{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:12:17Z","timestamp":1760112737212,"version":"build-2065373602"},"reference-count":39,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T00:00:00Z","timestamp":1722902400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Audiology Research"],"abstract":"<jats:p>Hearing aids (HAs), especially those with sound generators (SGs), are used in the management of tinnitus. However, their comparative efficacies and long-term outcomes remain unknown. Therefore, we investigated the efficacy and long-term outcomes of tinnitus therapy using various HA SG models. We retrospectively reviewed 666 patients with chronic tinnitus characterized by persistent symptoms for &gt;6 months. At the initial visit, the patients received educational counselling on tinnitus (Utsunomiya method) and completed a comprehensive questionnaire comprising the tinnitus handicap inventory, a visual analog scale, the state\u2013trait anxiety inventory, and the emotional intelligence scale. The scores were compared among various models of HA SGs and SGs. The patients underwent follow-ups for up to 2 years. Our results indicated that tinnitus retraining therapy using SGs and conventional HAs effectively managed chronic tinnitus. The prolonged use of HAs appeared to exacerbate tinnitus symptoms, emphasizing the superior long-term effectiveness of SG HAs, particularly ZEN (Widex ZEN, WS Audiology, Lynge, Denmark). Our findings indicate that HAs are useful in the first year, but their prolonged use may exacerbate tinnitus symptoms, whereas HA SGs are effective in the long term. Future studies should account for the variations in tinnitus treatment effects based on the type of sound employed.<\/jats:p>","DOI":"10.3390\/audiolres14040057","type":"journal-article","created":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T15:24:16Z","timestamp":1722957856000},"page":"674-683","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Optimizing Tinnitus Management: The Important Role of Hearing Aids with Sound Generators"],"prefix":"10.3390","volume":"14","author":[{"given":"Yuki","family":"Kosugi","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5977-0056","authenticated-orcid":false,"given":"Toru","family":"Miwa","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan"},{"name":"Department of Otolaryngology-Head and Neck Surgery, Graduate of School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuka","family":"Haruta","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kosuke","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoko","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3109\/03005368909077819","article-title":"Tinnitus\u2014A study of its prevalence and characteristics","volume":"23","author":"Axelsson","year":"1989","journal-title":"Br. J. Audiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.anl.2019.09.007","article-title":"Clinical practice guidelines for diagnosis and treatment of chronic tinnitus in Japan","volume":"47","author":"Ogawa","year":"2020","journal-title":"Auris Nasus Larynx"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1055\/s-0042-1748042","article-title":"Tinnitus retraining therapy (TRT) as a method for treatment of tinnitus and hyperacusis patients","volume":"11","author":"Jastreboff","year":"2000","journal-title":"J. Am. Acad. Audiol."},{"key":"ref_4","first-page":"CD013094","article-title":"Sound therapy (using amplification devices and\/or sound generators) for tinnitus","volume":"12","author":"Sereda","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/j.anl.2021.01.001","article-title":"Effective sound therapy using a hearing aid and educational counseling in patients with chronic tinnitus","volume":"48","author":"Shinden","year":"2021","journal-title":"Auris Nasus Larynx"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/j.anl.2020.03.005","article-title":"Retrospective evaluation of secondary effects of hearing aids for tinnitus therapy in patients with hearing loss","volume":"47","author":"Yokota","year":"2020","journal-title":"Auris Nasus Larynx"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1080\/14992027.2021.2007423","article-title":"Hearing more to hear less: A scoping review of hearing aids for tinnitus relief","volume":"61","author":"Jacquemin","year":"2022","journal-title":"Int. J. Audiol."