Outcomes of Tinnitus Interventions: An Umbrella Review of Systematic Reviews with Meta-Analysis.

OBJECTIVES

Tinnitus is a highly prevalent and challenging neurotologic condition affecting over 740 million individuals worldwide. Despite the growing number of studies, treatment approaches remain fragmented and inconsistent. This umbrella review aims to aggregate results from systematic review to comprehensively synthesize the available evidence.

METHODS

Following PRISMA guidelines, we systematically searched CINAHL, COCHRANE Library, PubMed, and Scopus through April 2025. Systematic reviews with meta-analyses of primary tinnitus interventions were included. Outcomes focused on validated measures of tinnitus severity, distress, loudness, and quality of life. Study quality was assessed using AMSTAR-2.

RESULTS

A total of 44 systematic reviews were included, covering 7 intervention domains. Cognitive behavioral therapy (CBT), hearing aids, tinnitus retraining therapy (TRT), and sound/music therapy consistently improved tinnitus-related outcomes (eg, THI reductions up to -14.50, P < .001). Cochlear implantation yielded the largest effects (eg, THI -29.97) but is reserved for patients with moderate-to-profound sensorineural hearing loss who are not adequately helped by hearing aids. Neuromodulation and acupuncture showed modest or inconsistent benefits with high heterogeneity.

CONCLUSIONS

This umbrella review provides the current and comprehensive analysis of tinnitus treatments. CBT, hearing aids, TRT, and sound/music therapy show consistent benefit. Cochlear implantation offers the greatest effect in patients with moderate-to-profound hearing loss unresponsive to hearing aids. Other therapies show mixed evidence. These findings offer a much-needed evidence framework to guide treatment decisions and future research.