Objective: Although tinnitus is one of the most commonly reported symptoms in the general population, patients with bothersome tinnitus are challenged by issues related to accessibility of care and intervention options that lack strong evidence to support their use. Therefore, creative ways of delivering evidence-based interventions are necessary. Internet-based cognitive behavioral therapy (ICBT) demonstrates potential as a means of delivering this support but is not currently available in the United States. This article discusses the adaptation of an ICBT intervention, originally used in Sweden, Germany, and the United Kingdom, for delivery in the United States. The aim of this study was to (a) modify the web platform's features to suit a U.S. population, (b) adapt its functionality to comply with regulatory aspects, and (c) evaluate the credibility and acceptability of the ICBT intervention from the perspective of health care professionals and patients with bothersome tinnitus. Materials/Method:Initially, the iTerapi ePlatform developed in Sweden was adopted for use in the United States. Functional adaptations followed to ensure that the platform's functional and security features complied with both institutional and governmental regulations and that it was suitable for a U.S. population. Following these adaptations, credibility and acceptance of the materials were evaluated by both health care professionals (n = 11) and patients with bothersome tinnitus (n = 8). Results:Software safety and compliance regulatory assessments were met. Health care professionals and patients reported favorable acceptance and satisfaction ratings regarding the content, suitability, presentation, usability, and exercises provided in the ICBT platform. Modifications to the features and functionality of the platform were made according to user feedback. Conclusions:Ensuring that the ePlatform employed the appropriate features and functionalities for the intended population was essential to developing the Internet-based interventions. The favorable user evaluations indicated that the intervention materials were appropriate for the tinnitus population in the United States.

Purpose: An Internet-based tinnitus intervention for use in the United States could improve the provision of tinnitus-related services. Although clinical trials of such interventions were completed in Europe, the United Kingdom, and Australia, their suitability for adults with tinnitus in the United States is yet to be established. The aim of this study was to improve the cultural and linguistic suitability, and lower the readability level, of an existing program for tinnitus to ensure its suitability for U.S. English- and Spanish-speaking populations. Method: Guidelines for adaptation were followed and involved four phases: (a) cultural adaptations, as interventions targeted at specific cultures have been shown to improve outcomes; (b) creating Spanish materials to improve access of the materials to the large Spanish-speaking population in the United States; (c) professional review of the materials for acceptability as an intervention tool for a U.S. population; and (d) literacy-level adjustments to make the content accessible to those with lower levels of health literacy skills. Results: Cultural adaptations were made by using word substitutions, changing examples, and modifying the spelling of certain words. The materials were then translated into Spanish and cross-checked. Professional review ensured suitability of the chapters. Literacy-level adjustments ensured all chapters were within the guidelines for readability grade levels below the sixth-grade level. Conclusions: The previously developed tinnitus materials were revised to adhere to best practice guidelines and ensure cultural suitability for adults with tinnitus in the United States. As it is also available in Spanish, members of the large Hispanic community also have access to the intervention in their first language. Further studies should determine whether these changes improve patients' self-efficacy, engagement, and motivation to complete the intervention.

PURPOSE: This study examined medication use by individuals with tinnitus who were seeking help for their tinnitus by means of a psychological intervention. METHOD: This study used a cross-sectional survey design and included individuals with tinnitus enrolled in an Internet-based cognitive behavioral therapy trial ( = 439). Study participants provided demographic details, completed various structured questionnaires and provided details about the medications used. The self-reported medications were classified using the United States Pharmacopeial Medicare Model Guidelines v7.0. RESULTS: Current medication use was reported by 67% ( = 293) of the study participants. Those currently using medication were older; had consulted their primary care physician, had greater tinnitus severity, depression, anxiety, and insomnia when compared with those not reporting any current medication use. The top 10 medication used included cardiovascular agents ( = 162; 55.3%), antidepressants ( = 80; 27.3%), electrolytes/minerals/metals/vitamins ( = 70; 23.9%), respiratory tract/pulmonary agents ( = 62; 21.2%), anxiolytics ( = 59; 20.1%), hormonal agents/stimulant/replacement/modifying (thyroid; = 45; 15.4%), gastrointestinal agents ( = 43; 14.7%), analgesics ( = 33; 11.3%), blood glucose regulators ( = 32; 10.9%), and anticonvulsants ( = 26; 8.87%). Some associations between type of medication used and demographic or tinnitus-related variables were noted especially for the cardiovascular agents, electrolytes/minerals/metals/vitamins, and anxiolytics. CONCLUSIONS: This exploratory study indicated a large percentage of patients using medication and a range of medications. Further studies are required to assess the effects of such medications on the tinnitus percept and concurrent medication moderate treatment effects.

