153

Index

A

Alcohol intake, 47, 48

Aminoglycoside antibiotics, 5

Amitryptiline, 48

Amphetamine abuse, 47

Antidepressants, 48

Anxiety, 47, 48, 69

Anxiolitics, 48

Appendixes. See Forms

Aspirin, 5, 48

Assessment. See also Audiologic Evaluation; 

Interdisciplinary Evaluation

mental health, 67–70

psychoacoustic, 72–73

Attention-deficit/hyperactivity disorder, 47

Attention Scale, 61, 129–130

Audiologic Evaluation

auditory function assessment, 42–43

and candidacy for Group Education, 40

Ear-Level Instrument Assessment/Fitting 

Flowchart, 45, 113

hearing aid evaluation, 45–47 (See also Hearing 

aids main entry)

Hearing Aid Special Considerations, 46, 115

Hearing Handicap Inventory, 42

and hyperacusis, 40, 41

LDLs, 53

and mental health referral, 47

objectives overview, 39, 99

otolaryngology exam need assessment, 43

otoscopy, 42

overview, 27, 49

patient example: sensorineural hearing loss, 41

procedures overview, 39, 99

pure-tone threshold evaluation, 42–43

sleep disorder referral assessment, 47–48

somatosounds assessment, 43–44

suprathreshold audiometric testing, 43

THI (Tinnitus Handicap Inventory), 41–42, 105–

106, 107

THS (Tinnitus and Hearing Survey), 39–41, 101

Tinnitus Handicap Inventory (THI), 41–42

Tinnitus Problem Checklist, 44–45

Audiology, 24

Individualized Support protocol, 77–79

patient education, 26

triage to, 37

Auditory imagery, 4

B

Bipolar disorder, 47

C

Caffeine intake, 5, 48

Case studies/patient examples

bilateral intermittent tinnitus, 32–33

bothersome tinnitus, 33

CBT (cognitive-behavioral therapy), 81

hearing loss/tinnitus, 32

Individualized Support, 81

phonophobia, 33

PTSD, 33

sensorineural hearing loss, 41

CBT (cognitive-behavioral therapy)

case study, 81

clues for tinnitus management, 3

extended support option, 81–82

Group Education, 63–66 (See also Group Education 

main entry)

Individualized Support, 80–81, 82

and individualized support level, 30

and patient education, 25, 31

in PTM foundational research, 17, 18–19

and STEM, 29, 55

telephone-based, 18

CD/DVD: Managing Your Tinnitus, 151–152

Changing Thoughts and Feelings Worksheet, 64

Chemotherapy, 5, 48

Chronic tinnitus, 2. See also Tinnitus

Cisplatin, 5

Clinical data of patients (tinnitus), 8–9
	154	 Progressive Tinnitus Management: Clinical Handbook for Audiologists

Clinical trial candidacy, 12–13

Cocaine abuse, 47

Cochlear cellular stress responses, 36

Cognitive-behavioral therapy (CBT). See CBT 

(cognitive-behavioral therapy)