},{"key":"ref_8","first-page":"S1","article-title":"Clinical practice guideline: Tinnitus","volume":"151","author":"Tunkel","year":"2014","journal-title":"Otolaryngol. Head. Neck Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1007\/s00106-015-0011-z","article-title":"On the interdisciplinary S3 guidelines for the treatment of chronic idiopathic tinnitus","volume":"63","author":"Zenner","year":"2015","journal-title":"HNO"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3766\/jaaa.25.1.2","article-title":"Underlying mechanisms of tinnitus: Review and clinical implications","volume":"25","author":"Henry","year":"2014","journal-title":"J. Am. Acad.Audiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/0168-0102(90)90031-9","article-title":"Phantom auditory perception (tinnitus): Mechanisms of generation and perception","volume":"8","author":"Jastreboff","year":"1990","journal-title":"Neurosci. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1080\/00016480410016333","article-title":"Cognitive tinnitus sensitization: Behavioral and neurophysiological aspects of tinnitus centralization","volume":"124","author":"Zenner","year":"2004","journal-title":"Acta Oto-Laryngol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1097\/01.mao.0000231604.64079.77","article-title":"Tinnitus sensitization: Sensory and psychophysiological aspects of a new pathway of acquired centralization of chronic tinnitus","volume":"27","author":"Zenner","year":"2006","journal-title":"Otol. Neurotol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"McKenna, L., Handscomb, L., Hoare, D.J., and Hall, D.A. (2014). A scientific cognitive-behavioral model of tinnitus: Novel conceptualizations of tinnitus distress. Front. Neurol., 5.","DOI":"10.3389\/fneur.2014.00196"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Ghodratitoostani, I., Zana, Y., Delbem, A.C., Sani, S.S., Ekhtiari, H., and Sanchez, T.G. (2016). Theoretical Tinnitus Framework: A Neurofunctional Model. Front. Neurosci., 10.","DOI":"10.3389\/fnins.2016.00370"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Ghodratitoostani, I., Vaziri, Z., Miranda Neto, M., de Giacomo Carneiro Barros, C., Delbem, A.C.B., Hyppolito, M.A., Jalilvand, H., Louzada, F., and Leite, J.P. (2024). Conceptual framework for tinnitus: A cognitive model in practice. Sci. Rep., 14.","DOI":"10.1038\/s41598-023-48006-7"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1097\/AUD.0000000000000093","article-title":"Validation of a novel combination hearing aid and tinnitus therapy device","volume":"36","author":"Henry","year":"2015","journal-title":"Ear Hear."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1044\/2021_JSLHR-21-00210","article-title":"Contributions of Counseling and Sound Generator Use in Tinnitus Retraining Therapy: Treatment Response Dynamics Assessed in a Secondary Analysis of a Randomized Trial","volume":"65","author":"Formby","year":"2022","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"461","DOI":"10.3766\/jaaa.21.7.5","article-title":"Effects of acoustical stimuli delivered through hearing aids on tinnitus","volume":"21","author":"Sweetow","year":"2010","journal-title":"J. Am. Acad. Audiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"96","DOI":"10.4103\/1463-1741.110289","article-title":"The use of fractal tones in tinnitus patient management","volume":"15","author":"Sweetow","year":"2013","journal-title":"Noise Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1159\/000377617","article-title":"Hearing aid or tinnitus masker: Which one is the best treatment for blast-induced tinnitus? The results of a long-term study on 974 patients","volume":"20","author":"Jalilvand","year":"2015","journal-title":"Audiol. Neurotol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1001\/archotol.1996.01890140029007","article-title":"Development of the tinnitus handicap inventory","volume":"122","author":"Newman","year":"1996","journal-title":"Arch. Otolaryngol. Head. Neck Surg."},{"key":"ref_23","unstructured":"Spielberger, C.D., Gorsuch, R.L., and Lushene, R.E. (1968). STAI Manual for the Stait-Trait Anxiety Inventory (\u2018Self-Evaluation Questionnaire\u2019), Consulting Psychologists Press. (Libro, 1970) [WorldCat.org]."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"39","DOI":"10.4103\/0972-6748.98413","article-title":"Emotional intelligence scale for medical students","volume":"20","author":"Srivastava","year":"2011","journal-title":"Ind. Psychiatry J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"254","DOI":"10.3757\/jser.82.254","article-title":"Characteristics of Vestibular Migraine Assessed Using the Emotional Intelligence Scale (EQS): A Pilot Study","volume":"82","author":"Kouga","year":"2023","journal-title":"Equilib. Res."