Magdalena Sereda 2,3, A-F
Jurek Olszewski 1, A,D-E
More details
Hide details
Department of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics, Medical University of Lodz, Lodz, Poland
Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham, UK
Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
A - Research concept and design; B - Collection and/or assembly of data; C - Data analysis and interpretation; D - Writing the article; E - Critical revision of the article; F - Final approval of article;
Publication date: 2019-09-30
Corresponding author
Marzena Mielczarek   

Marzena Mielczarek, Medical University of Lodz, 90-549 Lodz, 113 Zeromskiego St, Poland; email:, tel. +42-63 93 581
J Hear Sci 2019;9(3):9-23
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.

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.

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.

Langguth B, Kreuzer PM, Kleinjung T, De Ridder D. Tinnitus: causes and clinical management. Lancet Neurol, 2013; 12(9): 920–30.
Axelsson A, Ringdahl A. Tinnitus: a study of its prevalence and characteristics. Br J Audiol, 1989; 23(1): 53–62.
Heller AJ. Classification and epidemiology of tinnitus. Otolaryngology Clin North Am, 2003; 36(2): 239–48.
Kennedy V, Wilson C, Stephens D. Quality of life and tinnitus. Audiol Med, 2009; (1): 1–12.
Nondahl D, Cruickshanks, K, Dalton D et al. The impact of tinnitus on quality of life in older adults. J Am Acad Audiol, 2007; Mar; 18(3): 257–66.
Ziai K, Moshtaghi O, Mahboubi H, Djalilian HR. Tinnitus patients suffering from anxiety and depression: a review. Int Tinnitus J, 2017; 21(1): 68–73.
Hall DA, Fackrell K, Li AB et al. A narrative synthesis of research evidence for tinnitus-related complaints as reported by patients and their significant others. Health Qual Life Outcomes, 2018; 16(1): 61.
Haider, H, Bojić T, Ribeiro S, Paço J, Hall D, Szczepek A. Pathophysiology of subjective tinnitus: triggers and maintenance. Front Neurosci, 2018; 12: 866.
Eggermont JJ, Roberts LE. The neuroscience of tinnitus: understanding abnormal and normal auditory perception. Front Syst Neurosci, 2012; 6: 1–4.
Eggermont JJ, Tass PA. Maladaptive neural synchrony in tinnitus: origin and restoration. Front Neurol, 2015; 6: 1–17.
Henry J, Roberts L, Caspary D, Theodoroff S, Salvi R. Underlying mechanisms of tinnitus: review and clinical implications. J Am Acad Audiol, 2014; Jan; 25(1): 5–22.
Hoare DJ, Adjamian P, Sereda M. Electrical stimulation of the ear, head, cranial nerve, or cortex for the treatment of tinnitus: a scoping review. Neural Plast, 2016; 2016:5130503.
Ren T, Nuttall AL. Extracochlear electrically evoked otoacoustic emissions: a model for in vivo assessment of outer hair cell electromotility. Hear Res, 1995; 92: 178–83.
Nuttall AL, Ren T. Electromotile hearing: evidence from basilar membrane motion and otoacoustic emissions. Hear Res, 1995 Dec; 92(1–2): 170–7.
Aran JM, Cazals Y. Electrical suppression of tinnitus. Ciba Found Symp, 1981; 85: 217–31.
Matsushima J, Sakai N, Sakajiri M, Miyoshi S, Uemi N, Ifukube T. An experience of the usage of electrical tinnitus suppressor. Artif Organs, 1996; 20(8): 955–8.
Okusa M, Shiraishi T, Kubo T, Matsunaga T. Tinnitus suppression by electrical promontory stimulation in sensorineural deaf patients. Acta Otolaryngol Suppl, 1993; 113(501): 54–8.
Zeng FG, Djalilian H, Lin H. Tinnitus treatment with precise and optimal electric stimulation: opportunities and challenges. Curr Opin Otolaryngol Head Neck Surg, 2015; Oct; 23(5): 382–7.
