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People with tinnitus often characterize their tinnitus as “ringing in the ears” or a “buzzing sound.” The American Tinnitus Association (ATA) describes it as a subjective noise that only the patient can hear. About 50 million people in the United States experience tinnitus to some degree and, in severe cases, seek medical attention.
HR: Why should hearing care professionals who traditionally focus on hearing impairment get involved in tinnitus? Clint Keifer, AuD: As audiologists, we possess an in-depth understanding of the anatomical, physiological, and psychoacoustical aspects of the auditory system.
Wendy Switalski, AuD: In conversations I’ve had as an audiologist and as a consultant to audiologists, it is clear that these conditions coexist for so many of our patients. Clement Sanchez, AuD: Tinnitus can be a problem for those who are hearing impaired and have a hearing loss. Sanchez: Hearing aids can be very effective if they can reduce the symptoms related to the tinnitus.
A clinician can play a vital role in helping the patient deal with the sounds of everyday living, instead of avoiding sounds all together. Switalski: Professionals interested in expanding their services have so many resources available. Practices may begin by simply offering tinnitus assessment, patient questionnaires, or surveys.
Keifer: Ideally, practices would be “full-service,” but in practical terms, it is difficult for any one practice to offer every possible solution. Sanchez: Assessing tinnitus can be challenging, so clinicians who decide to add a full-service tinnitus treatment plan have a few details to consider. Aside from my traditional practice, I used to schedule consultation with tinnitus patients 1 day a week and this worked well. HR: I’ve heard that tinnitus patients can consume huge amounts of practice time and many dispensing professionals are not adequately staffed for that. Sanchez: Yes, tinnitus patients will need time to express their fears, frustrations, and the discomfort they are experiencing because the sounds they hear are unclear and can be difficult to describe. I would describe the tinnitus consultation as “a mix of charisma and empathy,” where clinicians can focus on gathering the information that can benefit the treatment. The MADSEN Astera2 features a dedicated tinnitus assessment module designed to help clinicians address increased claims for tinnitus and hearing loss disability. The new tinnitus test module we have developed as part of fundamental audiometry in MADSEN Astera2 supports the professional through a series of integrated questionnaires. Keifer: Tinnitus treatment protocols should not be rigid, but rather they should adapt to the individual. The treatment may also involve retraining strategies, amplification, masking, sound therapy device application, support group attendance, and so forth. Sanchez: In addition, it will entail an in-depth hearing assessment, such as audiometry with UCL, immittance, otoacoustic emissions (OAE), and auditory brainstem response (ABR).
The full tinnitus psychoacoustic test battery is designed to improve patient counseling and test precision. Visualization of the tinnitus on the audiogram is a great experience for a patient who has looked for help for years and may have felt misunderstood at times.
The electronic questionnaires—Tinnitus Functional Index (TFI), Tinnitus Handicap Inventory (THI) and Tinnitus and Hearing Survey (THS)—can be saved in NOAH and are designed to eliminate the need for paper records. The next step is explaining that, for example, a 7 dB tinnitus is quite a small issue that can be managed.
Once again, dialogue with other professionals is important and should be considered from the very beginning. HR: What types of equipment should you consider for your practice when starting up a tinnitus treatment program? Switalski: Having access to the proper audiometer features is important for performing a tinnitus assessment. Otometrics has developed a dedicated tinnitus management tool for audiologists, which is integrated with our clinical audiometer, the MADSEN Astera2. Our client, Michael Sommerlad, has enjoyed great success as an athlete in later life, helped also by great advances in hearing aid technology. Shortly after this, my doctor suggested more exercise, so I took up jogging and, rather foolishly, entered the ballot for the London Marathon. Eventually I needed a more powerful behind-the-ear model, but the disadvantage was more wind noise and problems when racing in the rain. My next aid was by Phonak, which came into its own when I was persuaded to try my luck at a duathlon. I have never worried much about appearances because I have grown up with an evident disability, but this new aid and mould is so small that it is only seen by people behind me.
If you are experiencing hearing problems, come along to our open house event at our main practice, 3b Headgate, Colchester CO1 1NU (by appointment only). Three times a year we produce a newsletter containing news and features on the latest hearing aids, issues related to hearing and hearing loss, latest developments at the Centre and more. You can choose to receive a paper copy of our newsletter or use the form on our 'contact us' page to request a digital PDF. Outstanding offer on a pair of cutting-edge new Widex Unique premium hearing aids PLUS 5 years’ free warranty, batteries and aftercare. With the new Widex Unique range of hearing aids, users can truly enjoy being outdoors and hear clearly, no matter the conditions.
