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Tinnitus Treatment: Clinical Protocols

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The quintessential clinical guide for audiologists on tinnitus and hyperacusis patient management

Since publication of the first edition in 2005, new developments have impacted the treatment paradigm for tinnitus, such as sensory meditation and mindfulness. Tinnitus Treatment: Clinical Protocols, Second Edition, by world-renowned tinnitus experts and distinguished authors Richard S. Tyler and Ann Perreau provides comprehensive background information, up-to-date strategies, essential tools, and online supplementary materials grounded in years of clinical experience and research. It fills a gap in graduate education and available materials to empower audiologists to effectively treat patients suffering from bothersome to severely debilitating symptoms associated with tinnitus or hyperacusis.

The textbook includes 15 chapters, starting with three chapters on tinnitus models, treatment approaches, and self-treatment options. The next three chapters summarize counseling approaches for audiologists and psychologists, including introduction of the three-track psychological counseling program for managing tinnitus. Chapters 7 and 8 discuss the use of hearing aids in patients with hearing loss-related tinnitus and sound therapy using wearable devices. Chapter 9 covers smartphone apps for tinnitus assessment, management, and education and wellness, including discussion of limitations. The last six chapters provide guidance on tinnitus management topics including treating children, implementing outcome measures, hyperacusis treatment, and future directions.

Key Features

  • New relaxation/distraction tactics including meditation, mindfulness, guided imagery, biofeedback, progressive muscle relaxation, art and music therapy, exercise, and exploration of new hobbies
  • Treatment guidance for patients with tinnitus associated with Meniere's disease, vestibular schwannoma, unilateral sudden sensorineural hearing loss, and middle ear myoclonus
  • Discussion and research-based evidence covering Internet-delivered self-help treatment strategies
  • New supplemental videos, brochures, handouts, questionnaires, and datasheets enhance knowledge, scope of practice, and incorporation of effective approaches into clinical practice

This is a must-have resource for every audiology student and advanced courses, as well as essential reading for all audiologists who feel underprepared in managing tinnitus and/or hyperacusis.

This book includes complimentary access to a digital copy on https://medone.thieme.com.

Author(s): Richard S. Tyler, Ann Perreau
Edition: 2
Publisher: Thieme Medical Publishers
Year: 2022

