Search Results (49)

Background/Objectives: Tinnitus can have an adverse impact on some patients’ lives, affecting the daily functioning for a proportion of patients. In recent years, audiologists in Singapore who are specialised in tinnitus and hyperacusis rehabilitation have increasingly been providing tinnitus and/or hyperacusis management. The aim of this study was to evaluate the outcome of audiologist-delivered tinnitus management at a public hospital in Singapore. Methods: Retrospective data from patients seen between 2016 and 2019 were extracted from the hospital’s electronic medical record system. Outcomes were analysed using pre-treatment and three-month post-treatment Tinnitus Handicap Inventory (THI) scores among patients referred to the audiologist-led tinnitus clinic. Results: A total of 201 patients aged 18 to 86 years received tinnitus management. Among patients who returned for follow-up, 93% showed a reduction in THI score three months after treatment. Mean THI scores decreased significantly from 46.9 to 24.3, with a corrected effect size of 1.16, indicating a large treatment effect. Among patients with moderate or greater tinnitus handicap at baseline, 81% improved by at least one severity grade. Conclusions: This is one of the first studies to report outcomes of an audiologist-led tinnitus management service in Singapore. The findings are consistent with a potential role for structured, audiologist-led tinnitus services in Asian healthcare settings, although controlled studies are needed to confirm treatment effectiveness. General practitioners, otolaryngologists and other healthcare providers can play an important role in recognising tinnitus-related distress, offering early reassurance and directing patients to appropriate audiological and supportive care. Full article

Background: Tinnitus is a prevalent auditory disorder associated with maladaptive cortical plasticity and aberrant neural synchronization across auditory and non-auditory brain networks. Acoustic desynchronization-based sound therapies, such as coordinated reset neuromodulation, aim to counteract pathological oscillatory patterns but commonly require prolonged daily listening sessions and specialized delivery formats, which may limit their accessibility and practicality in routine clinical settings. To address this limitation, a modified desynchronization protocol embedding therapeutic tones within music was developed to improve tolerability and engagement. This study aimed to evaluate the clinical effects of modified Music-Integrated Desynchronization Sound Therapy (mMIDST) on tinnitus severity in patients with chronic tinnitus. Methods: In this prospective, randomized, controlled, single-blind pilot trial conducted at the Otolaryngology Department of Hospital Clínico Universidad de Chile (Santiago, Chile) between July 2024 and July 2025, adults aged 18–75 years with chronic non-pulsatile tinnitus were assigned to receive either mMIDST or an active control intervention consisting of low-frequency stimulation (LFS) embedded within identical music tracks. Participants listened to personalized sound files for one hour daily, five days per week. Tinnitus severity was assessed using the Tinnitus Handicap Inventory (THI), with audiometric evaluations performed at baseline and after one, two, and three months. Between-group differences were analyzed using the Mann–Whitney U test. Results: Twenty-five participants completed the study (15 mMIDST, 10 LFS). Baseline audiometric thresholds and THI scores were comparable between groups. The mMIDST group showed significantly greater reductions in THI scores than the LFS group at two and three months of treatment (p < 0.05). Conclusions: mMIDST was associated with time-dependent improvements in tinnitus-related distress compared with an active control condition. Embedding desynchronization-based tonal stimulation within music may represent a promising and well-tolerated non-invasive approach for chronic tinnitus management. Full article

