Semin Hear 2008; 29(3): 300-309
DOI: 10.1055/s-0028-1082035
© Thieme Medical Publishers

Strategies for Managing Patients with Tinnitus: A Clinical Pathway Model

Craig W. Newman1 , Sharon A. Sandridge1 , Scott S. Meit2 , Neil Cherian3
  • 1Section of Audiology, Head and Neck Institute/A71, Cleveland Clinic, Cleveland, Ohio
  • 2Department of Psychiatry and Psychology, Section of General and Health Psychology/P-57, Cleveland, Ohio
  • 3Neurological Institute/T33, Center for Headache and Pain, Cleveland Clinic, Cleveland, Ohio
Further Information

Publication History

Publication Date:
19 August 2008 (online)

ABSTRACT

Tinnitus is a distressing symptom affecting the health-related quality of life of many individuals. Yet most audiologists feel ill equipped in providing clinical services to these patients. This article presents an overview of a clinical pathway for patients seen in the multidisciplinary Tinnitus Management Clinic at the Cleveland Clinic. The model illustrates an efficient approach for managing patients with varying levels of perceived tinnitus severity and annoyance by sequencing patient care and intervention strategies. After providing a general overview of the clinical pathway, three unique components of the model are highlighted: (1) benefits of a Group Education Session; (2) usefulness of the Sound Therapy Option Profile, a new tool designed to guide the clinician in selecting the most appropriate sound therapy device for a given patient; and (3) participation of a psychologist and neurologist on the multidisciplinary management team.

REFERENCES

  • 1 World Health Organization .International Statistical Classification of Diseases and Health Related Problems ICI-1. 10th ed. Geneva, Switzerland; World Health Organization 2004
  • 2 Newman C W, Sandridge S A, Jacobson G P. Psychometric adequacy of the Tinnitus Handicap Inventory (THI) for evaluating treatment outcome.  J Am Acad Audiol. 1998;  9 153-160
  • 3 Stouffer J L, Tyler R S. Characterization of tinnitus by tinnitus patients.  J Speech Hear Disord. 1990;  55 439-453
  • 4 Beck A T, Steer R A, Brown G K. BDI-Fast Screen for Medical Patients Manual. San Antonio, TX; Psychological Corporation 2000
  • 5 Leyfer O T, Ruberg J L, Woodruff-Borden J. Examination of the utility of the Beck Anxiety Inventory and its factors as a screener for anxiety disorders.  J Anxiety Disord. 2006;  20 444-458
  • 6 Newman C W, Sandridge S A. Sound Therapy Option Profile (STOP): a tool for selecting devices used in tinnitus treatment. http://Available at: www.audiologyonline.com/articles/article_detail.asp?article_id=1687 Accessed October 1, 2007
  • 7 Tyler R S. The psychoacoustical measurement of tinnitus. In: Tyler RS Tinnitus Handbook. San Diego, CA; Singular Publishing Group 2000: 149-179
  • 8 Henry J A. Audiologic assessment. In: Snow JB Tinnitus: Theory and Management. Hamilton, Canada; BC Decker 2004: 220-236
  • 9 Hallam R S, Rachman S, Hinchcliffe R. Psychological aspects of tinnitus. In: Rachman S Contribution to Medical Psychology. Vol 3. Oxford, United Kingdom; Pergamon Press 1984: 31-34
  • 10 Davis P B, Paki B, Hanley P J. Neuromonics tinnitus treatment: third clinical trial.  Ear Hear. 2007;  28 242-259
  • 11 Henry J A, Zaugg T L, Schechter M A. Clinical guide for audiologic tinnitus management. I: Assessment.  Am J Audiol. 2005;  14 21-48
  • 12 Henry J A, Zaugg T L, Schechter M A. Clinical guide for audiologic tinnitus management. II: Treatment.  Am J Audiol. 2005;  14 49-70
  • 13 Folmer R L, Martin W H, Shi Y, Edlefsen L L. Tinnitus sound therapies. In: Tyler RS Tinnitus Treatments. New York, NY; Thieme Medical Publishers 2006: 176-186
  • 14 Henry J A, Rheinsburg B, Zaugg T. Comparison of custom sounds for achieving tinnitus relief.  J Am Acad Audiol. 2004;  15 585-598
  • 15 Robb MJA. Tinnitus device directory, Part III.  Tinnitus Today. 2006a;  31(1) 14-16
  • 16 Robb MJA. Tinnitus device directory, Part IV.  Tinnitus Today. 2006b;  31(2) 9-11
  • 17 Vernon J A, Tabachnick Sanders S. Tinnitus Questions and Answers. Boston, MA; Allyn & Bacon 2001
  • 18 Lazarus R S, Folkman S. Stress, Appraisal and Coping. New York, NY; Springer Verlag 1984
  • 19 Pachter L M. Culture and clinical care: Folk illness beliefs and behaviors and their implications for health care delivery.  JAMA. 1994;  271 690-694
  • 20 Levine R A, Abel A, Cheng H. CNS somatosensory-auditory interactions elicit or modulate tinnitus.  Exp Brain Res. 2003;  153 643-648
  • 21 Sanchez T G, Guerra G C, Lornezi M C, Brandao A L, Bento R F. The influence of voluntary muscle contractions upon the onset and modulation of tinnitus.  Audiol Neurootol. 2002;  7 370-375

Craig W NewmanPh.D. 

Head and Neck Institute/A71, Cleveland Clinic, 9500 Euclid Avenue

Cleveland, OH 44195

Email: newmanc@ccf.org

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