title: A multidisciplinary systematic review of the treatment for chronic idiopathic tinnitus.
abstract: The majority of tinnitus patients are affected by chronic idiopathic tinnitus, and almost 60 different treatment modalities have been reported. The present study is a multidisciplinary systematic analysis of the evidence for the different forms of treatment for chronic tinnitus. The results are used to form the basis of an S3 guideline. A systematic search was carried out in PubMed and the Cochrane Library. The basis for presenting the level of evidence was the evidence classification of the Oxford Centre of Evidence-based Medicine. Whenever available, randomised controlled trials were given preference for discussing therapeutic issues. All systematic reviews and meta-analyses were assessed for their methodological quality, and effect size was taken into account. As the need for patient counselling is self-evident, specific tinnitus counselling should be performed. Due to the high level of evidence, validated tinnitus-specific, cognitive behavioural therapy is strongly recommended. In addition, auditory therapeutic measures can be recommended for the treatment of concomitant hearing loss and comorbidities; those should also be treated with drugs whenever appropriate. In particular, depression should be treated, with pharmacological support if necessary. If needed, psychiatric treatment should also be given on a case-by-case basis. With simultaneous deafness or hearing loss bordering on deafness, a CI can also be indicated. For auditory therapeutic measures, transcranial magnetic or direct current stimulation and specific forms of acoustic stimulation (noiser/masker, retraining therapy, music, and coordinated reset) for the treatment of chronic tinnitus the currently available evidence is not yet sufficient for supporting their recommendation.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076, Tübingen, Germany. ut@hpzenner.de.
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Zenner
authors.affiliation: Otorhinolaryngology Centre, Kaiserslautern, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Delb
authors.affiliation: Department of Psychology, Georg-August University of Göttingen, Göttingen, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Kröner-Herwig
authors.affiliation: Mental Health Centre, Clinic for Psychosomatics and Psychotherapy, Medical University of Hannover, Hannover, Germany.
authors.forename: Burkhard
authors.initials: B
authors.lastname: Jäger
authors.affiliation: Department for Dental Prosthetics, Geriatric Dentistry and Function, Charité Hospital, Medical School Berlin, Berlin, Germany.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Peroz
authors.affiliation: Tinnitus Clinic, Bad Arolsen Hospital, Arolsen, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hesse
authors.affiliation: Charité Hospital, Medical School Berlin, University Otorhinolaryngology Clinic, Berlin, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Mazurek
authors.affiliation: Department of Behavioural Medicine, Psychosomatics, Psychiatry and Psychotherapy, Schön Clinic in Roseneck, Prien am Chiemsee, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Goebel
authors.affiliation: Clinic and Outpatient Clinic for Neurology, University Hospital of Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Gerloff
authors.affiliation: Social Paediatric Centre, Neuropaediatrics and Epileptology, University Paediatric Clinic, Erlangen, Germany.
authors.forename: Regina
authors.initials: R
authors.lastname: Trollmann
authors.affiliation: Otorhinolaryngology Centre, Traunstein, Germany.
authors.forename: Eberhard
authors.initials: E
authors.lastname: Biesinger
authors.affiliation: MedClin Bosenberg Clinics, Saint Wendel, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Seidler
authors.affiliation: Department for Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
authors.forename: Berthold
authors.initials: B
authors.lastname: Langguth
mesh_terms: D000161:Acoustic Stimulation / Q000379:methods*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003937:Diagnosis, Differential; D019468:Disease Management; D004599:Electric Stimulation Therapy / Q000379:methods*; D034381:Hearing Loss / Q000175:diagnosis; D006801:Humans; D014012:Tinnitus / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy
keywords: Cochlear implant; Cognitive behavioural therapy; Drug therapy; Retraining therapy; Tinnitus