Background: Emerging evidence suggests that metabolic, nutritional, and lifestyle-related factors may be associated with tinnitus occurrence and symptom burden. Nutritional status, obesity, and sedentary behavior have been hypothesized to be linked with auditory function, neural excitability, and tinnitus-related outcomes. This scoping review aimed to map and summarize the available evidence on associations between dietary factors, nutrient intake, body mass index (BMI), obesity, physical activity, and tinnitus occurrence, severity, and related clinical outcomes. Methods: A scoping review was conducted in accordance with the PRISMA-ScR reporting guidelines. A comprehensive search of PubMed, Web of Science, and Cochrane Library databases was performed. Eligible designs included randomized controlled trials, cohort studies, case–control studies, and cross-sectional studies. Data were extracted and synthesized narratively due to methodological heterogeneity. Results: Twenty-four studies met the inclusion criteria. Several observational studies reported associations between protein intake, lipid profile, micronutrient status, BMI, obesity, physical activity, and tinnitus-related outcomes. Evidence on antioxidant supplementation was heterogeneous, with some trials reporting favorable changes in tinnitus-related measures and others showing no significant benefit compared with placebo. Elevated BMI, obesity, and altered body composition were generally associated with tinnitus occurrence or greater symptom severity. Randomized trials suggested that structured lifestyle programs involving dietary modification, weight reduction, and physical activity may be associated with improvements in tinnitus severity and quality of life in selected patient groups. Conclusions: The available literature suggests potential associations between nutritional, metabolic, and lifestyle-related factors and tinnitus occurrence or symptom severity. However, the evidence is heterogeneous and largely observational, with inconsistent adjustment for hearing loss, psychological distress, and general health status. Further well-designed prospective studies and randomized controlled trials are needed before causal or clinical recommendations can be formulated. Full article

Background: Tinnitus is a common and potentially distressing phenomenon for which no broadly effective curative treatment exists. Self-management skills and empowerment are crucial for coping with chronic conditions, but empirical studies investigating the association of these on individuals burdened by tinnitus are scarce. The primary aim of this cross-sectional study was to investigate the association between the use of an online self-help platform for people with tinnitus and self-perceptions of empowerment, self-management skills, and the cognitive and emotional representations of tinnitus. Methods: One hundred and fifty-two adult participants were recruited from an online self-help platform for people with tinnitus, resulting in a self-selected convenience sample. Self-management skills were assessed using the Patient Assessment of Chronic Illness Care (PACIC) and the Partners in Health Questionnaire. The cognitive and emotional representations of tinnitus were measured with the Illness Perception Questionnaire. Finally, the Empowering Processes and Outcomes Questionnaire was used to evaluate empowerment associated with engagement in the self-help platform. The type and frequency of user activity on the self-help platform were used to explore the relationship between the nature of contributions to the platform and the measured outcomes. Results: The key findings include: (1) The representations of tinnitus were negatively related to their ability to self-manage the condition. (2) The duration of tinnitus did not correlate with improved self-management skills. (3) Comparing those who visited a healthcare provider for their tinnitus with those who did not, we found that treatment adherence was higher among participants with clinical visits. (4) Participants in this study scored lower on all aspects of self-management skills (as measured by the PACIC) compared to patients using primary healthcare services. (5) Participants who actively contributed to the self-help platform by posting scored higher in two empowering processes: helping others and sharing experiences. Conclusions: The present findings suggest that tinnitus self-management skills are independent of tinnitus duration, whereas those skills correlate negatively with illness perception. Further, clinical visits are associated with higher treatment adherence, and active self-help platform use increases feelings related to helping others and shared experiences. Taken together, these results highlight the need for fostering self-management skills and structured peer-to-peer support programs. Because this was a self-selected convenience sample of users of an online tinnitus self-help platform, the findings should be interpreted in light of this recruitment context and not generalized to the broader tinnitus population. Full article

Objectives: This study aimed to analyse the effects of educational levels, sex, and residence on tinnitus-related distress, as well as the severity of depression and anxiety. Material and methods: A total of 235 patients with primary subjective tinnitus participated in the study. These patients underwent thorough evaluations in otorhinolaryngology and audiology. Additionally, all patients completed the Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), and the Generalised Anxiety Disorder-7 (GAD-7) questionnaires. Results: Patients with a primary school education scored significantly higher on the functional (F) subscale of the THI. When examining depression and anxiety levels, it was observed that patients with a primary school education exhibited the highest levels of anxiety, whereas those with a university education displayed the highest levels of depression. When analysing the effects of residency, slightly lower total THI scores were observed in individuals living in metropolitan areas. When comparing the subscale results of the THI, patients residing in metropolitan areas exhibited significantly lower scores on the F subscale. In terms of the total BDI and GAD-7 scores, there were no statistically significant differences observed. Women had slightly higher scores on the BDI and GAD-7, without statistical differences. However, women had significantly higher total THI scores. Additionally, women exhibited statistically significantly higher scores on the catastrophic (C) subscale. However, the results for the F and emotional (E) subscales did not show any statistically significant differences. There was no correlation between age and the THI, BDI, or GAD-7 scores. Conclusions: The results of this study reveal significant differences in tinnitus distress based on sex, educational levels, and residence locations, along with the presence of psychiatric symptoms, which should also be considered in tinnitus management. Full article

