Tinnitus: assessment and management

Context

Tinnitus is the perception of sounds in the ears or head that do not come from an outside source. It is a common condition, with similar prevalence rates in children young people and adults.

The NHS Joint Strategic Needs Assessment Guidance (2019) reports that '10% of the population will have tinnitus at some point and it will be moderately annoying in 2.8% of the population; severely annoying in 1.6%; and disrupting a person's ability to live a normal life in 0.5%'. It has also been estimated that 3% of adults might require a clinical intervention for tinnitus. The expectation is that a similar number of children will need clinical intervention for tinnitus.

Tinnitus can be associated with difficulty in concentrating and listening, and for some people it can be extremely distressing and have a significant impact on their mental wellbeing, family, work and social life. It is a heterogeneous condition that affects people differently both in its severity and its impact. Therefore, management of tinnitus is usually tailored according to the person's symptoms. Although there is no single effective treatment for tinnitus, there are a variety of approaches that may help people manage their tinnitus or the impact of their tinnitus.

Additionally, tinnitus is often associated with hearing loss. For example, 75% of people with hearing loss might experience tinnitus, while only 20% to 30% of people who report tinnitus have normal hearing.

Currently services across the UK vary in how accessible they are and the level of support offered for people with tinnitus. There is a lack of standardisation in assessment, referral and management approaches. This includes assessment of conditions underlying the tinnitus that need prompt, or even urgent, investigation and treatment by specialist services.

This guideline aims to improve care for people with tinnitus by providing advice to healthcare professionals on the assessment, investigation and management of tinnitus. It also offers advice on supporting people who are distressed by tinnitus and on when to refer for further assessment of their tinnitus and management.