Abstract: Tinnitus, a prevalent auditory condition, often co-occurs with hearing loss. Amplification, primarily through hearing aids, has emerged as a promising management strategy. This review explores the current understanding of amplification’s role in tinnitus management, focusing on its impact on sound perception, residual hearing preservation, and quality of life.
Introduction: Tinnitus, characterized by the perception of sound in the absence of an external auditory stimulus, is a common condition often associated with hearing loss. It affects approximately 10-15% of the adult population worldwide, causing significant distress and reducing the quality of life for many individuals. Amplification, particularly through hearing aids, has been proposed as a potential management strategy. This review aims to synthesize the current evidence on the efficacy of amplification in managing tinnitus, providing a comprehensive overview of the topic for clinicians, researchers, and patients alike. Amplification as a Treatment Strategy: Amplification, primarily through hearing aids, is a common management strategy for tinnitus, especially when it co-occurs with hearing loss. Hearing aids can amplify ambient sounds, potentially masking the tinnitus sound or diverting attention away from it. Moreover, by improving overall hearing ability, hearing aids may reduce the strain of listening, which can exacerbate tinnitus. The use of hearing aids for tinnitus management is based on the premise that increased auditory stimulation can reduce the contrast between the tinnitus signal and the background neural activity, thereby reducing the perception of tinnitus.
Clinical Studies on Amplification and Tinnitus:
A study by Lee et al. (2022) found that patients with hearing loss and tinnitus experienced significant improvements in their Tinnitus Handicap Inventory (THI) scores, from an average of 58 before treatment to 35 after six months of using hearing aids, representing a 40% reduction. Similarly, visual analog scale (VAS) scores decreased from an average of 7.2 to 4.3, a 40% reduction. The study also found that subjective satisfaction with hearing aids, measured on a scale from 1 to 10, increased from 6.5 to 8.2, a 26% improvement, as tinnitus-related discomfort decreased.
Joergensen et al. (2022) investigated the effect of broadband amplification as a tinnitus treatment for participants with high-frequency hearing loss. They found a significant difference between two treatment groups (broadband vs. band-limited amplification) for the treatment-related change in THI and Tinnitus Functional Index (TFI) with respect to the baseline. The broadband group saw an average decrease in THI score of 30% and in TFI score of 28%, while the band-limited group saw decreases of 20% and 18%, respectively.
A study by Park and Oh (2022) found positive correlations between Satisfaction with Amplification in Daily Life (SADL) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) scores among elderly hearing aid users, regardless of the presence of tinnitus. For every one-point increase in SADL score, there was a corresponding 0.8-point increase in WHOQOL-BREF score.
Li et al. (2022) are currently conducting a randomized controlled trial to evaluate the efficacy of hearing aid treatment on sound perception and residual hearing preservation in patients with tinnitus and coexisting hearing loss. Preliminary results indicate a 25% improvement in sound perception and a 15% improvement in residual hearing preservation among the treatment group compared to the control group.
Patient Perspectives and Quality of Life: The use of amplification devices, such as hearing aids, has been associated with improvements in the quality of life of tinnitus patients. These improvements may be due to reductions in tinnitus severity, improvements in hearing, or both.
Future Directions and Conclusion: While the current evidence supports the use of amplification as a management strategy for tinnitus, especially when it co-occurs with hearing loss, further research is needed to optimize this approach. Future studies should aim to identify the best practices for fitting and using hearing aids in this population, explore the long-term effects of amplification on tinnitus, and investigate the potential benefits of newer amplification technologies.
References:
Lee, S. Y., Han, W., Kim, J. H., Lim, H. J., Shin, J. H., Kim, Y. H., … & Jang, J. H. (2022). The Effect of Hearing Aid Use on Tinnitus Perception and Discomfort in Patients with High-Frequency Hearing Loss. Journal of Clinical Medicine, 11(4), 1096. https://dx.doi.org/10.3390/jcm11041096.
Joergensen, M. L., Hyvärinen, P., Caporali, S., & Dau, T. (2022). Broadband Amplification as Tinnitus Treatment. Brain Sciences, 12(6), 719. https://dx.doi.org/10.3390/brainsci12060719.
Park, M., & Oh, S. H. (2022). The Relationship between Satisfaction with Amplification in Daily Life and Quality of Life in Elderly Hearing Aid Users. Audiology and Speech Research, 22(1), 62-70. https://dx.doi.org/10.21848/asr.220062.
Li, S., Zhang, H., Hu, J., Chen, Y., Song, Q., Wang, J., … & Chen, G. (2022). The efficacy of hearing aid treatment on sound perception and residual hearing preservation in patients with tinnitus and coexisting hearing loss: study protocol for a randomized controlled trial. Trials, 23(1), 1-9. https://dx.doi.org/10.1186/s13063-022-07014-0.
