Evidence review for audiological assessment: Tinnitus: assessment and management

Excerpt

People who have tinnitus may be offered one or more tests to assess the function of their hearing. People present with tinnitus without realising that they have a hearing loss. Identifying a problem in the hearing system can be helpful to understand why someone might have tinnitus, and can inform management decisions, for instance, if a hearing aid is suitable or not.

In this review we considered the following tests:

1. Audiometry (hearing assessments) (including pure tone, distraction testing, visual reinforcement, play and performance audiometry and speech audiometry) to establish hearing thresholds and identify any existing hearing loss. Tinnitus can be associated with sensorineural hearing loss for example through exposure to loud noise or aging.

2. Tympanometry is used to assess the ear drum and the functioning of the middle ear and may help to identify the cause of tinnitus.

3. Acoustic reflexes measure the functioning of the middle ear muscles in reaction to loud sounds.

4. Uncomfortable loudness level (ULL)/ Loudness discomfort level (LDL) measures the volume at which external sounds become uncomfortable.

5. Otoacoustic emissions (OAEs) assess the functioning of the hair cells in the cochlea by measuring sounds produced by the movement of the basilar membrane.

Practice varies considerably across the country. This review has been carried out to identify which tests are clinically and cost effective for assessing the hearing system in patients with tinnitus.

The review aims to evaluate the clinical and cost-effectiveness of different audiological assessments used by different healthcare professionals for the assessment of tinnitus. These audiological assessments would be followed up by appropriate interventions for tinnitus and the resulting patient outcomes assessed.