Language: English
Pages: 241
City: New York

Tinnitus Treatment: Clinical Protocols
MedOne Access Information
Title Page
Copyright
Contents
Videos
Foreword
Preface
Acknowledgments
Contributors
1 Neurophysiological Models, Psychological Models, and Treatments for Tinnitus
1.1 What Is Tinnitus?
1.2 Neurophysiological Models of Tinnitus
1.3 Psychological Models of Tinnitus
1.4 Categories of Tinnitus Treatments
1.5 Counseling in the Treatment of Tinnitus
1.5.1 Be Supportive
1.5.2 Provide Information
1.5.3 Components of Counseling
1.5.4 Examples of Counseling Treatment Protocols
1.6 Sound Therapies for Treating Patients’ Reactions to Tinnitus
1.6.1 Counseling for Sound Therapies
1.6.2 Use of Hearing Aids
1.6.3 Music Therapy
1.6.4 Hyperacusis
1.7 Obstacles to Tinnitus Treatment
1.7.1 Negative Beliefs by Clinicians or Patients
1.8 Conclusion
Appendix 1.1 Tinnitus
2 Treating Tinnitus in Patients with Otologic Conditions
2.1 Treating Tinnitus in Patients with Meniere’s Disease
2.1.1 Treatment Protocol
2.2 Treating Tinnitus in Patientswith a Vestibular Schwannoma
2.2.1 Treatment Protocols
2.3 Treating Tinnitus in Patients with Unilateral Sudden Sensorineural Hearing Loss
2.3.1 Early Intervention
2.3.2 Information Regarding Mechanisms
2.3.3 Hearing Therapy
2.3.4 Treating Tinnitus Associated with Middle Ear Myoclonus
2.4 Other Relevant Conditions
2.5 Conclusion
3 Internet-Delivered Guided Self-Help Treatments for Tinnitus
3.1 Background
3.1.1 Tinnitus and Self-Help Material
3.2 Internet-Delivered GuidedSelf-Help
3.2.1 Technical Functionality of the Internet Platform
3.2.2 Conducting Assessments
3.2.3 Theoretical Foundation of the Intervention
3.2.4 The Intervention Content
3.2.5 Supporting Patients
3.2.6 Fostering Adherence
3.3 Evaluation of Internet-Interventions for Tinnitus and Potential Problems
3.3.1 Effects of the Internet-Based Self-Help for Tinnitus
3.3.2 Problems Related to Dropouts and Compliance
3.3.3 Security and Technical Concerns
3.4 Conclusion
Appendix 3.1 Suggested Self-Help Resources for Tinnitus
Appendix 3.2 Tinnitus Self-Treatment Brochure
4 Tinnitus Activities Treatment
4.1 Introduction
4.1.1 Patient Expectation Nurturing
4.1.2 Picture-Based Counseling
4.1.3 Patient-Centered Approach to Care
4.2 Discussion
4.2.1 Thoughts and Emotions
4.2.2 Hearing and Communication
4.2.3 Sleep
4.2.4 Concentration
4.3 Conclusion
Appendix 4.1 Tinnitus Primary Functions Questionnaire (12-Item Version)
Appendix 4.2 Things You Can Do for Your Tinnitus
Appendix 4.3a Tinnitus Diary
Appendix 4.3b Tinnitus Diary Example Case
Appendix 4.4 Strategies to Improve Hearing and Communication
Appendix 4.5 A Guide to a Good Night’s Sleep for Tinnitus Patients
Appendix 4.6 Strategies to Improve Your Sleep
Appendix 4.7 Strategies to Improve Concentration
Appendix 4.8 Daily Listening Diary
5 Three-Track Tinnitus Protocol: Counseling Emphasizing the Patient, the Clinician, and the Alliance
5.1 Introduction
5.2 Protocol
5.2.1 Making the Initial Contact
5.2.2 The First Session: The Contract
5.2.3 Working in the Tracks
5.3 Conclusion
6 The Psychological Management of Tinnitus-Related Insomnia
6.1 Introduction
6.2 The Cognitive Behavioral Model
6.2.1 Cognitive Behavioral Therapy and Insomnia
6.2.2 The CB Model, Tinnitus, and Sleep
6.3 Group Therapy
6.4 Selection and Definitions
6.5 Assessment
6.5.1 Questionnaire Measures
6.5.2 Sleep Diaries
6.6 Group Structure
6.7 Treatment Protocol: Key Components
6.7.1 Group Support
6.7.2 Psychoeducation
6.7.3 Individual Goal Setting
6.7.4 Creating an Individualized Sleep Program
6.7.5 Sleep Titration
6.7.6 Stimulus Control
6.7.7 Motivation and Video Modeling
6.7.8 Relaxation
6.7.9 Cognitive Restructuring (Cognitive Therapy)
6.7.10 Worry Period
6.7.11 Sleep Hygiene
6.7.12 Sound Enrichment
6.7.13 ClockWatching
6.8 Conclusion
Appendix 6.1 Relaxation Listening for Sleep
7 Optimizing Hearing Aid Fittings for Tinnitus Management
7.1 Introduction
7.2 Benefits, Modes, and Mechanisms
7.3 Clinic Protocol
7.3.1 Audiometry and Evaluation
7.3.2 Aural Rehabilitation and Goal Setting
7.3.3 Instruction
7.3.4 Counseling
7.3.5 Sensory Management: Selection of Hearing Aids and Their Features
7.3.6 Perceptual Training
7.3.7 Appointment Scheduling and Follow-Up
