(236) Treatments for Tinnitus: Current Evidence, Emerging Therapies, and the Role of Corticosteroids

Introduction: Tinnitus is a common and often debilitating condition for which evidence-based pharmacologic treatments remain limited.

Methods: This narrative review evaluates current and emerging therapies for tinnitus, focusing on pharmacologic agents and corticosteroid use. Conducted in winter 2025, the review includes studies of acute and chronic subjective tinnitus across outpatient clinical, audiology, and research settings. Interventions assessed encompass pharmacologic therapies, dietary supplements, neuromodulatory techniques, and other noninvasive modalities. Outcomes were measured using validated tinnitus-specific instruments such as the Tinnitus Functional Index and Tinnitus Handicap Inventory.

Results: Pharmacologic treatments demonstrated mixed efficacy. Agents such as selurampanel, acamprosate, sulodexide, and select antidepressant combinations showed improvement in some patients. OTO-313 was beneficial only in cases where tinnitus duration was under 6 months. Additional interventions, including lidocaine, botulinum toxin, and gentamicin, yielded positive effects, though gentamicin was associated with hearing loss. Neuromodulation and noninvasive techniques generally produced more favorable outcomes. Acupuncture targeting auditory regions showed promise, though standardized, validated outcome measures were lacking. Among corticosteroids, dexamethasone was largely ineffective, while methylprednisolone showed more consistent symptom improvement. Dietary supplements were most effective in individuals with baseline deficiencies, and certain herbal therapies improved outcomes when used in conjunction with hearing aids. Manganese combined with Lipoflavonoid did not show evidence of benefit.

Conclusions: Overall, no single therapy demonstrated consistent efficacy across populations. While select pharmacologic agents, neuromodulation, and methylprednisolone showed potential, treatment responses varied widely. These findings underscore the need for more rigorous, high-quality clinical trials to inform evidence-based management of tinnitus.