Clinical practice guidelines for diagnosis and treatment of chronic tinnitus in Japan
Abstract
Clinical practice guidelines in Japan for tinnitus were published in May 2019. Effective treatment of tinnitus contributes to quality of life and may improve depression, anxiety, and cognitive function. The highest priority of treatment recommended by this guideline involves educational counseling, including an explanation of the mechanisms of tinnitus. Understanding tinnitus pathology has also been reported to be a therapeutically effective educational counseling strategy. Further, explaining how sound therapy such as tinnitus retraining therapy (TRT) works is effective. Psychological and cognitive behavioral therapies may be an option. Here, the hearing aid is coupled with a sound generator in order to administer sound therapy for patients with more-severe symptoms. In Japan, it can be difficult to perform psychotherapy alongside otorhinolaryngology, and exemplary sound therapy is more likely to be carried out. In any case, the purpose of treatment is not to eliminate tinnitus, but rather reduce distress that manifests in response to tinnitus by promoting sensory adaptation. Clinically, the most important subject is not the loudness of tinnitus, but the severity of tinnitus distress. TRT consists of educational counseling and sound therapy. The tinnitus handicap inventory (THI) is used to measure the distress level for tinnitus and to determine treatment priorities. Rehabilitation of tinnitus is important because anxiety and depression are often observed in patients with severe tinnitus. Additionally, drug administration should be avoided. As a surgical treatment, a cochlear implant can affect tinnitus symptoms. It is essential to establish a treatment policy according to the disease condition and degree of distress.
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CBT is the only intervention strongly recommended in clinical practice guidelines for tinnitus.
“Currently, CBT is the only intervention strongly recommended in clinical practice guidelines for tinnitus (Tunkel et al., 2014; Cima et al., 2019; Ogawa et al., 2020)”
From Research trends and hotspots of cognitive behavioral therapy for tinnitus: a bibliometric analysis (2025) · cites this paper as Ogawa et al., 2020
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- Authors
- Ogawa, K., Sato, H., Takahashi, M., Wada, T., Naito, Y., Kawase, T., Murakami, S., Hara, A., & Kanzaki, S.
- Affiliations
- Keio University (JP)
- Iwate University (JP)
- Nagoya City University (JP)
- University of Tsukuba (JP)
- Tohoku University (JP)
- Corresponding author
- Kanzaki, Sho
- ORCID
- Venue
- Auris Nasus Larynx
- Publisher
- Elsevier BV
- Published
- 2020-02
- Volume
- 47
- Issue
- 1
- Pages
- 1-6
- ISSN
- 0385-8146 (ISSN-L)
- OpenAlex
- W2979557760
- Cited by
- 61
- References
- 51
- Citations by year
- 2026: 4 · 2025: 12 · 2024: 13 · 2023: 15 · 2022: 4 · 2021: 10 · 2020: 3
- FWCI
- 2.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Auris Nasus Larynx (publishedVersion)
- PubMed (publishedVersion)
- Funders
- AMED (2016−2019)
- Topics
- Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hearing Loss and Rehabilitation
- Health Sciences › Health Professions › Speech and Hearing › Noise Effects and Management
- Keywords
- chronic tinnitus, tinnitus diagnosis, tinnitus treatment, tinnitus retraining therapy, sound therapy, educational guidance, cognitive behavioral therapy, tinnitus distress, Tinnitus Handicap Inventory, hearing aids, cochlear implants, tinnitus rehabilitation, sensory adaptation
- MeSH terms
- Acoustic Stimulation, Anxiety, Chronic Disease, Depression, Hearing Aids, Humans, Japan, Patient Education as Topic, Tinnitus, Cognitive Behavioral Therapy, Practice Guidelines as Topic
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