Hearing Therapy Improves Tinnitus-Related Distress in Mildly Distressed Patients with Chronic Tinnitus and Mild-to-Moderate Hearing Loss: A Randomized-Controlled Cross-Over Design

Abstract

Background: The psychological effects of hearing aids and auditory training are underinvestigated. Objective: To assess the short- and long-term effects of an industry-developed auditory training on tinnitus-related distress, perceived stress, and psychological epiphenomena in patients with chronic tinnitus and mild-to-moderate hearing loss. Method: One-hundred-seventy-seven gender-stratified patients were randomized to an immediate [IIG] or delayed [DIG] intervention group. Following binaural hearing aid fitting, participants completed a CD-enhanced 14-days self-study program. Applying a randomized-controlled cross-over design, psychological measures were obtained at four times: pre-treatment/wait [IIG: t1; DIG: wait], post-treatment/pre-treatment [IIG: t2; DIG: t1], follow-up/post-treatment [IIG: t3; DIG: t2], and follow-up [DIG: t3]. Between- and within-group analyses investigated treatment-related effects and their stability at a 70-day follow-up. Results: Overall, distress symptom severity was mild. Unlike the DIG, the IIG showed significant improvements in tinnitus-related distress. Some psychological epiphenomena, notably anxiety, slightly improved in both groups. Within-group analyses demonstrated the stability of the tinnitus-distress-related effects, alongside uncontrolled improvements of perceived stress and mood-related symptoms at follow-up. Conclusions: The investigated hearing therapy lastingly improves tinnitus-related distress in mildly distressed patients with chronic tinnitus and mild-to-moderate hearing loss. Beneficial psychological knock-on effects deserve further investigation.

Tinnitus und beeinflussende Komorbiditäten

“…For individuals with hearing loss, hearing aids are the initial treatment option of choice, where applicable. Preliminary evidence suggests that the use of hearing aids can benefit tinnitus-related distress for patients with mild-to-moderate hearing loss 106 . In cases of profound hearing loss, a cochlear implant should be considered 117 118 119 .…”

“…Hearing aids may positively influence tinnitus-related distress 104 105 . For example, a recent randomized cross-over study demonstrated that a specific hearing aid fitting could reduce tinnitus-related distress in individuals with chronic tinnitus and mild-to-moderate hearing loss 106 . Whether hearing aids can also have a positive effect on cognitive difficulties is controversially discussed 80 107 108 109 110 .…”

“…Für Betroffene mit chronischem Tinnitus und Hörverlust können sich Hörgeräte zudem positiv auf die Tinnitusbelastung auswirken 104 105 . So zeigte zum Beispiel eine aktuelle randomisierte Wartegruppen-Kontroll-Studie, dass eine spezielle Hörgeräteanpassung für Personen mit chronischem Tinnitus und leicht-bis-mittelgradigem Hörverlust sowohl die Tinnitusbelastung, als auch subjektives Stressempfinden und stimmungsbezogene Symptome nachhaltig senken konnte 106 . Ob sich Hörgeräte auch positiv auf kognitive Einschränkungen auswirken können, wird kontrovers diskutiert 80 107 108 109 110 .…”

“…Zur Behandlung eines oftmals initial festgestellten Hörverlusts sind Hörgeräte Mittel der Wahl. Erste Erkenntnisse weisen darauf hin, dass der Einsatz von Hörgeräten auch schon bei gering- bis mittelgradigem Hörverlust die Tinnitusbelastung verringern kann 106 . Bei hochgradiger Schwerhörigkeit und belastend erlebtem Tinnitus sollte ein Cochlea-Implantat erwogen werden 117 118 119 .…”

The Effect of Alpha-Lipoic Acid in the Treatment of Chronic Subjective Tinnitus through the Tinnitus Handicap Inventory Scores

“…The mean improvement in the THI total score corresponds to the minimal clinically relevant change for evaluating treatment effects [ 53 ]. Since it was shown that THI significantly predicts depression, anxiety, and stress [ 54 ], we can conclude that a reduction in functional limitations is accompanied by the amelioration of distress, even though beneficial psychological knock-on effects deserve further investigation [ 55 ].…”