Korean Tinnitus Guidelines: Diagnosis and Treatment

The first standardized, evidence-based clinical guideline for managing tinnitus in Korean adults has been published, marking a major step forward for hearing health in the country. Developed by a multidisciplinary team led by Euyhyun Park, Ho Yun Lee, and Hyun Jung Kim, the guideline was created in response to a clear need for a structured, nationally relevant approach. It offers specific recommendations for diagnosis and treatment, tailored to the Korean healthcare system and patient population.

A Rigorous, Multidisciplinary Development Process

To build this framework, the guideline committee—composed of eight otorhinolaryngologists, one neurologist, one psychiatrist, and one audiologist—conducted systematic searches of major medical databases, including PubMed and Embase, up to 2025. They used the GRADE methodology to assess the quality of the evidence behind every potential treatment. The panel formulated nine key clinical questions in the PICO format (Patient, Intervention, Comparison, Outcome) to guide their review. Final recommendations were agreed upon through a modified Delphi process, requiring a consensus of at least 80% among the experts. This methodical approach ensures the guidelines are rooted in the best available science while being practical for clinicians.

Clear Recommendations for Diagnosis and Management

The guidelines provide clear, graded advice across several areas of tinnitus care. For diagnosis, they recommend imaging studies like MRI for patients with specific red flags, such as pulsatile tinnitus or asymmetric hearing loss (Grade B recommendation). This is a targeted approach meant to identify potential underlying vascular or structural causes.

For treatment, the evidence points most consistently toward psychological and rehabilitative strategies. Cognitive Behavioral Therapy (CBT) and Tinnitus Retraining Therapy (TRT) received conditional recommendations (Grade B) for helping patients manage the distress associated with tinnitus. Similarly, the use of hearing aids is conditionally recommended for individuals whose tinnitus coexists with hearing loss, addressing a common dual challenge. Sound therapy, which uses external noise to make tinnitus less noticeable, also earned a conditional recommendation for reducing distress.

An interesting conditional recommendation was made for Ginkgo (Ginkgo biloba extract) biloba extract for patients with subjective tinnitus (Grade B), while the guideline strongly recommends against the routine use of zinc or other vitamin supplements for symptom improvement (Grade D). This distinction helps steer patients away from ineffective over-the-counter options while noting a potential botanical alternative. For more persistent cases, neuromodulation techniques like transcranial direct current stimulation (tDCS) or repetitive transcranial magnetic stimulation (rTMS) are conditionally recommended as add-on treatments.

Practical Implications for Patients and Clinicians

The publication of these guidelines has immediate practical value. For Korean patients, it means the care they receive can now be more consistent and based on a transparent review of evidence. For clinicians, it offers a much-needed reference to inform decision-making, especially in a field where treatment options can seem fragmented. The authors explicitly integrated considerations of Korea’s National Health Insurance coverage and regional accessibility into their process, making these recommendations more than just academic; they are designed to be implementable in real-world clinical settings.

A critical point the guideline makes is that the majority of evidence supporting even the recommended interventions is of “low or very low certainty.” This openly acknowledges a significant gap in the research field and calls for higher-quality studies to strengthen future guidelines. The core therapeutic goal remains focused not on eliminating the tinnitus sound itself—which is often not possible—but on reducing the associated distress and improving daily function and quality of life. This patient-centered objective aligns with modern approaches to chronic condition management. Understanding a patient’s specific psychological profile is key to this approach, as explored in our article on Four Tinnitus Psychosocial Profiles Identified.

Connections to Broader Auditory Health

While focused on tinnitus, the guideline’s emphasis on a multidisciplinary evaluation is relevant to other auditory conditions. For instance, the recommendation for imaging in cases of asymmetric hearing loss or pulsatile tinnitus could intersect with the diagnostic process for conditions like Migraine Linked to Hyperacusis and Tinnitus, where vascular and neurological factors may be involved. Furthermore, the strong role given to behavioral therapies like CBT for tinnitus distress management mirrors strategies used for conditions such as misophonia, detailed in resources like Managing Misophonia in Teens and Young Adults.

This guideline represents a foundational document for South Korea. It moves tinnitus management away from anecdote and variability toward a standardized, evidence-informed model. By setting this baseline, it not only improves current care but also establishes a framework for measuring outcomes and guiding future research to build higher-quality evidence, ultimately benefiting patients across the spectrum of hearing health.

Source: Park E, Lee HY, Kim HJ. Development of an Evidence-Based Clinical Practice Guideline for Tinnitus in Korea. Clin Exp Otorhinolaryngol. 2026. PMID: 42409067 | DOI: 10.21053/ceo.2026-00130