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Tinnitus guidelines from the United Kingdom's National Institute for Health and Care Excellence (NICE)

Question clinique

What are the NICE guidelines for the assessment and management of tinnitus?

L’Essentiel

These guidelines, from the United Kingdom's National Institute for Health and Care Excellence (NICE), suggest support for patients and their families, treatment for concomitant hearing loss, and psychological therapy for patients whose tinnitus is affecting their life. The guidelines suggest imaging for patients with synchronous pulsatile tinnitus (tinnitus occurring with each heart beat), but only infrequently for patients with nonpulsatile tinnitus. Medications are ineffective. An algorithm outlining approaches and when to refer can be found here. 5

Référence

Lewis S, Chowdhury E, Stockdale D, Kennedy V, on behalf of the Guideline Committee. Assessment and management of tinnitus: summary of NICE guidance. BMJ 2020;368:m976.

Plan de l'etude: Practice guideline

Financement: Government

Cadre: Various (guideline)

Sommaire

The general approach to tinnitus consists of support, limited investigation, and offering treatment for concomitant hearing loss, if present. No medicine, including betahistine (Serc) and presumably other antihistamines, are effective. Consider offering virtual (Internet-based) psychological therapy, including cognitive behavioral therapy, acceptance and commitment therapy, and mindfulness-based therapies, to patients whose tinnitus is affecting their emotional and social well-being and daily activities. Imaging may only be helpful in patients with suspected pathology and in patients with synchronous pulsatile tinnitus. Offer amplification devices only to patients with hearing loss. These guidelines are based on a systematic review of the available evidence, which was graded for quality. The guidelines were developed by a committee composed of experts in tinnitus, a health economist, a methodologist, and a lay person (who also was a co-author). The committee members declared no financial conflicts of interest.

Reviewer

Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA


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