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Self-assessment forms and diagnostic tests were used to assess benefits of a treatment program that addressed tinnitus and hyperacusis severity in a population of 30 veterans (29 males, 1female) between the ages of 43 and 79. Patients were enrolled in the treatment program for an average of 20.8 months (range=12-31 months). For the purposes of this study, tinnitus was defined as the subjective perception of a sound lacking an environmental correlate. Hyperacusis was defined as the over-sensitivity to an environmental sound present at a level that would not produce excessive loudness for individuals with normal hearing sensitivity. Treatment strategies included guided counseling regarding auditory and neurological mechanisms of tinnitus coupled with sound therapy designed to reduce the tinnitus disruption. Sound therapy instruments utilized by the subjects included hearing aids, cochlear implants, bedside noise generators, and near-level tinnitus maskers. The tinnitus handicap inventory (THI), self-assessment forms, and loudness discomfort level (LDL) testing were administered to assess benefit of the treatment program. Subjects were first interviewed using an interview form adapted from Jastreboff and Jastreboff, 1999. The THI was then administered in interview format to all patients. Initial sessions were approximately two hours in length. Follow-up sessions lasted approximately one hour. Most patients returned for at least three follow-up visits over the course of their treatment. The correlation between the patients hearing thresholds and the tinnitus handicap inventory (THI) score were poor, consistent with previous reports. Pre and post-testing with the THI indicated that 36.7% of the test subjects experienced significant improvement in tinnitus handicap. The total scores and all sub-scale scores on the THI showed statistically significant improvements. An analysis of the self-assessment forms revealed that 27% of the subjects experienced improvement with concentration, 27% experienced improvement with sleep, 36.7% experienced improvement with quiet recreational activities, and 23.3% experienced improvement with social activities. LDL testing was administered at the initial and post treatment sessions with twenty-two of the thirty subjects. LDL testing indicated that hyperacusis severity was reduced by 13.6% in the right ear and 4.6% in the left ear from the initial evaluation to the post treatment evaluation. Regarding test subject satisfaction with the treatment program, 93.3% expressed satisfaction, and 90% indicated they would be unhappy if asked to return their sound generating devices. Test subjects appeared to be satisfied with their overall experiences with the tinnitus treatment program. The clinical implications of these findings will be discussed.

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Excerpt: Tinnitus: Clinical and Research Perspectives summarizes contemporary findings from basic and clinical research regarding tinnitus mechanisms, effects, and interventions. The text features a collection of international authors, active researchers, and clinicians who provide an expansive scope of material that ensures relevance for patients and professionals. Reviews and reports of contemporary research findings underscore the text s value for classroom use in audiology and otolaryngology programs. Patients and students of audiology will benefit from the text s coverage of tinnitus mechanisms, emerging practice considerations, and expectations for outcomes--for example, recent successes of cognitive behavioral therapy, neuromodulation, and hearing aid use. These and other topics, such as the effects of noise and drugs on tinnitus, are reported in a way that enhances clinicians ability to weave such strategies into their own work. The influence of tinnitus on all aspects of life is explored, from art to medicine and communication to isolation, thereby providing clinicians and patients a deeper understanding of and greater facility managing a tinnitus experience. Finally, this text includes case studies that provide a practical view of tinnitus effects and management approaches. The editors hope that the consideration of mechanisms, interventions, and outcomes resonates with patients, clinicians, and students of audiology.

Tinnitus has the potential to influence a wide range of routine and important activities in a person's life. It can impair sleep, communication, concentration, and in severe cases can be affected by depression, anxiety, and other mental health issues. Perhaps more important, tinnitus may influence the patient's psychological state; its bidirectional effects, although well established, often challenge patients and providers across a variety of clinical settings. Management of tinnitus requires audiologists to be adept at communicating and supporting coping strategies that may include, but should not be limited to, patient-centered counseling and delivery of sound therapy or hearing aids. In the short term, patient care may benefit from interprofessional collaborations and effective referral networks. In the long term, the inclusion of tinnitus clinic rotations, classes, and interprofessional opportunities for students in Audiology programs should provide AuD students the experiences and competencies to provide for patients with tinnitus.

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Trauma-provoked tinnitus challenges patients and clinicians. Effects of trauma may exacerbate tinnitus, and patients with both tinnitus and posttraumatic stress disorder rate distress levels as higher than patients who experience only one or the other. This presentation will highlight links between tinnitus and trauma histories relevant to clinical audiologists.