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. 2014 Jan 31;2014(1):CD010151.
doi: 10.1002/14651858.CD010151.pub2.

Amplification with hearing aids for patients with tinnitus and co-existing hearing loss

Derek J Hoare  1 , Mark Edmondson-Jones, Magdalena Sereda, Michael A Akeroyd, Deborah Hall
Affiliations

Amplification with hearing aids for patients with tinnitus and co-existing hearing loss

Derek J Hoare et al. Cochrane Database Syst Rev. .

Abstract

Background: Tinnitus is described as the perception of sound or noise in the absence of real acoustic stimulation. In the current absence of a cure for tinnitus, clinical management typically focuses on reducing the effects of co-morbid symptoms such as distress or hearing loss. Hearing loss is commonly co-morbid with tinnitus and so logic implies that amplification of external sounds by hearing aids will reduce perception of the tinnitus sound and the distress associated with it.

Objectives: To assess the effects of hearing aids specifically in terms of tinnitus benefit in patients with tinnitus and co-existing hearing loss.

Search methods: We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; Cambridge Scientific Abstracts; ICTRP and additional sources for published and unpublished trials. The date of the search was 19 August 2013.

Selection criteria: Randomised controlled trials and non-randomised controlled trials recruiting adults with subjective tinnitus and some degree of hearing loss, where the intervention involves amplification with hearing aids and this is compared to interventions involving other medical devices, other forms of standard or complementary therapy, or combinations of therapies, no intervention or placebo interventions.

Data collection and analysis: Three authors independently screened all selected abstracts. Two authors independently extracted data and assessed those potentially suitable studies for risk of bias. For studies meeting the inclusion criteria, we used the mean difference (MD) to compare hearing aids with other interventions and controls.

Main results: One randomised controlled trial (91 participants) was included in this review. We judged the trial to have a low risk of bias for method of randomisation and outcome reporting, and an unclear risk of bias for other criteria. No non-randomised controlled trials meeting our inclusion criteria were identified. The included study measured change in tinnitus severity (primary measure of interest) using a tinnitus questionnaire measure, and change in tinnitus loudness (secondary measure of interest) on a visual analogue scale. Other secondary outcome measures of interest, namely change in the psychoacoustic characteristics of tinnitus, change in self reported anxiety, depression and quality of life, and change in neurophysiological measures, were not investigated in this study. The included study compared hearing aid use to sound generator use. The estimated effect on change in tinnitus loudness or severity as measured by the Tinnitus Handicap Inventory score was compatible with benefits for both hearing aids or sound generators but no difference was found between the two alternative treatments (MD -0.90, 95% confidence interval (CI) -7.92 to 6.12) (100-point scale); moderate quality evidence. No negative or adverse events were reported.

Authors' conclusions: The current evidence base for hearing aid prescription for tinnitus is limited. To be useful, future studies should make appropriate use of blinding and be consistent in their use of outcome measures. Whilst hearing aids are sometimes prescribed as part of tinnitus management, there is currently no evidence to support or refute their use as a more routine intervention for tinnitus.

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Conflict of interest statement

DJH, MS and DH are researchers involved in an ongoing programme of research funded by National Institute for Health Research to assess the efficacy and effectiveness of current and novel sound‐based interventions for tinnitus. They are also conducting research on devices for treating tinnitus with The Tinnitus Clinic (DJH and DH) and Oticon A/S (MS and DH). DH has received fees for consultancy from Merz Pharmaceuticals GmbH. DJH is vice‐chair of the British Tinnitus Association's Professional Advisory Committee and a media spokesperson for the charity. DH is a member of the Board of Trustees of the British Tinnitus Association. ME‐J and MAA have no interests to declare.

Figures

1
1
Process for sifting search results and selecting studies for inclusion.
2
2
'Risk of bias' summary: review authors' judgements about each risk of bias item for the included study.
1.1
1.1. Analysis
Comparison 1 Hearing aid versus sound generator, Outcome 1 Tinnitus severity, as measured by change in tinnitus questionnaire score.
1.2
1.2. Analysis
Comparison 1 Hearing aid versus sound generator, Outcome 2 Tinnitus sound quality, loudness measured using change in visual analogue scale.
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