BACKGROUND: Tinnitus is a symptom that can be very distressing owing to hearing sounds not related to any external sound source. Managing tinnitus is notoriously difficult, and access to evidence-based care is limited. Cognitive behavioral therapy (CBT) is a tinnitus management strategy with the most evidence of effectiveness but is rarely offered to those distressed by tinnitus. The provision of internet-based CBT for tinnitus overcomes accessibility barriers; however, it is not currently readily available in the United States. OBJECTIVE: The aim of this study is to investigate the efficacy of internet-based CBT compared with that of weekly monitoring for the management of tinnitus in reducing tinnitus distress; reducing tinnitus-related comorbidities, including tinnitus cognitions, insomnia, anxiety, and depression; and assessing the stability of the intervention effects 2 months after the intervention. METHODS: A 2-arm randomized clinical trial comparing audiologist-guided internet-based CBT (n=79) to a weekly monitoring group (n=79) with a 2-month follow-up assessed the efficacy of internet-based CBT. Eligible participants included adults seeking help for tinnitus. Recruitment was conducted on the web using an open-access website. Participants were randomized via 1:1 allocation, but blinding was not possible. The study was undertaken by English or Spanish speakers on the web. The primary outcome was a change in tinnitus distress as measured using the Tinnitus Functional Index. Secondary outcome measures included anxiety, depression, insomnia, tinnitus cognition, hearing-related difficulties, and quality of life. RESULTS: Internet-based CBT led to a greater reduction in tinnitus distress (mean 36.57, SD 22) compared with that in weekly monitoring (mean 46.31, SD 20.63; effect size: Cohen d=0.46, 95% CI 0.14-0.77) using an intention-to-treat analysis. For the secondary outcomes, there was a greater reduction in negative tinnitus cognition and insomnia. The results remained stable over the 2-month follow-up period. No important adverse events were observed. Further, 16% (10/158) of participants withdrew, with low overall compliance rates for questionnaire completion of 72.3% (107/148) at T1, 61% (91/148) at T2, and 42% (62/148) at T3. CONCLUSIONS: This study is the first to evaluate and indicate the efficacy of audiologist-delivered internet-based CBT in reducing tinnitus distress in a US population. It was also the first study to offer internet-based CBT in Spanish to accommodate the large Hispanic population in the United States. The results have been encouraging, and further work is indicated in view of making such an intervention applicable to a wider population. Further work is required to improve compliance and attract more Spanish speakers. TRIAL REGISTRATION: ClinicalTrials.gov NCT04004260; https://clinicaltrials.gov/ct2/show/NCT04004260.

No description available.

Les acouphènes touchent une grande proportion de Canadiens. Cette condition est associée à de nombreuses comorbidités et affecte de manière significative la qualité de vie des patients qui en souffrent. Malheureusement, les mécanismes de génération et de persistance des acouphènes sont méconnus et il demeure de nombreux questionnements dans la communauté scientifique. Notamment, aucun traitement curatif n’est disponible pour l’instant. Ce mémoire fait état des différents types d’acouphènes qui peuvent se manifester ainsi que des diverses thérapies étudiées pour le traitement des acouphènes. Les grands modèles neurobiologiques prédominants dans la littérature sont aussi présentés. De plus, ce mémoire étudie la neuromodulation non invasive comme nouvelle avenue de traitement pour les acouphènes. Nous avons réalisé une méta-analyse et une étude de modélisation afin d’évaluer l’efficacité de ce traitement pour les acouphènes ainsi que les impacts sur les substrats neurobiologiques des acouphènes. Les résultats de cette étude montrent que la neuromodulation non invasive magnétique (SMTr) diminue de manière statistiquement significative les scores d’évaluation de l’acouphène, et que ces effets sont plus marqués chez les femmes. Les résultats montrent aussi que la neuromodulation du cortex auditif est l’approche qui diminue le plus les acouphènes et qu’elle génère un champ électrique plus fort dans l’insula en comparaison à d’autres régions d’intérêt. Finalement, ce mémoire discute des principales méthodes d’évaluation des acouphènes ainsi que de l’effet placébo présent lors du traitement des acouphènes. Des parallèles avec la douleur chronique sont établis, afin d’orienter la recherche sur de prochains traitements. Le futur de la neuromodulation non invasive pour le traitement des acouphènes est aussi discuté en marge de perspectives et de limites du travail. / Tinnitus impacts a large proportion of Canadians. It is linked to various comorbidities