Noise Induced Hearing Loss with Tinnitus: Does TRT Help?

Introduction To determine if hearing augmentation and tinnitus retraining therapy (TRT) helps in cases of Tinnitus with Noise induced hearing loss (NIHL) and does degree of hearing loss, severity or duration of tinnitus affect recovery Materials and Methods A prospective study was done on 100 patients of NIHL with tinnitus from Jan 14-Jul 15. Degree of hearing loss was assessed. Tinnitus severity was scored on Tinnitus handicap inventory (THI) scale as Slight, Mild, Moderate, severe or catastrophic and patients were subjected to TRT. Patients scored after 1 year of TRT. A relation between tinnitus severity, duration and degree of hearing loss on recovery from tinnitus was analysed. Result 62 of the 100 patients improved following TRT. Discussion In 100 patients THI scores improved from a mean of 63.12 (SD-21.12) to 38.16 (SD-18.21). Mean difference between pre and post-intervention THI scores was 24.96 (SD-17.97). Improvement was significant in severe or profound hearing loss (P<.001). Tinnitus severity was slight, mild, moderate, severe or catastrophic on THI. Following TRT, 82.35% with Catastrophic, 70.96% with severe, 52.63% with moderate, 20% with mild tinnitus improved. 1 patient with slight tinnitus did not improve. Based on duration of tinnitus three groups made; 0-6 months, 6-12 months and >12 months. All groups showed improvement. Reduction in Post-TRT THI was significant but did not show any difference among groups. Conclusion TRT helps in tinnitus with NIHL particularly if hearing loss is severe. Severe or catastrophic tinnitus patients experience greater improvement. Duration of tinnitus has no impact.

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A consideration of the effect of ear canal resonance and hearing loss upon white noise generators for tinnitus retraining therapy

The Journal of Laryngology & Otology ◽

10.1017/s0022215100138708 ◽

1997 ◽

Vol 111 (9) ◽

pp. 810-813 ◽

Cited By ~ 4

Author(s):

David M. Baguley ◽

Graham J. Beynon ◽

Frances Thornton

Keyword(s):

Hearing Loss ◽

White Noise ◽

Noise Generator ◽

Major Advance ◽

Ear Canal ◽

Tinnitus Retraining Therapy ◽

Hearing Sensitivity ◽

Actual Spectrum ◽

Retraining Therapy ◽

White Noise Generator

AbstractTinnitus retraining therapy has been heralded as a major advance in the alleviation of tinnitus perception. A cornerstone of this technique is to use white noise produced by a white noise generator (WNG) over a period of several months in order to assist the patient to habituate to their tinnitus. There are three factors which influence the frequency spectrum of the perceived noise such that the perception of white noise from a WNG is unlikely. These factors are the actual spectrum of the emitted noise, the ear canal resonance of the patient and the hearing sensitivity of the patient.Advocates of tinnitus retraining therapy state that white noise is the optimal stimulation to assist habituation of tinnitus. This paper demonstrates that this optimal situation is unlikely to be achieved and that this may account for the long periods needed for patients to achieve benefit from the technique. The development of devices that allow for the above factors to be countered is suggested.

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Evaluation of the relationship of the type of hearing loss to noise preference from a TCI (Tinnitus Control Instrument) in patients undergoing TRT (Tinnitus Retraining Therapy)

AUDIOLOGY JAPAN ◽

10.4295/audiology.51.61 ◽

2008 ◽

Vol 51 (1) ◽

pp. 61-68 ◽

Cited By ~ 1

Author(s):

Mari Ito ◽

Keiko Soma ◽

Reiko Ando ◽

Etsuko Sato

Keyword(s):

Hearing Loss ◽

Tinnitus Retraining Therapy ◽

Control Instrument ◽

Retraining Therapy ◽

Relationship Of ◽

The Relationship

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The DizzyQuest: relation between self-reported hearing loss, tinnitus and objective hearing thresholds in patients with Meniere’s disease

Journal of Neurology ◽

10.1007/s00415-021-10909-8 ◽

2021 ◽

Author(s):

E. C. Martin ◽

R. Verkaik ◽

J. J. A. Stultiens ◽

M. R. van de Berg ◽

A. M. L. Janssen ◽

...

