Hearing Aids as a Treatment for Tinnitus Patients with Slight to Mild Sensorineural Hearing Loss

A Review of Auditory Rehabilitation Uses in Hearing Aid-Based Therapy for Tinnitus (2013-2024)

The weight of evidence supports hearing aids playing an important role in tinnitus management. Less information is available about the role of auditory rehabilitation (AR) in the hearing aid therapy process. The research question was "what role has amplification and AR played in the management of tinnitus." To identify relevant studies, database searches of Scopus (keywords), Embase (keywords), and PubMed (title and abstract) were carried out in April/May 2024 using the following search terms [tinnitus] and [amplification] or [hearing aids]. Articles were excluded if not written in English or unavailable in full text. Reviews and protocols were excluded. Once duplicates were removed, 495 articles were screened with 58 articles being included in the review. After cataloguing, articles were divided into those that described use of AR in their methods and those that did not. AR was subcategorized into four categories and described as (1) instruction, (2) counseling, (3) sensory management, (4) perceptual training. Articles published in the last 12 years support the use of hearing aids. The use of AR in addition to amplification was common but its content, application, and contribution to outcomes were ambiguous. Augmentation of amplification benefits for tinnitus through AR presents an opportunity for future research. In future research, each AR component needs to be described in greater detail and the relative merits of different types of AR and their role in personalized therapy needs to be ascertained.

Efficacy of Amplification for Tinnitus Relief in People With Mild Hearing Loss

PURPOSE

The study aimed to evaluate the efficacy of amplification with hearing aids for people with chronic subjective tinnitus and mild hearing loss.

METHOD

In this randomized, controlled, three-arm trial, 38 subjects with a primary complaint of tinnitus were randomly assigned to one of the three treatment groups. Twelve subjects received informational counselling (IC) only, 13 received IC with hearing aid fitting, and 13 subjects received IC with individualized music stimulation for 12 months. The primary efficacy analysis in tinnitus severity was based on the change from baseline to 12 months after the 1st day of the intervention. Secondary outcome measures included tinnitus impact, psychological and mental health effects, subjective ratings, and psychoacoustically measured tinnitus loudness.

RESULTS

A statistically significant treatment difference among the three groups in the Chinese Tinnitus Functional Index (TFI-CH) total score at the predefined end point in Month 12 was observed (F = 3.34, p = .04, partial η2 = .16). Reductions in the TFI-CH scores in both the hearing aid and the customized music group were more prominent than in the IC-only group. Only the hearing aid group showed a significantly greater treatment effect than the IC-only group.

CONCLUSION

Results from this study support that a combination of hearing aid use and IC can help improve tinnitus in people with mild hearing loss.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25015979.

Clinical practice guideline: Chronic tinnitus—diagnosis and treatment

BACKGROUND

Chronic tinnitus is a commonly occurring symptom of the auditory system. Epidemiological studies assume a lifetime prevalence in men and women of 3.5% for chronic tinnitus requiring treatment. Almost 25% of all Germans have experienced at least one episode of tinnitus. No causal therapy is yet available, but numerous treatment strategies are being pursued. Rigorous scientific assessment of these procedures is essential.

METHODS

For this exhaustive revision of the German clinical practice guideline, the literature in the medical databases PubMed and Cochrane Library, including existing guidelines from various countries, was systematically searched using keywords on the topic of chronic tinnitus. On the basis of the revised guideline, a separate guideline was written in language accessible to patients.

RESULTS

Chronic tinnitus is often associated with hearing loss, but the mental distress caused by the ear noise is another crucial element. Apart from expert counseling, the recommended treatment comprises psychotherapeutic interventions, particularly cognitive behavioral therapy (with effect sizes of 0.54 to 0.91 for reduction of the tinnitus-related distress), and measures to improve the hearing. There is insufficient evidence regarding the effects of drug treatment, sound and music therapy, and neuromodulation (magnetic stimulation or electrostimulation).

CONCLUSION

Alongside thorough and sound diagnosis and counseling, the principal treatment options for chronic tinnitus are specific cognitive behavioral therapy and expert psychotherapeutic interventions on an individual or group basis. Future-preferably interdisciplinary-research should evaluate the long-term effects of the treatment options, with particular attention to psychosomatic comorbidity.

Development and Preliminary Evaluation of the Tinnitus Severity Short Form

Purpose Tinnitus, or the perception of sounds that occur without an external sound source, is a prevalent condition worldwide. For a subset of adults, tinnitus causes significant distress and impairment. Several patient-reported outcome measures have been developed to assess severity of tinnitus distress. However, at present, the field lacks a brief measure that is sensitive to treatment change. The purpose of the current study was to develop and preliminarily validate a brief questionnaire for tinnitus severity from two existing measures of tinnitus-related distress, the Tinnitus Handicap Inventory (THI) and Tinnitus Functional Index (TFI). Method Using data from nine study samples in the United States and United Kingdom, we conducted exploratory and confirmatory factor analyses to identify a short measure with good psychometric properties. We also assessed sensitivity to treatment-related change by examining associations with change in the TFI and THI. Finally, we conducted a confirmatory factor analysis of the final short questionnaire in a new sample of adults seeking treatment for tinnitus-related distress. Results We identified 10 items from the THI and TFI that exhibited limited loadings on secondary factors. The resulting Tinnitus Severity Short Form achieved good to excellent fit, including in a unique sample of individuals seeking online treatment for tinnitus, and appeared sensitive to treatment-related change. Conclusions The Tinnitus Severity Short Form developed in the current study may be a useful tool for the assessment of subjective severity and distress associated with tinnitus, especially when patient burden is a concern. Further research is necessary to fully validate the questionnaire for the assessment of treatment-related change.

A Pilot Randomized Controlled Trial of Transcutaneous Electrical Nerve Stimulation for Patients With Acute Tinnitus

BACKGROUND

This pilot study aimed to evaluate the feasibility effectiveness and safety of transcutaneous electrical nerve stimulation (TENS) for patients with acute tinnitus.

METHODS

A total of 46 eligible patients with acute tinnitus were entered and included in this randomized controlled trial. All the included patients were equally and randomly divided into a verum TENS group and a sham TENS group, each group 23 participants. All patients received parenteral intramuscular therapy of 1 ml Vitamin B12 weekly for a total of 4 weeks. In addition, they also underwent verum or sham TENS 30 min daily, 3 times weekly for 4 weeks. The primary efficacy endpoint was measured by the Tinnitus Severity Scale (TSS) and Tinnitus Questionnaire (TQ) sum score. The secondary efficacy endpoints were assessed by the Tinnitus Handicap Inventory (THI), 12-Item Short Form Health Survey (SF-12) questionnaire, and adverse events. All outcome efficacy endpoints were measured at baseline and after 4 weeks of treatment.

RESULTS

After 4-week treatment, the patients undergoing verum TENS showed statistically efficacy of symptoms relief, as measured by the scales of TSS (P < .01), TQ (P < .01), and THI (P < .01), and improvement of quality of life, as assessed by the SF-12 (P < .01), compared with patients receiving sham TENS. In addition, no adverse events related to the treatment were recorded in either group.

CONCLUSIONS

The results of this study showed that verum TENS may benefit patients with acute tinnitus after 4 weeks of treatment.