Tinnitus is an incredibly prevalent disability in the United States, affecting approximately 25% of the general population (Shargorodsky, Curhan, & Farwell, 2010, as cited in Theodoroff & Saunders, 2019a), including many veterans. The Veterans Administration (VA) Rehabilitation Research and Development (RR&D) National Center for Rehabilitative Auditory Research (NCRAR) made tinnitus research—and the translation of these findings into practice—the theme of their biennial conference in Fall 2017. The American Journal of Audiology is highlighting seven of these presentations in this special issue.
“Approaches to Assessment and Management” is the theme for the first group of articles. James A. Henry and Candice Manning (2019) open with “Clinical Protocol to Promote Standardization of Basic Tinnitus Services by Audiologists.” As the title suggests, the authors examine current clinical services for tinnitus, which are unstandardized, leading to uneven patient care across facilities. They recommend progressive tinnitus management (PTM), an evidence-based clinical protocol endorsed by the Veterans Health Administration (VHA). Continuing the theme, Jenifer E. Beck, Tara L. Zaugg, Jessica L. Egge, Elizabeth N. Lima, and Emily J. Thielman describe PTM outcomes in two different VA clinics using modified protocols. The final article of this section explores the relationship between psychoacoustic characteristics of tinnitus and its impact on an individual. In their research note, Candice Manning, Emily J. Thielman, Leslie Grush, and James A. Henry compared the correlations between (a) the psychoacoustic meaures of tinnitus (i.e., loudness and pitch) and (b) the functional effects of tinnitus.
The next article looks at tinnitus management with comorbid mental health diagnoses, particularly among veterans. Kathleen F. Carlson and colleagues sampled 10% of VA health care users over 5 years in order to examine the connection between tinnitus care and mental health care services. Although tinnitus is the top service-connected disability among veterans, the number of veterans seeking health care, inside the VA or otherwise, was unknown. The authors highlighted the importance of coordinated services between tinnitus and mental health care experts.
The final three articles focus on tinnitus mechanisms. No objective measure of tinnitus currently exists, but brain-imaging research may be helpful. Fatima T. Husain and colleagues explore the replicability of neural correlates of tinnitus using functional magnetic resonance imaging (FMRI) in “Replicability of Neural and Behavioral Measures of Tinnitus Handicap in Civilian and Military Populations: Prelminary Results.” Next, Julia Campbell, Alison LaBrec, Connor Bean, Mashhood Nielsen, and Won So examined patients with and without tinnitus, attempting to discover whether or not patients with tinnitus also had lower sensory gating, a neurological process designed to filter out unimportant stimuli. Finally, in “The Role of the Brainstem in Generating and Modulating Tinnitus,” Special Issue Co-Guest Editor Sarah M. Theodoroff and James A. Kaltenbach present a new perspective about the role of the brainstem in tinnitus and other comorbid conditions.
We’d like to thank Special Issue Guest Co-Guest Editors Gabrielle H. Saunders and Sarah M. Theodoroff for their work on this special issue. The two bookend the special issue with an introductory editorial and an epilogue, in which they sum up the special issue and provide four key takeaways. You can explore the entire issue here, or check out the individual articles below.
Reference
Theodoroff, S., & Saunders, G. H. (2019a). Editorial: Translating tinnitus research findings into clinical practice. American Journal of Audiology, 28, 149–151. https://doi.org/10.1044/2019_AJA-TTR17-19-0015
Explore the Issue
Beck, J., Zaugg, T. L., Egge, J., Lima, E., & Thielman, E. (2019). Progressive tinnitus management at two veterans affairs medical centers: Clinical implementation with modified protocols. American Journal of Audiology, 28, 162–173. https://doi.org/10.1044/2018_AJA-TTR17-18-0040
Campbell, J., LaBrec, A., Bean, C., Nielson, M., & So, W. (2019). Auditory gating and extended high-frequency thresholds in normal-hearing adults with minimal tinnitus. American Journal of Audiology, 28, 209–224. https://doi.org/10.1044/2019_AJA-TTR17-18-0036
Carlson, K F., Gilbert, T. A., O’Neil, M. E., Zaugg, T. L., Manning, C. A., Kaelin, C., . . . Henry, J. A. (2019). Health care utilization and mental health diagnoses among veterans with tinnitus. American Journal of Audiology, 28, 181–190. https://doi.org/10.1044/2018_AJA-TTR17-18-0042
Henry, J. A., & Manning, C. (2019). Clinical protocol to promote standardization of basic tinnitus services by audiologists. American Journal of Audiology, 28, 152–161. https://doi.org/10.1044/2018_AJA-TTR17-18-0038
Husain, F. T., Schmidt, S. A., Tai, Y., Granato, E. C., Ramos, P., Sherman, P., & Esquivel, C. (2019). Replicability of neural and behavioral measures of tinnitus handicap in civilian and military populations: Preliminary results. American Journal of Audiology, 28, 191–208. https://doi.org/10.1044/2019_AJA-TTR17-18-0039
Manning, C., Thielman, E., Grush, L., & Henry, J. A. (2019). Perception versus reaction: Comparison of tinnitus psychoacoustic measures and Tinnitus Functional Index (TFI) scores. American Journal of Audiology, 28, 174–180. https://doi.org/10.1044/2018_AJA-TTR17-18-0041
Theodoroff, S., & Kaltenbach, J. (2019). The role of the brainstem in generating and modulating tinnitus. American Journal of Audiology, 28, 225–238. https://doi.org/10.1044/2018_AJA-TTR17-18-0035
Theodoroff, S., & Saunders, G. H. (2019a). Editorial: Translating tinnitus research findings into clinical practice. American Journal of Audiology, 28, 149–151. https://doi.org/10.1044/2019_AJA-TTR17-19-0015
Theodoroff, S. M., & Saunders, G. H. (2019b). Key findings from tinnitus research and clinical implications. American Journal of Audiology, 28, 239–240. https://doi.org/10.1044/2019_AJA-TTR17-19-0016
