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Ginkgo biloba for tinnitus

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Abstract

Background

This is an update of a Cochrane Review first published in The Cochrane Library in Issue 2, 2004 and previously updated in 2007.

Tinnitus can be described as the perception of sound in the absence of external acoustic stimulation. At present no specific therapy for tinnitus is acknowledged to be satisfactory in all patients. There are a number of reports in the literature suggesting that Ginkgo biloba may be effective in the management of tinnitus. However, there also appears to be a strong placebo effect in tinnitus management.

Objectives

To assess the effect of Ginkgo biloba in patients who are troubled by tinnitus.

Search methods

We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; AMED; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; mRCT and additional sources for published and unpublished trials. The date of the most recent search was 22 September 2009, following a previous search update in January 2006.

Selection criteria

Adults (18 years and over) complaining of tinnitus.
Adults with a primary complaint of cerebral insufficiency where tinnitus forms part of the syndrome.

Data collection and analysis

Both authors independently extracted data and assessed trials for quality.

Main results

Three trials were included in the review (a further ten were excluded on methodological grounds). Several trials of Ginkgo biloba for tinnitus in patients with cerebral insufficiency were identified but none reached a satisfactory standard for inclusion in the review. There was no evidence that Ginkgo biloba was effective for the primary complaint of tinnitus. The incidence of side effects was small.

Authors' conclusions

The limited evidence did not demonstrate that Ginkgo biloba was effective for tinnitus which is a primary complaint. There was no reliable evidence to address the question of whether Ginkgo biloba is effective for tinnitus associated with cerebral insufficiency.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Plain language summary

Ginkgo biloba for tinnitus

People with tinnitus hear sounds such as crackling or whistling in the absence of external noise. Noises appear to arise in the ears or inside the head and may be experienced all of the time, or only intermittently. The causes of tinnitus are not yet fully understood and a variety of treatments are offered including medication, psychotherapy, noise 'maskers' and Tinnitus Retraining Therapy. The review of trials assessed the effectiveness of extract of Ginkgo biloba. Few good quality trials were found and there was no evidence that Ginkgo biloba is effective for tinnitus. Further research is needed.