Cazals Y, Negrevergne M, Aran JM. Electrical stimulation of the cochlea in man: hearing induction and tinnitus suppression. J Am Audiol Soc, 1978; 3(5): 209–13.
Cazals Y, Rouanet JF, Negrevergne M, Lagourgue P. First results of chronic electrical stimulation with a round-window electrode in totally deaf patients. Arch Otorhinolaryngol, 1984; 239(3): 191–6.
Daneshi A, Mahmoudian S, Farhadi M, Hasanzadeh S, Ghalebaghi B. Auditory electrical tinnitus suppression in patients with and without implants. Int Tinnitus J, 2005; 11(1): 85–91.
Di Nardo W, Cianfrone F, Scorpecci A, Cantore I, Giannantonio S, Paludetti G. Transtympanic electrical stimulation for immediate and long term tinnitus suppression. Int Tinnitus J, 2009; 15(1): 100–6.
Graham JM, Hazell JW. Electrical stimulation of the human cochlea using a transtympanic electrode. Br J Audiol, 1977; May; 11(2): 59–62.
Hazell JW, Jastreboff PJ, Meerton LE, Conway MJ. Electrical tinnitus suppression: frequency dependence of effects. Audiology, 1993; 32(1): 68–77.
Kuk FK, Tyler RS, Rustad N, Harker LA, Tye-Murray N. Alternating current at the eardrum for tinnitus reduction. J Speech Hear Res, 1989; 32(2): 393–400.
Matsushima JI, Fujimura H, Sakai N et al. A study of electrical promontory stimulation in tinnitus patients. Auris Nasus Larynx, 1994; 21(1): 17–24.
Perez R, Shaul C, Vardi M, Muhanna N, Kileny P, Sichel J. Multiple electrostimulation treatments to the promontory for tinnitus. Otol Neurotol, 2015; Feb; 36(2): 366–72.
Watanabe K, Okawara D, Baba S, Yagi, T. Electrocochleographic analysis of the suppression of tinnitus by electrical promontory stimulation. Audiology, 1997; May-Jun; 36(3): 147–54.
Rubinstein JT, Tyler RS, Johnson A, Brown CJ. Electrical suppression of tinnitus with high-rate pulse trains. Otol Neurotol, 2003; 24(3): 478–85.
Mielczarek M, Konopka W, Olszewski J. The application of direct current electrical stimulation of the ear and cervical spine kinesitherapy in tinnitus treatment. Auris Nasus Larynx, 2013; 40(1): 61–5.
Mielczarek M, Michalska J, Polatynska K, Olszewski J. An Increase in alpha band frequency in resting state EEG after electrical stimulation of the ear in tinnitus patients: a pilot study. Front Neurosci, 2016; 10: 453.
Mielczarek M, Norena A, Schlee W, Olszewski J. Excitation of the auditory system as a result of non-invasive extra-cochlear stimulation in normal subjects and tinnitus patients. Front Neurosci, 2018; 12: 146.
Aran JM. Electrical stimulation of the auditory system and tinnitus control. J Laryngol Otol Suppl, 1981; 153–61.
Konopka W, Zalewski P, Olszewski J, Olszewska-Ziaber A, Pietkiewicz P. Tinnitus suppression by electrical promontory stimulation (EPS) in patients with sensorineural hearing loss. Auris Nasus Larynx, 2001; 28(1): 35–40.
Mielczarek M, Olszewski J. Direct current stimulation of the ear in tinnitus treatment: a double-blind placebo-controlled study. Eur Arch Oto-Rhino-Laryngology, 2014; 271(6): 1815–22.
Dobie RA, Hoberg KE, Rees TS. Electrical tinnitus suppression: a double-blind crossover study. Otolaryngol Head Neck Surg, 1986; 95(3 Pt 1): 319–23.
Kapkin O, Satar B, Yetiser S. Transcutaneous electrical stimulation of subjective tinnitus. A placebo-controlled, randomized and comparative analysis. ORL J Otorhinolaryngol Relat Spec, 2008; 70(3): 156–61.
Journals System - logo
Scroll to top