Tinnitus outcomes after ginkgo biloba extract in sudden sensorineural hearing loss: a dose-comparative and prognostic...

Tinnitus is a common symptom in otolaryngology with a complex and multifactorial etiology. Ginkgo biloba extract (EGB 761) is widely used in clinical practice, but the reported results vary across studies, partly due to differences in dosage and outcome assessment.

To compare tinnitus outcomes between two commonly used EGB 761 dosages (120 mg/day vs. 240 mg/day) in patients with SSNHL-associated newly onset tinnitus, and to identify clinical factors associated with tinnitus prognosis.

Participants from mainland China were randomly assigned (1:1) to receive either 120 mg/day or 240 mg/day of EGB 761 tablets for one month. Follow-up assessments were conducted at 1, 2, 3, 4, 6, 9, 12, and 18 months after treatment initiation.

A total of 195 valid data sets were analyzed. The mean baseline Tinnitus Handicap Inventory (THI) score of 48.99 significantly decreased to 28.33 at 1 month, 16.97 at 6 months, and 10.54 at 18 months. A slightly higher proportion of patients met the improvement criterion in the high-dose group (95.9%) than in the low-dose group (91.9%), but the between-group differences were not statistically significant for THI reduction or other outcomes. In multivariable analyses, higher anxiety (GAD-7 ≥ 10), higher reflux symptom burden (RSI ≥13), and a history of vestibular disorders were associated with less favorable tinnitus outcomes at follow-up.

Both 120 mg/day and 240 mg/day dosages of EGB 761 demonstrated similar tinnitus outcomes over follow-up. Anxiety, LPR, and a history of vestibular disorders may be prognostic factors for tinnitus.