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Introduction: Past studies have shown connections between the somatosensory system (the neck and temporomandibular joint region) and the auditory system. It is therefore likely that tinnitus patients might benefit from neck therapy. The aim of this study was to investigate the effects of physiotherapy of the neck, comprising cervical spine kinesiotherapy and interspinal muscles massage, on subjective tinnitus. We also investigated the effects of the therapy on the range of cervical spine motion and cervical muscles tension. Material and methods: This was a non-randomised controlled trial. Adult patients with chronic subjective tinnitus (n = 118) were enrolled in an intervention group and received 10 sessions, over 2 weeks, of neck therapy comprising active exercises, massage of the cervical interspinal muscles, and post-isometric relaxation exercises. There was also a control group (waiting list). The effects of the therapy on tinnitus were assessed at baseline, immediate post-treatment, and follow-up (2 weeks after the end of therapy) using the Polish Tinnitus Functional Index (TFI-Pl, primary outcome measure), a visual analogue scale (VAS) of tinnitus loudness, and the Polish Tinnitus Handicap Inventory (THIPl). Effects of therapy on neck were assessed using two measures: the range of cervical spine movement (cervical flexion, cervical rotation, and cervical side bending measured in cm using a tape measure); and muscle tension -- assessed by palpation and graded using a scale of either 0 (normal) or 1 (increased). Results: In the intervention group, the mean TFI score was reduced significantly from baseline (mean = 52.6, SD = 20.4) to post treatment (mean = 40.9, SD = 19.0, p < 0.001) and at follow-up (mean = 40.4, SD = 21.1, linear mixed model). In the control group, mean TFI score did not change significantly from baseline (mean = 46.8, SD = 20.1) to post treatment (mean = 45.8, SD = 40.9) and follow-up (mean = 45.2, SD = 26.2, linear mixed model). Improvement in tinnitus in the intervention group was accompanied by a reduction in cervical muscles tension and improvement in the range of cervical spine motion. Conclusions: Complex neck therapy of the neck appears to be a promising intervention for tinnitus treatment. Further randomised studies are needed to confirm the positive effects of the therapy on tinnitus and explore the mechanisms leading to improvement. [ABSTRACT FROM AUTHOR]

Background: Tinnitus is a common symptom, affecting about 10–15% of the adult population. When input from the somatosensory system can influence and/or elicit tinnitus, this type of subjective tinnitus is called somatosensory tinnitus. Recently, a new type of bimodal neurostimulation treatment has shown promising results for a specific subgroup within the somatosensory tinnitus population. It is, however, not clear if this bimodal stimulation is also effective in patients with other types of subjective tinnitus. Aim: The aim of this study was to evaluate the feasibility and efficacy of noninvasive bimodal auditory-somatosensory stimulation in reducing tinnitus severity among a general population of people with subjective tinnitus. Methods: Chronic subjective tinnitus patients were recruited from the ENT department of the Antwerp University Hospital. Somatosensory stimulation was delivered by Transcutaneous Electrical Nerve Stimulation (TENS), and it was combined with auditory stimulation via headphones. The therapy comprised six sessions of thirty minutes twice a week for a period of 3 consecutive weeks. Follow up measurements were scheduled 9–12 weeks after the last treatment session. The change of the Tinnitus Functional Index (TFI) score, a questionnaire evaluating tinnitus burden and effects on the quality of life, was the primary outcome measure. Results: Twenty-nine patients were enrolled in the study. A linear mixedeffects model was used to analyze the efficacy of bimodal treatment. The results of this analysis showed a statistically significant decrease (by 6, 9 points) in average TFI score at the follow up visit when compared to baseline. The ability to modulate tinnitus did not have an influence on the treatment results. Conclusion: Our study showed that bimodal stimulation is a feasible and safe method of tinnitus treatment. The method might be an effective treatmentfor some participants with tinnitus, especially those who have accompanying neck/temporomandibular problems, although, the evidence from this trial is quite weak. Additional research is needed toward establishing the optimal treatment protocol, as well as selecting the most appropriate inclusion criteria. [ABSTRACT FROM AUTHOR]

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Background: This paper is a review of the literature on electrical stimulation of the ear to treat tinnitus. This method of treatment has been used since the 1970s and different techniques have been explored. The primary aim of this work was to review the literature on electrical stimulation of the ear to suppress tinnitus, with a specific focus on the methods and stimulation parameters used so far and the efficacy of the different methods. A secondary aim was to formulate recommendations on electrical ear stimulation parameters that suppress tinnitus. Material and methods: Four databases were searched: PubMed, Ovid Embase, Web of Science, and Science Direct. Database searches were conducted during November 2018 using the search terms: tinnitus and electrical stimulation. Inclusion criteria: All research articles on invasive and non-invasive electrical stimulation of the ear for suppressing tinnitus were included. Other inclusion criteria were records in English and involving adult human participants. Exclusion criteria: Studies on intracochlear stimulation using cochlear implants and studies where stimulation extended beyond the ear (e.g. transcutaneous electrical nerve stimulation, TENS) were excluded. Results: Twenty publications met the inclusion criteria and were analysed in this review. A comparison was made between invasive and non-invasive electrical ear stimulation in terms of efficacy, type of current used, laterality of stimulation, intensity and frequency of the current, duration of tinnitus suppression, and adverse effects. Due to the non-standardised methodology of the studies, there was only a low level of evidence available in terms of the advantages of a particular technique or stimulation parameter. The difficulties in comparing the effectiveness of the studies were related to many factors, and these are discussed. One factor is the variability in outcome measures, including different definitions of treatment success and limited use of standardised or validated outcome measures. Conclusions: Based on the reviewed literature, it is concluded there is no clear advantage of one stimulation condition over the other in terms of method, stimulation parameter, or effectiveness. This leads us to conclusion that the present body of evidence is insufficient to formulate definite recommendations for electrical ear stimulation. [ABSTRACT FROM AUTHOR]