The event raised another ?900 towards this amazing charity and the fantastic work they do to train and support hearing dogs.


Margo Harrison, a hearing impaired recipient, came along to speak at the event, also introducing us to 'Pebbles'. Thank you to all our loyal supporters and participants for helping make this year's Golf Day another great success. We commemorated 15 years since the establishment of The Hearing Care Centre with a scrummy Champagne Afternoon Tea at the newly refurbished Colchester Castle, on 25 June. Joined by many of our longstanding clients, we also welcomed as special guests the new Mayor and Mayoress of Colchester, John and Janet Elliott, as well as Mr Don McFerran, local Consultant ENT Surgeon.
We were also delighted to have father-and-daughter duo, Roger and Ruth Montgomery, providing background music. Vicki Skeels and Nancy Usher, the Centre's marketing manager, had the honour of helping to judge last year's Colchester Business Awards. As The Hearing Care Centre has itself been the proud recipient of numerous Excellent Customer Service awards over the years, and with Vicki just finishing her reign as Colchester Business Woman of the Year, we believe we are well equipped to accurately judge this category.'Outstanding customer service is something we continually strive for at the Centre,' says Vicki, 'and we know what this requires from all parts of our business – from frontline staff right through to back-office operations.
Vicki  and Dr Ella Carmaciu (our new micro-suction specialist) with Carolina, one of our new 'patients' in Brasov, Romania. During the October 2013 half-term, Vicki and a small team of volunteers had the opportunity to visit Romania, to bring help – and hearing – to hearing impaired pensioners unable to afford hearing aids.
Vicki Skeels has been appointed to the Council of the Association of Independent Hearing Healthcare Professionals (AIHHP).
AIHHP is dedicated to promoting excellence within the UK hearing industry, with members providing a range of higher quality services than is found on the high street.. We are proud to have joined a new scheme, run in conjunction with Help for Heroes and hearing aid manufacturer, Phonak.
As a member of AIHHP, we will provide free, state-of-the-art hearing aids to British Servicemen and women, who have been discharged from the forces due to damaged hearing in recent conflicts. Sound Therapy International - Tinnitus treatment, relieve stress and get emotional relief.
Sound Therapy International – Tinnitus treatment, relieve stress and get emotional relief. Sound Therapy has proven affective for tinnitus relief and is a key element of effective tinnitus treatment. Tinnitus is caused by repeated firing of auditory brain pathways that have become hyperactive and cannot switch off.
Sound Therapy works on neural plasticity, helping to stimulate and remap the auditory pathways. An 8 minute documentary with interviews and graphics explaining what Sound Therapy is and how it works. In some cases of objective tinnitus, physicians can identify the symptom with the use of a stethoscope placed on the neck or directly in the ear canal. There is currently no known cure for tinnitus; however, there are advanced devices and treatments today that can help alleviate tinnitus symptoms. Drs Sanchez, Switalski, and Keifer share their thoughts on the benefits of tinnitus assessment, and provide advice to audiologists and hearing care professionals who are interested in adding tinnitus assessment to their practice. As hearing care professionals, we are skilled in diagnostic, counseling, and rehabilitative approaches to managing auditory disorders.
And for some of them, treating the tinnitus is necessary to address the concerns that led them to seek hearing care in the first place.
They may have difficulty sleeping, be unable to concentrate, and experience irritability and high stress levels.
A hearing aid can amplify soft sounds, which can have a “masking” effect and helps to decrease the contrast between the environmental sounds and the tinnitus. This is an important step to address the patient’s fears and provide supportive tools when the tinnitus is too intense.
Today, tinnitus management tools also include sound enrichment devices, sound generation pillows, as well as sound generators like MP3 and relaxing music. Are there different levels at which practices can participate, or should every hearing care practice seek to have a full-service tinnitus treatment plan? They can also provide informational counseling and supplement their fittings with hearing instruments that include features and options for tinnitus relief.
My recommendation would be to offer as many options as possible within the means of the practice and the practitioner. Collaboration with other professionals like ENTs, psychologists, and general practitioners is helpful. Prior to the consultation, patients can fill out questionnaires in the waiting room to avoid external influences during the test. While proper diagnostic testing and quantification measures should be performed for hearing and tinnitus aspects, the treatment options will vary greatly based on the individual and should focus on addressing identifiable needs. Tinnitus can be viewed as a spectrum disorder where trying a combination of approaches may be necessary.
Highlighted in magnifying glass on lower left is the electronic questionnaires for the TFI, THI, and Tinnitus and Hearing Survey (THS), which saves in NOAH and eliminates the need for paper records. Clinicians should ensure they are working with a subjective tinnitus and characterization via the existing questionnaires, like the Tinnitus Handicap Inventory (THI), Tinnitus Functional Index (TFI), and Tinnitus Handicap Questionnaire (THQ). Testing efficiency and immediate availability of measurement results allow more time for consultation.