Cognitive restructuring, 65–66

Combination Instrument In-Clinic Trial Use, 75, 147

Conductive tinnitus, 6, 7

Corticosteroids, 36

D

Depression, 47, 69

Diuretics, 5, 48

DVD/CD: Managing Your Tinnitus, 151–152

E

Ear-Level Instrument Assessment/Fitting Flowchart, 

45, 46, 70, 74, 113

Ear-Level Instrument In-Clinic Trial Use, 145

Ear-Level Instrument Trial Use Guide, 75, 143

Ear noise, transient, defined, 1–2

Education. See Group Education

Epidemiology, 6

Epworth Sleepiness Scale, 69, 141

Etiology of tinnitus, 6

Evaluation. See Audiologic Evaluation

Examples. See Case studies/patient examples

F

Forms

Attention Scale, 129–130

Audiologic Evaluation objectives/procedures 

overview, 99

Combination Instrument In-Clinic Trial Use, 147

Ear-Level Instrument Assessment/Fitting 

Flowchart, 113

Ear-Level Instrument In-Clinic Trial Use, 145

Ear-Level Instrument Trial Use Guide, 75, 143

Epworth Sleepiness Scale, 141

Hearing Aid Special Considerations, 115

Hospital Anxiety and Depression Scale (HADS), 

137–138

Loudness Discomfort Levels—Clinical Guide, 123

Noise Generator In-Clinic Trial Use, 149

Primary Care PTSD Screening Tool (PC-PTSD), 

139

PTM Flowchart, 95

Relief Scale, 127–128

Sound Plan Worksheet, 125–126

Sound Tolerance Interview, 117–119

Sound Tolerance Worksheet, 121–122

Tinnitus and Hearing Survey, 101

Tinnitus Contrast Activity, 62, 131–132

Tinnitus Handicap Inventory, 105–106

Tinnitus Handicap Inventory: Screening Version, 

107

Tinnitus Interview: Interdisciplinary Evaluation, 

133–136

Tinnitus Problem Checklist, 111

Tinnitus Triage Guidelines, 97

What to Do When Everyday Sounds Are Too Loud 

(without hearing aids), 103–104

Foundational research

assessment protocol development, 15

and ATM (audiologic tinnitus management), 

14

and clinical trial candidacy, 12–13

educational component need, 14

efficacy: TM versus TRT, 12–13

efficacy: TM versus TRT, veterans, 14–15

group intervention, 13–14

and multidisciplinary team, 17–18

overview, 12, 19

paths can differ for management, 12

and psychological concerns, 17–18

and self-help workbook (PTM), 14, 17, 18

sound attention diversion, 14

studies

first, 12–13

second, 13–14

third, 14–15

fourth, 15–17

fifth, 17–18

TBI: veterans, 17–18

and telephone-based administration, 17

and therapeutic sound, 14, 18

veterans, 14–18

G

Glucocorticoids, 36

Group Education

first session, 59–63

second session, 63

attention diversion, 65

Attention Scale, 61, 129–130

audiologist-conducted workshops

and Attention Scale, 61

background sound type taught, 61

demonstration of sound types, 61–62
Index	 155

individualized sound plan development, 59

interesting sound type taught, 60–61

and Relief Scale, 61

soothing sound type taught, 60

Sound Plan Worksheet, 57, 59, 60, 62, 64

sound types taught, 60–61

THS (Tinnitus and Hearing Survey) review, 

59–60, 101

Tinnitus Contrast Activity, 62

candidacy, 40

CBT (cognitive-behavioral therapy)

essential componments, 64

overview, 63–64

Session 1, 64–65

Session 2, 65–66

Session 3, 66

Changing Thoughts and Feelings Worksheet, 

64

cognitive restructuring, 65–66

collaborative self-management, 58, 66

continuity with Interdisciplinary Evaluation, 76

follow-up, 66

overview, 28–29, 66

patient self-help workbook, 58

pleasant activities for diversion, 65

psychologist-conducted workshops

overview, 63–66’

relaxation techniques, 65, 151

Relief Scale, 61

sound grid use, 62

stress reduction, 64–65

therapeutic sound use education, 58–59

Tinnitus Contrast Activity, 131–132

Tinnitus Problem Checklist, 60–62, 64, 66

H

Hallucinations (auditory/musical), 4–5

Hallucinogen abuse, 47

Health literacy, 26

Hearing aids

needed for PTM, 45–46

and tinnitus, 46–47

tinnitus management reaction, 46

Hearing Aid Special Considerations, 46, 115

Hearing Handicap Inventory for the ElderlyScreening (HHIE-S), 42, 109

Hearing loss, 7

case study, 32

idiopathic sudden sensorineural hearing loss 

(ISSHL), 36, 37

sensorineural, 41

HHIE-S (Hearing Handicap Inventory for the 

Elderly-Screening), 42, 109

Hospital Anxiety and Depression Scale (HADS), 69, 

137–138

How to Manage Your Tinnitus (J.A. Henry et al.), 27–

28, 40, 45, 48, 58, 78. See also Patient self-help 

workbook main entry

Hyperacusis, 33. See also Loudness recruitment; 

Misophonia; Phonophobia; Sound Tolerance 

Interview (STI); STEM (sound tolerance 

evaluation and management)

