Tinnitus Management

Question 1

Tinnitus

Answer 1

• The perception of sound in the head without an external cause; phantom sensation
• gradual or sudden
• subjective

Question 2

Chronic tinnitus

Answer 2

Should last at least 5 minutes & occur at least twice a week

Question 3

Tinnitus in military

Answer 3

• Number 1 service-connected disability
• more than 2 million veterans

Question 4

Heterogeneity of experiences & impact

Answer 4

• wide range of explanations on the ‘sound’
• can be hardly noticeable to debilitating

Question 5

Effects of tinnitus

Answer 5

• can increase change of depression
• can reduce concentration, sleep disruptions, impact speech perception

Question 6

Types of tinnitus

Answer 6

• Non-bothersome = 80%
• bothersome = clinically significant

Question 7

Clinically significant tinnitus

Answer 7

Does the tinnitus disrupt at least 1 important life activity and/or cause emotional reactions resulting in a noticeable reduction in quality of life?

Question 8

Etiology of tinnitus

Answer 8

• noise related
• head & neck trauma
• head & neck illness
• other medical conditions

Question 9

Intake interviews

Answer 9

• constancy
• location
• pitch
• composition
• fluctuations
• loudness
• annoyance
• effects on concentration & sleep
• depression
• conditions make it worse = caffeine, salt, smoking, alcohol, stress

Question 10

Tinnitus questionnaires

Answer 10

• use to gather info
• can use as baseline & measure change after treatment
• patient perception

Question 11

Tinnitus handicap questionnaire (THQ)

Answer 11

• Measures physical, emotional, social consequences
• heading ability of patient
• patient view of tinnitus

Question 12

VA recommends …

Answer 12

• progressive tinnitus management
• 5 levels

Question 13

Sound therapy

Answer 13

• Maskers: give them some other noise to drown out tinnitus
• hearing aids
• noise makers
• Moffat & McNeil: those who achieved masking w hearing aids had improvements in tinnitus reaction questionnaire

Question 14

Counseling

Answer 14

• info about what tinnitus is & is not
• reflection on experiences & emotions
• talk about reactions to tinnitus
• talk about solutions

Question 15

Cognitive-behavioral therapy

Answer 15

• Goal to reduce internal attention and develop alternate ways of thinking to distract from tinnitus
• reduces depressive symptoms/tinnitus severity ratings & increases quality of life

Question 16

Tinnitus retraining therapy

Answer 16

• uses brain’s ability to habituate to stimuli

Question 17

Henry et Al., 2006

Answer 17

• masking vs retraining
• both treatments improved tinnitus ratings
• m: effects remained constant over time, most at 3 & 6 months
• r: effects improved over time, most at 12 & 18 months

Question 18

Henry et Al., 2017

Answer 18

• received progressive tinnitus management
• PMT group improved tinnitus functional index scores