Test results will provide the professional with information concerning the effect of an external sound on the tinnitus.
A high-resolution audiometer in frequency (1 Hz) and intensity (1 dB) is required to perform a characterization of the tinnitus.


Today’s clinicians and audiologists can now more effectively evaluate the tinnitus and its impact on the lives of their patients.
We continually invite comments and suggestions for improvement via our Customer Satisfaction Questionnaire and other regular surveys. Your professionalism and genuine care goes a long way to keeping my loyalty to the Hearing Care Centre, nothing ever seems to be too much trouble and together with Sharon and Toni on reception, who are every cheerful and welcoming, it is just a pleasure to step inside the door.
Vicki helped me solve this with a waterproof cover for the aid and security cord attached to my collar.
Changing from run to bike and back again involves a hasty change of shoes and helmet, with the risk of dislodging the aid.
When I stood on the rostrum as gold medal World Champion, I could not see the end of the roaring crowd but I could certainly hear the applause - and nobody in that crowd could have seen that I was wearing a hearing aid.
Looking on are audiologist Debbie Lawrence (left), who will run the new clinic, and Carole Butterfield, manager of the Foundry Court Community Centre. These will be run by Richard Lusher-Seaman on alternate Mondays at the Old Road Clinic, 115 Old Road, Frinton CO13 9BX. He gave an informative speech about the massive leaps forward in hearing aid technology, also praising the Centre for always keeping abreast of developments and offering the very best quality instruments on the market. Ruth, a flautist, is profoundly deaf, but this has not stopped her carving out a musical and teaching career for herself.
They had responsibility for the Excellent Customer Service category, always a hotly-contested award with the highest number of entries. Romanian-born Dr Carmaciu is the micro-suction specialist at our Colchester and Chelmsford centres, who initiated the trip. Her dedication to her work is truly outstanding and also juggling a family has shown inspiration to others.
In fact, we have already welcomed our first client, ex-paratrooper Ben Lancaster, who suffered hearing loss after being injured in an IED strike in Afghanistan.
It also activates the middle ear muscles and sensory cells in the inner ear, so the ear-brain connection is improved. With this clinical foundation, few other health professionals are as well suited to help those with tinnitus. For example, the US Center for Health Statistics estimates that tinnitus was reported by 25% of those who are hearing impaired and have hearing loss. The hearing care professional needs to consider these issues if they want to succeed in managing the hearing loss on top of the tinnitus. However, it’s important to check the effect of the external sound on the tinnitus before introducing the benefits of wearing a hearing aid to the patient. Additionally, training from hearing instrument manufacturers and collaborating with colleagues can be valuable. Then be sure to include information that the patient may benefit from—like additional options or resources not offered at your practice. It is important to consider that treating patients with tinnitus requires the ability to listen and a high degree of patience.
When testing patients with tinnitus, clinicians should consider scheduling a dedicated time just for consultation because it will take longer than usual and the patient is expecting a solution.
For this, I would recommend using an analog visual scale of relief to set the objective from the very beginning.
When the patient becomes more comfortable describing their situation, the clinician should then begin to drive the conversation.
Then the follow-up treatment can be done online, where the answers provided previously can help clinicians evaluate the impact of this strategy. This may include education, information, or recommendations for further medical evaluation or treatment by other professionals. Psychoacoustical tests are also important and can include pitch and loudness matching and minimum masking level (MML).
If there is a positive impact, like an attenuation of the perception, a strategy like the TRT (Tinnitus Retraining Therapy) can be considered. After a recent operation on my ear drum, I was told it would now be possible to wear a small, water resistant Phonak ear mould that fitted deep into the canal, eliminating all wind noise. Many of the recipients heard properly for the first time in decades, and their emotions often brought tears to our eyes. Good tinnitus resources are needed in every community to bring new exposure and business to your office. The Tinnitus Clinic at Oregon Health and Science University found that 90% of their patients who have tinnitus also have some degree of hearing loss. If the patient can accept a sound generating strategy, many hearing instrument manufacturers deliver interesting solutions today—with or without an amplifier for the hearing loss.
My performance qualified me for the 80+ age group in the Great Britain Team World Championships in France. For example, a clinician may have to wait for the patient to fall asleep using a sound generator pillow.
Wearing a GB tracksuit and kit so soon after the London Olympics was sufficiently inspiring and I came second in my age group, winning the silver medal.  It was an experience that I did not think could be beaten.



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