Tinnitus Assessment and Management: A Survey of Practicing Audiologists in the United States and Canada

Abstract

Background Tinnitus is a prevalent auditory disorder that can become severely debilitating. Despite decades of investigation, there remains no conclusive cure for tinnitus. Clinical practice guidelines (CPGs) are available for assessing and managing tinnitus. Even though such guidelines have been available for several years, the degree that audiologists adhere to them has remained unexplored. Purpose of Study To determine what clinical practices are commonly used by audiologists in the assessment and management of the patient population with tinnitus, we administered an online survey to audiologists practicing in the United States and Canada. Results Among the audiologists that completed the survey and were included in the final analysis (n = 61), 70% were from the United States and 30% were from Canada. The audiologists represented a wide range of clinical experience (1–35 years). On average, those who completed the survey were relatively confident in their ability to assess and manage tinnitus patients indicated by a 0 to 100 Likert scale, with 0 representing no confidence (mean 72.5, ± 21.5 standard deviation). The most commonly reported tinnitus assessment tools were pure tone audiogram (0.25–8 kHz), administration of standardized questionnaires, and tinnitus pitch and loudness matching. Approximately half (55%) of audiologists indicated they include otoacoustic emissions, while less audiologists (<40%) reported measuring high-frequency thresholds, minimum masking levels, or loudness discomfort levels. The most common recommendation for tinnitus patients was amplification (87%), followed by counseling (80%) and sound therapy (79%). Conclusion Few audiologists administer a truly comprehensive tinnitus assessment and ∼20% indicated not recommending counseling or sound therapy to manage tinnitus. The results are discussed in the context of what is explicitly indicated in published CPGs, professional organization recommendations, and recent findings of peer-reviewed literature.

Seeking Help for Tinnitus and Satisfaction With Healthcare Providers Including Diagnosis, Clinical Services, and Treatment: A Scoping Review

“…Studies surveying health professionals who provide services for tinnitus mainly GPs, ENTs and audiologists show that there is a need for appropriate adherence of healthcare providers to tinnitus guidelines, improved access to specialised tinnitus assessment, tinnitus management or treatments and access to tailored psychological tinnitus care ( El-Shunnar et al, 2011 ; Gander et al, 2011 ; Hall et al, 2011 ; Hoare et al., 2012 , 2015 ; Kochkin & Tyler, 2008 ; McFerran et al, 2019 ; Redmond, 2010 ; Sheppard et al, 2022 ). A survey of members of the British Tinnitus Association (BTA), which included individuals with tinnitus as well as health professionals working with tinnitus patients, identified a number of uncertainties in tinnitus assessment, diagnosis and treatment along the clinical pathway ( Hall et al, 2013 ).…”

Improving Audiology Student Training by Clinical Simulation of Tinnitus: A Glimpse of the Lived Experience of Tinnitus

“…These findings are consistent with what is known on the short-term effects of the simulation of the experience of illness on learners [ 28 ]. Still, psychoacoustic measures of tinnitus are not widely used in clinical settings by audiologists in the US and Canada [ 19 ]. This may not be surprising, considering that specific training devoted to tinnitus was only incorporated into the audiology curriculum very recently in the US [ 20 ].…”

“…Still, it is now well accepted that tinnitus evaluation and management are professional acts that are within the scope of practice of audiologists, as advocated by national professional organizations such as the American Speech and Hearing Association and the American Academy of Audiology (USA), Speech and Audiology Canada and the Canadian Academy of Audiology (Canada). However, the level of knowledge regarding tinnitus evaluation and care shown by audiologists may vary greatly from one professional to another [ 19 ]. One potential factor contributing to this heterogeneity may be the differences in training devoted to tinnitus across audiology programs.…”