Effect of Tinnitus Habituation Therapy on Auditory Abilities

Burle, Najlla Lopes de O.; Resende, Luciana Macedo de; Alves, Luciana Mendonça; Garcia, Vinícius Soares; Mancini, Patricia Cotta

doi:10.1055/s-0040-1708897

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International Archives of Otorhinolaryngology

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Original Research • iao 25 (1) • Jan-Mar 2021 • https://doi.org/10.1055/s-0040-1708897 copy

Effect of Tinnitus Habituation Therapy on Auditory Abilities

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

Research with tinnitus patients presenting with hearing loss and normal hearing subjects have verified that tinnitus interferes with auditory processing. One treatment option for this symptom consists of tinnitus habituation therapy.

Objective

To determine the influence of tinnitus habituation therapy on auditory abilities, on the self-perception of tinnitus regarding loudness and discomfort, and its impact on the quality of life.

Methods

A quasi-experimental study was conducted with 19 individuals with tinnitus. Audiological tinnitus and auditory processing evaluations were performed. Subsequently, the volunteers underwent tinnitus habituation therapy for 6 months. Ultimately, all of the individuals were reevaluated.

Results

A statistically significant reduction in tinnitus self-perception was observed in relation to loudness, discomfort, and its impact on the quality of life (p = 0.001, 0.001, 0.023, respectively). However, the influence of tinnitus habituation therapy on auditory abilities was not verified.

Conclusion

Tinnitus habituation therapy was effective in reducing the self-perception of tinnitus loudness and discomfort, as well as the impact of the symptom on the quality of life. However, these factors did not improve the auditory processing skills in tinnitus patients.

Keywords
tinnitus; auditory abilities; auditory perception

Hyperacusis	Discomfort Threshold
Negative	95 db or > at all frequencies
Mild	80-90 db at two or more frequencies
Moderate	65-75 at two or more frequencies
Severe	60 db or < at two or more frequencies

Test	Hearing Abilities	Performance Parameters
NS	Auditory Closing	Monoaural presentation at 40 dBSL of 25 monosyllables with ipsilateral white noise at a S/R ratio = + 5
SSW	Figure-background for verbal sounds Binaural integration Binaural separation	Dichotic presentation at 50 dBSL of four alternate disyllables.
PPS	Temporal ordination	Monoaural presentation at 50 dBSL of three pure tones in sequence for the patient to designate as delicate/heavy (sharp/bass).
GIN	Temporal resolution	Monoaural presentation at 50 dBSL for the detection of silence intervals in the noise.
MLD	Binaural interaction	Binaural presentation at 50 dBSL of noise and pulsatile tones of 500 Hz, in and out of phase.

Tinnitus characteristics		n	%
Sound description	Cricket	7	36.8
	Wheezing/Creaking	7	36.8
	Pressure Pot	2	10.5
	Cicada	1	5.3
	Bee	1	5.3
	Drops	1	5.3
Localization	RE	4	21.1
	LE	1	5.3
	RE > LE	4	21.1
	LE > RE	4	21.1
	RE = LE	4	21.1
	Head	2	10.5
Duration of tinnitus	Constant	16	84.2
Duration of tinnitus	Variable	2	15.8
Loudness	Mild	5	26.3
	Moderate	9	47.4
	Intense	2	10.5
	Variable	3	15.8
Occurrence	Sporadic	2	10.5
	Frequent	4	21.1
	Very frequent	13	68.4
Onset	Sudden	9	47.4
Onset	Progressive	10	52.6

Frequent pain	N	%
Headache Neck pain TMJ Otalgia	8 5 3 1	42.1 26.3 15.8 5.3

Diseases	N	%
High blood pressure Migraines Diabetes Heart disorders Cranial trauma High cholesterol	5 4 3 2 1 1	26.3 21.1 15.8 10.6 5.3 5.3

Loudness (dBNS)	Minimum	Maximum	Average	Standard deviation	p-value
Initial Final	1 1	12 10	7.16 4.26	3.35 2.46	0.001*

Discomfort Threshold		N	%	p-value
Initial RE	Negative Mild Moderate Severe	6 6 3 4	31.6 31.6 15.8 21.1	0.416
Final RE	Negative Mild Moderate Severe	9 6 3 1	47.4 31.6 15.8 5.3	0.416
Initial LE	Negative Mild Moderate Severe	7 5 3 4	36.8 26.3 15.8 21.1	0.287
Final LE	Negative Mild Moderate Severe	11 2 5 1	57.9 10.5 26.3 5.3	0.287

	Assessments		Minimum	Maximum	Average	Standard deviation	p-value
CAP	SSW CR SSW CL NS RE NS LE PPS RE PPS LE GIN RE GIN LE MLD	Initial Final Initial Final Initial Final Initial Final Initial Final Initial Final Initial Final Initial Final Initial Final	57.5 60.0 18.0 17.5 72.0 80.0 76.0 84.0 30.0 73.3 46.6 73.3 5.0 5.0 5.0 5.0 8.0 8.0	100 100 98.0 97.5 100 100 100 100 100 100 100 100 15.0 12.0 12.0 10.0 20.0 18.0	83.6 85.7 72.8 76.8 91.3 92.6 91.7 93.8 88.5 90.6 89.7 90.6 7.0 7.3 8.2 8.5 13.5 12.9	12.4 11.5 23.3 20.6 7.9 6.5 7.3 5.0 16.7 8.7 13.7 8.4 2.8 2.4 1.8 1.8 3.3 2.8	0.243 0.061 0.299 0.082 0.592 0.948 0.418 0.626 0.626
THI	Functional Emotional Catastrophic Total	Initial Final Initial Final Initial Final Initial Final	0.0 0.0 0.0 0.0 0.0 0.0 8.0 4.0	28.0 20.0 30.0 28.0 14.0 14.0 72.0 54.0	12.5 7.6 12.6 8.0 6.9 6.5 32.1 21.6	8.3 6.5 8.8 6.9 4.3 3.7 19.5 13.7	0.044* 0.004* 0.706 0.023*
VAS	Initial Final	2.0 1.0	10.0 8.0	6.7 4.9	2.4 2.1	0.001*

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[1] Address for correspondence Patrícia Cotta Mancini, PhD, Departmento de Fonoaudiologia, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, Brazil (patmancini@gmail.com)