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Krauss, P., Tziridis, K., Metzner, C., Schilling, A., Hoppe, U., and Schulze, H. (2016). Stochastic resonance controlled upregulation of internal noise after hearing loss as a putative cause of tinnitus-related neuronal hyperactivity. Front. Neurosci., 10.","DOI":"10.3389\/fnins.2016.00597"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Auerbach, B.D., Rodrigues, P.V., and Salvi, R.J. (2014). Central Gain Control in Tinnitus and Hyperacusis. Front. Neurol., 5.","DOI":"10.3389\/fneur.2014.00206"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"107","DOI":"10.4103\/1463-1741.110292","article-title":"Recent technological advances in sound-based approaches to tinnitus treatment: A review of efficacy considered against putative physiological mechanisms","volume":"15","author":"Hoare","year":"2013","journal-title":"Noise Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1044\/2017_AJA-16-0009","article-title":"The effectiveness of the progression of widex zen tinnitus therapy: A pilot study","volume":"26","author":"Tyler","year":"2017","journal-title":"Am. J. Audiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e38986","DOI":"10.2196\/38986","article-title":"The Treatment Outcome of Smart Device\u2013Based Tinnitus Retraining Therapy: Prospective Cohort Study","volume":"11","author":"Suh","year":"2023","journal-title":"JMIR mHealth uHealth"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/S1808-8694(15)30835-1","article-title":"Correlation analysis of the visual-analogue scale and the Tinnitus Handicap Inventory in tinnitus patients","volume":"75","author":"Figueiredo","year":"2009","journal-title":"Braz. J. Otorhinolaryngol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1177\/1084713808319943","article-title":"Tinnitus Outcomes Assessment","volume":"12","author":"Meikle","year":"2008","journal-title":"Trends Amplif."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Fuller, T.E., Haider, H.F., Kikidis, D., Lapira, A., Mazurek, B., Norena, A., Rabau, S., Lardinois, R., Cederroth, C.R., and Edvall, N.K. (2017). Different teams, same conclusions? A systematic review of existing clinical guidelines for the assessment and treatment of tinnitus in adults. Front. Psychol., 8.","DOI":"10.3389\/fpsyg.2017.00206"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1002\/lary.26107","article-title":"Relationships Between Tinnitus And The Prevalence Of Anxiety And Depression","volume":"127","author":"Bhatt","year":"2017","journal-title":"Laryngoscope"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"10","DOI":"10.7874\/jao.2022.00290","article-title":"Impact of Hearing Aid Usage on Emotional and Social Skills in Persons With Severe to Profound Hearing Loss","volume":"27","author":"Yadav","year":"2023","journal-title":"J. Audiol. Otol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Lee, H.J., Kang, D.W., Yeo, S.G., and Kim, S.H. (2022). Hearing Aid Effects and Satisfaction in Patients with Tinnitus. J. Clin. Med., 11.","DOI":"10.3390\/jcm11041096"},{"key":"ref_37","first-page":"CD012614","article-title":"Cognitive behavioural therapy for tinnitus","volume":"1","author":"Fuller","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Gilar-Corbi, R., Pozo-Rico, T., S\u00e1nchez, B., and Castej\u00f3n, J.L. (2019). Can emotional intelligence be improved? A randomized experimental study of a business-oriented EI training program for senior managers. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0224254"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1080\/10874200903107405","article-title":"Alpha suppression and symmetry training for generalized anxiety symptoms","volume":"13","author":"Kerson","year":"2009","journal-title":"J. Neurother."}],"container-title":["Audiology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4349\/14\/4\/57\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:30:59Z","timestamp":1760110259000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4349\/14\/4\/57"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,6]]},"references-count":39,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["audiolres14040057"],"URL":"https:\/\/doi.org\/10.3390\/audiolres14040057","relation":{},"ISSN":["2039-4349"],"issn-type":[{"type":"electronic","value":"2039-4349"}],"subject":[],"published":{"date-parts":[[2024,8,6]]}}}