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Tinnitus in Patients with Sensorineural Hearing Loss: Management and Quality of Life
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
2012 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Approximately 15 % of Swedish people experience tinnitus, but only 2.4 % of them experience severe problems. Treatment modalities for tinnitus are varied, but the most common treatment model is counselling. The majority of patients with tinnitus report some degree of hearing loss, and in addition, hearing aids have been used for many years in patients who suffer from both tinnitus and hearing impairment.

The aim of the present thesis was to investigate the disease management and identify the quality of life in patients with tinnitus and sensorineural hearing loss.

Both studies described here are retrospective, descriptive studies of patients who sought care for tinnitus and hearing loss at the two ENT clinics in Östergötland County, Sweden, during 2004 - 2007 and who also received a diagnosis code. A medical record review of all patients (study I contained 1672 subjects) revealed that 714 patients were diagnosed with both tinnitus and SNHL between 2004 and 2007 and could be included in study II.

The results showed that 70% of our cohort had tinnitus, but many of the patients initially did not receive a diagnosis for their tinnitus. Information about the patients’ vertigo, heredity for hearing loss and tinnitus, diabetes history, cardiovascular disease history and other factors related to their health was often missing from the medical records. Our findings showed that the Stepped Care Model, which however was only used in a minority of the cases, could be effective in patients with tinnitus and could provide a better care process for these patients. Of the cohort, 56% of the patients received a diagnosis of bilateral hearing loss. The pure tone average (PTA) of the left ear was significantly higher than that of the right ear. There were 314 patients (44%) who had hearing aids out of the total of 714, even though it is likely that hearing aids could be beneficial for these patients. We found that the overall scores for the Tinnitus Handicap Inventory (THI) were higher in female patients than male patients. All patients who participated in study II estimated their life quality and general health at a good level. This could be due to the fact that they were investigated 4.5 years after they first reported their tinnitus and that tinnitus annoyance decrease over time. Further, the outcomes of study II demonstrated that the majority of patients, who were dissatisfied with the care they obtained, had no hearing aids. This could indicate a support the use of hearing aids fitting as main treatment model in patients with both tinnitus and hearing loss.

Future research is needed to investigate how hearing aid professionals could motivate patients who suffer from both tinnitus and hearing loss to use hearing aids.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2012. , 56 p.
Series
Linköping Studies in Health Sciences. Thesis, ISSN 1100-6013 ; 123
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-81413ISBN: 978-91-7519-830-9 (print)OAI: oai:DiVA.org:liu-81413DiVA: diva2:552301
Presentation
2012-10-05, Flemingsalen, plan 10, Södra entren, Campus US, Linköpings universitet, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2012-09-14 Created: 2012-09-13 Last updated: 2012-09-14Bibliographically approved
List of papers
1. A cohort study of patients with tinnitus and sensorineural hearing loss in a Swedish population
Open this publication in new window or tab >>A cohort study of patients with tinnitus and sensorineural hearing loss in a Swedish population
2013 (English)In: Auris, nasus, larynx, ISSN 0385-8146, E-ISSN 1879-1476, Vol. 40, no 1, 41-45 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: We aimed to describe a large cohort of patients with tinnitus and sensorineural hearing loss (SNHL) in Sweden, and also to explore the possibility of finding potential possible differences between various diagnoses within SNHL. It is also of great interest to see how a multidisciplinary team was used in the different subgroups and the frequency of hearing aids use in patients with tinnitus.

METHODS: Medical records of all patients who had received the diagnosis SNHL in Östergötland County, Sweden between 2004 and 2007 were reviewed. Patients between 20 and 80 years with tinnitus and a pure tone average (PTA) lower than 70dB HL were included in the study. Patients were excluded from the analyses if they had a cochlear implantation, middle ear disorders or had a hearing loss since birth or childhood. The investigators completed a form for each included patient, covering background facts, and audiograms taken at the yearly check up.

RESULTS: Of a total 1672 patients' medical record review, 714 patients were included. The majority of patients (79%) were in the age group over 50 years. In male patients with bilateral tinnitus, the PTA for the left ear was significantly higher than for the right ear. The results regarding the configuration of hearing loss revealed that 555 patients (78%) had symmetric and 159 (22%) asymmetric hearing loss. Retrocochlear examinations were done in 372 patients and MRI was the most common examination. In all patients, 400 had no hearing aids and out of those 220 had unilateral tinnitus and 180 patients had bilateral tinnitus. 219 patients had a PTA>20dB HL and did not have any hearing aid. Results demonstrated that the Stepped Care model was not used widely in the daily practice. In our study, patients with bilateral-, unilateral hearing loss or Mb Ménière were the most common patients included in the Stepped Care model.

CONCLUSION: In a large cohort of patients with SNHL and tinnitus, despite their hearing loss only 39% had hearing aids. It was observed that the medical record review often showed a lack of information about many background factors, such as; patients' general health condition, which could be a quality factor that needs improvement. Our results show that the Stepped Care model could be an effective option for providing a better access for tinnitus-focused treatment, although the number of patients in this study who were included in the Stepped Care model was low.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-81411 (URN)10.1016/j.anl.2012.05.005 (DOI)22652486 (PubMedID)
Available from: 2012-09-13 Created: 2012-09-13 Last updated: 2017-12-07Bibliographically approved
2. Quality of life in patients with tinnitus and sensorineural hearing loss
Open this publication in new window or tab >>Quality of life in patients with tinnitus and sensorineural hearing loss
2014 (English)In: B-ENT, ISSN 1781-782X, Vol. 10, no 1, 41-51 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: The aim of this study was to evaluate the quality of life in patients with tinnitus and SNHL, to investigate patients’ mental and physical health and to measure the level of satisfaction concerning the care experienced by the patients.

Methods: Three questionnaires related to patients` physical and psychological health, were mailed to 714 Swedish patients with tinnitus and sensorineural hearing loss.

Results: Female patients had significantly higher Tinnitus Handicap Inventory scores than male patients. Patients who were satisfied with the care they obtained had significantly higher PTA. It was found that the satisfied group had significantly lower THI-scores. In the dissatisfied group, 61% of patients had no hearing aids compared to 42% in the satisfied group.

Conclusion: Our cohort of patients estimated their life quality and general health at a good level almost 4.5 years after their first report of tinnitus. Another finding was that 47% of patients were not satisfied with the treatment they obtained. In the dissatisfied group, 61% of patients had no hearing aids. Further research is required to find an approach that could motivate patients with both tinnitus and hearing impairment to use hearing aids.

Place, publisher, year, edition, pages
ROYAL BELGIAN SOC EAR, NOSE, THROAT, HEAD & NECK SURGERY, 2014
Keyword
Tinnitus, Sensorineural hearing loss, Questionnaire, Quality of life
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-81412 (URN)000334566200007 ()24765828 (PubMedID)
Available from: 2012-09-13 Created: 2012-09-13 Last updated: 2017-02-20Bibliographically approved

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