Acoustic CR Neuromodulation for adults with chronic subjective tonal tinnitus

Evidence is based on 1 exploratory proof‑of‑concept randomised controlled trial, and 1 single‑arm study reported as a conference abstract. Neither study reported outcomes beyond 6 months. Methodological limitations mean that results from these studies should be interpreted cautiously.

The limited available evidence suggests that treatment with Acoustic CR Neuromodulation may improve patient‑reported tinnitus symptoms compared with before treatment, and that it may improve tinnitus more than using a placebo.

There is no evidence comparing Acoustic CR Neuromodulation with standard care for tinnitus, and no evidence that improvements in tinnitus symptoms are maintained in the long term.

The randomised controlled trial of 63 patients (5 of whom received placebo) reported 8 mild or moderate adverse events related to treatment with Acoustic CR Neuromodulation.

The current list price for an Acoustic CR Neuromodulation system is £1850 for the device and medical earphones, £20 for rechargeable batteries, and £1500 for the programming station.

There is no evidence available on whether Acoustic CR Neuromodulation would cost more or less than standard care. Currently offered treatments include hearing aids (£65–£85) and cognitive behavioural therapy (£157 per session, several sessions likely to be needed).

There is no published evidence reporting costs or resource use.

The device is worn for between 4 and 6 hours a day over a course of 4‑6 months of treatment (depending on the response to therapy).

The Acoustic CR Neuromodulation device must be programmed and fitted by a trained audiologist. The device needs reprogramming when the patient reports changes in their tinnitus frequency.

Acoustic CR Neuromodulation treatment is intended to be delivered alongside supporting tinnitus therapies such as counselling, sound enrichment, relaxation exercises and fitting of a hearing aid (if appropriate). The Acoustic CR Neuromodulation earphones cannot be worn at the same time as a hearing aid.