
Botulinum Toxin for Tinnitus: What the Evidence Actually Supports Across Masseter, Temporalis, Peri-Auricular and Migraine Protocols
Tinnitus affects an estimated 10–15% of adults, and no pharmacological agent is recommended for its routine treatment by either the American Academy of Otolaryngology–Head and Neck Surgery clinical practice guideline (2014) or NICE guideline NG155 (2020). Botulinum toxin has been proposed for tinnitus on several distinct rationales — chemodenervation of myoclonic middle ear and palatal muscles, reduction of masticatory nociceptive input in somatosensory tinnitus, and modulation of central sensitisation in patients with comorbid chronic migraine. These rationales are frequently conflated in clinical marketing.