defined, 9

Loudness Discomfort Levels—Clinical Guide, 123

screening for, 27, 28

Sound Tolerance Interview form, 117–119

sound tolerance management approach, 40

Sound Tolerance Worksheet, 52, 121–122

therapy for, 10, 37, 52, 82–83

What to Do When Everyday Sounds Are Too Loud 

(without hearing aids), 40, 41, 52, 103–104

Hypersensitivity to sound. See Hyperacusis

I

Idiopathic sudden sensorineural hearing loss 

(ISSHL), 36, 37

Individualized Support

appointments’ process, 77–79

audiologist standard protocol, 77–79

augmentative sound, 80

CBT (cognitive-behavioral therapy), 80–81, 82

counseling, 79–80

criteria for progress from Interdisciplinary 

Evaluation, 76

extending intervention, 79

NTT (neuromonics tinnitus treatment) extended 

support, 83

overview, 77, 83–84

patient self-help workbook, 79

personal listening devices, 80

Sound Plan Worksheet, 77, 79

stationary sound devices, 80

telephone counseling, 79

THS (Tinnitus and Hearing Survey), 77–78, 101

Tinnitus Handicap Inventory (THI), 77–78

Tinnitus Interview: Interdisciplinary Evaluation, 

78

TM (tinnitus masking) extended support, 82

TRT (tinnitus retraining therapy) extended 

support, 82–83

Individualized support

overview, 30–31
	156	 Progressive Tinnitus Management: Clinical Handbook for Audiologists

Insomnia, 47, 48, 69, 70

Interdisciplinary Evaluation

anxiety screening, 69

BTE (behind-the-ear) instrument in-clinic trials, 

75–76

Combination Instrument In-Clinic Trial Use, 75, 

147

continuity with Group Education, 76

criteria for progress to Individualized Support, 76

depression screening, 69

Ear-Level Instrument Assessment/Fitting 

Flowchart, 70, 74, 113

ear-level instrument follow-up, 76

Ear-Level Instrument In-Clinic Trial Use, 74–76, 

145

Ear-Level Instrument Trial Use Guide, 75, 143

forms for in-clinic ear-level trials, 75

Hospital Anxiety and Depression Scale (HADS), 

69, 137–138

interview administration, 70–72

Noise Generator In-Clinic Trial Use, 75, 149

noise generators for in-clinic trials, 75

nonmental health clinician screening, 68–69

overview, 29–30, 67

PC-PTSD (Primary Care PTSD) screening tool, 69

psychoacoustic assessment, 72–73

PTSD (posttraumatic stress disorder), 69

sleep disorders, 69–70

Sound Plan Worksheet, 72, 76

THS (Tinnitus and Hearing Survey), 70, 74, 101

Tinnitus Handicap Inventory (THI), 70, 105–106, 

107

Tinnitus Interview, 67, 70, 74, 78, 133–136

Intervention

Group Education overview, 26–27 (See also

Education main entry; Group Education main 

entry)

ISSHL (idiopathic sudden sensorineural hearing 

loss), 36, 37

L

Labyrinthine membrane ruptures, 36

Labyrinthitis, 36

LDL (loudness discomfort level). See loudness 

discomfort levels (LDL)

Level 1. See Triage main entry

Level 2. See Audiologic Evaluation main entry

Level 3. See Individualized Support main entry

Level 4. See Interdisciplinary Evaluation main entry

Loop diuretics, 5, 48

Lorazepam, 48

Loudness Discomfort Levels—clinical guide, 123

Loudness discomfort levels (LDL), 10, 52–53

Loudness recruitment. See also Hyperacusis

defined, 9–10, 54

treatment, 10

M

Managing Your Tinnitus, 59, 80, 151–152

Managing Your Tinnitus (DVD/CD), 151–152

Marijuana use, 47

Masking. See TM (tinnitus masking)

Masking as term, 60. See also TM (tinnitus masking)

Medications

aminoglycoside antibiotics, 5

amitryptiline, 48

antibiotics, 5

antidepressants, 48

anxiolitic, 48

aspirin, 5, 48

chemotherapy, 5, 48

cisplatin, 5

corticosteroids, 36

diuretics, 5, 48

glucocorticoids, 36

loop diuretics, 5, 48

lorazepam, 48

NSAIDs (nonsteroidal antiinflammatory drugs), 

5, 48

quinine, 5, 48

Mental health professionals

referral to, 47

on team, 24–25

triage to, 24–25

Misophonia. See also Hyperacusis

in case history, 33

defined, 9, 54

and evaluation, 28

treatment, 10

N

Narcolepsy, 69, 70

NCRAR (National Center for Rehabilitative 

Auditory Research), 19, 22

Neuro-otologology, 24

Noise Generator In-Clinic Trial Use, 75, 149

Nonpulsatile tinnitus, 2, 43, 44

Nonsteroidal antiinflammatory drugs (NSAIDs), 5

NSAIDs (nonsteroidal antiinflammatory drugs), 5, 

48

NTT (neuromonics tinnitus treatment), 83
Index	 157

O

Obsessive-compulsive disorder, 47

Opiate abuse, 47

Otolaryngology, 24

referral to criteria, 43–44

triage to, 36, 37

Ototoxicity, 48

P

Panic episodes, 47

Pathophysiology of tinnitus, 7–8

Patient clinical data (tinnitus), 8–9

Patient examples. See Case studies/patient examples

Patient self-help workbook

Group Education, 58

Individualized Support, 79

overview, 27–28

timing of distribution, 48–49

PC-PTSD (Primary Care PTSD) screening tool. 

