There is no evidence to suggest that the use of betahistine to treat tinnitus is effective.Botulinum toxin injection has been tried with some success in some of the rare cases of objective tinnitus from a palatal tremor.Caroverine is used in a few countries to treat tinnitus. The evidence for its usefulness is very weak. Neuromodulation
In 2020, information about recent clinical trials has indicated that bimodal neuromodulation may be a promising treatment for reducing the symptoms of tinnitus. It is a noninvasive technique that involves applying an electrical stimulus to the tongue while also administering sounds. Equipment associated with the treatments is available through physicians. Studies with it and similar devices continue in several research centers.There is some evidence supporting neuromodulation techniques such as transcranial magnetic stimulation; transcranial direct current stimulation and neurofeedback. However, the effects in terms of tinnitus relief are still under debate. Alternative medicine
Ginkgo biloba does not appear to be effective. The American Academy of Otolaryngology recommends against taking melatonin or zinc supplements to relieve symptoms of tinnitus, and reported that evidence for the efficacy of many dietary supplements—lipoflavonoids, garlic, traditional Chinese/Korean herbal medicine, honeybee larvae and various other vitamins and minerals, as well as homeopathic preparations—did not exist. A 2016 Cochrane Review also concluded that evidence was not sufficient to support taking zinc supplements to reduce symptoms associated with tinnitus. Prognosis
While there is no cure, most people with tinnitus get used to it over time; for a minority, it remains a significant problem. Epidemiology
Adults
Tinnitus affects 10–15% of people.
This type is called somatic or craniocervical tinnitus, since it is only head or neck movements that have an effect.There is a growing body of evidence suggesting that some tinnitus is a consequence of neuroplastic alterations in the central auditory pathway. These alterations are assumed to result from a disturbed sensory input, caused by hearing loss. Hearing loss could indeed cause a homeostatic response of neurons in the central auditory system, and therefore cause tinnitus. Hearing loss
The most common cause of tinnitus is hearing loss. Hearing loss may have many different causes, but among those with tinnitus, the major cause is cochlear injury.Ototoxic drugs also may cause subjective tinnitus, as they may cause hearing loss, or increase the damage done by exposure to loud noise. Those damages may occur even at doses that are not considered ototoxic. More than 260 medications have been reported to cause tinnitus as a side effect. In many cases, however, no underlying cause could be identified.Tinnitus can also occur due to the discontinuation of therapeutic doses of benzodiazepines. It can sometimes be a protracted symptom of benzodiazepine withdrawal and may persist for many months. Medications such as bupropion may also result in tinnitus. In many cases, however, no underlying cause can be identified. Associated factors
Factors associated with tinnitus include:
ear problems and hearing loss:
conductive hearing loss
acoustic shock
loud noise or music
middle ear effusion
otitis
otosclerosis
Eustachian tube dysfunction
sensorineural hearing loss
excessive or loud noise; e.g.