that significantly affect the quality of life of those who suffer from it. Unfortunately, generation and maintenance mechanisms are still unclear and numerous questions remain in the scientific community. Notably, no cure is available for tinnitus as of now. This dissertation reports the different types of tinnitus that can occur, besides the diverse therapies that have been reviewed for the treatment of tinnitus. The main neurobiological models of tinnitus prevailing in the literature are also presented. Furthermore, this dissertation investigates noninvasive neuromodulation as a new approach to treat tinnitus. A meta-analysis and modeling study have evaluated the efficacy of this treatment for tinnitus along with its impact on neurobiological substrates of tinnitus. The results of the study show that repetitive transcranial magnetic stimulation (rTMS) decreases statistically significantly tinnitus scores and that those effects are more marked in women. The results also show that noninvasive neuromodulation of the auditory cortex is the approach that decreases tinnitus the most and that this approach generates a stronger electric field in the insula among other regions of interest. Finally, this dissertation discusses the main methods to rate tinnitus and the placebo effect measured during tinnitus treatment. We also draw parallels with chronic pain, to orient prospective research. The future of noninvasive neuromodulation is also discussed in terms of treatment for tinnitus alongside perspectives and limits of the work.

Introdução: alguns pacientes com zumbido podem apresentar pontosgatilho miofasciais, principalmente na musculatura mastigatória e cervical. No entanto, este tema é pouco abordado na literatura. Os objetivos deste estudo foram investigar a associação entre (1) zumbido e pontos-gatilho, (2) a orelha com pior zumbido e o lado do corpo com maior número de pontosgatilho, além de (3) verificar a capacidade de o ponto-gatilho modular o zumbido. Métodos: neste estudo caso-controle foram avaliados 94 pacientes com zumbido e 94 assintomáticos, pareados por sexo e idade, sem queixa de dor generalizada ou mioclonia. Todos foram submetidos, pelo mesmo investigador, a um protocolo de avaliação e à pressão digital para pesquisa de pontos-gatilho em 9 músculos bilateralmente: infra-espinal, levantador da escápula, trapézio, esplênio da cabeça, escaleno, esternocleidomastóideo, digástrico, masseter e temporal. A intensidade do zumbido foi avaliada por uma escala numérica de 0 a 10, considerando-se como modulação o aumento ou diminuição imediata de pelo menos um ponto na escala e/ou mudança no tipo de som. Os exames foram executados em local silencioso para facilitar a percepção da modulação do zumbido. Resultados: os pontos-gatilho estavam presentes em 72,3% dos pacientes com zumbido (OR= 4,87; p< 0,001) e 55,9% deles relataram modulação do sintoma durante a pressão digital nos pontos-gatilho ativos e latentes, em pelo menos um músculo, principalmente no masseter, esplênio da cabeça, esternocleidomastóideo e temporal. A modulação do zumbido pelo ponto-gatilho examinado foi predominantemente ipsilateral em 6 dos 9 músculos avaliados. Houve correlação de lateralidade entre a orelha com pior zumbido e o lado do corpo com maior número de pontos-gatilho em 56,5% dos casos (Kappa= 0,29; p< 0,001). Houve diferença significante quanto à presença de queixa prévia de dor na comparação dos pacientes com zumbido que modularam com aqueles que não modularam (p< 0,008). Conclusões: a presença significante dos pontos-gatilho em pacientes com zumbido associada à freqüente modulação do sintoma durante sua palpação, além da sua presença em maior número no lado da orelha com pior zumbido, sugere que os pontos-gatilho sejam um fator etiológico ou coadjuvante do zumbido. / Introduction: some patients suffering from tinnitus may present myofascial trigger points, mainly in head and neck muscles. However, this issue is poorly explored in the literature. The objectives of this study were to investigate an association between (1) tinnitus and trigger points, (2) the ear with the worst tinnitus and the side of the body with more trigger points, (3) presence of trigger points and their capacity of modulating tinnitus. Methods: in this case control study 94 subjects with tinnitus, and 94 without such symptom were analyzed, matched by age and gender, excluding those with widespread musculoskeletal pain or myoclonus. All of them underwent an evaluation protocol and digital pressure in order to search for trigger points in 9 bilateral muscles: infraspinatus, levator scapulae, trapezius, splenius capitis, scalenus, sternocleidomastoid, digastric, masseter and temporalis. The intensity of tinnitus was evaluated with a scale ranging from 0 to 10, and modulation was considered present in cases of immediate increase or decrease of at