Description:

tinnitus is a prevalent and often debilitating symptom that affects millions worldwide. Despite its frequency, clinicians frequently struggle with its management due to the heterogeneity of causes and responses to treatment. This instruction course is designed to provide a clear, concise, and practical guide for managing tinnitus patients in real-world clinical settings. It will focus on decision-making strategies, categorizing patients, and selecting appropriate interventions.

the session is divided between three expert clinicians. The first speaker, dr. Maryam sadeghijam, will focus on patient profiling and clinical decision-making. Drawing on audiological, psychological, and subjective patient data, she will demonstrate how to formulate an individualized treatment strategy and determine the most appropriate therapeutic direction. The second speaker, dr. Ahmad reza nazeri, will present an overview of current treatment modalities—including counseling, sound therapy, hearing aids, cognitive-behavioral therapy (CBT), and neuromodulation— and explain how to match each approach to specific patient profiles. The third speaker, mevlüde işık, will focus on neuromodulation in tinnitus, with an emphasis on transcranial direct current stimulation (tdcs). This section will briefly cover the clinical rationale for tdcs, patient selection criteria, and its role as an adjunctive tool within multimodal tinnitus management.

outcome objectives:

by the end of this course, participants will be able to:

• integrate audiological, psychological, and subjective assessments to guide treatment planning

• select personalized management strategies using a structured clinical algorithm

• compare counseling, sound therapy, CBT, and neuromodulation based on patient profiles

structure of session:

part 1 – clinical decision-making in tinnitus management

speaker: dr. Maryam sadeghijam

- quick overview of tinnitus subtypes (e.G., subjective vs. Objective, chronic vs. Acute, bothersome vs. Non-bothersome)

- the essential components of initial assessment: audiological, psychological, and subjective evaluations

- clinical decision-making models based on patient profiles

- simple checklists and red flags to guide early-stage planning

part 2 – treatment options and how to match each approach to specific patient profiles

speaker: dr. Ahmad reza nazeri

- concise review of core management approaches:

·       counseling and patient education

·       sound therapy and hearing aids

·       cognitive behavioral therapy (CBT)

·       mindfulness-based interventions

·       neuromodulation

- comparative table of approaches: strengths, limitations, ideal patient types

- common pitfalls in choosing or applying treatments

- a brief, actionable algorithm for everyday clinical decision-making

 part 3 – neuromodulation in tinnitus: practical use of tdcs

speaker: mevlüde işık

-neurophysiological basis of neuromodulation in tinnitus

-tdcs in tinnitus management:

.             core mechanisms and main cortical targets

.             commonly used stimulation protocols and safety considerations

-patient selection and clinical integration:

.             tinnitus profiles most suitable for tdcs

.             influence of severity, chronicity, and treatment resistance

background:

1-     shannon entropy measures for EEG signals in tinnitus

2-     an increase in the auditory steady-state response amplitudes after a period of listening to binaural beat stimuli in tinnitus patients: a pilot study

3-     does tinnitus lead to chaos?

4-     the hypothetical relation between the degree of stress and auditory cortical evoked potentials in tinnitus sufferers

5-     use of some relevant parameters for primary prediction of brain activity in idiopathic tinnitus based on a machine learning application

6-     persian version of the hyperacusis questionnaire: psychometric evaluation and prevalence determination

7-     a preliminary study on the reliability of the persian version of the tinnitus functional index in a military population

A better understanding of cortical neuroplasticity accompanying hearing loss may allow us to improve intervention and rehabilitation for patients with hearing loss.  compensation for the deleterious effects of hearing loss include recruitment of alternative brain networks during cortical processing. Our experiments suggest that early stage, mild-moderate, age-related hearing loss ranging results in significant changes in neural resource allocation, reflecting patterns of cross-modal compensation from the visual and somatosensory modalities, increased listening effort, and decreased cognitive spare capacity. Adults with untreated age-related hearing loss also show evidence of cognitive decline. Treatment with hearing aids reverse cross-modal recruitment of auditory cortex over the course of 6 months, coinciding with gains in auditory speech perception abilities, social-emotional processing and significant improvements in cognitive performance as measured by clinical tests of neurocognition. New data on results of neurocognitive changes with over-the-counter hearing aids will be discussed.

Multimodal plasticity to tinnitus and hyperacousismultimodal plasticity to tinnitus and hyperacousismultimodal plasticity to tinnitus and hyperacousismultimodal plasticity to tinnitus and hyperacousismultimodal plasticity to tinnitus and hyperacousismultimodal plasticity to tinnitus and hyperacousismultimodal plasticity to tinnitus and hyperacousismultimodal plasticity to tinnitus and hyperacousis