Event Report: British Tinnitus Association Conference September 2014

Dr Anita Nathan, NHS GP and BAPAM Clinician reports from the BTA conference 2014 

The British Tinnitus Association (BTA) is the leading source of information about tinnitus in the UK. All patients contacting BAPAM with concerns about the condition are advised to contact the BTA and investigate their many excellent publications. BAPAM’s recently updated Factsheet on hearing, Don’t Lose the Music, also highlights the BTA as a vital resource.

I attended their fascinating conference, held in September 2014 at the British Library Conference Centre in London. This short report summarises a few key points of particular interest to BAPAM clinicians and performing arts medicine specialists.

In an overview of the highlights of recent research into tinnitus, we heard about a trial of MDMA assisted psychotherapy for tinnitus, investigations into neural plasticity and multisensory processing, ‘residual inhibition’ (a brief suppression of tinnitus sounds after an offset (i.e. a presentation) of an external sound), and the way that sound therapy depends on the degree of hearing loss associated with tinnitus.

Investigations have been made into the effects of amplification with hearing aids in tinnitus patients with a co-existing mild to moderate hearing loss. One trial found that a hearing aid had an equal effect to a sound generator. Hearing aids can act as both noise generators and amplifiers for tinnitus treatment. Some early trial results suggest positive results from low level input from hearing aids for tinnitus sufferers without any hearing loss.

Some research suggests that stress may be a more significant factor in tinnitus than other causes (such as hearing loss and noise exposure). Cortisol, which is a marker for stress, affects hearing. Trials are ongoing into mindfulness based stress reduction approaches to managing tinnitus.

People with severe tinnitus have chronically higher basal cortisol levels than those with less severe symptoms and people without tinnitus.

A number of systematic reviews have shown the efficacy of CBT (Cognitive Behavioural Therapy).

Both avoidant coping and active coping mechanisms can seem to worsen tinnitus so it is necessary to find a balance. Increasing age is associated with increasing tinnitus annoyance.

GPs and assessing clinicians need to be aware that the first contact with someone suffering from tinnitus is very important. Catastrophic thinking worsens tinnitus so think carefully about giving the advice ‘learn to live with it’. Audiology-led tinnitus services seem to be the way forward, with an ENT opinion sought afterwards if necessary. There are shorter waiting times, less anxiety for the patient, and all initial investigations can be done by the audiology team.

All tinnitus patients should be given a hearing test to find out if they have hearing loss.

The BTA’s own Conference Reports from 2010 – 2013 can be found on their website here: http://tinnitus.org.uk/conference-reports.

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