A triage guide for tinnitus.

W ith an estimated 10% to 15% of adults experiencing chronic tinnitus, most primary care physicians are familiar with this complaint. Th e prevalence of tinnitus increases with age and with exposure to high levels of noise—the most commonly reported cause. With people living longer and such “toxic” noise levels on the rise, tinnitus is a condition you can expect to encounter even more frequently. Despite the prevalence of tinnitus, however, there are no clinical standards or best practice guidelines for managing it. Th us, many physicians are uncertain about what to tell patients with this distressing disorder, and when (or whether) to refer them to specialists. So patients are sometimes told that “nothing can be done” and that they simply must “learn to live with” tinnitus. Such negative messages from a trusted physician can have a detrimental eff ect, causing some patients to stop seeking help and to become increasingly disturbed by tinnitus. What’s more, these messages are untrue. Some conditions that result in tinnitus can be treated. And, although tinnitus itself cannot normally be cured, there are numerous interventions and educational strategies that can help patients change their reactions to—and learn to cope with—the ringing in their ears. We developed this evidence-based review and tinnitus triage guide (TABLE 1) to help family physicians respond appropriately to this distressing, but common, condition.