Background: There is a need for a tinnitus review linking models, assessment, and clinical treatments. Purpose: The purpose of this review is to show how integration of mechanisms, assessment, and treatment of tinnitus may be beneficial for clinical practice. Methods: A literature review and interpretation will illustrate mechanisms of tinnitus, identify how these mechanisms currently (and partially) may be assessed, demonstrate how the mechanisms may be influenced by tinnitus treatment strategies, and compare current tinnitus treatment outcomes. Results: Tinnitus etiology is heterogeneous; no one assessment measurement or treatment strategy is likely to benefit all patients, or all patients to the same extent. The many models of tinnitus mechanisms do, however, have one or all of the following schemas: auditory system dysfunction, cognitive/emotional nonauditory central neural circuits, and somatosensory input. Efficacious treatments reviewed here include sound therapy, counseling approaches, and bimodal stimulation. Conclusions: The three tinnitus treatments have different treatment goals and target different mechanisms of both auditory and nonauditory networks to reduce tinnitus distress. Despite these differences, these treatments show some effectiveness in managing bothersome tinnitus and should be recommended in our clinical practice guidelines for patients. Clinical Relevance Statement: Incorporating tinnitus assessment measures that address all three schemas allows clinicians to better identify the underlying mechanisms or contributing factors in each patient, thereby guiding the selection of a more targeted and effective treatment approach. Because tinnitus etiology is heterogeneous and possibly multifaceted, combinations of treatments may be advisable. Rather than suggesting a shotgun approach or even a synergistic approach, combinations of treatments may reflect an integrated approach, targeting all aspects of tinnitus measured in the assessment protocol.
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