Tinnitus can make it difficult for a patient to distinguish between test tones (pure tones) being presented and those generated by their tinnitus. As a result false-positive responses will occur. In effect, the tones presented are masked when the tinnitus is of the same pitch but of a higher intensity than the presented tone. As an unfortunate result, a patient may be misdiagnosed and mismanaged.In most cases, when a patient enters an audiology clinic complaining of tinnitus, an audiologist will first conduct a hearing test. This is a vital part of tinnitus assessment and required to identify the underlying cause of the patient's tinnitus.
Tinnitus is a prevalent condition that the majority of health professionals encounter in their patients. Tinnitus is often referred to as ‘ringing in the ears’, however tinnitus sufferers may also hear ticking, hissing and roaring sounds. It involves the perception of noise or ringing in the ears without an external acoustic source. It is not a disease, but a symptom of various underlying diseases.
There is general consensus that tinnitus is associated with hearing loss. Thus, patients with existing hearing loss could show exaggerated, negative hearing assessment results on their audiogram.
However, some tinnitus patients have thresholds within the normal range but may show a degree of hearing loss as a result of the tinnitus.
Beep… Beep… Beep…
ASHA (2005) guidelines for Pure Tone Audiometry recommend the use of Warble tones and Pulsed Tones when accurate test results cannot be achieved due to tinnitus.
The British Society of Audiology (Reviewed 2018) further advocates for the use of Warble tones, however, does not recommend the use of pulsed tones due to calibration and perception problems.
In my own clinical experience, one should always switch to warble tones as soon as a patient walks complains of tinnitus. Warble tones are far easier to distinguish from the background tinnitus noise, thus making it easier on the patient and increasing the accuracy of the results obtained. However, many audiometers are not provided with warble tone features as standard.
Never miss a note
With KUDUwave audiometers, you can easily switch between warble or pure tones right in the interface so that your patient will never miss a test tone. It's as easy as that.
Click play to listen to how warble tones sound like from 250 Hz to 8000 Hz.
Click play to listen to how pure tones sound like from 250 Hz to 8000 Hz.
Get the right diagnosis and manage your patient correctly, with just a click!