Determination of a Threshold Adjusted Noise Prescription for Tinnitus Management

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dc.contributor.advisor Searchfield, G en Lim, Joanne en 2020-07-17T00:40:51Z en 2020 en
dc.identifier.uri en
dc.description Full Text is available to authenticated members of The University of Auckland only. en
dc.description.abstract Background: Tinnitus refers to the perception of auditory sensations in the absence of external stimuli (McFadden, 1982). Sound therapy refers to the use of sound to convey positive effects on tinnitus (Searchfield, Linford & Durai, 2017). Threshold adjusted noise (TAN) aims to equalise audibility of a broadband noise across individual audiometric thresholds (Searchfield, Warr, Kuklinski & Purdy, 2002, Callaway, 2014). Aims: To elucidate the optimal masker level of TAN for acute tinnitus improvement, defined as reductions in tinnitus loudness and annoyance, and determine factors affecting acute effectiveness of TAN in sound therapy. Methods: In a randomised cross-over trial design, 20 tinnitus participants (12 males, 8 females) trialled four TAN prescriptions over 10-minute intervals in a sound-treated room. Baseline and outcome measures were visual analogue scale (VAS) scores of tinnitus loudness and annoyance, noise annoyance and sound quality. Results: Results indicated the self-adjusted TAN prescription, set at approximately 72.8% of preferred narrowband listening levels and minimum masking levels, contributed the most acute reductions in tinnitus loudness and annoyance, but also elicited the most noise annoyance. Analysis of variance indicated no significant differences in VAS scores between TAN prescriptions, but VAS scores were significantly different from each other. Bivariate correlation analysis indicated change in tinnitus loudness was strongly positively correlated with change in tinnitus annoyance (r= 0.810, p<0.001), whereas noise annoyance and sound quality were weakly inversely correlated (r = -0.355, p = 0.001). Both correlations were significant. Differences in individual and tinnitus characteristics (age, TFI scores, HADS scores, hearing loss and tinnitus pitch) had no significant effects on the selfadjusted TAN prescription. Conclusions: Optimal partial masking levels to achieve tinnitus reduction varied between individuals, suggestive of an effective range of partial masking levels for use in sound therapy. Separate adaptation levels were suggested to exist for tinnitus and sound audibility. A participant-driven approach for use of TAN in sound therapy is recommended to accommodate heterogeneous tinnitus and individual characteristics. However, the optimal TAN prescription remains to be validated for efficacy in a long-term trial. Suggestions for future research are also recommended.
dc.publisher ResearchSpace@Auckland en
dc.relation.ispartof Masters Thesis - University of Auckland en
dc.relation.isreferencedby UoA en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights Restricted Item. Full Text is available to authenticated members of The University of Auckland only. en
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dc.title Determination of a Threshold Adjusted Noise Prescription for Tinnitus Management en
dc.type Thesis en Audiology en The University of Auckland en Masters en
dc.rights.holder Copyright: The author en
pubs.elements-id 805755 en
pubs.record-created-at-source-date 2020-07-17 en

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