Keyword(s):

Hearing Loss ◽

Daily Life ◽

Meniere’S Disease ◽

Ménière’S Disease ◽

Tinnitus Severity ◽

Hearing Thresholds ◽

Hearing Test ◽

Ménière's Disease ◽

The Relationship ◽

Loss Severity

Abstract Background Combining a mobile application-based vestibular diary called the DizzyQuest and an iPad-based hearing test enables evaluation of the relationship between experienced neuro-otological symptoms and hearing thresholds in daily life setting. The aim was to investigate the relationship between self-reported hearing symptoms and hearing thresholds in patients with Meniere’s disease (MD), using the DizzyQuest and the iPad-based hearing test simultaneously. Methods The DizzyQuest was administered for 3 weeks in 21 patients. Using the experience-sampling-method (ESM), it assessed hearing loss and tinnitus severity for both ears separately. Each day after the DizzyQuest, an iPad-based hearing test was used to measure hearing thresholds. A mixed model regression analysis was performed to investigate relationships between hearing thresholds and self-reported hearing loss and tinnitus severity. Results Fifteen patients were included. Overall, pure-tone averages (PTAs) were not correlated with self-reported hearing loss severity and tinnitus. Individual differences in PTA results between both ears did not significantly influence the difference in self-reported hearing loss severity between both ears. Self-reported hearing loss and tinnitus scores were significantly higher in ears that corresponded with audiometric criteria of MD (p < 0.001). Self-reported tinnitus severity significantly increased with self-reported hearing loss severity in affected (p = 0.011) and unaffected ears (p < 0.001). Conclusion Combining the DizzyQuest and iPad-based hearing test, facilitated assessment of self-reported hearing loss and tinnitus severity and their relationship with hearing thresholds, in a daily life setting. This study illustrated the importance of investigating neuro-otological symptoms at an individual level, using multiple measurements. ESM strategies like the DizzyQuest should therefore be considered in neuro-otological research.

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Outcomes of Clinical Trial: Tinnitus Masking versus Tinnitus Retraining Therapy

Journal of the American Academy of Audiology ◽

10.3766/jaaa.17.2.4 ◽

2006 ◽

Vol 17 (02) ◽

pp. 104-132 ◽

Cited By ~ 84

Author(s):

James A. Henry ◽

Martin A. Schechter ◽

Tara L. Zaugg ◽

Susan Griest ◽

Pawel J. Jastreboff ◽

...

Keyword(s):

Military Veterans ◽

Severity Index ◽

Tinnitus Retraining Therapy ◽

Tinnitus Severity ◽

Retraining Therapy ◽

Clinically Significant ◽

Intent To Treat ◽

Tinnitus Masking ◽

Controlled Clinical Study ◽

Time Aware

A controlled clinical study was conducted to evaluate prospectively the clinical efficacy of tinnitus masking (TM) and tinnitus retraining therapy (TRT) in military veterans having clinically significant tinnitus. Qualifying patients were placed into the two groups in an alternating manner (to avoid selection bias), and treatment was administered at 0, 3, 6, 12, and 18 months. Outcomes of treatment were evaluated using three self-administered tinnitus questionnaires (Tinnitus Handicap Inventory, Tinnitus Handicap Questionnaire, Tinnitus Severity Index) and the verbally administered TRT interview forms. Findings are presented from the three written questionnaires, and from two of the interview questions (percentage time aware of, and annoyed by, tinnitus). Outcomes were analyzed on an intent-to-treat basis, using a multilevel modeling approach. Of the 123 patients enrolled, 118 were included in the analysis. Both groups showed significant declines (improvements) on these measures, with the TRT decline being significantly greater than for TM. The greater declines in TRT compared to TM occurred most strongly in patients who began treatment with a "very big" tinnitus problem. When patients began treatment with a "moderate" tinnitus problem, the benefits of TRT compared to TM were more modest.

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Hearing Phenotypes of Patients with Hearing Loss Homozygous for the GJB2 c.235delc Mutation

Neural Plasticity ◽

10.1155/2020/8841522 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Chang Guo ◽

Sha-Sha Huang ◽

Yong-Yi Yuan ◽

Ying Zhou ◽

Ning Wang ◽

...

