The history of tinnitus: from ancient interpretations to contemporary neuroscience and neuromodulation.

OBJECTIVE

To review the historical evolution of tinnitus from ancient civilizations to contemporary neuromodulation-based therapies.

METHODS

A narrative historical review was undertaken using PubMed, Google Scholar, historical archives, classical medical texts, and landmark otological publications. Sources were selected according to historical significance, relevance to tinnitus, and contribution to major shifts in its conceptualisation and management.

RESULTS

As a non-systematic narrative review, this study traces the conceptual paradigm shifts in tinnitus understanding. Early civilizations attributed tinnitus to supernatural causes, while Greek and Islamic scholars introduced humoral and clinical theories. The nineteenth century established scientific otology, rooting tinnitus in peripheral ear pathology. Crucially, modern neuroscience prompted a paradigm shift from these peripheral cochlear models to central network theories. This shift has driven the exploration of specific neuromodulation modalities, such as repetitive transcranial magnetic stimulation (rTMS) and bimodal stimulation.

CONCLUSION

The history of tinnitus reflects the broader evolution of medicine, progressing from superstition to evidence-based neuro-otological science.