least one point in the scale and/or changes in the type of sound. The exams took place in a silent environment, so as to make it easier for tinnitus\' modulation to be perceived. Results: the presence of trigger points was observed in 72.3% of tinnitus patients (OR= 4.87; p< 0,001). Among them, 55.9% reported tinnitus modulation during digital pressure in both active and latent trigger points, in at least one muscle, mainly in masseter, splenius capitis, sternocleidomastoid and temporalis muscles. The rate of tinnitus modulation was significantly higher at the same side of the trigger point subject to examination in 6 out of 9 muscles. There was an association of laterality between the ear with worst tinnitus and the side of the body with more trigger points in 56.5% of the cases (Kappa value = 0.29; p< 0.001). There was a significant difference related to the presence of previous pain complaint when patients with tinnitus that modulated were compared to patients with tinnitus that did not modulate (p< 0.008). Conclusions: significant presence of trigger points in tinnitus patients, associated to frequent modulation of this symptom during palpation, besides the presence of more trigger points in the side of the ear with the worst tinnitus, suggests that trigger points are an etiologic factor or adjuvant in tinnitus onset.

Introdução: Muitos pacientes com zumbido também apresentam algum grau de perda auditiva associada e o uso de próteses auditivas pode ser uma boa opção para melhorar ambos os sintomas. Porém, na prática clínica, a oclusão do meato acústico externo pelo molde da prótese auditiva pode até piorar o zumbido em alguns casos. A literatura apresenta poucos estudos sobre a real influência da ventilação do molde da prótese auditiva na percepção do zumbido. Objetivo: avaliar a resposta do zumbido à prótese auditiva retro-auricular com dois tipos de ventilação no molde (molde aberto e ventilação de alívio) em pacientes com perda auditiva neurossensorial simétrica após um mês de uso. Métodos: 50 pacientes atendidos no Grupo de Pesquisa em Zumbido com zumbido bilateral e perda auditiva neurossensorial simétrica de grau leve a severo foram submetidos a um ensaio clínico randomizado cego crossover. Destes, 26 pacientes iniciaram o ensaio utilizando próteses auditivas com molde aberto (ventilação de 4mm) e 24 iniciaram usando molde com ventilação de alívio (ventilação de 1mm). Após 30 dias de teste com o primeiro tipo de molde e um período de wash-out (15 dias), o tipo de molde foi trocado e o segundo molde foi usado por mais 30 dias. O zumbido foi avaliado de modo qualitativo (classificado em melhora, inalterado e piora) e quantitativo (variação de 0 a 10 de uma escala numérica). Resultados: A melhora do zumbido foi observada em 82% dos casos com pelo menos um tipo de molde e não houve diferença significante na diminuição do incômodo com o zumbido nas avaliações qualitativa e quantitativa com ambos os moldes. Apesar disto, 66% dos pacientes preferiram o molde aberto. Conclusão: A curto prazo, a melhora do zumbido por meio da prótese auditiva em pacientes com perda auditiva neurossensorial simétrica de grau leve a severo não depende do tamanho da ventilação do molde auricular / Introduction: Most tinnitus patients also have some degree of associated hearing loss, and the use of hearing aids is an option to improve both symptoms. In daily practice, the occlusion of the external meatus by the earmold during hearing aids fitting may enhance the tinnitus perception. However, the literature lacks studies about the real influence of the earmold ventilation on tinnitus perception. Objective: to evaluate the tinnitus response to the BTE hearing aids using two types of ventilation (open mold and relief ventilation) in patients with symmetric sensorineural hearing loss after one month usage. Methods: 50 patients attended in our Tinnitus Clinic who presented bilateral tinnitus and mild to severe symmetric sensorineural hearing loss underwent a randomized blind crossover clinical trial. Among them, 26 first used BTE hearing aids with open molds (4mm ventilation) and 24 first used hearing aids with relief ventilation mold (1mm ventilation). After 30 days using the first mold and a 15-day wash-out period, the type of earmold was changed in a crossover way and the second mold was used for another 30-day-period. Tinnitus evaluation was performed by a qualitative way (classified in improvement, unchanged and worsening) and by a quantitative way (variation of a numeric scale from 0 to 10). Results: Tinnitus improvement was observed by 82% of the patients with at least one type of earmold and there was no significant difference in the decrease of tinnitus discomfort by both, quantitative and qualitative evaluation. Despite the similar tinnitus control, 66% of the patients preferred to acquire the hearing aids with open mold. Conclusion: In a short-term evaluation, the tinnitus improvement by the use of hearing aids in patients with mild to severe symmetric sensorineural hearing loss does not depend on the size of earmold ventilation

