Tinnitus Management Guideline

Evidence-Based Treatment Options

The American Academy of Otolaryngology-Head and Neck Surgery recommends Cognitive Behavioral Therapy (CBT) for patients with persistent, bothersome tinnitus, based on randomized controlled trials showing a preponderance of benefit over harm 4
The American Academy of Otolaryngology-Head and Neck Surgery recommends hearing aid evaluation for patients with hearing loss and persistent, bothersome tinnitus, even if the hearing loss is mild or unilateral 1, 3, 5
Education and counseling should be provided to all patients with persistent, bothersome tinnitus about management strategies, as recommended by the American Academy of Otolaryngology-Head and Neck Surgery 3
The American Academy of Otolaryngology-Head and Neck Surgery does not recommend medical therapy, including antidepressants, anticonvulsants, anxiolytics, or intratympanic medications, for treating persistent, bothersome tinnitus 2, 6
Dietary supplements, such as Ginkgo biloba, melatonin, zinc, or other supplements, should not be recommended for tinnitus treatment, according to the American Academy of Otolaryngology-Head and Neck Surgery 7
Transcranial Magnetic Stimulation (TMS) should not be recommended for routine tinnitus treatment, as stated by the American Academy of Otolaryngology-Head and Neck Surgery 7
The American Academy of Otolaryngology-Head and Neck Surgery found insufficient evidence to make a recommendation for or against acupuncture for tinnitus treatment 2, 7

The American Academy of Otolaryngology-Head and Neck Surgery suggests distinguishing between bothersome and non-bothersome tinnitus, and determining if tinnitus is recent onset or persistent (≥6 months) 8, 9
A comprehensive audiologic examination should be conducted, especially for unilateral, persistent tinnitus, or tinnitus associated with hearing difficulties, as recommended by the American Academy of Otolaryngology-Head and Neck Surgery 8, 9
For patients with hearing loss, the American Academy of Otolaryngology-Head and Neck Surgery recommends hearing aid evaluation 1, 5
For all patients with persistent, bothersome tinnitus, the American Academy of Otolaryngology-Head and Neck Surgery recommends CBT 4
The American Academy of Otolaryngology-Head and Neck Surgery suggests providing education and counseling about tinnitus management strategies 3
Optimal management often requires addressing any underlying hearing loss, which is frequently associated with tinnitus, as noted by the American Academy of Otolaryngology-Head and Neck Surgery 1, 5