Incidence of Discomfort During Pure-Tone Audiometry and Measurement of Uncomfortable Loudness Levels Among People Seeking Help for Tinnitus and/or Hyperacusis Purpose The aim of this study was to assess the proportion of patients seen in a tinnitus and hyperacusis therapy clinic for whom presentation levels based on the British Society of Audiology (BSA)–recommended procedures for pure-tone audiometry and determination of uncomfortable loudness levels (ULLs) exceed ULLs, leading to discomfort during ... Clinical Focus
Clinical Focus  |   September 18, 2017
Incidence of Discomfort During Pure-Tone Audiometry and Measurement of Uncomfortable Loudness Levels Among People Seeking Help for Tinnitus and/or Hyperacusis
 
Author Affiliations & Notes
  • Hashir Aazh
    Audiology Department, Royal Surrey County Hospital NHS Foundation Trust, Guildford, United Kingdom
  • Brian C. J. Moore
    Department of Psychology, University of Cambridge, United Kingdom
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Hashir Aazh: hashir.aazh@nhs.net
  • Editor: Sumitrajit Dhar
    Editor: Sumitrajit Dhar×
  • Associate Editor: Ann Eddins
    Associate Editor: Ann Eddins×
Article Information
Hearing Disorders / Clinical Focus
Clinical Focus   |   September 18, 2017
Incidence of Discomfort During Pure-Tone Audiometry and Measurement of Uncomfortable Loudness Levels Among People Seeking Help for Tinnitus and/or Hyperacusis
American Journal of Audiology, September 2017, Vol. 26, 226-232. doi:10.1044/2017_AJA-17-0011
History: Received February 1, 2017 , Revised March 27, 2017 , Accepted April 10, 2017
 
American Journal of Audiology, September 2017, Vol. 26, 226-232. doi:10.1044/2017_AJA-17-0011
History: Received February 1, 2017; Revised March 27, 2017; Accepted April 10, 2017

Purpose The aim of this study was to assess the proportion of patients seen in a tinnitus and hyperacusis therapy clinic for whom presentation levels based on the British Society of Audiology (BSA)–recommended procedures for pure-tone audiometry and determination of uncomfortable loudness levels (ULLs) exceed ULLs, leading to discomfort during administration of these procedures.

Method This was a retrospective cross-sectional study of 362 consecutive patients who attended a National Health Service audiology clinic for tinnitus and/or hyperacusis rehabilitation.

Results For 21% of the patients, presentation levels based on the BSA procedure for pure-tone audiometry exceeded the ULL for at least 1 of the measured frequencies (excluding the first frequency tested, 1 kHz): 0.25, 0.5, 2, 3, 4, 6, and 8 kHz. For 24% of patients, the starting presentation level of 60 dB hearing level recommended for determination of ULLs exceeded the ULL for at least 1 frequency.

Conclusion The starting presentation levels used for pure-tone audiometry and measurement of ULLs should be lower than those recommended by the BSA for people with tinnitus and hyperacusis.

Acknowledgment
We thank the members of the Tinnitus and Hyperacusis Therapy Specialist Clinic at Royal Surrey County Hospital for their assistance in data collection.
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