Introdução: alguns pacientes com zumbido podem apresentar pontosgatilho miofasciais, principalmente na musculatura mastigatória e cervical. No entanto, este tema é pouco abordado na literatura. Os objetivos deste estudo foram investigar a associação entre (1) zumbido e pontos-gatilho, (2) a orelha com pior zumbido e o lado do corpo com maior número de pontosgatilho, além de (3) verificar a capacidade de o ponto-gatilho modular o zumbido. Métodos: neste estudo caso-controle foram avaliados 94 pacientes com zumbido e 94 assintomáticos, pareados por sexo e idade, sem queixa de dor generalizada ou mioclonia. Todos foram submetidos, pelo mesmo investigador, a um protocolo de avaliação e à pressão digital para pesquisa de pontos-gatilho em 9 músculos bilateralmente: infra-espinal, levantador da escápula, trapézio, esplênio da cabeça, escaleno, esternocleidomastóideo, digástrico, masseter e temporal. A intensidade do zumbido foi avaliada por uma escala numérica de 0 a 10, considerando-se como modulação o aumento ou diminuição imediata de pelo menos um ponto na escala e/ou mudança no tipo de som. Os exames foram executados em local silencioso para facilitar a percepção da modulação do zumbido. Resultados: os pontos-gatilho estavam presentes em 72,3% dos pacientes com zumbido (OR= 4,87; p< 0,001) e 55,9% deles relataram modulação do sintoma durante a pressão digital nos pontos-gatilho ativos e latentes, em pelo menos um músculo, principalmente no masseter, esplênio da cabeça, esternocleidomastóideo e temporal. A modulação do zumbido pelo ponto-gatilho examinado foi predominantemente ipsilateral em 6 dos 9 músculos avaliados. Houve correlação de lateralidade entre a orelha com pior zumbido e o lado do corpo com maior número de pontos-gatilho em 56,5% dos casos (Kappa= 0,29; p< 0,001). Houve diferença significante quanto à presença de queixa prévia de dor na comparação dos pacientes com zumbido que modularam com aqueles que não modularam (p< 0,008). Conclusões: a presença significante dos pontos-gatilho em pacientes com zumbido associada à freqüente modulação do sintoma durante sua palpação, além da sua presença em maior número no lado da orelha com pior zumbido, sugere que os pontos-gatilho sejam um fator etiológico ou coadjuvante do zumbido. / Introduction: some patients suffering from tinnitus may present myofascial trigger points, mainly in head and neck muscles. However, this issue is poorly explored in the literature. The objectives of this study were to investigate an association between (1) tinnitus and trigger points, (2) the ear with the worst tinnitus and the side of the body with more trigger points, (3) presence of trigger points and their capacity of modulating tinnitus. Methods: in this case control study 94 subjects with tinnitus, and 94 without such symptom were analyzed, matched by age and gender, excluding those with widespread musculoskeletal pain or myoclonus. All of them underwent an evaluation protocol and digital pressure in order to search for trigger points in 9 bilateral muscles: infraspinatus, levator scapulae, trapezius, splenius capitis, scalenus, sternocleidomastoid, digastric, masseter and temporalis. The intensity of tinnitus was evaluated with a scale ranging from 0 to 10, and modulation was considered present in cases of immediate increase or decrease of at least one point in the scale and/or changes in the type of sound. The exams took place in a silent environment, so as to make it easier for tinnitus\' modulation to be perceived. Results: the presence of trigger points was observed in 72.3% of tinnitus patients (OR= 4.87; p< 0,001). Among them, 55.9% reported tinnitus modulation during digital pressure in both active and latent trigger points, in at least one muscle, mainly in masseter, splenius capitis, sternocleidomastoid and temporalis muscles. The rate of tinnitus modulation was significantly higher at the same side of the trigger point subject to examination in 6 out of 9 muscles. There was an association of laterality between the ear with worst tinnitus and the side of the body with more trigger points in 56.5% of the cases (Kappa value = 0.29; p< 0.001). There was a significant difference related to the presence of previous pain complaint when patients with tinnitus that modulated were compared to patients with tinnitus that did not modulate (p< 0.008). Conclusions: significant presence of trigger points in tinnitus patients, associated to frequent modulation of this symptom during palpation, besides the presence of more trigger points in the side of the ear with the worst tinnitus, suggests that trigger points are an etiologic factor or adjuvant in tinnitus onset.

