The interdisciplinary management of tinnitus – Chris Waterworth interviews PhD candidate Siobhan McGinnity

chris-waterworth-audiologistChris Waterworth, Audiologist at the University of Melbourne, interviewed fellow Audiologist and PhD candidate, Siobhan McGinnity on her role in establishing a specialised program for the interdisciplinary management of tinnitus within the University Clinic.

Siobhan, how would you describe tinnitus?

Tinnitus is the ability to hear a sound in the head or ears without an external source. Many people describe these sounds as a ringing or hiss, but it can also sound like an ocean roar, clicking, rhythmic pulses or even musical tones. Studies have shown that each individual experiences their tinnitus differently; what makes one’s tinnitus better or worse may not necessarily be the same for others. With the help of an Audiologist, patients can work towards finding solutions to manage their tinnitus.

Who gets it?

siobhan-mcginnityThe World Health Organisation estimates that 278 million people world-wide have tinnitus, however, studies have shown that almost everybody would hear some sort of internal sound when placed in a sound-proof room. Unlike a fleeting ringing that is heard from time to time, or after a loud night out, chronic tinnitus lasts for more than 6 months. For roughly 5% of the population this can cause distress, impact sleep, concentration, mood and quality of life. Tinnitus management is crucial to addressing these symptoms and starts with the reassurance found in diagnosis.

What do you see as the role of an audiologist in the management of tinnitus?

Tinnitus management requires individualised care tailored to the patients’ needs and lifestyle. Best management will often start with a hearing test by a specialised audiologist who may also refer on to other clinicians to assist with further investigation and management. Such professionals will often include Ear Nose and Throat specialists, Psychologists, Physiotherapists and Dentists. These are all areas known to help support the management of tinnitus and will be referred to when clinically indicated.

Recently Siobhan held a round table discussion on the interdisciplinary management of tinnitus with a spokesperson from each of these areas.

Siobhan, what struck you hearing about how others are managing tinnitus?

Compassion. The individuals I’ve heard from specialising in this area appear to have a great deal of compassion and empathy for clients going through what can be for some, a very difficult condition. Each discipline has its own unique way of contributing to the management of the sound, whether it be addressing possible muscular input (i.e. commonly seen in TMJ), or using psychology to assist in reducing the stress response that often ramps up the intensity and intrusiveness of the condition. From the round table discussion, it also became apparent that the role of the audiologist in an interdisciplinary approach to tinnitus is almost akin to a case manager for the client; advocating and triaging them for other disciplines when necessary.

As an audiologist I know how difficult it can be to help individuals presenting with tinnitus as their main concern. How do you think an interdisciplinary approach might change the way tinnitus is managed in future?

I think it could see clinicians from various fields working more collaboratively on behalf of the client. Too often we can be siloed into our own niches, but tinnitus management presents an opportunity for both the clinician and the client to find support in a team, not just an individual.

What impact might this have on the curriculum in Universities?

I feel a lot of clinicians get overwhelmed by tinnitus, how to describe it, how to manage it and what to recommend next. The difficulty can be compounded further by the client’s distress, grief and search for answers. A clinician that says ‘there’s nothing that can be done for you’, to me, sounds disempowered. It would be my hope that we could move toward empowering students working with clients to not only reassure them, but co-create a management plan they can have confidence in.

Do you have any examples where the interdisciplinary management of tinnitus has resulted in a positive outcome?

Yes, absolutely. Whether it be from the ‘hope’ described by a client at the end of an appointment as we make their management plan and they realise they have more control of their situation, or seeing a returning client who has followed up on their plan and gained further support and input from other professionals. It’s truly wonderful to watch their progress and help them become their own self-managers of their tinnitus.

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