Introduction: Tinnitus affects ~14% of the population, often causing distress and affecting quality of life. Despite its frequency in outpatient clinics, understanding of its pathophysiology and optimal management strategies remains poor, and there is limited guidance available to clinicians. Aim: To audit UK tinnitus care pathways to gain better understanding of the presentation, investigation, and management of patients with tinnitus. Methods: A collaborative multicentre retrospective audit was conducted nationally across ENT, Audiology and AVM services within the UK. Anonymised data were collected on adults presenting between August-October 2022. These included: demographics, medical history, tinnitus features, associated symptoms, examination findings, audiometry, investigation results, management, and outcomes. Results: Thirty-six sites submitted data for 1,136 patients. 824 patients (73%) were found to have some form of hearing loss on audiometric testing, with nearly two-fifths of these (38%) receiving hearing aid provision. The most common management strategies were self-management techniques (52%), relaxation techniques (26%), sound generators (5%) and masking devices (4%). 46 patients (4%) received CBT. Almost all patients (94%) had no tinnitus questionnaires used for documenting the severity of their symptoms, and only two patients in the whole cohort had follow-up questionnaires used to monitor progression or improvement. Conclusions: Previous reviews of tinnitus practice have relied on questionnaires sent to departments rather than reviewing granular data in hospital records. This work provides analysis of a large group of patient journeys through tinnitus services. It highlights a gap in monitoring and follow-up of these patients and will be useful in shaping future pathways.

Background Vertigo can have a negative impact on the quality of life of patients. Mobile health apps have the potential to promote autonomy, and improve symptoms through self-management and vestibular rehabilitation exercises. This study aimed to systematically evaluate the quality of apps for vertigo using the published literature and smartphone stores. Design A systematic review of the literature, utilising Embase, Medline, Cochrane and clinicaltrials.org, and Apple and Google Play Stores were used to identify mobile device apps relating to vertigo. Apps were evaluated for characteristics, content, healthcare involvement and quality using the Mobile App Rating Score (MARS) system (a standardised tool for assessing app quality). Results The literature search identified no eligible articles. The app search identified and evaluated 32 eligible apps. Four main categories of apps were identified: exercise provision, information provision, symptom monitoring and assessment. Six apps included healthcare professionals in their development. MARS scoring ranged between 1.8 and 4.05 (maximum 5), with only 25% of apps scoring the minimum acceptability score of 3. The highest scoring apps were those providing rehabilitation exercises and symptom monitoring. Conclusion There is great potential in the use of mobile apps to help monitor and manage vertigo. This article demonstrates that despite numerous readily available vertigo apps, few are of an acceptable standard. There is scope for apps to improve. We propose involving health professionals and patients in their development to ensure high quality evidence-based information and evaluating their efficacy through future patient-centred trials.