Understanding Tinnitus Clinical Care in the Veterans Health Administration and Department of Defense: Overview of Survey Results.

Purpose: In 2021, the Veterans Health Administration (VHA) and Department of Defense (DOD) Tinnitus Working Group conducted a survey of DOD and VHA clinicians to evaluate clinical services provided for tinnitus.

Method: The online survey included a mix of multiple-choice and open-ended questions. Respondents included VHA and DOD health care providers in audiology, otolaryngology, mental health, and primary care, as well as DOD hearing conservation technicians.

Voices From the Field: A Quality Improvement Project for Progressive Tinnitus Management 2.0.

Purpose: Tinnitus is a common health condition in the general population, with increased prevalence among military Veterans. Tinnitus is, in fact, the most prevalent military service-connected disability. There is no cure for tinnitus, but interventions are available to help patients manage their reactions to tinnitus and reduce its functional impact.

Auditory System Injury on the Battlefield-Solutions for Point-of-Injury and Prolonged Casualty Care: A DOTmLPF-P Analysis.

Introduction: "Good hearing" (DoDI 6030.03 6.5&6.

Evaluating the Clinical Reliability and Reference Values of the International Outcome Inventory for Cochlear Implants in the Department of Defense Population.

Background:  Hearing loss significantly affects an individual's well-being, communication, social interaction, and quality of life. Cochlear implants serve as a viable management option. Given the variability in the impact of impairment, self-report measures are crucial for evaluating the perceived benefits of management options.

Comprehensive Characterization of Hearing Loss and Tinnitus in Military-Affiliated and Non-Military-Affiliated Individuals.

Purpose: Military-affiliated individuals (MIs) are at a higher risk of developing hearing loss and tinnitus. While these disorders are well-studied in MIs, their impact relative to non-military-affiliated individuals (non-MIs) remains understudied. Our study compared hearing, speech-in-noise (SIN) perception, and tinnitus characteristics between MIs and non-MIs.

Normative Values for the Head Shake Sensory Organization Test in an Active Duty Military Cohort.

Introduction: The Head Shake Sensory Organization Test (HS-SOT) assesses postural stability while the head is moving and may also identify deficits in attention associated with the dual task conditions of moving the head at a specified speed while maintaining balance. Normative values for the HS-SOT have not been established in a healthy military population or other highly trained populations such as athletes. Establishing normative values in a military population will enable clinicians to compare the scores of patients with medical conditions that affect postural stability and sensory integration such as concussion or traumatic brain injury, vestibular dysfunction, or migraine to those of a healthy population to determine a need for intervention and for return to duty considerations.

Leveraging Technology for Vestibular Assessment and Rehabilitation in the Operational Environment: A Scoping Review.

Introduction: The vestibular system, essential for gaze and postural stability, can be damaged by threats on the battlefield. Technology can aid in vestibular assessment and rehabilitation; however, not all devices are conducive to the delivery of healthcare in an austere setting. This scoping review aimed to examine the literature for technologies that can be utilized for vestibular assessment and rehabilitation in operational environments.

Rehabilitation Service Needs and Preferences among Veterans with Tinnitus: A Qualitative Study.

Tinnitus is prevalent among military Veterans, yet there is a gap between the demand and the provision of services for tinnitus rehabilitation services within the Veterans Health Administration (VHA). We sought to understand tinnitus rehabilitation service needs and preferences among Veterans with bothersome tinnitus who use Veterans Affairs (VA) services. We conducted semistructured telephone interviews in 2019 with Veterans diagnosed with tinnitus, who reported it as bothersome.

Military and Nonmilitary TBI Associations with Hearing Loss and Self-Reported Hearing Difficulty among Active-Duty Service Members and Veterans.

Objective: Identify associations between self-reported history of military and nonmilitary traumatic brain injury (TBI) on hearing loss and hearing difficulty from the Noise Outcomes in Servicemembers Epidemiology (NOISE) study.

Study Design: Cross-sectional.

Setting: Multi-institutional tertiary referral centers.

The Design and Application of a Health Behavioral Change (HBC) Roadmap.

Introduction: To assist in addressing medical readiness challenges, the DOD has established various Centers of Excellence to focus efforts to protect, treat, train, and educate service members concerning risks and potential injuries. Using the hearing health domain as a pilot, this effort used DOD methods to evaluate all facets of successful health behavior change (HBC) practices within a military environment and developed a framework and pathway for HBC.

Methods: The DOD uses the Joint Capabilities Integration and Development System (JCIDS) to ensure new DOD capabilities are identified and fielded in a manner that is interoperable, resilient, and supportables.

Department of Defense Medical Examination Review Board Audiogram Screening Comparative Analysis.

Introduction: The Department of Defense Medical Examination Review Board (DoDMERB) plays a pivotal role in the assessment of medical fitness for aspiring military officers. A crucial component of this process is the screening audiogram, designed to evaluate hearing capabilities. However, recent observations of high disqualification rates following screening audiograms led to concerns about their accuracy.

