Guidance to rehabilitate patients with hearing and balance problems and tinnitus

Hearing and balance-related problems are often chronic conditions which can be managed but not always cured. Now new guidance by the British Society of Audiology – devised in collaboration with the National Institute for Health Research – promises to improve quality of life for patients with hearing and balance problems and tinnitus.

01 sept 2012--Effective rehabilitation is best achieved through a process that goes beyond addressing the sensory impairment by providing support both to the person experiencing the hearing or balance-related problem and their partner or immediate family.

New Practice Guidance on Common Principles of Rehabilitation in Routine Audiology Services will be launched in Nottingham on Wednesday 5 September by Professor Deborah Hall with collaborator Dr Daniel Rowan, during the Annual Conference of the British Society of Audiology (BSA). 

Consultation and expert collaboration

Over the past decade there have been important developments in understanding how people with chronic conditions can be helped to maximise their quality of life. This includes unifying some general principles across a wide range of conditions including hearing loss, tinnitus and dizziness.

There is widespread acceptance that rehabilitation will fail to deliver its full potential if it focuses exclusively on addressing sensory impairment, without considering clients' specific social and emotional needs.

The guidance was developed by the Professional Practice Committee of the British Society of Audiology (BSA) in collaboration with the National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, the Ida Institute, the BSA Adult Rehabilitation Interest Group, the BSA Balance Interest Group, and the wider audiology community. 

Professor Deborah Hall, Director of the National Institute for Health Research Nottingham Hearing Biomedical Research Unit, said: "This guidance brings together the latest scientific evidence concerning what rehabilitative strategies best improve people's quality of life."

Utilising "considerable improvements in technology"

Dr Daniel Rowan, Chair of the BSA's Professional Practice Committee, said: "This guidance was inspired by growing efforts within audiology to utilise fully the considerable improvements in technology at times of great challenge.

"The BSA aims to support these efforts by recognising the end goals of audiology and by promoting the core principles that we currently understand are necessary to achieve them. The intention is for audiology professionals to consider these principles as being at the heart of their practice, helping to guide their interactions with clients with a wide variety of needs and in a wide variety of contexts."

This general approach is in keeping with current trends seen across other clinical disciplines in the rehabilitation of chronic illnesses. Although this new guidance is intended primarily to inform the practice of audiology professionals directly involved in the rehabilitation process, it is also intended to be a reference for commissioners, policy makers and other stakeholders as to what comprises best practice in rehabilitation

This new Practice Guidance will be presented during the BSA's Annual Conference, which is being held this year at Nottingham Trent University.

Provided by University of Nottingham

Tinnitus in the elderly is prevalent and impacts quality of life

Alexandria, VA, 08 oct 2010 — Tinnitus is common among elderly Nigerians and associated with treatable health conditions like otitis media, rhinosinusitis, head injury and hypertension, according to new research published in the October 2010 issue of Otolaryngology – Head and Neck Surgery.

Nearly 36 million Americans, however, suffer from tinnitus or head noises. It may be an intermittent sound or an annoying continuous sound in one or both ears. In Nigeria, tinnitus affects between 10.1% and 33% of the population, with about 3 to 4% consulting a doctor on at least one occasion in their lifetime. Its effect makes it a significant contributor to morbidity in the elderly.

The study included face-to-face interviews of 1,302 elderly people aged 65 years and over; age, sex, economic status or residence were not associated with the occurrence of tinnitus. The researchers found a significant difference between the prevalence of tinnitus among "young elderly" subjects aged 65-69 (6.5%), and the older (80+ years) group (41.9 %). Also in this study, a non-significant trend was observed for the prevalence of tinnitus to increase with decreasing socioeconomic and educational level.

"Our results are of potential value in the overall consideration of the health consequence of aging in this setting, especially given the projections of a rapid increase in the proportion of the elderly in developing countries," said study author Akeem Olawale Lasisi, MBChB, FWACS, FMCORL.

In spite of its public health significance, tinnitus among the elderly has received poor research attention in Sub-Saharan Africa where, with relatively poor access to health service, etiologically important medical conditions that would otherwise be readily treated could become chronic and increase vulnerability to tinnitus. In this study, the authors focused on subjective tinnitus; in selecting risk factors to study, they speculated that the presence of chronic recurrent rhinosinusitis may lead to eustachian tube dysfunction, hence middle ear pressure dysregulation and tinnitus. In addition, chronic medical conditions predisposing to arteriosclerosis have been considered as correlates because when untreated or complicated (as often found in this area), they might lead to hypoperfusion of the cochlear and dysregulation of inner ear fluid dynamics, which could then cause tinnitus. Furthermore, control of these risk factors may help in ameliorating tinnitus and improving quality of life, which would be a significant benefit to the majority of the elderly.

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Otolaryngology – Head and Neck Surgery is the official scientific journal of the American Academy of Otolaryngology – Head and Neck Surgery Foundation (AAO-HNSF). The study's authors are Akeem Olawale Lasisi, MBChB, FWACS, FMCORL; Taiwo Abiona, MSc; Oye Gureje, MBBS, PhD,