15 Establishing a Tinnitus and Hyperacusis Clinic

Patricia C. Mancini, Shelley A. Witt, Richard S. Tyler, and Ann Perreau

Abstract

Tinnitus is a common symptom among individuals with hearing loss, but specific treatment for tinnitus is not provided in most audiology clinics. Licensed audiologists generally have the essential training necessary to provide counseling and sound therapy to treat tinnitus and hyperacusis patients. This chapter provides an overview on structuring clinical services for tinnitus and hyperacusis patients. We usually initiate treatment with group educational sessions, and individual counseling sessions are provided for those patients who are more severely bothered by their tinnitus. Follow-up and referrals might be necessary in severe cases. Tinnitus and hyperacusis management typically involves some form of counseling and sound therapy. Tinnitus Activities Treatment (TAT) is an excellent approach that combines counseling and the use of partial masking therapy. In counseling, we provide information to the patient about tinnitus and related problems, consider the patient’s overall well-being, and suggest appropriate coping strategies based on the issues that are especially important to each single patient. Sound therapy options are presented at the group session, and patients also have the opportunity to discuss and try a variety of wearable ear-level devices for tinnitus management in individual sessions. Tailoring the sessions to the patient’s level of tinnitus severity (interested, concerned, or distressed) is important. We often include partners and significant others in group and individual sessions to help them understand tinnitus, and to suggest strategies that enable partners to help the patients cope with tinnitus. Similar to TAT, Hyperacusis Activities Treatment is a picture-based counseling and sound therapy treatment that targets the areas that are largely impacted by hyperacusis. The tinnitus and hyperacusis clinic must provide an individualized treatment, estimating the need for additional staff and resources, and providing reasonable reimbursement options.

Schlüsselwörter

tinnitus - hyperacusis - outpatient care - counseling - therapy

• 1 Andersson G, Strömgren T, Ström L, Lyttkens L. Randomized controlled trial of internet-based cognitive behavior therapy for distress associated with tinnitus.. Psychosom Med 2002; 64 (5) 810-816 PubMed

• 2 Hannula S, Bloigu R, Majamaa K, Sorri M, Mäki-Torkko E. Self-reported hearing problems among older adults: prevalence and comparison to measured hearing impairment.. J Am Acad Audiol 2011; 22 (8) 550-559 PubMed

• 3 Tyler RS, Noble W, Coelho C, Haskell G, Bardia A. Tinnitus and hyperacusis. In: Katz J, Burkard R, Medwetsky L, Hood L, eds. Handbook of clinical audiology. 6th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2009:647–658

• 4 Tyler RS, Stouffer JL, Schum R. Audiological rehabilitation of the tinnitus client.. J Acad Rehabilitative Audiol 1989; 22: 30-42

• 5 Tyler RS. The use of science to find successful tinnitus treatments. In Proceedings of the Sixth International Tinnitus Seminar. London: The Tinnitus-Hyperacusis Center; 1999:3–9

• 6 Tyler RS, Haskell G, Preece J, Bergan C. Nurturing patient expectations to enhance the treatment of tinnitus.. Semin Hear 2001; 22 (1) 15-21

• 7 Perry BP, Gantz BJ. Medical and surgical evaluation and management of tinnitus. In: Tyler RS, ed. Tinnitus handbook. San Diego, CA: Singular; 2000:221–241

• 8 Tyler RS, Noble W, Coelho C, Rocancio ER, Jun HJ. Tinnitus and hyperacusis. In: Katz J, ed. Handbook of clinical audiology. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2015:647–658

• 9 Newman CW, Sandridge SA. Incorporating group and individual sessions into a tinnitus management clinic. In: Tyler RS, ed. Tinnitus treatment: clinical protocols. New York, NY: Thieme; 2006:187–197

• 10 Tyler RS, Gehringer AK, Noble W, Dunn CC, Witt SA, Bardia A. Tinnitus activities treatment. Chapter 9. In: Tyler RS, ed. Tinnitus treatment: clinical protocols. New York: Thieme; 2006:116–132

• 11 Sweetow R. Cognitive behavior therapy for tinnitus. In: Tyler RS, ed. Tinnitus handbook. San Diego, CA: Singular; 2000:297–312

• 12 Tyler R, Ji H, Perreau A, Witt S, Noble W, Coelho C. Development and validation of the tinnitus primary function questionnaire.. Am J Audiol 2014; 23 (3) 260-272 PubMed

• 13 Mancini PC, Tyler RS, Perreau A, Batterton LF, Ji H. Considerations for partners of our tinnitus patients.. Int Tinnitus J 2018; 22 (2) 113-122

• 14 Tyler RS, Baker LJ. Difficulties experienced by tinnitus sufferers.. J Speech Hear Disord 1983; 48 (2) 150-154 PubMed

• 15 Perreau AE, Tyler RS, Mancini PC, Witt S, Elgandy MS. Establishing a group educational session for hyperacusis patients.. Am J Audiol 2019; 28 (2) 245-250 PubMed

• 16 Mancini PC, Tyler RS, Smith S, Ji H, Perreau A, Mohr AM. Tinnitus: how partners can help?. Am J Audiol 2019; 28 (1) 85-94 PubMed

• 17 Kochkin S, Tyler RS. Tinnitus treatment and the effectiveness of hearing aids: hearing care professional perceptions.. Hearing Rev 2008; 15 (13) 14-18

• 18 Kochkin S, Tyler R, Born J. MarkeTrak VIII: prevalence of tinnitus and efficacy of treatments.. Hearing Rev 2011; 18 (12) 10-26

• 19 Tyler RS. Neurophysiological models, psychological models, and treatments for tinnitus. In: Tyler RS, ed. Tinnitus treatment: clinical protocols. New York: Thieme; 2006b:1–22

• 20 Tyler RS, Gogel SA, Gehringer AK. Tinnitus activities treatment.. Prog Brain Res 2007; 166: 425-434 PubMed

• 21 Surr RK, Montgomery AA, Mueller HG. Effect of amplification on tinnitus among new hearing aid users.. Ear Hear 1985; 6 (2) 71-75 PubMed

• 22 Sizer DI, Coles RRA. Tinnitus self-treatment. In: Tyler RS, ed. Tinnitus treatment: Clinical protocols. New York, NY: Thieme; 2006:23–28

• 23 Tyler RS, ed. The consumer handbook on tinnitus. 2nd ed. Sedona, AZ: Auricle Ink Publishers; 2016

• 24 Tyler RS, Erlandsson S. Management of the tinnitus patient. In: Luxon LM, Furman JM, Martini A, Stephens D, eds. Textbook of audiological medicine. London, England: Taylor & Francis Group; 2003:571–578

• 25 Tyler RS, Haskell GB, Gogel SA, Gehringer AK. Establishing a tinnitus clinic in your practice.. Am J Audiol 2008; 17 (1) 25-37 PubMed