Background/Objectives: Ménière’s disease (MD) is a chronic inner-ear disorder characterized by vertigo, tinnitus, and fluctuating sensorineural hearing loss (SNHL) that impairs health-related quality of life (HRQoL) and is frequently accompanied by psychological distress. This study aims to quantify psychological distress and generic HRQoL in patients with definite MD compared with age- and sex-matched general-population controls and to examine the associations between hearing loss (HL) severity, symptom-related handicap, and these outcomes within the MD cohort. Methods: In this observational cross-sectional study, 45 adults with definite MD were recruited from an otolaryngology clinic in Portugal and individually matched (1:3) by sex and 10-year age strata to 135 participants from the EpiDoC population cohort. HRQoL was assessed using the SF-36v2 and EQ-5D-3L, psychological distress using the HADS, and tinnitus- and dizziness-related handicap using the THI and DHI. HL severity was staged using the AAO-HNS (1995) criteria. Results: Patients with MD had higher anxiety and depression scores and nearly twice the prevalence of abnormal anxiety compared with controls. SF-36v2 scores were significantly worse in several role and psychosocial domains, with less bodily pain but similar physical functioning and general health. EQ-5D-3L revealed a lower utility index and higher pain/discomfort and anxiety/depression. Within the MD cohort, HL stage was only weakly related to distress and HRQoL. In contrast, higher THI and DHI scores were consistently associated with more severe anxiety and depression and lower SF-36v2 scores. In multivariable analysis, abnormal anxiety was strongly associated with moderate-to-severe tinnitus handicap (OR = 17.5), whereas higher depressive symptoms independently predicted moderate-to-severe dizziness handicap, with abnormal anxiety showing a strong but borderline association with the latter. Conclusions: MD confers clinically meaningful HRQoL decrements and a higher psychological distress burden than in the general population. Tinnitus- and dizziness-related handicap and psychological distress, particularly anxiety, rather than HL severity, are key multidisciplinary management targets. Systematic screening for anxiety and depression, regardless of audiometric stage, should be integrated into MD care pathways. Full article

Background: Tinnitus, the perception of sound in the absence of an external source, is a prevalent condition that can substantially affect physical and mental health. Although tinnitus is not typically curable, it is often manageable with structured, multidisciplinary care. This pilot research describes the Sensation–Emotion–Cognition (SEC) model, a practical audiological framework developed by Danesh et al. that targets three core dimensions of the tinnitus experience. Methods: We integrate findings from an exploratory retrospective cohort and a prospective expansion study. The SEC protocol included sound therapy, counseling and relaxation training, and cognitive behavioral therapy (CBT) delivered through either unguided, module-based internet CBT, clinician-guided module-based internet CBT, or six therapist-led CBT sessions. The objective was to evaluate whether this multifactorial approach is associated with reductions in tinnitus-related distress. Results: In this prospective study, preliminary results from 16 participants who completed the study were associated with significant pre–post changes in tinnitus-related outcomes: 4C management confidence increased from M = 30.38 to 60.19 (p < 0.001; Cohen’s dz = 1.04), and SAD-T emotional distress decreased from M = 4.75 to 2.38 (p = 0.001; Cohen’s dz = 0.99). Conclusions: These findings suggest the potential value of an integrated management strategy; however, given the single-group pre–post design and attrition, the results should be interpreted as exploratory and warrant confirmation in larger controlled trials. Full article

