The repetitive stutter of a machine gun, shocking boom of mortars, the deafening drone of helicopter rotors; the sounds of war are hard to ignore and can leave many Veterans with permanent hearing damage.
Tinnitus is the number one disability among Veterans and it affects at least one in every 10 American adults.
Some describe ringing sounds, a buzzing sound, a high-pitched whistle, or numerous other sounds. The causes and effects of tinnitus vary from individual to individual, so researchers at the National Center for Rehabilitative Auditory Research approached treatment options the same way.
“Because tinnitus has many causes, many of which are outside the audiology scope of practice, the approach to tinnitus should be interdisciplinary,” explained Dr. Paula Myers, Audiology Section Chief at the Tampa VA Hospital.
“Some of these services are performed by audiologists and some are referred to appropriate professionals. The goal is not to silence tinnitus, because there is no cure. Rather, the goal is for patients to learn to self-manage their reactions to the tinnitus.”
Dr. Myers is a member of the VA research team that developed the Progressive Tinnitus Management (PTM) approach. The culmination of years of studies and clinical trials, PTM evolved into a national management protocol for VA medical centers.
The model is designed to address the needs of all patients who complain about tinnitus, while efficiently utilizing clinical resources. There are five hierarchical levels of management: (1) Triage, (2) Audiologic Evaluation, (3) Group Education, (4) Interdisciplinary Evaluation, and (5) Individualized Support. Throughout the process, patients work with a team of clinicians to create a personalized action plan that will help manage their reactions to tinnitus and make it less of a problem.
“A lot can be done for tinnitus”
“Patients have often been told to go home and learn to live with it, nothing can be done — and it’s really not true. A lot can be done for tinnitus,” said Dr. James Henry, PTM author and Research Professor in Otolaryngology at the Oregon Health & Science University.
Educating patients and providers is a significant element in the PTM approach. For health care providers, the authors of PTM organized a triage procedure to help identify tinnitus patients and access exactly what kind of medical services will best serve their needs. Typically, audiologists coordinate all tinnitus care.
“That’s our front line, when they come in for the hearing test,” said Dr. Cheri Ribbe, audiologist at the Boston VA Healthcare Systemwhere they started using PTM over two years ago. Her audiology clinic has seen over 500 Veterans take part in PTM — some who just came in for more information, and some who have gone on to higher levels of the PTM program.
The majority of people with tinnitus, about 80 percent, are not bothered by it; it doesn’t affect their sleep or their ability to concentrate. The small percentage of people who struggle with the noise in their head can be more prone to other debilitating mental health problems, like depression and anxiety. It is not yet understood why tinnitus affects people so differently.
After years of having few resources to offer tinnitus patients, Dr. Ribbe said she was excited to institute the PTM protocol. “It’s been gratifying and satisfying for us and the patient to know that we are offering something for them.”
Read more here: https://www.va.gov/health/NewsFeatures/20110524a.asp