A group of scientists led by Xinyi Wang from the Department of Oto-Rhino-Laryngology and the National Clinical Research Center for Geriatrics at West China Hospital, Sichuan University, has reported new insights into the comparative benefits of standard care versus acoustic therapy for tinnitus associated with ISSNHL. The findings, published in BMC Medicine, help clarify an area where clinical guidance has been limited and inconsistent.
ISSNHL frequently presents with sudden hearing impairment accompanied by acute tinnitus, significantly interfering with patients’ daily functioning, sleep, and emotional well-being. Although acoustic therapy is widely used to reduce tinnitus distress, robust evidence supporting its effectiveness in this specific population has been lacking. This trial aimed to address that uncertainty.
The research team conducted a two-stage investigation between 2019 and 2024 across 19 hospitals in Sichuan, enrolling 213 adults diagnosed with ISSNHL and tinnitus. In the first stage, participants were randomly assigned to one of four short-term (10-day) inpatient treatment arms: international standard care with systemic steroids, Chinese standard care combining steroids and intravenous batroxobin, and both protocols with the addition of daily acoustic therapy.
Following discharge, the participants entered a 170-day follow-up phase, during which they could choose to continue personalized acoustic therapy at home or pursue alternative treatments. Their progress and clinical outcomes were objectively tracked over this period.
The trial revealed the following findings:
- Short-term analyses showed no significant differences between the treatment groups, irrespective of whether acoustic therapy was included.
- Tinnitus remission rates and scores on the Tinnitus Handicap Inventory, tinnitus questionnaires, and visual analog scales were comparable across all groups.
- Measures related to anxiety, depression, sleep quality, and general health also showed similar outcomes, indicating no immediate benefit from acoustic therapy during initial recovery.
- Long-term follow-up among patients with severe ISSNHL revealed substantially higher tinnitus remission rates in those who continued acoustic therapy at home (45.5% vs. 20%).
- Other long-term measures, including hearing-related distress and tinnitus severity on visual analog scales, did not differ significantly between groups.
- The higher remission rate suggests that acoustic therapy may be valuable as a long-term management option for selected patients.
- No severe adverse events or deaths were observed, reaffirming the safety of acoustic therapy as an additional treatment.
The authors concluded that while acoustic therapy may not produce immediate relief, it could play a meaningful role in promoting sustained improvement, especially in those with severe hearing loss. They noted that future research should focus on refining therapy duration, identifying ideal candidates, and developing optimized treatment schedules to maximize benefits.
Reference:
Wang, X., Qiu, K., Zhang, Y. et al. Efficacy of standard care versus acoustic therapy on acute tinnitus in idiopathic sudden sensorineural hearing loss: a randomized controlled trial. BMC Med (2025). https://doi.org/10.1186/s12916-025-04506-z
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