The effect of hearing amplification on tinnitus improvement

  • Sara Bahaghighat Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
  • Saeid Farahani Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
  • Reza Hoseinabadi Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
  • Shohreh Jalaie Biostatistics, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
Keywords: Tinnitus handicap inventory; psychoacoustic measurement; visual analogue scale


Background and Aim: Using hearing aids is one of the most important management methods for patients with hearing loss and tinnitus. Many studies have been conducted to assess the effect of hearing aids on tinnitus using different tools, but there is no consensus on their usefulness and effect in relieving tinnitus. The present study aimed to investigate the effect of hearing amplification on tinnitus using the tinnitus handicap inventory (THI) and tinnitus psychoacoustic measurements.Methods: A total of 10 patients (5 male and 5 female), aged 39 to 70 years old with mild to severe sensorineural hearing loss (amplifiable hearing loss) and chronic tinnitus entered the study. The Persian version of the THI was completed for the patients and tinnitus psychoacoustic measurements, the visual analogue scale (VAS) loudness, and the annoyance VAS were performed. The patients used hearing aids for six weeks, and measurements were repeated after the intervention.Results: Comparing the total mean score of all of the study variables before and after the intervention showed significant reductions (p<0.05). Based on tinnitus pitch matching, no significant difference was observed in mean score changes in the THI between low-pitch and high-pitch groups.Conclusion: Improvement was observed in tinnitus annoyance after using hearing aids for 6 weeks. Tinnitus pitch is not a good criterion for determining tinnitus treatment prognosis.


