HAC Tinnitus Management & Treatment 2 — Questions and Answers
Question 1: Which tinnitus management approach uses low-level broadband noise to reduce the contrast between tinnitus and background sound?
- Cognitive behavioral therapy
- Sound therapy with partial masking (Correct answer)
- Tinnitus retraining therapy directive counseling
- Progressive tinnitus management education
Correct answer: Sound therapy with partial masking
Sound therapy using partial masking introduces low-level broadband noise to reduce the perceptual contrast between tinnitus and silence without fully covering the tinnitus.
Question 2: A patient reports that their tinnitus pitch matches approximately 4000 Hz during pitch matching. This finding most commonly correlates with which condition?
- Conductive hearing loss at low frequencies
- Noise-induced or high-frequency sensorineural hearing loss (Correct answer)
- Meniere's disease with low-frequency fluctuation
- Otosclerosis affecting the stapes footplate
Correct answer: Noise-induced or high-frequency sensorineural hearing loss
Tinnitus pitch near 4000 Hz is classically associated with high-frequency sensorineural hearing loss, often from noise exposure, where the cochlear dead region generates phantom sound.
Question 3: In Tinnitus Retraining Therapy (TRT), what is the primary goal of the directive counseling component?
- Eliminate tinnitus perception entirely through desensitization
- Reclassify tinnitus as a neutral stimulus by retraining the limbic and autonomic systems (Correct answer)
- Teach relaxation techniques to reduce stress-related tinnitus spikes
- Identify and remove the underlying cause of tinnitus
Correct answer: Reclassify tinnitus as a neutral stimulus by retraining the limbic and autonomic systems
TRT directive counseling aims to reclassify tinnitus from a threat to a neutral signal by educating the patient and retraining limbic/autonomic reactions.
Question 4: Which questionnaire is most widely used to assess tinnitus-related handicap in clinical practice?
- Beck Anxiety Inventory
- Tinnitus Handicap Inventory (THI) (Correct answer)
- Glasgow Hearing Aid Benefit Profile
- Abbreviated Profile of Hearing Aid Benefit (APHAB)
Correct answer: Tinnitus Handicap Inventory (THI)
The Tinnitus Handicap Inventory (THI) is the most widely validated and used tool for measuring the functional, emotional, and catastrophic impact of tinnitus.
Question 5: A hearing aid dispenser recommends a combination device for a tinnitus patient who also has a hearing loss. What does a combination device provide?
- Amplification only with a tinnitus-focused fitting algorithm
- Both amplification and a built-in sound generator in a single unit (Correct answer)
- Bone-anchored amplification with masking via bone conduction
- FM transmission to improve signal-to-noise ratio for tinnitus relief
Correct answer: Both amplification and a built-in sound generator in a single unit
A combination device integrates a traditional hearing aid with a sound generator, providing both amplification and tinnitus sound therapy in one unit.
Question 6: What term describes tinnitus that can be heard by both the patient and an examiner using a stethoscope or microphone?
- Subjective tinnitus
- Objective tinnitus (Correct answer)
- Somatic tinnitus
- Pulsatile tinnitus
Correct answer: Objective tinnitus
Objective tinnitus is a rare form where the sound has an actual acoustic source and can be detected externally by the clinician.
Question 7: Which medication class is sometimes implicated as a reversible cause of tinnitus when used at high doses?
- Beta-blockers
- Salicylates (aspirin) (Correct answer)
- ACE inhibitors
- Proton pump inhibitors
Correct answer: Salicylates (aspirin)
High-dose salicylates such as aspirin are a well-known reversible ototoxic cause of tinnitus that typically resolves upon dose reduction or discontinuation.
HAC Tinnitus Management & Treatment 2
Which tinnitus management approach uses low-level broadband noise to reduce the contrast between tinnitus and background sound?