Tinnitus Assessment and Management Flashcards

Tinnitus is MOST accurately defined as:

Answer: The perception of sound in the absence of an external acoustic source

Tinnitus is defined as the perception of sound — such as ringing, buzzing, hissing, or roaring — that has no external source. It can be subjective (heard only by the patient) or, rarely, objective (audible to an examiner). It is not the same as hyperacusis (sound sensitivity) or hearing loss itself, though these often co-occur.

The most common cause of chronic subjective tinnitus is:

Answer: Sensorineural hearing loss from noise exposure or aging

The most prevalent cause of chronic subjective tinnitus is sensorineural hearing loss, particularly from noise-induced hearing loss (NIHL) or age-related hearing loss (presbycusis). Damage to cochlear hair cells disrupts normal auditory signals, which the brain may interpret as phantom sound. While otosclerosis and Ménière's can also cause tinnitus, they are far less common overall.

During a tinnitus assessment, a specialist uses a procedure called tinnitus pitch matching. The purpose of this procedure is to:

Answer: Determine the frequency or pitch the patient perceives for their tinnitus

Tinnitus pitch matching involves presenting pure tones or narrowband noises to the patient and asking them to identify which frequency most closely matches their perceived tinnitus. This helps characterize the tinnitus and can guide sound therapy or masking choices. Loudness matching is a separate, complementary procedure.

Sound therapy for tinnitus management works primarily by:

Answer: Reducing the perceived contrast between the tinnitus and background sound environment

Sound therapy (including masking, sound enrichment, and neuromodulation approaches) works by reducing the contrast — or 'signal-to-noise ratio' — between the tinnitus signal and the auditory environment. By introducing background or therapeutic sound, the brain has less opportunity to focus on the tinnitus, reducing its perceived intrusiveness. It does not eliminate tinnitus at the neural level.

Which hearing aid feature is specifically designed to provide tinnitus relief alongside amplification?

Answer: Built-in tinnitus sound generators (maskers)

Many modern hearing aids include built-in tinnitus sound generators that deliver configurable sounds (white noise, pink noise, nature sounds, or fractal tones) directly into the ear canal. These are used alongside amplification to provide dual benefit: improving hearing and delivering tinnitus relief. Directional mics, telecoils, and feedback cancellation serve other purposes.

Tinnitus Retraining Therapy (TRT) combines which two key components?

Answer: Directive counseling and sound therapy

TRT, developed by Jastreboff and Hazell, is based on the neurophysiological model of tinnitus and combines: (1) directive counseling to demystify the tinnitus and reduce its emotional significance, and (2) sound therapy using low-level broadband noise to promote habituation. The goal is for the brain to reclassify the tinnitus signal as neutral and insignificant, reducing conscious awareness over time.