Tinnitus Assessment Template

Present Symptoms: The patient reports a persistent ringing in both ears that started around two years ago. The tinnitus is characterized as a high-pitched sound that becomes more noticeable in quiet settings. The patient experiences frustration and anxiety due to the ongoing noise, which impacts concentration and sleep quality.
Medical history: The patient has a history of high blood pressure and mild hearing loss. There is no history of ear infections or head injuries.
Current Medications: Lisinopril 10mg daily, Atorvastatin 20mg daily.
Audiological testing results: Comprehensive audiology tests reveal mild sensorineural hearing loss in both ears. Middle ear testing results are within normal limits. DPOAE results indicate reduced emissions in high frequencies. Tinnitus pitch matching is at 8 kHz with a loudness match of 10 dB SL. UCL findings are consistent with normal tolerance levels.
Education on Tinnitus: The patient was informed about the hearing test results, the functioning of the auditory system, and the relationship between cochlear decline and tinnitus. She was educated on the anatomy and physiology of the ear, the known origins and/or causes of tinnitus, as well as the negative feedback loop that can occur with bothersome tinnitus and the limbic system. Tinnitus causes, medications that can exacerbate tinnitus, tinnitus triggers, and management methods were discussed at length. Tinnitus is a complex phenomenon. It is estimated that 44 million Americans experience tinnitus. Of those, about 8 million find tinnitus to be a significant problem with 2 million finding tinnitus to be debilitating. There are more than 550 prescription and non-prescription medications and chemicals documented that are associated with tinnitus, however, individual’s side effects will depend on many factors such as body chemistry, sensitivity to drugs, dosages, pre-existing otologic factors, and length of time the drugs are taken. Tinnitus can exist because of cochlear decline and be exacerbated by medications. Problematic tinnitus is a combination of otologic origins compounded with the negative reactions from the limbic system. Regardless of the origin of tinnitus the treatment objective would be - to habituate the tinnitus so that the patient 'experiences tinnitus but it is not a problem.' Patients with bothersome tinnitus have involvement of the limbic system with negative emotions and reactions associated with the tinnitus.
The patient was counseled about the multiple treatment approaches to managing tinnitus, such as TRT (Tinnitus Retraining Therapy), Lenire Tinnitus Treatment device, Sound Enrichment using sound generators, hearing devices/combo devices, and CBT (Cognitive Behavior Therapy). Tinnitus management apps can be helpful, as well as use of tabletop sound generators for use at night with or without pillow speakers. We discussed how and why on-ear hearing devices are useful in treating tinnitus. When sleep is an issue a sleep study could be helpful. Diet and exercise can have an impact on tinnitus loudness and ability to fall asleep.
Lenire Assessment
The patient rates the current tinnitus loudness as 7 out of 10 and annoyance as 8 out of 10. She has tried using white noise machines and meditation to manage tinnitus, with limited success.
The patient was provided with a glass of water prior to the examination and mouth was confirmed to be free from food and gum. Visual examination of the upper and lower lips, buccal mucosa underneath the upper and lower lips, as well as tongue, palate was conducted.
No ulcerations, cold sores, lesions, inflammation, evidence or oral surgery, piercings or other abnormalities of the mouth were noted. The patient denied impaired sensitivity of the tongue, teeth or gums.
Recommendations: 1. Utilize strategies for coping with and habituating to tinnitus (avoid silence, wear hearing protection when in loud environments etc) 2. Use of sound generator and/or tinnitus relief app 3. Behavior modifications, including relaxation, meditation, breathing exercises, stretching, yoga. 4. Lenire Tinnitus Treatment Device 5. Tinnitus Retraining Therapy 7. Referral to Sleep Clinic 8. Cognitive Behavioral Therapy with mental health care provider 9. Prescription hearing aids/combo devices