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Background: For many healthcare providers, tinnitus and hyperacusis are difficult symptoms to treat. There remains no conclusive cure for either symptom; however, helpful management strategies have been developed utilising counselling and sound therapy. Nowadays, most modern hearing aids have integrated sound therapy as a programable option; although, unlike hearing aid gain characteristics, output verification of sound therapy programs is not common practice. Recent electrophysiological studies suggest that accurately weighting the spectral content of noise in sound therapy could potentially lead to improved outcomes for tinnitus or hyperacusis patients. Methods: To determine if discrepancies exist between sound therapy programing software and hearing aid output, we compared the differences between software intensity settings and hearing aid outputs measured in a Verifit test box for three commonly dispensed manufactures. Results: Results indicate that hearing aid outputs are dramatically different from software readings, and each manufacture output was substantially different from each other. Furthermore, only one hearing aid incorporated audiometric data to normalize noise intensities across frequencies, and two of the aids reached potentially damaging levels. In sum, the data suggests clinical verification of sound therapy programs should be used to ensure the output is appropriate for individual patient's hearing and consistent with the clinician's desired approach to tinnitus management. [ABSTRACT FROM AUTHOR]

Objective: This article reviews: (1) the evidence related to enhanced central gain as a potential mechanism for the generation of tinnitus and hyperacusis, (2) the neuroplastic changes induced by prolonged, low-level sound stimulation and (3) the clinical effectiveness of various sound therapies and amplification for the treatment of tinnitus and hyperacusis. Design: General literature review. Study sample: Peer-reviewed articles related to auditory neural gain, prolonged low-level noise exposure and effectiveness of sound therapy. Results: A large body of literature exists supporting the enhanced neural gain model of tinnitus and hyperacusis. Neuroplastic changes associated with prolonged low-level noise show evidence of reversing enhanced neural gain, which should theoretically reduce percepts of tinnitus and/or hyperacusis. However, the available clinical evidence assessing the efficacy of sound therapy to reduce tinnitus or hyperacusis lacks controlled clinical trials to accurately assess the effectiveness of sound therapy. Conclusions: The available literature from basic science studies supports the neural gain model of tinnitus and hyperacusis, which conceivably should be effectively managed with sound therapy. However, well-controlled clinical trials are needed before conclusions can be made on the effectiveness of sound therapy for tinnitus and hyperacusis. [ABSTRACT FROM AUTHOR]