How do I prescribe sound therapy headphones for patients with tinnitus (ringing in the ears)?

From the Guidelines

To prescribe medical headphones for tinnitus, you should first refer your patient to an audiologist or otolaryngologist for proper evaluation, as recommended by the clinical practice guideline: tinnitus executive summary 1. This evaluation is crucial in determining the type and severity of tinnitus, which will guide the selection of appropriate sound therapy devices.

Key Considerations

• Medical headphones for tinnitus typically include tinnitus maskers, sound generators, or combination devices that provide both amplification and sound therapy.
• Common prescription options include the Widex Zen, ReSound LiNX Quattro, Oticon More, Phonak Audéo Paradise, or Starkey Livio Edge AI devices.
• The prescription should specify the device type, sound therapy program settings, recommended usage duration (typically 4-8 hours daily), and whether the device should be used during specific times like bedtime for sleep disturbances.
• Clinicians should educate patients with persistent, bothersome tinnitus about management strategies, including sound therapy, as stated in Statement 6 of the guideline 1.
• Cognitive-behavioral therapy (CBT) should also be recommended to patients with persistent, bothersome tinnitus, as it has been shown to have a preponderance of benefit over harm 1.

Follow-up and Adjustment

Follow-up appointments should be scheduled at 2-4 weeks after fitting and then every 3-6 months to adjust settings as needed.

• Insurance coverage varies significantly, so it is essential to verify benefits and provide proper documentation of medical necessity.
• These devices work by providing background sounds that help reduce tinnitus perception through habituation or masking, making the tinnitus less noticeable to the brain over time.

From the Research

Prescribing Medical Headphones for Tinnitus

To prescribe medical headphones for tinnitus, consider the following steps:

• Evaluate the patient's tinnitus symptoms and medical history to determine the best course of treatment 2
• Perform a comprehensive audiologic evaluation to assess the patient's hearing and identify any underlying conditions that may be contributing to the tinnitus 2
• Consider cognitive behavioral therapy (CBT) as a treatment option, as it has been shown to improve quality of life in patients with tinnitus 2, 3, 4
• Sound therapy, including notched sound therapy, may also be effective in reducing tinnitus symptoms 5, 6
• Medical headphones can be used to deliver sound therapy, and may be prescribed as part of a comprehensive treatment plan

Treatment Options

Some treatment options for tinnitus include:

• Cognitive behavioral therapy (CBT) to address psychological and cognitive impairments associated with tinnitus 2, 3, 4
• Sound therapy, including notched sound therapy, to reduce tinnitus symptoms 5, 6
• Refined sound therapy combined with CBT to treat tinnitus 6
• Avoidance of noise exposure to prevent the development or progression of tinnitus 2

Considerations

When prescribing medical headphones for tinnitus, consider the following:

• The patient's individual needs and preferences
• The severity and frequency of the tinnitus symptoms
• The presence of any underlying medical conditions that may be contributing to the tinnitus
• The potential benefits and limitations of sound therapy and CBT 2, 5, 3, 6, 4