Clinicians should (a) perform a targeted history and physical examination at the initial evaluation of a patient with presumed primary tinnitus to identify conditions that if promptly identified and managed may relieve tinnitus; (b) obtain a prompt, comprehensive audiologic examination in patients with tinnitus that is unilateral, persistent (≥ 6 months), or associated with hearing difficulties; (c) distinguish patients with bothersome tinnitus of recent onset from those with persistent symptoms (≥ 6 months) to prioritize intervention and facilitate discussions about natural history and follow-up care; (d) educate patients with persistent, bothersome tinnitus about management strategies; (e) recommend a hearing aid evaluation for patients who have persistent, bothersome tinnitus associated with documented hearing loss; and (f) recommend cognitive behavioral therapy to patients with persistent, bothersome tinnitus. The development group provided the following options: Clinicians may (a) obtain an initial comprehensive audiologic examination in patients who present with tinnitus (regardless of laterality, duration, or perceived hearing status); and (b) recommend sound therapy to patients with persistent, bothersome tinnitus.
References: Tunkel, David & Bauer, Carol & Sun, Gordon & Rosenfeld, Richard & Chandrasekhar, Sujana & Cunningham, Eugene & Archer, Sanford & Blakley, Brian & Carter, John & Granieri, Evelyn & Henry, James & Hollingsworth, Deena & Khan, Fawad & Mitchell, Scott & Monfared, Ashkan & Newman, Craig & Omole, Folashade & Phillips, Clifford & Robinson, Shannon & Whamond, Elizabeth. (2014). Clinical Practice Guideline: Tinnitus. Otolaryngology–head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. 151. S1-S40. 10.1177/0194599814545325.