To show how tinnitus is a substantial health burden
To reveal the role of hearing loss in tinnitus
To present the options for management, including the central role of hearing aids
Perception of sound but no external source
Perception of sound but no external source
Usually experienced as buzzing, hissing or ringing
Not fully-formed sounds e.g. speech or music
Not sound hallucinations experienced during bouts of mental illness
Occurs in one or both ears, or arising within the head
It can have a profound effect on the sufferer
“… perceived severity of tinnitus correlates closer to psychological and general health factors, such as pain or insomnia, than to audiometrical parameters …” (Zoger et al, 2006)
Tinnitus is highly variable. Some patients are able to cope with the noise and their lives continue as normal.
Tinnitus is highly variable. Some patients are able to cope with the noise and their lives continue as normal.
A range of peripheral events can lead to central neuronal changes that manifest as tinnitus
A range of peripheral events can lead to central neuronal changes that manifest as tinnitus
Other factors can be involved in either the development or the persistence of tinnitus
Patients with tinnitus exhibit enhanced auditory sensitivity
Patients with tinnitus exhibit enhanced auditory sensitivity
This is caused by hyperactivity of the auditory central nervous system
Homeostatic pathways cause increased central ‘gain’ (i.e. sensitivity) in response to auditory deprivation to:
Maintain central nervous system activity during low sensory input
Ensure nerve activity is modulated to respond to changes in sensory input
In patients with tinnitus and hearing loss, the tinnitus pitch and the hearing loss frequency spectrum are usually matched
The decreased input from the cochlea, due to outer hair cell damage, results in readjustments in the central auditory system resulting in abnormal neural activity including hyperactivity, bursting discharges and increases in neural synchrony.
The decreased input from the cochlea, due to outer hair cell damage, results in readjustments in the central auditory system resulting in abnormal neural activity including hyperactivity, bursting discharges and increases in neural synchrony.
Most patients with tinnitus have some degree of hearing loss
Most patients with tinnitus have some degree of hearing loss
Experiencing sound in the absence of an external stimulus can be emotionally upsetting
Experiencing sound in the absence of an external stimulus can be emotionally upsetting
This reaction can make the sounds appear worse
This results in a vicious cycle of worsening tinnitus and increasing distress
Tinnitus is associated with increased levels of psychological problems
Tinnitus is associated with increased levels of psychological problems
24/90 (26.7%) versus 5/90 (5.6%) for age-matched controls without tinnitus
Currently, there is no cure for tinnitus, but management is possible
Currently, there is no cure for tinnitus, but management is possible
Reports of the use of hearing aids in the management of tinnitus go back over 60 years
Reports of the use of hearing aids in the management of tinnitus go back over 60 years
Because hearing loss is often associated with tinnitus, at least partial restoration of hearing should help to reduce the central gain in auditory perception that is a feature of tinnitus
A recent scoping review of studies of hearing aids in tinnitus revealed that 17/18 publications showed improvements in tinnitus symptoms by fitting hearing aids
A scoping review identified 11 interventional studies of hearing aids
A scoping review identified 11 interventional studies of hearing aids
Six types of tinnitus evaluation were used:
THI x 4; THQ x 1; TRQ x 1; TSI x 1; TQ x 1; VAS x 3
Up to 50% reduction in tinnitus severity
10/11 studies showed improvements >10%
Retrospective study of 70 patients with tinnitus in Australia
Retrospective study of 70 patients with tinnitus in Australia
Tinnitus severity measured using the tinnitus reaction questionnaire (TRQ)
Overall, 51% of patients experienced “clinically significant” change (≥40% change in TRQ score)
No approved drugs (European Medicines Agency [EMA] or US Food and Drug Administration [FDA])
No approved drugs (European Medicines Agency [EMA] or US Food and Drug Administration [FDA])
Some psychopharmacological agents may help reduce the severity of psychological issues associated with tinnitus, and some may also lessen tinnitus symptoms
Tinnitus management should include hearing aids with appropriate frequency ranges together with psychological support and education
Tinnitus management should include hearing aids with appropriate frequency ranges together with psychological support and education
This requires a multidisciplinary care team
GP, ENT specialist, psychologist/psychiatrist and hearing-care professional
As a leading supplier of hearing aids, Phonak can be another member of your team, helping your patient to have the optimal hearing aid for their situation
