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Transcutaneous Electrical Nerve Stimulation for Subjective Tinnitus: A Systematic Review and Meta-Analysis of
Rong Shen1,2,3,4, Limeng Li5,6, Yanxun Han2,3,4
1Anhui University of Traditional Chinese Medicine.
Summary
Transcutaneous electrical nerve stimulation (TENS) offers a safe, clinically meaningful reduction in tinnitus handicap, but doesn't significantly improve loudness or annoyance. Further research is needed to confirm these findings for tinnitus treatment.
Area of Science:
- Otorhinolaryngology
- Neurology
- Medical Devices
Background:
- Subjective tinnitus significantly impacts quality of life.
- Limited evidence exists on non-invasive treatment efficacy.
- Transcutaneous electrical nerve stimulation (TENS) is a potential therapeutic option.
Purpose of the Study:
- To evaluate the efficacy and safety of TENS for subjective tinnitus in adults.
- To synthesize evidence from randomized controlled trials (RCTs).
Main Methods:
- Systematic literature search across multiple databases (Cochrane Library, PubMed, EMBASE, etc.).
- Inclusion of RCTs comparing TENS with sham or active controls.
- Meta-analysis of Tinnitus Handicap Inventory (THI) and Visual Analog Scale (VAS) scores, following PRISMA guidelines.
Main Results:
- Seven RCTs (N=342) indicated TENS significantly reduced THI scores (MD=-8.60), though heterogeneity was high (I2=62%).
- TENS did not significantly alter tinnitus loudness or annoyance.
- Sensitivity analysis revealed a single active-control trial as the source of heterogeneity; its removal showed a larger, consistent effect of TENS vs. sham on THI (MD=-10.48, I2=11%).
- Evidence certainty was rated 'Very Low'; no severe adverse events were reported.
Conclusions:
- TENS provides a safe, clinically meaningful reduction in tinnitus handicap based on very low-certainty evidence.
- The benefit of TENS on perceived loudness or annoyance remains unclear.
- High-quality RCTs with larger sample sizes are required to validate these findings and guide clinical practice.
