3 things to consider when exploring hearing aids in tinnitus care

While there is no clear causal relationship between the existence of hearing loss and tinnitus, hearing loss and tinnitus can co-occur.¹ In those patients, it’s important to explore the use of a hearing aid. This third article in my Tinnitus Management series discusses 3 things to take into account.

3 things to keep in mind when exploring hearing aids

1. Degree of hearing loss is not always predictive – As you consider a patient’s need for a hearing aid, remember that the degree of hearing loss is not always predictive of a self-perceived hearing handicap. Therefore, even with mild degrees of hearing loss, hearing aids can often reduce stressors related to communication.²
   
   In turn, the lower levels of stress may go a long way toward easing symptoms of tinnitus. The amplification of sound may also partially mask sounds associated with tinnitus, which can also offer relief.³
   
   
2. Sound generators might provide tinnitus relief – One of the more useful developments in traditional (prescription) hearing aids in recent years is the incorporation of sound generators within the devices. These generators are helpful in facilitating sound therapy, which is a widely accepted, evidence-based management method to provide relief to patients.
   
   If using a tinnitus masker or sound generator program with a patient, make sure to explain to the patient how they should use it and the goals of treatment. They’ll likely have questions about how and when to use a sound generator, how long the relief lasts, and whether to set the sound at a level so the tinnitus is still audible (as in tinnitus retraining therapy) or try to mask it altogether.
   
   These are questions that you and your patient should discuss together to make sure expectations and best use cases are clear. It’s also worth mentioning to patients that there are many methods of receiving sound therapy and no consistent evidence that one method is superior to another.
   
   
3. Realistic expectations should be set– Lastly, if you and your patient choose to explore hearing aids, it’s important to explain realistic expectations for how the devices may help. Because hearing loss and tinnitus aren’t mutually causal, hearing aids have not been conclusively shown to reduce tinnitus in all cases.
   
   Like so many management options, hearing aids are just one of a number of potentially useful treatment options that should be monitored closely.^4,5

Finding the right balance to address both tinnitus and hearing loss can be a challenge, but it is possible. As highlighted in this article, there are several things to take into consideration when recommending hearing amplification devices. With that being said, it is important to remember that each individual experiences their tinnitus and hearing impairment differently.

When walking through this process with a patient, it’s crucial to offer detailed feedback in order for them to comprehend the full picture and have realistic expectations moving forward.

To read Dr. Ben Thompson’s previous articles in this Tinnitus Care series, please click here.

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References

1. Henry, J. A., Roberts, L. E., Caspary, D. M., Theodoroff, S. M., & Salvi, R. J. (2014). Underlying mechanisms of tinnitus: review and clinical implications. Journal of the American Academy of Audiology, 25(01), 005-022.
2. Weinstein, B. E., & Ventry, I. M. (1983). Audiometric correlates of the hearing handicap inventory for the elderly. Journal of Speech and Hearing Disorders, 48(4), 379-384.
3. Shekhawat, G. S., Searchfield, G. D., & Stinear, C. M. (2013). Role of hearing aids in tinnitus intervention: a scoping review. Journal of the American Academy of Audiology, 24(08), 747-762.
4. Hoare, D. J., Edmondson‐Jones, M., Sereda, M., Akeroyd, M. A., & Hall, D. (2014). Amplification with hearing aids for patients with tinnitus and co‐existing hearing loss. Cochrane Database of Systematic Reviews, (1).
5. 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).

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