See Primary Care PTSD Screening Tool 

(PC-PTSD)

Phobias, 47

Phonophobia. See also Hyperacusis; Sound Tolerance 

Interview (STI); STEM (sound tolerance 

evaluation and management)

in case study, 33

defined, 9

and LDL, 53

Loudness Discomfort Levels—Clinical Guide, 123

Sound Tolerance Interview form, 117–119

Sound Tolerance Worksheet, 52, 121–122

treatment, 10

What to Do When Everyday Sounds Are Too Loud 

(without hearing aids), 40, 41, 52, 103–104

Prevalence of tinnitus, 6

Primary Care PTSD Screening Tool (PC-PTSD), 69, 

139

Progressive Tinnitus Management: Counseling Guide

(J.A. Henry et al.), 31, 52, 67, 79

Prosthetics, 25

Psychotic disorders, 47

PTM (progressive tinnitus management)

assessment as starting point, 26 (See also

Audiologic Evaluation main entry;

Interdisciplinary Evaluation main entry; Triage 

main entry)

audiologists on team, 24

basic premises, 21–26

and CBT (cognitive-behavioral therapy (See CBT 

(cognitive-behavioral therapy) main entry)

clinical service progressivity, 22–23

collaborative self-management, 26, 58, 66

efficiency of, 22

five levels of, 22, 23

flowchart, 26, 36, 41, 52, 95

foundational research, 11–19 (See also

Foundational research main entry for details)

and hearing needed for participation, 45–46

hierarchical approach, 22, 23

interdisciplinary approach, 24–25

intervention (See Intervention main entry)

levels’ overview, 26–30 (See also Triage, 

Audiologic Evaluation, Group Education, 

Interdisciplinary Evaluation, Individualized 

Support main entries for details)

mental health professionals on team, 24–25

neuro-otologists on team, 24

otolaryngologists on team, 24

overview, 21–34, 31–32

and prosthetics, 25 (See also Prosthetics main 

entry)

PTSD (posttraumatic stress disorder), 24, 47 (See 

also PTSD (posttraumatic stress disorder) 

main entry)

reaction to tinnitus management, 21–22

sleep disturbances, 25–26 (See also Sleep 

disturbances main entry)

sound tolerance management approach, 40

PTSD (posttraumatic stress disorder), 24

case study, 33

and psychologist group sessions, 63

referral for, 47

screening, 69

Pulsatile tinnitus

Audiologic Evaluation, 43–44

causes, 44

clinical presentation, 43

defined, 2, 44

differential diagnosis, 24

site of, 24

and surgery, 44

and triage, 37

Q

Quinine, 5, 48

R

Relaxation techniques, 65, 151

Relief Scale, 61, 127–128

REM behavior disorders, 69
	158	 Progressive Tinnitus Management: Clinical Handbook for Audiologists

S

Sedative abuse, 47

Self-help workbook. See Patient self-help workbook 

main entry

Sensorineural tinnitus

and noise exposure, 7

origin of, 3

as phantom auditory perception, 3

Sleep apnea, 47, 48, 69

Sleep disorders, 25–26

management of, 48

referral for, 47–48

screening, 69–70

Sleepiness Scale, Epworth, 69, 141

Somatosound

Audiologic Evaluation, 43–44

overview, 2–3

and triage, 37

Sound hypersensitivity. See Hyperacusis

Sound Plan Worksheet, 57, 59, 60, 62, 64, 72, 76, 77, 

79, 125–126

Sound Tolerance Interview form, 117–119

Sound Tolerance Interview (STI), 52, 53, 117–119. See 

also STEM (sound tolerance evaluation and 

management)

Sound Tolerance Worksheet, 52, 121–122

STEM (sound tolerance evaluation and 

management), 40. See also Hyperacusis; 

