A trial of a hearing aid is often worthwhile as a noninvasive, first-line intervention for patients with tinnitus and SNHL. Hearing aids reduce the perception of tinnitus by amplifying ambient sounds.8 Some hearing aids also incorporate masking devices and are used to treat tinnitus in patients with hearing loss. Cochlear implants also are an option for certain patients with confirmed severe SNHL. One study found that tinnitus intensity and awareness were reduced in up to 86% of patients who received cochlear implants.26
The American Tinnitus Association also advises patients with tinnitus to eliminate potential aggravating factors, including salt, artificial sweeteners, sugar, alcohol, tobacco, and caffeine.27
CASE 1 › Mr. L was referred for audiometric testing, which revealed severe high-frequency SNHL that was worse in the right ear. His symptoms improved slightly following a trial of a combination hearing aid/masking device and participation in TRT. He was counseled to quit smoking and use dual hearing protection for future high-noise exposure.
CASE 2 › Ms. B had normal audiometric testing and was referred for angiography. This revealed a dural arteriovenous fistula that was categorized as type III (draining directly into subarachnoid veins) with a small adjacent aneurysm. She underwent a successful clipping of the draining vein to prevent future hemorrhage. Her tinnitus subsequently resolved. Her aspirin use was not modified because it was low dose.
CORRESPONDENCE Ethan Zimmerman, MD, Mike O’Callaghan Federal Hospital, 4700 Las Vegas Boulevard North, Nellis Air Force Base, NV 89191; ethanzimmerman@yahoo.com
