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Asking patients: How long have you had tinnitus? According to the American Academy of Otolaryngology - Head and Neck Surgery Foundation (AAO-HNSF; Tunnel et al., 2014), tinnitus that has been experienced for less than six months is considered recent-onset. Tinnitus of at least six months duration is persistent. Does it matter whether tinnitus has been experienced for more or less than six months? It does matter because the longer a person has had tinnitus, the more likely it is to persist. The great majority of clinical trials for tinnitus have required participants to have tinnitus of “at least six months duration” to be reasonably sure it won’t change during treatment. This is why the AAO-HNSF chose six months as the break point between recent-onset and persistent tinnitus. People who are still bothered by their tinnitus after six months require special consideration for services because “tinnitus symptoms of 6 months or longer are less likely to improve spontaneously.” (p. 13)

Persistent versus Recent-Onset Tinnitus According to the American Academy of Otolaryngology--Head & Neck Surgery Foundation (AAO-HNSF; Tunkel et al, 2014), persistent tinnitus is also referred to as chronic tinnitus. Persistent tinnitus has been experienced for at least six months. Why six months? Because most trials of tinnitus therapies require participants who have experienced tinnitus for long enough to be reasonably sure that the tinnitus is stable (that is, unlikely to change). Tinnitus of shorter duration (less than six months) is recent-onset tinnitus, which others might call acute tinnitus. Recent-onset tinnitus is thought to be more labile, meaning it is more likely to fluctuate in intensity, or to completely disappear, relative to persistent tinnitus. Source: Henry JA, Carlson KF. Understanding Tinnitus and What to Do About It. (2021). Tinnitus Today 46(2):4-10. 

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Conclusions from systematic reviews have influenced recommendations made in clinical practice guidelines for tinnitus, such as those published by the American Academy of Otolaryngology - Head and Neck Surgery Foundation (AAO-HNSF). These conclusions, however, can make it appear that a treatment for tinnitus is not effective, even if the opposite is true. We contend that the strict inclusion criteria for these reviews are counterproductive and have the effect of obscuring decades of evidence demonstrating the clinical effectiveness of sound therapies for tinnitus. Ultimately, this process has resulted in many patients not receiving sound therapy, despite what should be sufficient evidence that this is an effective form of treatment. If we rely on systematic reviews using contemporary risk-of-bias (RoB) assessment criteria for studies published prior to these reporting guidelines, then we risk excluding important conclusions regarding treatments that could help patients in need. Henry JA, Carlson KF, Theodoroff S, Folmer RL. Reevaluating the use of sound therapy for tinnitus management: Perspectives on relevant systematic reviews. Journal of Speech, Language and Hearing Research 65(6):2327-2342, 2022.