Phonophobia

described, 51–52

ear-level instrument trial use, 53–54

hyperacusis/allied conditions’ definitions, 54

overview, 28, 51, 54–55

Sound Tolerance Interview (STI), 52, 53, 117–119

STI (Sound Tolerance Interview). See also

Hyperacusis; Phonophobia; Sound Tolerance 

Interview (STI)

Stria vascularis ion transport problems, 36

Substance abuse, 47

T

TBI (traumatic brain injury), 6, 17–18

Telephone appointments/follow-up, 17, 18, 63, 66, 

78, 79

Therapeutic sound, 10, 12, 14, 17, 18, 25, 28, 30, 45, 

51, 52, 58–59, 66, 70, 72, 73, 77, 79, 81, 82

THI (Tinnitus Handicap Inventory). See Tinnitus 

Handicap Inventory (THI)

THS (Tinnitus and Hearing Survey). See Tinnitus 

and Hearing Survey (THS)

Tinnitus. See also Chronic tinnitus

amplification benefits, 46–47

associated auditory pathologies, 6, 7

criterion, 2

delayed-onset, 6

hallucinations (auditory/musical), 4–5

and hearing loss degree, 7

neurological origin, 2

neurophysiologic, 3 (See also Sensorineural 

tinnitus main entry)

nonpulsatile, 2 (See also under Tinnitus main entry)

objective, 3

onset, 5–6, 8

pathophysiology, 7–8

permanent versus temporary, 5

and prescription medication, 48 (See also

Medications main entry)

pulsatile, 2 (See also under Tinnitus main entry)

recent-onset, 5–6

risk factors, 6–7

sensorineural overview, 3 (See also Sensorineural 

tinnitus main entry)

somatic, 2–3

somatically modulated, 44

somatic versus neurophysiologic origin, 2

somatosound, 2–3 (See also Nonpulsatile tinnitus; 

Pulsatile tinnitus; Somatosounds; Tinnitus 

main entry)

overview, 2–3 (See also Somatosound main entry)

symptoms, 2

types, 2

sound types, patient reports, 8–9

subjective, 4

subjective versus objective, 3–4

temporary versus permanent, 5

Tinnitus and Hearing Survey, 101

Tinnitus Contrast Activity, 62, 131–132

Tinnitus Handicap Inventory, 105–106

Tinnitus Handicap Inventory: Screening Version, 

107

Tinnitus Interview: Interdisciplinary Evaluation, 

67, 70, 74, 78

tinnitus neural signal defined, 2

Tinnitus Problem Checklist, 44–45, 60–62, 64, 66, 111

triage guidelines, 35–36, 37, 97 (See also Tinnitus 

Triage Guidelines under main entry Forms)

video Web site, 49

Tinnitus and Hearing Survey (THS), 13, 25, 28, 

39–41, 44, 51, 59–60, 67, 70, 74, 77–78, 101. See 

also Audiologic Evaluation; Interdisciplinary 

Evaluation

versus THI (Tinnitus Handicap Inventory), 4
Index	 159

Tinnitus Contrast Activity, 62, 131–132

Tinnitus Handicap Inventory (THI), 41–42, 70, 

77–78, 79, 105–106, 107. See also Audiologic 

Evaluation; Individualized Support; 

Interdisciplinary Evaluation

Tinnitus Interview: Interdisciplinary Evaluation, 

133–136

Tinnitus masking (TM). See TM (tinnitus masking)

Tinnitus Problem Checklist. See also Audiologic 

Evaluation

TM (tinnitus masking)

Individualized Support extended support, 82

overview, 82

in PTM, 12

research, 12, 14

TMJ (temporomandibular joint), 2, 43

Transient ear noise defined, 1–2

Traumatic brain injury (TBI), 16–17

Triage

to audiology, 37

guidelines, 35–36, 37 (See also Tinnitus Triage 

Guidelines under main entry Forms)

to mental health, 36–37

to otolaryngology, 36, 37

overview, 27, 35, 37–38

to urgent care, 36

TRT (tinnitus retraining therapy)

Individualized Support extended support, 82–83

overview, 82–83

in PTM, 12, 61

research, 12, 14

V

Vascular disruption, 36

Veteran research, 14–18. See also Primary Care 

PTSD Screening Tool (PC-PTSD); PTSD 

(posttraumatic stress disorder)

W

What to Do When Everyday Sounds Are Too Loud 

(without hearing aids), 40, 41, 52, 103–104

Workbook. See Patient self-help workbook main entry