The burden of vestibular disorders among military health system (MHS) beneficiaries, fiscal years 2018-2019.

Introduction: Vestibular disorders affect an estimated 33 million adults and 3.5 million children and adolescents in the United States. Previous research relying on self-reported symptoms versus actual diagnosis has limited the ability to provide prevalence estimates for specific vestibular disorders at the population level.

Post-concussion Return to Shooting Progression for Military Service Members: A Scoping Review and Conceptual Framework.

Introduction: There are established protocols for staged return to physical activity in sport and military settings following concussion. Currently, there is no evidence-based staged return to shooting protocol in use by the U.S.

Training to Improve Spatial Hearing and Situation Awareness when Wearing Hearing Protection.

Introduction: Hearing protection devices (HPDs) are standard personal protective equipment in military settings, but many service members may choose to not use HPDs because they impair spatial hearing and situation awareness. In an effort to reduce barriers to compliance by improving situation awareness while wearing HPDs, this study investigated whether brief training could counteract spatial hearing deficits when wearing HPDs. Participant's ability to correctly apply the HPDs across days was also examined.

Battlefield Acupuncture as a Treatment Option for Chronic Tinnitus: A Pilot Study.

Introduction: There is no cure for tinnitus, which is a highly prevalent condition in service members and veterans. Battlefield acupuncture (BFA) can be used to manage pain and stress-related symptoms. We investigated BFA as a safe, low-cost treatment for tinnitus perception and coping in eight chronic tinnitus patients who were followed for 6 months after two BFA treatments to identify changes in tinnitus severity or impact.

Central Auditory Processing Dysfunction in Service Members and Veterans: Treatment Considerations and Strategies.

Purpose: Military risk factors such as blast exposure, noise exposure, head trauma, and neurotoxin exposure place Service members and Veterans at risk for deficits associated with auditory processing dysfunction. However, there is no clinical guidance specific to the treatment of auditory processing deficits in this unique population. We provide an overview of available treatments and their limited supporting evidence for use in adults, emphasizing the need for multidisciplinary case management and interdisciplinary research to support evidence-based solutions.

Grooved Pegboard adds incremental value over memory-apparent performance validity tests in predicting psychiatric symptom report.

The present study evaluated whether Grooved Pegboard (GPB), when used as a performance validity test (PVT), can incrementally predict psychiatric symptom report elevations beyond memory-apparent PVTs. Participants ( = 111) were military personnel and were predominantly White (84%), male (76%), with a mean age of 43 ( 12) and having on average 16 years of education ( = 2). Individuals with disorders potentially compromising motor dexterity were excluded.

Tinnitus Screener: Short-Term Test-Retest Reliability.

Purpose: The Tinnitus Screener was introduced in 2015 as a four-item algorithmic instrument to assess the temporal characteristics of a person's reported tinnitus. The Tinnitus Screener was then revised as a six-item version to include a new temporal category and to capture tinnitus duration (acute < 6 months vs. chronic ≥ 6 months).

Invariant structural and functional brain regions associated with tinnitus: A meta-analysis.

Tinnitus is a common, functionally disabling condition of often unknown etiology. Neuroimaging research to better understand tinnitus is emerging but remains limited in scope. Voxel-based physiology (VBP) studies detect tinnitus-associated pathophysiology by group-wise contrast (tinnitus vs controls) of resting-state indices of hemodynamics, metabolism, and neurovascular coupling.

Personal attenuation ratings versus derated noise reduction ratings for hearing protection devices.

National and international regulatory and consensus standards setting bodies have previously proposed derating hearing protector ratings to provide a better match between ratings determined in a laboratory and the real-world measurements of attenuation for workers. The National Institute for Occupational Safety and Health has proposed a derating scheme that depends upon the type of protector. This paper examines four real-world studies where personal attenuation ratings (PARs) were measured at least twice, before and after an intervention in earplug fitting techniques.

Treatment of Posttraumatic Stress Disorder Alleviates Tinnitus-Related Distress Among Veterans: A Pilot Study.

Purpose: Military service personnel are at increased risk for developing tinnitus due to heightened exposure to acoustic trauma. The auditory disorder is the leading service-connected disability among veterans and is highly comorbidly diagnosed with posttraumatic stress disorder (PTSD). The biopsychosocial model illustrates that chronic health conditions are exacerbated or maintained by psychiatric distress.

Progressive Tinnitus Management Level 3 Skills Education: A 10-Year Clinical Retrospective.

Purpose: The purpose of this study was to examine progressive tinnitus management (PTM) Level 3 skill utilization among Veterans in the Bay Pines Veterans Affairs Healthcare System 6-10 years after completing the PTM workshops.

Method: In fiscal year 2020, the Tinnitus Workshop Follow-Up form was mailed to Veterans who completed the workshops during fiscal years 2010-2014. Veterans were identified as receiving care via the traditional face-to-face method or clinical video telehealth (CVT).