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Around 10% of people experience subjective tinnitus (the perception of sound, only audible to the patient, in the absence of an external auditory stimulus).1–3 It may be associated with hearing loss, anxiety, depression, sleep disturbance, concentration problems or reduced quality of life; for around 0.5% it is extremely disturbing.1–4 Risk factors include aging, significant noise exposure, drug therapy (e.g. aminoglycosides, NSAIDs, diuretics), or disorders of the outer, middle or inner ear or auditory nerve (e.g. ear wax, infections, vestibular schwannoma, otosclerosis).1,2,4 It may be due to excessive spontaneous activity in the auditory system and brain; if the signal (normally suppressed by the subconscious) becomes noticed it becomes more intrusive and annoying in a vicious cycle.5 Here, we discuss symptomatic drug and non-drug treatments for subjective tinnitus in adults. We do not cover treatment of underlying causes of tinnitus.

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