Tinnitus is described as ringing, buzzing, clicking, or pulsating noise perceived only by the patient (subjective) or the examiner and the patient's objective. It may be without aberrant cause (Primary) or due to a specific cause (Secondary) (Strong Recommendation).

Clinicians should perform a targeted history and physical examination at the initial evaluation of a patient with presumed primary tinnitus (Strong Recommendation).

Clinicians must distinguish patients with bothersome tinnitus from patients with no bothersome tinnitus (Strong Recommendation).

Clinicians should distinguish patients with bothersome tinnitus of recent onset from those with persistent symptoms (≥ 6 months) (Strong Recommendation).

Clinicians should obtain a prompt, comprehensive audiological examination in patients with tinnitus that is unilateral, persistent (≥ six months), or associated with hearing difficulties (Strong Recommendation).

Clinicians may obtain an initial comprehensive audiological examination in patients who present with tinnitus (regardless of laterality, duration, or perceived hearing status) (Conditional recommendation).

Clinicians should obtain imaging studies of the head and neck in patients with tinnitus, especially if they have one or more of the following:  tinnitus that localises to 1 ear, pulsatile tinnitus, focal neurological abnormalities, or asymmetric hearing loss (Strong Recommendation).

Clinicians should educate patients with persistent, bothersome tinnitus about management strategies (Strong Recommendation).

Clinicians should recommend a hearing aid evaluation for patients with hearing loss and persistent, bothersome tinnitus (Strong Recommendation).

Clinicians may recommend sound therapy to patients with persistent, bothersome tinnitus (Strong Recommendation).

Clinicians should recommend cognitive behavioural therapy to patients with persistent, bothersome tinnitus (Strong Recommendation).

Clinicians can recommend antidepressants, anticonvulsants, or anxiolytics for a primary indication of treating persistent, bothersome tinnitus (Neramexane, Vestipitant alone or in combination with paroxetine, acamprosate, and dietary zinc supplements) (Conditional recommendation).

Clinicians can recommend Ginkgo biloba, melatonin, zinc, or other dietary supplements for treating patients with persistent, bothersome tinnitus (Conditional recommendation).

Clinicians should not prescribe for patients with persistent bothersome tinnitus (Strong Recommendation).

Intratympanic steroids should be used in acute tinnitus, cases with sudden SNHL and cases with SNHL not more than 30 dB, while Intratympanic lidocaine should be tried only for chronic tinnitus (Conditional recommendation).

Surgical treatment is offered for specific causes of tinnitus (e.g. glomus, vestibular schwannoma) (Strong Recommendation).