Keyword(s):

Hearing Loss ◽

Type A ◽

Pathogenic Mutation ◽

Considerable Proportion ◽

Homozygous Mutation ◽

Type B ◽

Profound Hearing Loss ◽

Severe Hearing Loss ◽

Type C ◽

Loss Severity

Hereditary hearing loss is characterized by remarkable phenotypic heterogeneity. Patients with the same pathogenic mutations may exhibit various hearing loss phenotypes. In the Chinese population, the c.235delC mutation is the most common pathogenic mutation of GJB2 and is closely related to hereditary recessive hearing loss. Here, we investigated the hearing phenotypes of patients with hearing loss associated with the homozygous c.235delC mutation, paying special attention to asymmetric interaural hearing loss. A total of 244 patients with the GJB2 c.235delC homozygous mutation encountered from 2007 to 2015 were enrolled. The severity of hearing loss was scaled with the American Speech-Language-Hearing Association (ASHA). Auditory phenotypes were analyzed, and three types of interaural asymmetry were defined based on audiograms: Type A (asymmetry of hearing loss severity), Type B (asymmetry of audiogram shape), and Type C (Type A plus Type B). Of the 488 ears (244 cases) examined, 71.93% (351) presented with profound hearing loss, 14.34% (70) with severe hearing loss, and 9.43% (46) with moderate to severe hearing loss. The most common audiogram shapes were descending (31.15%) and flat (24.18%). A total of 156 (63.93%) of the 244 patients exhibited asymmetric interaural hearing loss in terms of severity and/or audiogram shape. Type A was evident in 14 of these cases, Type B in 106, and Type C in 36. In addition, 211 of 312 ears (67.63%) in the interaural hearing asymmetry group showed profound hearing loss, and 59 (18.91%) exhibited severe hearing loss, with the most common audiogram shapes being flat (27.88%) and descending (22.12%). By contrast, in the interaural hearing symmetry group, profound hearing loss was observed in 140 ears (79.55%), and the most common audiograms were descending (46.59%) and residual (21.59%). Hearing loss associated with the GJB2 c.235delC homozygous mutation shows diverse phenotypes, and a considerable proportion of patients show bilateral hearing loss asymmetry.

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Effects of tinnitus retraining therapy (TRT) for patients with tinnitus and subjective hearing loss versus tinnitus only

Scandinavian Audiology ◽

10.1080/010503901300007542 ◽

2001 ◽

Vol 30 (1) ◽

pp. 206-208 ◽

Cited By ~ 9

Author(s):

Grażyna Bartnik ◽

Anna Fabijańska ◽

Marek Rogowski

Keyword(s):

Hearing Loss ◽

Tinnitus Retraining Therapy ◽

Retraining Therapy

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Evaluation of tinnitus retraining therapy for patients with normal audiograms versus patients with hearing loss

Auris Nasus Larynx ◽

10.1016/j.anl.2017.03.009 ◽

2018 ◽

Vol 45 (2) ◽

pp. 215-221 ◽

Cited By ~ 4

Author(s):

Kana Lee ◽

Kunihiko Makino ◽

Kohei Yamahara

Keyword(s):

Hearing Loss ◽

Tinnitus Retraining Therapy ◽

Retraining Therapy

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Characterization of Tinnitus by Tinnitus Patients

Journal of Speech and Hearing Disorders ◽

10.1044/jshd.5503.439 ◽

1990 ◽

Vol 55 (3) ◽

pp. 439-453 ◽

Cited By ~ 184

Author(s):

J. L. Stouffer ◽

Richard S. Tyler

Keyword(s):

Gender Differences ◽

Hearing Loss ◽

Daily Life ◽

Normal Hearing ◽

Population Characteristics ◽

Noise Induced Hearing Loss ◽

Tinnitus Severity ◽

Perceptual Characteristics ◽

The Impact

A questionnaire was administered to 528 tinnitus patients to obtain data on their reactions to tinnitus. Results include a discussion of: (a) population characteristics, (b) perceptual characteristics, (c) the impact of tinnitus on daily life, and (d) etiology. Significant gender differences are also discussed. Tinnitus was not an occasional phenomenon, but was present for more than 26 days per month in 74% of the patients. Other important findings about tinnitus include: (a) Hearing levels at 1000 and 4000 Hz were ≤ 25 dB HL for 18% of the tinnitus patients, which suggests that some patients had normal hearing or mild hearing losses; (b) the prevalence of tinnitus in patients with noise-induced hearing loss (NIHL) was 30% for males and only 3% for females; (c) about 25% of the patients reported tinnitus severity had increased since tinnitus onset; (d) the effects of tinnitus were more severe in patients who reported tinnitus as their primary complaint and in patients diagnosed as having Meniere's syndrome tinnitus; and (e) some patients reported that noise exacerbated their tinnitus, whereas others reported that a quiet background exacerbated their tinnitus.

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