyzed using qualitative content analysis. Results: Of the 164 eligible participants, 32.3% (n = 53) provided at least 1 positive experience both at pre- and post-intervention, with 9.1% (n = 19) providing positive experiences only at pre-intervention, 49 (29.9%) providing positive experiences only at post-intervention, and 28.7% (n = 47) of the participants did not provide any positive experiences on either measurement occasion. Significantly more positive experiences were reported following the intervention in the overall sample (p < 0.0001, paired sample t-test). In addition, participants who reported positive experiences in both pre- and post-intervention also reported more positive experiences following intervention (p = 0.008, paired sample t-test). Conclusions: Internet-based CBT can help individuals with tinnitus to think more positively by changing unhelpful thought patterns. Open-ended questions can supplement structured questionnaires to measure treatment outcomes. Full article