TMR Non-Drug Therapy 1 Submit a manuscript: https://www.tmrjournals.com/ndt doi: 10.12032/TMRND20210529032 Integrating cupping therapy in the management of tinnitus and dizziness: a pilot study Zainab Almusleh 1* , Maha Al Sulaiteen 2 , Khalid A.Hadi 1 , Entissar Hassan 3 , Amna Ali 3 , Jaleel Charalil 3 1 Senior Consultant, Hearing & Balance Disorders, Hamad Medical Corporation, Doha, Qatar. 2 Specialist Hearing & Balance Disorders, Hamad Medical Corporation, Doha, Qatar. 3 Hearing & Balance technician, Hamad Medical Corporation, Doha, Qatar. *Corresponding to: Zainab Almusleh. Senior Consultant, Hearing & Balance Disorders, Hamad Medical Corporation, Doha, Qatar, PO. Box 3050. E-mail: Almusleh70@hotmail.com. Abstract Background: Cupping therapy is one of integrative medicine modalities which is used by several nations. Its mechanism of action is not well known but there are several theories explained how it can play a rule in the treatment of diseases. In recent years, huge advances have taken place in understanding of inner ear pathophysiology causing sensorineural hearing loss, tinnitus, and vertigo. Research articles providing evidence of acupuncture treating dizziness and vertigo but no studies of cupping therapy. The aim of this pilot study was to evaluate the safety and efficacy of integrating wet cupping therapy in the management of tinnitus and dizziness associated with ear pathologies. Methods: This is a prospective interventional pilot study in which pre and post intervention outcomes (tinnitus handicap inventory and dizziness handicap inventory) were assessed and compared. 27 patients diagnosed with Ménière's disease and idiopathic tinnitus or tinnitus secondary to inner ear pathology were included in this study and received usual medical treatment and wet cupping therapy. Results: There was a significant improvement after 6 sessions of cupping in tinnitus handicap inventory and dizziness handicap inventory but not in patient’s hearing. No adverse events were reported in this study. Conclusion: Wet cupping therapy demonstrates a promising effectiveness in reducing discomforts of both dizziness and tinnitus. A large scale randomized controlled trial is recommended. Keywords: Cupping therapy, Inner ear disease, Tinnitus, Meniere’s disease, Dizziness Competing interests: The authors declare no conflicts of interest. Acknowledgments: The Medical Research Center t Hamad Medical Corporation approved this study (Protocol: #13322/13). Authors contributions: All authors shared the design of the trial. Almusleh Z and Sulaiteen MA searched the literature. Almusleh Z, Sulaiteen MA and Hadi KA wrote the first draft. All authors reviewed the draft and approved the final version of the manuscript. Abbreviations: MD, Meniere’s disease; WCT, wet cupping therapy; HL, hearing level; THI, Tinnitus Handicap Inventory; DHI, Dizziness Handicap Inventory; LDL, low density lipoprotein. Citation: Almusleh Z, Sulaiteen MA, Hadi KA, Hassan E, Ali A, Charalil J. Integrating cupping therapy in the management of tinnitus and dizziness: a pilot study. TMR Non-Drug Ther. 2021;4(2):11. doi: 10.12032/TMRND20210529032. Executive editor: Shan-Shan Lin. Submitted: 07 February 2021, Accepted: 29 May 2021, Online: 06 June 2021. © 2021 By Authors. Published by TMR Publishing Group Limited. This is an open access article under the CC-BY license (http://creativecommons.org/licenses/BY/4.0/).