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Conservative management of functional middle ear disorders: a systematic review with narrative synthesis and conceptual clinical framework

A dispatch from PubMed — filed

To systematically evaluate the efficacy and safety of conservative (non-surgical) interventions for functional middle ear disorders (FMEDs), including tinnitus, auditory tube dysfunction, middle ear myoclonus, and related functional auditory syndromes. DATA SOURCES: PubMed/MEDLINE, Scopus, Embase, and Web of Science were searched through June 21, 2025, using PRISMA 2020 guidelines. REVIEW

Clinical Takeaway

This systematic review may support structured decision-making for conservative management of functional middle ear disorders including tinnitus, but the narrative synthesis limits definitive evidence grading; no immediate protocol change is warranted without reading the full framework.

Why It Matters

A standardized clinical framework for conservative middle ear disorder management could reduce practice variability and improve patient outcomes across audiology and ENT settings.

Key Points
  1. 01Systematic review with narrative synthesis of conservative interventions for functional middle ear disorders.
  2. 02Tinnitus is included as one of the target conditions.
  3. 03A conceptual clinical framework is proposed to guide treatment selection.
  4. 04Published in European Archives of Oto-Rhino-Laryngology (DOI: 10.1007/s00405-026-10360-3).
  5. 05Narrative synthesis design limits strength of evidence compared to meta-analysis.
Claims & Evidence

Conservative interventions are efficacious for functional middle ear disorders including tinnitus.

studypartially supported

A conceptual clinical framework can be proposed to guide conservative management of functional middle ear disorders.

studypartially supported
Research metadata
PMID
42223612
DOI
10.1007/s00405-026-10360-3.
Journal
European Archives of Oto-Rhino-Laryngology
Publication type
review
Evidence level
2a
Population
Patients with functional middle ear disorders including tinnitus
Intervention
Conservative (non-surgical) interventions for functional middle ear disorders

Primary outcomes

Efficacy of conservative interventions; Safety of conservative interventions

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