Introdução: Muitos pacientes com zumbido também apresentam algum grau de perda auditiva associada e o uso de próteses auditivas pode ser uma boa opção para melhorar ambos os sintomas. Porém, na prática clínica, a oclusão do meato acústico externo pelo molde da prótese auditiva pode até piorar o zumbido em alguns casos. A literatura apresenta poucos estudos sobre a real influência da ventilação do molde da prótese auditiva na percepção do zumbido. Objetivo: avaliar a resposta do zumbido à prótese auditiva retro-auricular com dois tipos de ventilação no molde (molde aberto e ventilação de alívio) em pacientes com perda auditiva neurossensorial simétrica após um mês de uso. Métodos: 50 pacientes atendidos no Grupo de Pesquisa em Zumbido com zumbido bilateral e perda auditiva neurossensorial simétrica de grau leve a severo foram submetidos a um ensaio clínico randomizado cego crossover. Destes, 26 pacientes iniciaram o ensaio utilizando próteses auditivas com molde aberto (ventilação de 4mm) e 24 iniciaram usando molde com ventilação de alívio (ventilação de 1mm). Após 30 dias de teste com o primeiro tipo de molde e um período de wash-out (15 dias), o tipo de molde foi trocado e o segundo molde foi usado por mais 30 dias. O zumbido foi avaliado de modo qualitativo (classificado em melhora, inalterado e piora) e quantitativo (variação de 0 a 10 de uma escala numérica). Resultados: A melhora do zumbido foi observada em 82% dos casos com pelo menos um tipo de molde e não houve diferença significante na diminuição do incômodo com o zumbido nas avaliações qualitativa e quantitativa com ambos os moldes. Apesar disto, 66% dos pacientes preferiram o molde aberto. Conclusão: A curto prazo, a melhora do zumbido por meio da prótese auditiva em pacientes com perda auditiva neurossensorial simétrica de grau leve a severo não depende do tamanho da ventilação do molde auricular / Introduction: Most tinnitus patients also have some degree of associated hearing loss, and the use of hearing aids is an option to improve both symptoms. In daily practice, the occlusion of the external meatus by the earmold during hearing aids fitting may enhance the tinnitus perception. However, the literature lacks studies about the real influence of the earmold ventilation on tinnitus perception. Objective: to evaluate the tinnitus response to the BTE hearing aids using two types of ventilation (open mold and relief ventilation) in patients with symmetric sensorineural hearing loss after one month usage. Methods: 50 patients attended in our Tinnitus Clinic who presented bilateral tinnitus and mild to severe symmetric sensorineural hearing loss underwent a randomized blind crossover clinical trial. Among them, 26 first used BTE hearing aids with open molds (4mm ventilation) and 24 first used hearing aids with relief ventilation mold (1mm ventilation). After 30 days using the first mold and a 15-day wash-out period, the type of earmold was changed in a crossover way and the second mold was used for another 30-day-period. Tinnitus evaluation was performed by a qualitative way (classified in improvement, unchanged and worsening) and by a quantitative way (variation of a numeric scale from 0 to 10). Results: Tinnitus improvement was observed by 82% of the patients with at least one type of earmold and there was no significant difference in the decrease of tinnitus discomfort by both, quantitative and qualitative evaluation. Despite the similar tinnitus control, 66% of the patients preferred to acquire the hearing aids with open mold. Conclusion: In a short-term evaluation, the tinnitus improvement by the use of hearing aids in patients with mild to severe symmetric sensorineural hearing loss does not depend on the size of earmold ventilation