Background and Objectives: Chronic tinnitus in patients with bilateral sensorineural hearing loss (SNHL) is frequently linked to psychological distress and affective temperament traits. This study examined audiological characteristics, psychological profiles, and their interrelations in adults with tinnitus. Materials and Methods: In this cross-sectional single-centre study, 38 adults with chronic tinnitus and bilateral SNHL underwent otoscopy, tympanometry, and pure-tone audiometry. Participants were classified into two audiometric groups: high-frequency gently sloping (N = 19) and ski-slope hearing loss (N = 19). The audiological and psychological assessment included the THI, TFI, TEMPS-A, and STAXI-2. Groups were compared using non-parametric statistics (Mann–Whitney U, Chi-square). Relationships between anger and psychological variables were examined using Spearman correlations. Results: Females were more frequently represented in the gently sloping group (p = 0.044) and showed greater quality-of-life impairment (p = 0.045) and lower hyperthymic scores (p = 0.004). Patients with gently sloping loss had longer tinnitus duration (p = 0.026), while cyclothymic temperament was higher in the ski-slope group (p = 0.013). THI scores differed significantly between audiometric groups (p = 0.011). State and trait anger were strongly associated with several affective temperaments, and sleep disturbance correlated with both anger and anxious temperament. THI correlated positively with anxious temperament and sleep impairment. Conclusions: Audiometric phenotype, affective temperament, and anger-related traits are closely intertwined with tinnitus severity and its psychological burden. These findings support the need for multidisciplinary assessment in the management of tinnitus. Full article

Background/Objectives: Tinnitus affects various aspects of health, yet its impact on occupational functioning remains less well explored. This study investigated the impact of tinnitus on work productivity, the role of comorbidities of anxiety, depression, and quality of life, and explored whether an evidence-based intervention may potentially influence workplace functioning. Methods: The study used cross-sectional and longitudinal data and employed mixed methods design to enable comparing work productivity before and after undertaking ICBT for tinnitus. Data were collected from 449 participants (64% employed; mean age of 54.4 years) who were seeking to enroll in an internet-based psychological intervention. Of these, 200 also completed an internet-based cognitive behavioral therapy intervention (ICBT). Data were analyzed using descriptive statistics, analysis of variance, qualitative content analysis and comparisons made between those whose work was unaffected due to tinnitus and those who worked less. Results: Pre-intervention, 81% reported no change in work patterns. Because of tinnitus 11% worked fewer hours, 7% had stopped working, and 1% received disability allowance. Participants were significantly less effective in their work capacity prior to undertaking the intervention compared to post-intervention and at follow-up; for the overall sample and post-intervention improvements were observed in tinnitus distress, anxiety, depression, and insomnia. There was significant time difference between group interactions for tinnitus, anxiety and insomnia but not for depression and quality of life when comparing those working and not working. Qualitative findings highlighted challenges related to attention, fatigue, and communication, as well as coping strategies and role modifications. Conclusions: Further studies are required to build on this exploratory research. The present findings underscore the need for workplace policies recognizing tinnitus as a potential disability and providing reasonable accommodation and options to access tinnitus interventions. Clinical interventions should also consider how to improve workplace functioning in individuals with bothersome tinnitus. Future research should explore ways to address cognitive load and enhance productivity. Full article

Background/Objectives: This study aims to explore both the psychosocial outcomes of hearing aid use and the factors that differentiate users from non-users among older adults with sensorineural hearing loss (SNHL) in Romania. Methods: We conducted a cross-sectional, comparative study with follow-up, including 201 patients aged between 49 and 92 years (mean age 70.76 ± 11.86 years), diagnosed with moderate to severe SNHL, evaluated between 1 November 2023, and 30 November 2024, at the Municipal Clinical Hospital Orăștie, Romania. Audiological assessment involved pure-tone audiometry and speech testing. Outcome measures included the Word Recognition Score (WRS), International Outcome Inventory for Hearing Aids (IOI-HA), Hearing Handicap Inventory for Adults (HHIA), Tinnitus Handicap Inventory (THI), and the Self-Esteem Scale (SES). Results: Of the 201 patients, 105 (52.2%) accepted hearing aid (HA) fitting and 96 (47.8%) declined. No significant differences were found in age (p = 0.565) or sex (p = 0.476) between groups. HA users reported significantly lower perceived handicap (HHIA: 46.48 ± 24.83 vs. 77.74 ± 28.02, p = 0.015) and higher self-esteem scores (SES: 35.68 ± 4.88 vs. 23.03 ± 4.90, p < 0.001), while tinnitus-related distress (THI) did not differ significantly (p = 0.785). Word recognition scores improved significantly post-fitting across all degrees of hearing loss: moderate (48.52% → 86.13%), moderately severe (47.47% → 85.31%), and severe (47.55% → 85.46%), all p < 0.001. Conclusions: Hearing aid use in older adults with SNHL was associated with significant improvements in speech perception and reduced perceived hearing handicap. These benefits were consistent across all severity levels and were independent of unilateral or bilateral device use. The difference in self-esteem observed between users and non-users may reflect pre-existing psychological factors influencing HA adoption, underlining the importance of personalized counseling in hearing rehabilitation. Full article

