Hearing Aids Mitigate Tinnitus, But Does It Matter if the Patient Receives Amplification in Accordance With Their Hearing Impairment or Not? A Meta-Analysis

Abstract

Purpose: The purpose of the present meta-analysis is to explore the potential effects of objective verification of hearing aid amplification on tinnitus-related outcomes. Method: Twenty-seven studies reporting tinnitus outcomes pre and post hearing aid fitting were identified through a systematic literature search. From these studies, data from 1,400 participants were included in the present meta-analysis. Studies were divided into subgroups based on whether they had reported performing objective verification of the participants' hearing aid amplification or not. Outcome measures were tinnitus distress and tinnitus loudness. Results: Meta-analyses of all included studies indicated verified amplification to result in significantly enhanced reduction of tinnitus loudness ( p < .00001), while the enhanced reduction of tinnitus distress only approached statistical significance ( p = .07). However, when excluding an outlier from the subgroup of studies using unverified amplification, individuals receiving verified amplification showed significantly greater reduction of tinnitus distress ( p = .02). In addition, analyses of longitudinal effects revealed that the reductions of tinnitus distress decreased over time among individuals receiving unverified amplification but increased over time among individuals receiving verified amplification. Conclusions: The present meta-analysis indicates verified hearing aid amplification to be superior to unverified amplification in terms of reduction of tinnitus loudness and distress. The longitudinal increase of mitigation of tinnitus distress with verified amplification only may reflect improved neural reorganization and/or better adherence to hearing aid use, with verified compared to unverified amplification. Due to the low cost of hearing aid verification compared to the high societal cost of tinnitus, objective verification of hearing aid amplification for tinnitus patients is recommended.