Combined Amplification and Sound Generation for Tinnitus: A Scoping Review.
Lindsey Tutaj, Derek J Hoare, Magdalena Sereda
PMID 29189522WHAT IT FOUND
Combination hearing aids are widely used for tinnitus, but evidence that the sound generation helps more than amplification alone is weak.
Most studies showed no difference between the two, and many relied on uncontrolled designs. Clinical practice varies significantly regarding who gets fitted and how the devices are used.
Key findings
01Most studies comparing combination aids to amplification alone found no difference in tinnitus distress or handicap.
02Clinical recommendations for candidacy, fitting, and sound settings vary widely between different management programs and clinics.
03There is a lack of evidence for the specific efficacy of different sound options, such as nature sounds versus broadband noise.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Most included studies were uncontrolled before-and-after designs, which cannot account for natural improvement or placebo effects. The review included gray literature and non-peer-reviewed sources, which may introduce bias. There was significant variability in outcome measures across studies, making direct comparison difficult. Many studies were small, with only one study using a power analysis to determine sample size. The contribution of the sound generation component alone is difficult to separate from the amplification component or other parts of multicomponent treatment programs.
Declared interests
The authors declared no conflicts of interest. However, the review noted that 17 of the included records reported conflicts of interest, such as funding from hearing aid manufacturers or authors employed by manufacturers.
The easy way to misread this
Do not assume that combination hearing aids are more effective than standard hearing aids for tinnitus. The review found that most studies comparing the two showed no difference in tinnitus distress, and the evidence for the added benefit of sound generation is weak and inconsistent.