Background/Objectives: Hearing impairment in middle-aged adults is a significant, modifiable risk factor for cognitive decline and dementia, and therapy with hearing aids or cochlear implants has been suggested to reduce this risk. However, most research on auditory rehabilitation and cognition has focused on older adults, and evidence regarding cognitive outcomes in middle-aged adults remains scarce despite this group being identified as critical for dementia prevention. Thus, this study aimed to assess cognitive skills in middle-aged hearing-impaired individuals 1 year after receiving a cochlear implant (CI) as part of auditory rehabilitation. Methods: Thirty-two patients with a mean age of 52.4 were enrolled in a prospective pre-post study. Hearing was tested using the Freiburg Monosyllable Test (FS) and the Oldenburg Inventory (OI). Cognitive performance was assessed using the WAIS-IV, operationalized through the Working Memory Index (Digit Span, Arithmetic) and Processing Speed Index (Symbol Search, Coding). Quality of life was assessed with the NCIQ, tinnitus-related distress with the Tinnitus Questionnaire (TQ), and depressive symptoms with the ADS-L. Results: After one year, speech intelligibility (FS) improved from a median of 0 to 70.0 (Wilcoxon Z = −4.864, p < 0.001, r = −0.61), and subjective hearing from a median of 2.55 to 3.18 (Wilcoxon Z = −3.072, p = 0.002). The NCIQ score increased from 52.3 to 60.6 (Z = −3.899, p < 0.001), and tinnitus-related distress decreased from 25 to 21 (Wilcoxon Z = −2.209, p = 0.027). Depressive symptoms declined numerically, although this change did not reach statistical significance. Working memory improved from 82.0 to 89.0 (Wilcoxon Z = −4.090, p < 0.001), and processing speed from 89.5 to 95.5 (Wilcoxon Z = −2.533, p = 0.011). Before CI, WMI and PSI showed a strong correlation (ρ = 0.533, p = 0.002), and WMI correlated moderately with education level (ρ = 0.452, p = 0.012). One year after CI, correlations strengthened between PSI and NCIQ (ρ = 0.510, p = 0.006), PSI and OI (ρ = 0.400, p = 0.039), and WMI and TQ (ρ = –0.459, p = 0.021), indicating emerging associations between cognitive outcomes and auditory or psychosocial measures. Conclusions: One year of CI-based auditory rehabilitation improves auditory function, quality of life, tinnitus distress, and—critically—working memory and processing speed in middle-aged adults. These findings address a previously unfilled research gap and support the relevance of CIs for preserving cognitive health during midlife. Full article

Background/Objectives: Subjective tinnitus, defined as the perception of sound without an external source, is a common and often debilitating condition. In the absence of pharmacotherapy, disease management guidelines recommend counseling interventions to alleviate tinnitus-related distress and improve patient outcome. This study evaluated the benefit of guideline-compliant counseling provided by “Meine Tinnitus App”, a smartphone-based application, for the treatment of subjective tinnitus. Methods: A randomized controlled study was conducted in 204 patients with confirmed chronic subjective tinnitus enrolled at 33 ear, nose and throat (ENT) practices in Germany. Tinnitus improvement was evaluated after 10 weeks of intervention (digital counseling in addition to standard care vs. standard care only). The primary endpoint was the change in tinnitus-related distress (measured by the Mini-TQ-12 validated questionnaire). The secondary endpoint was the change in tinnitus-associated daily burden and coping difficulties (measured by the validated BVB-2000 questionnaire). Treatment effects for the primary and secondary endpoints were represented by the estimated marginal means (EMMs). Results: Patients of the intervention group showed a significant reduction in tinnitus-related distress (EMM [95% CI]: 4.5 [3.3–5.8]; p < 0.001) and a significant improvement in tinnitus-associated daily burden and coping difficulties (EMM [95% CI]: 0.5 [0.2–0.7]; p < 0.001) compared to patients of the control group, with large to moderate effect sizes (Hedges’ g between 1.1. and 0.5). These positive treatment effects were confirmed by responder and sensitivity analyses. Additionally, patients with high vs. low app usage showed a greater improvement in treatment effect for both endpoints (p < 0.05), further supporting the health benefits of digital counseling. Conclusions: This study demonstrated the efficacy of tinnitus counseling provided by “Meine Tinnitus App” to alleviate tinnitus-related distress, daily burden, and coping difficulties in patients with subjective tinnitus (German Clinical Trials Register DRKS00025379). Full article

