Hearing aid amplification and tinnitus: 2011 overview

Abstract

Some 50 million people in the United States have tinnitus. 1 Although no one knows the exact numbers, Henry, Dennis, and Schechter 2 suggest perhaps ten to twenty percent of tinnitus patients manifest a “clinically significant condition,” and the average tinnitus patient waits more than six years between tinnitus onset and seeking relief. 3 Tinnitus is associated with virtually every otologic disorder and the majority of tinnitus patients have sensorineural hearing loss. 4,5 A differential diagnosis regarding the etiology of tinnitus for each patient, derived via a multi-disciplinary team prior to treatment, is clearly the recommended pathway. Indeed, tinnitus originating from ear disorders such as acoustic neuroma, eustachian tube dysfunction, pulsatile tinnitus, and other objective tinnitus etiologies are generally managed through medical and/ or surgical treatment. However, the vast majority (perhaps 95% or more) of all tinnitus patients have subjective tinnitus. 6 Subjective tinnitus typically accompanies sensorineural hearing loss, secondary to presbycusis, noiseinduced hearing loss, and acoustic trauma, etc. Subjective tinnitus is generally defined as the perception of sound in the absence of an external sound source. There are many options for management of subjective tinnitus. The condition is generally managed by hearing aid amplification, biofeedback, hypnosis, counseling, cognitive behavioral therapy, habituation, electrical stimulation, tinnitus maskers, combined tinnitus masker and hearing aids, sound machines, selfhelp and support groups, educational groups, stress management, pharmacology, and more. The specific management protocol is chosen by the hearing healthcare professional working in concert with the patient, taking into consideration their needs, abilities, and desires.