Tinnitus Assessment & Management Flashcards

What is tinnitus and what is its prevalence in adults with hearing loss?

Answer: Tinnitus is the perception of sound (ringing, buzzing, hissing) without an external acoustic stimulus; approximately 80-90% of people with hearing loss have some degree of tinnitus

Tinnitus is the subjective perception of sound without an external source. It is extremely common in people with hearing loss—estimated to affect 80-90% of those with sensorineural hearing loss to some degree.

What is sound therapy in the context of tinnitus management and how does it help?

Answer: Using background sound (white noise, nature sounds, or hearing aid amplification) to partially mask or blend with tinnitus, reducing its perceived loudness and annoyance

Sound therapy uses ambient sound to reduce the contrast between tinnitus and the acoustic environment, making the tinnitus less noticeable through partial masking, habituation facilitation, or neuroplastic auditory pathway changes.

What is Tinnitus Retraining Therapy (TRT) and what are its two main components?

Answer: A therapy combining directive counseling (to reclassify tinnitus as a neutral signal) and low-level sound therapy (to promote habituation), based on the neurophysiological model of tinnitus

TRT, developed by Jastreboff, combines directive counseling to help the patient understand and reframe tinnitus as a non-threatening neutral signal, and low-level broadband sound therapy to reduce auditory contrast and facilitate neural habituation.

Which validated questionnaire is most commonly used to assess tinnitus handicap and severity?

Answer: THI (Tinnitus Handicap Inventory)

The Tinnitus Handicap Inventory (THI) is a 25-item self-report questionnaire measuring the functional, emotional, and catastrophic impact of tinnitus, with total scores classifying severity from slight (0-16) to catastrophic (78-100).

How do hearing aids help patients with tinnitus even when the primary indication is hearing loss?

Answer: Hearing aids restore ambient sound audibility, reducing the contrast between tinnitus and the acoustic environment, and by restoring auditory input may reduce tinnitus-generating neural hyperactivity

Hearing aids address tinnitus by restoring auditory input (reducing the deprivation-driven neural hyperactivity thought to generate tinnitus) and by amplifying ambient sound, reducing the perceptual contrast that makes tinnitus bothersome.

When should a patient with tinnitus be referred to a physician or specialist?

Answer: When tinnitus is pulsatile (rhythmic, heartbeat-like), unilateral, associated with sudden hearing loss, vertigo, or neurological symptoms—these may indicate a serious underlying condition

Red flag tinnitus presentations—pulsatile, unilateral, or associated with sudden hearing loss, vertigo, facial weakness, or neurological symptoms—require prompt medical referral to rule out vascular abnormalities, acoustic neuroma, or other serious pathology.