Background: Tinnitus has been increasingly reported during the COVID-19 pandemic, following both infection and vaccination. While these reports suggest that pandemic-related factors may influence the onset or worsening of tinnitus, the perceptual characteristics and functional consequences of such cases remain poorly understood. This study examined the nature, severity, and communication-related impact of self-reported tinnitus following COVID-19 vaccination. Methods: A total of 770 adults who self-reported new or worsened tinnitus after vaccination completed a structured online survey between August 2021 and May 2023. Standardized instruments included the Tinnitus Functional Index (TFI), the Speech, Spatial and Qualities of Hearing Scale (SSQ), and visual analog scales assessing loudness discomfort and hyperacusis-related symptoms. Analyses included descriptive statistics, chi-square tests, t-tests, and correlation matrices. Results: Respondents reported moderate to severe tinnitus-related distress, with the greatest impacts on emotional control, sleep, and relaxation. Many described communication difficulties in noisy or multi-talker environments, despite relatively preserved spatial hearing and sound quality. A substantial subset endorsed hyperacusis symptoms, including sound-induced annoyance, fear, and intolerance. Correlation analyses revealed strong associations between emotional, cognitive, and auditory domains, underscoring the multidimensional burden of tinnitus in this population. Conclusions: Self-reported tinnitus after COVID-19 vaccination was associated with distress, sleep disruption, and communication difficulties, mirroring patterns commonly observed in tinnitus more broadly. Although causality cannot be determined, these findings highlight the importance of comprehensive audiological and psychological assessment for individuals reporting auditory complaints after vaccination and support the inclusion of functional hearing outcomes in tinnitus evaluation protocols. Full article

Background/Objectives: The purpose of this study was to analyze changes in speech intelligibility, health-related quality of life, and the degree of comorbidities (depressive and anxiety symptoms and tinnitus-related distress) in a large cohort of 227 adults who underwent auditory rehabilitation with a cochlear implant (CI). The second goal was to identify the factors that influence the health-related quality of life in this cohort. Methods: Pre- and one-year post-CI data were collected on speech intelligibility (Freiburg Monosyllabic Test, FS), subjective hearing ability (Oldenburg Inventory, OI), health-related quality of life (Nijmegen Cochlear Implant Questionnaire, NCIQ), depressive symptoms (General Depression Scale, ADS-L), anxiety (Generalized Anxiety Disorder 7, GAD-7), perceived stress (Perceived Stress Questionnaire, PSQ), and tinnitus-related distress (Tinnitus Questionnaire, TQ). Results: The Wilcoxon matched-pairs signed-rank test showed significant improvements across the entire cohort in speech intelligibility, subjective hearing, and the quality of life. The scores indicating anxiety, depressiveness, perceived stress, and tinnitus-related distress decreased. The Spearman correlation showed that before implantation, quality of life positively related to subjective hearing, while depression, anxiety, stress, and tinnitus distress were negatively correlated. After a year, these links persisted but grew stronger. Regression analyses found subjective hearing (OI) as a positive predictor, and depression (ADS-L) and tinnitus distress (TQ) as negative predictors of life quality, especially in patients with low or median NCIQ scores. Conclusions: In a substantial cohort of adult patients with diverse CI indications, auditory rehabilitation enhances speech intelligibility and subjective hearing, improves health-related quality of life, and reduces the severity of depressive and anxiety symptoms, as well as tinnitus-related distress. Subjective hearing contributes positively to quality of life, whereas depressive symptoms and tinnitus distress negatively impact quality of life in patients with low NCIQ scores post-CI, highlighting the importance of monitoring and psychological intervention. 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