The efficacy of notched music therapy vs conventional music therapy for chronic subjective tinnitus patients: a systematic review and meta-analysis.

Purpose: The etiology and mechanism of chronic subjective tinnitus (CST) are still unclear, thus there is no specific treatment yet. The notched music therapy (NMT) has been found to relieve patients' tinnitus symptoms, but its efficacy is still controversial. This study aims to resolve the controversy through meta pooling method.

Methods: By searching Embase, Pubmed, Elsevier, WOS, CNKI, and CBM (China Biology Medicine disc) databases, relevant literature on "notch music therapy" and "tinnitus" was obtained, and suitable clinical controlled trials were screened. Cochrane ROB v2.0 was used to assess the risk of literature bias, and the efficacy after treatment was evaluated by pooling the effect size of tinnitus handicap inventory (THI) and visual analog scale (VAS) between intervention group and control group.

Results: A total of 14 randomized controlled trial studies were included for quantitative analysis, with a total of 793 CST patients participating, including 395 patients in the intervention group and 398 patients in the control group. Among them, five studies were evaluated as biased with "some concerns of risk". The meta-analysis results showed a pooling effect size of THI score of patients after 3 months of treatment (MD = - 8.62, 95% CI (- 17.01, - 0.23), Z = - 2.01, P = 0.044) and VAS score of tinnitus after 3 months of treatment (MD = - 1.13, 95% CI (- 2.49, - 0.11), Z = - 2.14, P = 0.003) between NMT and conventional music therapy (CMT). Heterogeneity investigation and regression analysis found that notch frequency range, publication year, and patient age were not specific factors affecting the merged results. The sensitivity analysis results showed that the comprehensive effect size was stable and reliable, with no significant publication bias (P > 0.05).

Conclusion: Compared to traditional music therapy, notched music therapy can significantly reduce the scores of the tinnitus disability scale and tinnitus loudness score for patients after treatment. It is a good non-pharmacological treatment that is worthy of clinical promotion.