Tinnitus Research Digest: ICBT Long-Term Data, Digital CBT, Musical Ear Syndrome, and Vestibular Schwannoma

A follow-up analysis of a nonrandomized clinical trial examined whether the benefits of internet-based cognitive behaviour therapy (ICBT) for tinnitus persist over a six-year period. Of 138 participants from the original trial invited to complete the six-year follow-up, 49 (35.5%) did so (mean age 54.5 years; 37% female). The intervention consisted of a guided, 21-module ICBT programme delivered over eight weeks.

At the six-year mark, significant improvements in tinnitus distress were maintained, with a large within-group effect size (Cohen’s d = 1.00; 95% CI, 0.80–1.32). Using the Reliable Change Index criterion, 19 of 49 participants (39%) showed clinically meaningful improvement; using the minimal clinically important difference threshold, 27 of 49 (55%) did. Benefits also held for anxiety, depression, insomnia, and satisfaction with life, but not for hearing disability or hyperacusis.

Key limitations are significant. The study was nonrandomized, meaning participants were not randomly assigned, which limits causal conclusions. Only 35.5% of those invited completed the six-year assessment, raising questions about whether the completers were those who benefited most. There was no active control group at six years. Replication in a randomized design with higher retention would strengthen these findings considerably.

A clinical review examined the current evidence base for digital cognitive behaviour therapy (dCBT) as a treatment for tinnitus, covering what the research shows about effectiveness, the methodological weaknesses in existing studies, and directions for future work. The review is published in the journal Explore.

No abstract was available for this item. Based on the available information — the title, authorship, and the triage assessment — the review appears to address the growing availability of dCBT apps and programmes for tinnitus patients, evaluating which have evidence behind them, what outcomes patients can reasonably expect, and where research gaps remain.

Because full abstract details are not available, it is not possible to report specific effect sizes, sample sizes reviewed, or the number of studies included. Readers should access the full text for those details.

For a clinical review of this type, key remaining questions typically include: which specific platforms or programmes have been evaluated in adequately powered trials, whether dCBT outcomes differ across tinnitus severity groups, and how dropout rates in digital programmes compare to in-person therapy. The degree to which this review offers actionable guidance for clinicians recommending specific tools is unclear without the full text.

This case report describes a 19-year-old woman with normal hearing who experienced vivid, complex musical hallucinations continuously for two years — a condition called musical ear syndrome (MES). All audiological and neurological assessments, including pure-tone audiometry, imaging, and otoacoustic emissions, were normal. There was no psychiatric diagnosis.

A 12-session intervention over three months was delivered, combining psychoeducation, sound enrichment, and auditory retraining using stimuli chosen by the patient. The patient’s Tinnitus Handicap Inventory score fell from 54 (moderate handicap) to 12 (slight handicap). She also reported reduced hallucination intensity, improved emotional coping, and greater social engagement.

This is a single case report, which means no causal conclusions can be drawn. There is no comparison group, no blinding, and no way to determine how much of the improvement was due to the intervention versus natural fluctuation in symptoms or placebo effects. MES is rare, and this case is unusual in that it affected a young person without hearing loss — most reported cases involve older adults with hearing impairment. Whether these results generalise to other MES patients with normal hearing is unknown. Larger case series or controlled studies would be needed to draw broader conclusions.

A retrospective study analysed 175 patients treated for vestibular schwannoma (a benign tumour on the hearing nerve) between 1998 and 2023. Two radiotherapy approaches were compared: single-fraction radiosurgery (SRS, n=69) and normofractionated stereotactic radiotherapy (NFSRT, n=106). Median patient age was 61 years; median follow-up was 46 months.

Overall tumour control was high: 94.3% within the treated field. All 10 recurrences occurred in NFSRT patients who received doses of 55.8–56 Gy. Higher total dose predicted recurrence (hazard ratio 2.97; p=0.003), suggesting that doses above 55 Gy do not improve efficacy and may increase recurrence risk. The authors support moderate-dose regimens of 50–54 Gy for NFSRT.

At baseline, 42.3% of patients reported tinnitus. After treatment, most symptoms — including tinnitus — remained stable rather than worsening. Headache incidence increased from 14.3% to 22.3% after treatment (p=0.02). Early side effects such as fatigue and hair loss were more common with NFSRT but had resolved at late follow-up.

Limitations include the retrospective design, which means treatment allocation was not randomised. The 46-month median follow-up, while reasonable, may not capture very late symptom changes. Symptom data relied on clinical records rather than standardised patient-reported outcome measures.

A review paper examines the pathophysiological mechanisms underlying neurological tinnitus and surveys therapeutic approaches. The paper is authored by Cortez, de Medeiros, São, and Mandic, and was published in April 2025.

No abstract was available for this item. Based on the available information — the title and authorship — the paper appears to cover the neurological basis of tinnitus (how changes in auditory processing in the brain contribute to tinnitus perception) and the range of treatments that have been studied in this context.

Without access to the full text or abstract, it is not possible to report which specific mechanisms are covered, which therapies are reviewed, how many studies are included, or what conclusions the authors draw. The scope and novelty of this review relative to existing literature cannot be assessed here.

Key remaining questions for any review of this type would include: whether it covers treatments that are currently available to patients or only experimental approaches, whether it assesses the quality of evidence behind each therapy, and whether its conclusions go beyond what existing reviews have already established. Readers with access to the full text should assess those points directly.