7.4 Conclusion
8 Combining Sound Therapy with Amplification
8.1 Introduction
8.2 Sound Therapy Framework
8.2.1 The Presence of Sound Effect
8.2.2 The Context of Sound Effect
8.2.3 Reaction to Sound Effect
8.2.4 Adaptation to Sound
8.2.5 WHO International Classification of Functioning, Disability, and Health
8.3 Protocol
8.3.1 Audiometry and Evaluation
8.3.2 Aural Rehabilitation and Goal Setting
8.3.3 Instruction
8.3.4 Counseling
8.3.5 Sensory Management: Selection and Use of Different Sounds
8.3.6 Device Selection and Fitting
8.3.7 Negative Effects
8.3.8 Perceptual Training
8.3.9 Follow-Up
8.3.10 New and Emerging Concepts
8.4 Conclusion
9 The Clinical Relevance of Apps for Tinnitus
9.1 Introduction
9.2 Apps for Tinnitus Assessment and Management
9.2.1 Apps for Education and Information on Tinnitus
9.2.2 Apps for Wellness
9.2.3 Limitations and Risks Associated with Smartphone Apps
9.3 Conclusions
10 Distractions, Relaxation, and Peace with Tinnitus: Guided Imagery, Meditation, Mindfulness, and More
10.1 Introduction
10.2 Meditation
10.3 Mindfulness
10.4 Guided Imagery
10.5 Biofeedback
10.6 Progressive Muscle Relaxation
10.7 Art Therapy
10.8 Music Therapy
10.9 Exercise
10.10 A New Hobby
10.11 Conclusions
11 Tinnitus in Children
11.1 Introduction
11.2 Prevalence
11.3 Etiology of Tinnitus in Children
11.4 Factors that may Promote Tinnitus in Children
11.4.1 Age
11.4.2 Gender
11.4.3 Hearing Loss
11.4.4 Temporary Threshold Shifts
11.4.5 Motion Sickness
11.4.6 Hyperacusis
11.5 Criteria of Tinnitus in Children
11.6 Impact of Tinnitus on Children and Parents
11.7 Evaluation
11.7.1 History
11.7.2 Physical Examination
11.7.3 Audiological
11.7.4 Laboratory Evaluations
11.7.5 Radiological
11.8 Preventing Tinnitus in Children
11.9 Treatment Options
11.9.1 Medical Treatment
11.9.2 Surgical Treatment
11.9.3 Counseling Treatment for Young Children
11.10 Conclusion
12 Measuring Tinnitus and Reactions to Tinnitus
12.1 Introduction
12.2 Measuring Tinnitus
12.2.1 Psychoacoustic Measurements
12.2.2 Measuring Reactions to Tinnitus
12.3 Measuring Quality of Life
12.3.1 Measuring Related Problems
12.4 Conclusions
Appendix 12.1 Data Sheet
Appendix 12.2 Tinnitus Handicap Questionnaire
Appendix 12.3 Tinnitus Intake Questionnaire
Appendix 12.4 Meaning of Life and Happiness Questionnaire
Appendix 12.5 Ordered References for Tinnitus Outcome Measures
13 Hyperacusis
13.1 Introduction
13.2 Terminology
13.3 Causes
13.4 Mechanisms
13.5 Measuring Hyperacusis
13.6 Questionnaires
13.7 Treatments
13.7.1 Counseling—Hyperacusis Activity Treatment
13.7.2 Introduction
13.7.3 Thoughts and Emotions
13.7.4 Hearing and Communication
13.7.5 Sleep
13.7.6 Concentration
13.7.7 Hearing Protection
13.7.8 Sound Therapies
13.7.9 Using Hearing Aids to Help with Hyperacusis
13.8 Conclusion
Appendix 13.1 Hyperacusis Problems Questionnaire
Appendix 13.2 Hyperacusis Intake Questionnaire
Appendix 13.3 Hyperacusis Disability and Handicap Scales
Appendix 13.4 Life too Loud? Let’s Talk Hyperacusis
Appendix 13.5 Hyperacusis Activities Treatment
Appendix 13.6 Sound Therapy Treatment Protocol for Hyperacusis
Appendix 13.7 Hyperacusis Listening Diary Example Case
14 Navigating Future Directions in Tinnitus Treatment
14.1 Introduction
14.1.1 What Should a Clinician Tell a Patient About Novel Treatment Methods?
14.2 Neuromodulation—Magnetic Stimulation, Electric Stimulation
14.2.1 What Is Magnetic Neuromodulation?
14.2.2 Magnetic Stimulation and Tinnitus
14.2.3 Caveats
14.2.4 Electric Stimulation
14.2.5 Electric Stimulation and Tinnitus
14.2.6 Caveats
14.3 Vagus Nerve Stimulation
14.3.1 Vagus Nerve Stimulation and Tinnitus
14.3.2 Caveats
14.4 Neurofeedback
14.4.1 Neurofeedback and Tinnitus
14.4.2 Caveats
14.5 Conclusions
15 Establishing a Tinnitus and Hyperacusis Clinic
15.1 Introduction
15.2 Structuring Clinical Services
15.2.1 Group Educational Session
15.2.2 Individual Sessions
15.3 Different Treatment Levels for Different Tinnitus and Hyperacusis Patients
15.3.1 Tinnitus
15.3.2 Hyperacusis
15.4 Billing for Tinnitus Services
15.5 Conclusion
Appendix 15.1 Shared Medical Visit Waiver
Appendix 15.2 Tinnitus Intake Questionnaire
Appendix 15.3 Tinnitus Treatment Fact Sheet
Index
Additional MedOne Access Information