Complex tinnitus intervention in patients with severe to profound hearing loss

In cases of severe to profound hearing loss and tinnitus, it is crucial for Ear Nose and Throat (ENT) doctors to first rule out treatable issues….

In cases of severe to profound hearing loss and tinnitus, it is crucial for Ear Nose and Throat (ENT) doctors to first rule out treatable issues such as excessive cerumen in the ear canal, or other underlying medical conditions, before initiating any tinnitus intervention.² The current best practice is tinnitus management based on the individual needs, providing a thorough individual tinnitus history, education and sound therapy; as well as advanced counselling such as Cognitive Behavioral Therapy (CBT), which has been clinically proven to be effective and is considered the gold standard in tinnitus therapy.¹³ Given that individuals with severe to profound hearing loss often experience higher levels of social isolation, anxiety and depression compared to better hearing peers,⁴⁵ these special counselling techniques, which focus on tinnitus-related anxiety or depression, are highly recommended to be included early in the rehabilitation process.² Depending on the type of counselling, the focus may involve understanding tinnitus, learning to relax, and/or acquiring tinnitus confrontation techniques.  

References: 

1 Cima, R.F.F., Mazurek, B., Haider, H., Kikidis, D., Lapira, A., Noreña, A., & Hoare, D.J. (2019). A multidisciplinary European guideline for tinnitus: diagnostics, assessment, and treatment. HNO, 67(1), 10–42. https://doi.org/10.1007/s00106-019-0633-7 

2 Turton, L., Souza, P., Thibodeau, L., Hickson, L., Gifford, R., Bird, J., Stropahl, M., Gailey, L., Fulton, B., Scarinci, N., Ekberg, K., & Timmer, B. (2020). Guidelines for best practice in the audiological management of adults with severe and profound hearing loss. Seminars in Hearing, 41(03), 141–246. https://doi.org/10.1055/s-0040-1714744 

3 Sereda, M., Xia J., El Refaie, A., Hall, D., A., & Hoare, D. J. (2018). Sound therapy (using amplification devices and/or sound generators) for tinnitus. Cochrane Database of Systematic Reviews, (12).https://doi.org/10.1002/14651858.CD013094.pub2 

4 Hallam, R., Ashton, P., Sherbourne, K., Gailey, L. (2006) Acquired profound hearing loss: Mental health and other characteristics of a large sample. International Journal of Audiology, 45(12), 715–723. https://doi.org/10.1080/14992020600957335 

5 Grimby, A., & Ringdah, A. (2000) Does having a job improve the quality of life among post-lingually deafened Swedish adults with severe-profound hearing impairment? British Journal of Audiology, 34(3), 187–195. https://doi.org/10.3109/03005364000000128 

6 Tunkel, D. E., Bauer, C. A., Sun, G. H., Rosenfeld, R. M., Chandrasekhar, S. S., Cunningham Jr, E. R., Archer, S. M., Blakley, B. W., Carter, J. M., Granieri, E. C., Henry, J. A., Hollingsworth, D., Khan, F. A., Mitchell, S., Monfared, A., Newman, C. W., Omole, F. S., Philips, C. D., Robinson, S. K., . . . Whamond, E. J. (2014). Clinical practice guideline: Tinnitus. Otolaryngology–Head and Neck Surgery, 151(2_suppl), S1–S40. https://doi.org/10.1177/0194599814545325