Sound therapy (using amplification devices and/or sound generators) for tinnitus

Area of Science:

• Audiology
• Otolaryngology
• Evidence-based medicine

Background:

• Tinnitus affects 10-15% of adults, significantly impacting quality of life and burdening healthcare systems.
• Management strategies include education, TRT, CBT, sound enrichment (hearing aids, sound generators), and pharmacotherapy for comorbid conditions.
• Sound therapy devices are a first-line management option in audiology for tinnitus.

Purpose of the Study:

• To assess the effectiveness of sound therapy, including amplification devices and sound generators, for managing tinnitus in adults.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) comparing sound therapy devices (hearing aids, sound generators, combination devices) against control groups (waiting list, placebo, education only) or each other.
• Primary outcomes included tinnitus symptom severity and adverse effects; secondary outcomes included depressive symptoms, anxiety, and quality of life.
• Searched multiple databases up to July 2018, including Cochrane ENT Register, MEDLINE, Embase, and ClinicalTrials.gov.

Main Results:

• Eight RCTs with 590 participants were included; risk of bias was generally unclear due to methodological limitations.
• No data were available for comparisons against waiting list, placebo, or education-only groups.
• Limited data from comparisons between devices showed no significant difference in tinnitus symptom severity between hearing aids and sound generators, or between combination devices and hearing aids (low-quality evidence).
• Adverse effects and secondary outcomes were not adequately assessed in the included studies.

Conclusions:

• There is no evidence to support the superiority of sound therapy over placebo or no device for tinnitus.
• Insufficient evidence exists to rank the effectiveness of hearing aids, sound generators, or combination devices against each other.
• Future research requires rigorous methodology, including robust randomization and blinding, and validated patient-centered outcome measures.