1. Hoare DJ, Edmondson-Jones M, Sereda M, Akeroyd MA, Hall D. Amplification with hearing aids for patients with tinnitus and co-existing hearing loss. Cochrane Database Syst Rev. 2014;(1):CD010151. doi: 10.1002/14651858.CD010151.pub2
2. Kaltenbach JA, Zhang J, Finlayson P. Tinnitus as a plastic phenomenon and its possible neural underpinnings in the dorsal cochlear nucleus. Hear Res. 2005;206(1-2):200-26. doi: 10.1016/j.heares.2005.02.013
3. Kajsa-Mia H, Marie-Louise B, Jan S, Sigyn Z. Clinical evaluation of tinnitus: a review. Audiol Med. 2003;1(2):101-6. doi: 10.1080/16513860301714
4. Ruppert SD, Fay VP. Tinnitus evaluation in primary care. Nurse Pract.2012;37(10):20-6. doi: 10.1097/01.NPR.0000419297.02688.f4
5. Tunkel DE, Bauer CA, Sun GH, Rosenfeld RM, Chandrasekhar SS, Cunningham ER Jr, et al. Clinical practice guideline: tinnitus. Otolaryngol Head Neck Surg. 2014;151(2 Suppl):S1-S40. doi: 10.1177/0194599814545325
6. Henry JA. “Measurement” of Tinnitus. Otol Neurotol. 2016;37(8): e276-85. doi: 10.1097/MAO.0000000000001070
7. Newman CW, Sandridge SA, Snow J. Tinnitus questionnaires. In: Snow JB, editor. Tinnitus: theory and management. Hamilton, London: BC Decker Inc; 2004. p. 237-55.
8. Surr RK, Kolb JA, Cord MT, Garrus NP. Tinnitus handicap inventory (THI) as a hearing aid outcome measure. J Am Acad Audiol. 1999;10(9):489-95.
9. Araujo Tde M, Iório MC. Effects of sound amplification in self-perception of tinnitus and hearing loss in the elderly. Braz J Otorhinolaryngol. 2016;82(3):289-96. doi: 10.1016/j.bjorl.2015.05.010
10. Rocha AV, Mondelli MFCG. Sound generator associated with the counseling in the treatment of tinnitus: evaluation of the effectiveness. Braz J Otorhinolaryngol. 2017;83(3):249-55. doi: 10.1016/j.bjorl.2016.03.021
11. Cribari J, Ribas A, Fonseca VR, Moretti CM, Zeigelboim BS, Martins J, et al. Description of tinnitus and its relation to discomfort level in a group of elderly hearing aid wearers. Int Tinnitus J. 2016;20(1):36-41. doi: 10.5935/0946-5448.20160007
12. Melin L, Scott B, Lindberg P, Lyttkens L. Hearing aids and tinnitus--an experimental group study. Br J Audiol. 1987;21(2):91-7. doi: 10.3109/03005368709077782
13. Zhao F, Manchaiah V, St Claire L, Danermark B, Jones L, Brandreth M, et al. Exploring the influence of culture on hearing help-seeking and hearing-aid uptake. Int J Audiol. 2015;54(7):435-43. doi: 10.3109/14992027.2015.1005848
14. Folmer RL, Martin WH. Mechanisms and treatment of tinnitus. In: Valente M, Hosford-Dunn H, Roeser RJ, editors. Audiology treatment. 2nd ed. New York. Thieme Medical Publishers Inc.; 2008. p. 485-506.
15. Alberti PW. Hearing aids and aural rehabilitation in a geriatric population. J Otolaryngol Suppl. 1977;4:I-V, 1-50.
16. Mahmoudian S, Shahmiri E, Rouzbahani M, Jafari Z, Keyhani M, Rahimi F, et al. Persian language version of the "tinnitus handicap inventory": translation, standardization, validity and reliability. Int Tinnitus J. 2011;16(2):93-103.
17. Newman CW, Jacobson GP, Spitzer JB. Development of the tinnitus handicap inventory. Arch Otolaryngol Head Neck Surg. 1996;122(2):143-8. doi: 10.1001/archotol.1996.01890140029007
18. Henry JA, Dennis KC, Schechter MA. General review of tinnitus: prevalence, mechanisms, effects, and management. J Speech Lang Hear Res. 2005;48(5):1204-35. doi: 10.1044/1092-4388(2005/084)
19. Degeest S, Corthals P, Dhooge I, Keppler H. The impact of tinnitus characteristics and associated variables on tinnitus-related handicap. J Laryngol Otol. 2016;130(1):25-31. doi: 10.1017/S0022215115002716
20. Adamchic I, Langguth B, Hauptmann C, Tass PA. Psychometric evaluation of visual analog scale for the assessment of chronic tinnitus. Am J Audiol. 2012;21(2):215-25. doi: 10.1044/1059-0889(2012/12-0010)
21. Figueiredo RR, Azevedo AA, Oliveira Pde M. Correlation analysis of the visual-analogue scale and the tinnitus handicap inventory in tinnitus patients. Braz J Otorhinolaryngol. 2009;75(1):76-9.
22. Beck DL. Hearing aid amplification and tinnitus: 2011 overview. Hear J. 2011;64(6):12-4. doi: 10.1097/01.HJ.0000399148.45621.0f
23. Schaette R, König O, Hornig D, Gross M, Kempter R. Acoustic stimulation treatments against tinnitus could be most effective when tinnitus pitch is within the stimulated frequency range. Hear Res. 2010;269(1-2):95-101. doi: 10.1016/j.heares.2010.06.022
24. Jalilvand H, Pourbakht A, Haghani H. Hearing aid or tinnitus masker: which one is the best treatment for blast-induced tinnitus? The results of a long-term study on 974 patients. Audiol Neurootol. 2015;20(3):195-201. doi: 10.1159/000377617
25. Newman CW, Sandridge SA, Jacobson GP. Psychometric adequacy of the tinnitus handicap inventory (THI) for evaluating treatment outcome. J Am Acad Audiol. 1998;9(2):153-60.
26. Berberian AP, Ribas A, Imlau D, Guarinello AC, Massi G, Tonocchi R, et al. Benefit of using the prosthesis with sound generators in individuals with tinnitus associated with mild to moderately severe hearing loss. Int Tinnitus J. 2017;20(2):64-8. doi: 10.5935/0946-5448.20160012
27. dos Santos GM, Bento RF, de Medeiros IR, Oiticcica J, da Silva EC, Penteado S. The influence of sound generator associated with conventional amplification for tinnitus control: randomized blind clinical trial. Trends Hear. 2014;18. pii: 2331216514542657. doi: 10.1177/2331216514542657
28. Andersson G, Keshishi A, Baguley DM. Benefit from hearing aids in users with and without tinnitus. Audiol Med. 2011;9(2):73-8. doi: 10.3109/1651386X.2011.570914
29. Meikle MB, Stewart BJ, Griest SE, Henry JA. Tinnitus outcomes assessment. Trends Amplif. 2008; 12(3): 223-35. doi: 10.1177/1084713808319943
30. Shekhawat GS, Searchfield GD, Stinear CM. Role of hearing aids in tinnitus intervention: a scoping review. J Am Acad Audiol. 2013;24(8):747-62. doi: 10.3766/jaaa.24.8.11
31. Folmer RL, Carroll JR. Long-term effectiveness of ear-level devices for tinnitus. Otolaryngol Head Neck Surg. 2006;134(1):132-7. doi: 10.1016/j.otohns.2005.09.030
32. Jastreboff PJ, Hazell JW, Graham RL. Neurophysio¬logical model of tinnitus: dependence of the minimal masking level on treatment outcome. Hear Res. 1994;80(2):216-32.
33. McNeill C, Távora-Vieira D, Alnafjan F, Searchfield GD, Welch D. Tinnitus pitch, masking, and the effectiveness of hearing aids for tinnitus therapy. Int J Audiol. 2012;51(12):914-9. doi: 10.3109/14992027.2012.721934
34. Lee K, Makino K, Yamahara K. Evaluation of tinnitus retraining therapy for patients with normal audiograms versus patients with hearing loss. Auris Nasus Larynx. 2018;45(2):215-21. doi: 10.1016/j.anl.2017.03.009
How to Cite
Bahaghighat S, Farahani S, Hoseinabadi R, Jalaie S. The effect of hearing amplification on tinnitus improvement. Aud Vestib Res. 27(4):223-30.
Research Article(s)