A review of tinnitus symptoms beyond 'ringing in the ears': a call to action

Background: Tinnitus, often referred to as 'ringing in the ears', is highly prevalent. However, patients may also present with a number of other symptoms. Scope: To review the broad range of symptoms of tinnitus, to evaluate their impact on patient quality of life and to explore methods of diagnosis and assessment. An electronic literature search was performed in PubMed between September and December 2010. Findings: Accumulating evidence suggests that the symptoms of tinnitus are not confined to the characteristic 'ringing in the ears', but instead encompass wide-ranging symptoms that include emotional components such as sleep disturbance, anxiety, depression, irritation, and concentration difficulties. Conclusion: Patients with tinnitus experience a spectrum of distressing symptoms that impact their quality of life and there is a clear need for action. Clinicians need to recognize and diagnose tinnitus that occurs with other wide-ranging symptoms to ensure that these symptoms are identified and patients receive effective treatment.