Seminars in Hearing最新文献

Clinical services for tinnitus have expanded greatly since the "masking" method was introduced by Jack Vernon in the 1970s. According to PubMed, the number of peer-reviewed publications has increased dramatically since that time (seven with "tinnitus" in the title in 1975; 477 in 2023). With so much research and overall interest, it might be expected that tinnitus services have improved accordingly. In reality, there are many variations of treatment, but no one method has been shown to be more effective than any other. This diversity of methods is evident when researching "tinnitus" on the internet and considering the many different ways clinicians offer tinnitus services. Some offer an evidence-based method but may not have the competency to ensure fidelity. Further is the proliferation of commercial methods that can cost thousands of dollars. In this article, I propose a framework for providing tinnitus clinical services called Tinnitus Stepped-Care. This framework does not promote specific procedures for tinnitus assessment and treatment, but rather suggests guiding principles that are essential in each of six progressive steps of tinnitus clinical care. It is further proposed to test the stepped-care model in the (currently under development) Tinnitus Learning Health Network (TLHN). The TLHN would consist of a network of clinicians, patients, and researchers from around the world who collaborate in establishing "best tinnitus practices." Collaboration would involve using and sharing data for the ongoing monitoring of a large, diverse, well-described patient population, and using quality improvement science to test and monitor outcomes over time, to determine the most effective treatments for different subgroups of tinnitus patients.

There is strong evidence that attention plays an important role in tinnitus perception, but less is known about its role in treating tinnitus. This review scoped the literature for evidence of the role attention plays in tinnitus therapy and catalogued the methods employed, clinical outcomes, and the degree to which interventions for tinnitus were supported. The research question was "what role does attention play in the management or treatment of tinnitus." To identify relevant studies, database searches of Scopus (keywords) PsychArticle (title and abstract), CINAHL complete (title and abstract), and PubMed (title and abstract) were performed in March/April 2024 using the following search terms: [tinnitus] and [attention] and [treatment] or [therapy] or [management]. After the removal of duplicates, 494 articles were identified. After exclusions, and additions from references, 38 articles were included in the review. Treatments were classified into five types: electrical/magnetic stimulation, psychological, sound therapy, music therapy, and perceptual training. Sound therapy and perceptual training were identified as having the most evidence for their benefit via an attention mechanism. A model of sound and perceptual training in alleviating tinnitus through an attention pathway is presented.

The weight of evidence supports hearing aids playing an important role in tinnitus management. Less information is available about the role of auditory rehabilitation (AR) in the hearing aid therapy process. The research question was "what role has amplification and AR played in the management of tinnitus." To identify relevant studies, database searches of Scopus (keywords), Embase (keywords), and PubMed (title and abstract) were carried out in April/May 2024 using the following search terms [tinnitus] and [amplification] or [hearing aids]. Articles were excluded if not written in English or unavailable in full text. Reviews and protocols were excluded. Once duplicates were removed, 495 articles were screened with 58 articles being included in the review. After cataloguing, articles were divided into those that described use of AR in their methods and those that did not. AR was subcategorized into four categories and described as (1) instruction, (2) counseling, (3) sensory management, (4) perceptual training. Articles published in the last 12 years support the use of hearing aids. The use of AR in addition to amplification was common but its content, application, and contribution to outcomes were ambiguous. Augmentation of amplification benefits for tinnitus through AR presents an opportunity for future research. In future research, each AR component needs to be described in greater detail and the relative merits of different types of AR and their role in personalized therapy needs to be ascertained.

This article is the first in a two-part series intended to provide guidance related to the essential components of establishing a tinnitus care pathway in your clinic. Please see Part 2: Implementation for Additional Details Related to Implementation of the Suggested Protocols.

Tinnitus is the perception of sound without the presence of an external stimulus. The mechanisms associated with tinnitus are not entirely known, making diagnosis and treatment challenging. Although tinnitus mechanisms are not entirely known, there is evidence supporting an association between tinnitus with cochlear damage, reduced inhibition, and atypical cortical function. These mechanisms have been studied in animal models and people with tinnitus using a variety of different approaches. One approach that is a possible indicator of tinnitus in humans is sensory or auditory gating, which is a measure of inhibition. The goals of this article are to (1) review the mechanistic evidence associating tinnitus with cochlear damage and reduced inhibition, (2) discuss evidence of inhibitory impairments in people with tinnitus represented by auditory gating, and (3) address potential future directions to improve our ability to evaluate auditory gating mechanisms in people with tinnitus.

[This corrects the article DOI: 10.1055/s-0044-1786506.].