Gain adjustment at tinnitus pitch to manage both tinnitus and speech perception in noise

Abstract

To investigate how much gain variation is required from prescription to effect tinnitus percept, and if this revised prescription affects speech recognition. Twenty participants who experienced catastrophic tinnitus even after fitted with hearing aid were included. Participants were grouped based on their tinnitus pitch and the prescriptive formula used to fit hearing aid. They were evaluated for handicap from tinnitus using Tinnitus Handicap Inventory (THI). Hearing aid was programmed using either NAL- NL2 or DSL (I/o) v5 prescriptive formula and gain at tinnitus pitch was adjusted till the tinnitus get suppressed. SNR 50 was determined soon after fitted with hearing aid and 30 days of hearing aid use. Further, THI and international outcome inventory for hearing aid (IOI-HA) were determined after 30 days of hearing aid use. A significant higher gain adjustment was needed at tinnitus pitch to reduce tinnitus precept using NAL- NL2 than DSL (I/o) v5 prescriptive formula. Further, SNR 50 was not affected by either tinnitus pitch or revised prescription formulas. However, SNR 50 improved after 30 days of hearing aid use. A 76% of the participants’ experienced habituation to perception after 30 days of hearing aid use, 10% had slight, 10% had mild, and 4% had a moderate degree of tinnitus on THI. On IOA-HA, 96% (N=19) of participants have reported satisfactory, and 4% (N=1) reported moderate benefit from hearing aid. Irrespective of prescriptive formula adjusting gain at tinnitus pitch is an efficient method to reduce tinnitus symptoms and improve speech perception.

Hearing More to Hear Less: A Scoping Review of Hearing Aids for Tinnitus Relief

“…Shekhawat et al (2013) and Shetty and Pottackal (2019) focused on the fitting parameters preferred by patients for tinnitus relief. The study by Shekhawat et al aimed to identify the optimized high frequency amplification for a first-fit.…”

“…These findings may be limited as it was a lab experiment, and as such no follow up data on the effect of these prescriptions in daily life were available. More recently, the gain needed for tinnitus suppression was investigated in a more extensive study design which was applied by Shetty & Pottackal (2019). The effect on tinnitus perception and speech understanding in noise (SPIN) was evaluated up to 30 days of hearing aid use.…”

“…In summary, out of the 16 studies described above, nine studies showed significant improvements in tinnitus perception (Araujo and Iório 2016; Cabral et al 2016; Haab et al 2019; Hodgson et al 2015; Shekhawat et al 2014; Yakunina et al 2019; Yokota et al 2020; Zarenoe et al 2017; Zarenoe et al 2016), while four studies did not report significant tinnitus relief (Marcrum et al 2020; McNeill et al 2012; Peltier et al 2012; Strauss et al 2015). The other three studies did not test whether hearing aids’ use leads to tinnitus relief (Andersson et al 2011; Shekhawat, Searchfield, Kobayashi, et al 2013; Shetty and Pottackal 2019).…”

“…The idea behind switching these digital features off is that continuous exposure to ambient noise levels may lead to reduction of gain in the auditory pathway. However, these features might be needed for beneficial effects in terms of hearing (dos Santos et al 2014; Marcrum et al 2020; McNeill et al 2012; Shekhawat, Searchfield, Kobayashi, et al 2013; Shetty and Pottackal 2019). Unfortunately, this topic was not further investigated since 2011 to our knowledge.…”

Hearing Aid Fitting in Tinnitus: A Scoping Review of Methodological Aspects and Effect on Tinnitus Distress and Perception

“…Shetty, 2019 [43] (1) to determine the effect of gain adjustment on tinnitus perception in low and high pitch tinnitus groups (2) to compare SNR 50 using NAL NL 2 and DSL (I/o) v 5.0 fitting formulae in high and low pitch tinnitus groups and (3) to compare tinnitus relief data and SNR-50 scores pre-and post-hearing aid use.…”