CAA 2025 Pre-Conference
Tinnitus in Focus: New Insights, Connections, and Clinical Applications
Thursday, September 18, 2025
12:45 - 4:00 PM
The California Academy of Audiology is proud to announce this year’s Pre-Conference session focusing on tinnitus. Three invited speakers will explore the connections between tinnitus and migraines; as well as cochlear, central, and somatic functions; and the implications of Covid-19 - issues that are highly relevant to audiologists. Attendees can look forward to three informative presentations addressing the etiology, impact, and clinical applications related to this critical subject. Participants will gain valuable insights and enhanced resources to assist their patients effectively.
There is an additional fee to attend the 2025 Pre-Conference Session. Please see the Conference Registration page for details and pricing.
Root Cause of Tinnitus: A Clinician's Guide to Central, Cochlear, and Somatic Subtypes
Ben Thompson, Au.D.
Treble Health
Audiologists are uniquely positioned to provide the best care for patients with tinnitus. This presentation introduces a straightforward framework to help audiologists easily identify the three main root causes of tinnitus—Central, Cochlear, and Somatic. By understanding these subtypes, clinicians can provide more accurate diagnoses and effective treatments.
Central tinnitus is linked to changes in the brain's hearing pathways, often influenced by stress and heightened awareness of sound. Cochlear tinnitus comes from inner ear issues, such as noise damage, aging, or ototoxic medications. Somatic tinnitus is related to muscle and joint problems, including neck tension and jaw issues.
This session will explain how to tell these subtypes apart using clear diagnostic signs and simple assessment techniques. Three real-world case studies will show the most common ways these subtypes appear in clinics and demonstrate effective treatment options for each one. Audiologists will be educated on which treatment modalities are most appropriate for different types of tinnitus patients, ensuring a personalized and effective approach to care.
This presentation is designed to be practical and easy to understand, giving audiologists the confidence to handle tinnitus cases with greater accuracy and success. By learning how to identify the root cause of tinnitus and choosing the right treatment, attendees can better support their patients and grow their expertise. Whether you’re new to tinnitus care or looking to expand your knowledge, this session will equip you with real-world skills to elevate your impact and transform the lives of tinnitus patients.
Learning Objectives:
Upon completion, participants will be able to:
- Distinguish between the three main root causes of tinnitus—Central, Cochlear, and Somatic.
- Apply diagnostic techniques to accurately determine the subtype of tinnitus in clinical settings.
- Recommend targeted treatment strategies for each tinnitus subtype, improving patient outcomes.
Ben Thompson is an audiologist and the founder of Treble Health - a private practice that focuses on helping people with tinnitus who has managed to help over 5,000 patients and enroll more than 2,000 people in their comprehensive tinnitus treatment program, with an 85% success rate.
Dr. Thompson was part of the inaugural class at the University of the Pacific AuD program and completed his externship at UCSF Medical Center under tinnitus expert Dr. Troy Cascia, who was trained by Dr. Robert Sweetow. He also had the opportunity to study directly with his mentor, Dr. Pawel Jastreboff, who founded Tinnitus Retraining Therapy.
In 2020, Dr. Thompson decided to give YouTube a shot, thinking maybe a few people would watch. Fast forward to today, and his channel has grown to over 150,000 subscribers and 25 million views. He has hosted the biggest names in tinnitus research on his YouTube podcast, including ENT Doctors from House Ear Institute and Stanford University. Dr. Thompson has also been a guest lecturer for the University of the Pacific AuD program and speaker at several industry conferences.
Migraine Enhances Tinnitus Perception Leading to Loud Tinnitus
Hamid Reza Djalilian, M.D.
University of California Irvine Medical Center Otolaryngology
While 10% of the U.S. population has experienced tinnitus, approximately 1-3% of the population experiences loud or fluctuating tinnitus. This talk will discuss how patients suffering from certain subtypes of tinnitus are likely suffering from an atypical migraine or central sensitivity disorder.
Population study based on the NHANES database looking at the incidence of migraine in tinnitus sufferers and vice versa. In addition, two clinical trials were conducted for cognitive behavioral therapy targeting migraine as an etiology of tinnitus, as well as a randomized clinical trials of migraine medications for the treatment of tinnitus.
We have found that, 1) Migraine is more common in patients with tinnitus and vice versa. 2) Migraine causes enhanced tinnitus perception by increasing central sensitivity and thus attention to the tinnitus percept. 3) Migraine and tinnitus have common triggers including stress, sleep disturbances, dietary factors (caffeine, wine, etc.), weather changes, and exposure to loud sounds. 4) Most patients with fluctuating tinnitus have benefited from a treatment approach directed to treating an underlying atypical migraine process. Migraine medication combinations have been found to reduce tinnitus fluctuations and loudness.
Otologic migraine, which is the effects of migraine on the ear and is often not accompanied by headaches, may be partly responsible for the link between tinnitus and migraine. Given the complex association between tinnitus and migraine, we have found that some subtypes of tinnitus respond to a comprehensive atypical migraine management strategy. The pillars of treatment are medication therapy and lifestyle changes. The subtypes of tinnitus that respond to this treatment include, 1. Intermittent tinnitus (tinnitus on some days and silence on others), 2. Fluctuating tinnitus (good quiet tinnitus days interspersed with loud bothersome tinnitus), 3. Change in the level of tinnitus (tinnitus went from a quiet baseline to a louder sustained level), 4. Somatic tinnitus (patients can change the tinnitus with manipulation of their face, neck, or jaw), 5. Sustained loud bothersome tinnitus, 6. Tinnitus combined with hyperacusis, and 7. Tinnitus combined with any of the following: neck stiffness, sinus pressure, headaches, vertigo, aural fullness (in the absence of Eustachian tube dysfunction).
Learning Objectives:
Upon completion, participants will be able to
- Explain the intimate relationship between atypical migraine (central sensitization) and tinnitus
- Discuss how treating the underlying atypical migraine process reduces the loudness of tinnitus
- Describe new medical therapies available for treating tinnitus
Dr. Hamid Djalilian is a professor of otolaryngology, neurosurgery, and biomedical engineering and director of otology and neurotology at the University of California Irvine. He completed his residency at the University of Minnesota and his fellowship at the Minnesota Ear Head and Neck Clinic.
He has published 2 books, over 200 peer-reviewed papers, 150 invited papers and chapters, and lectured more than 250 times at regional, national, and international meetings. In addition to a busy clinical practice, his clinical research interests are in the role of otologic migraine and its effect on the ear, developing novel treatments for tinnitus, medical devices, and improvement of surgical outcomes. He has developed several medical devices that are undergoing clinical trials and has several granted and pending patents related to these devices and tinnitus treatment. His basic science lab is studying gene therapy for restoration of hearing, mitochondrial preservation and function enhancement for prevention and treatment of hearing loss.
He is the president of the Migraine in Otolaryngology Society.
Impact of COVID-19 Vaccination on Tinnitus Severity and Psychological Well-Being
Anusha Yellamsetty, Ph.D.
San Jose State University
Emerging evidence indicates that both SARS-CoV-2 infection and COVID-19 vaccination may contribute to the onset and exacerbation of tinnitus, potentially through pro-inflammatory mechanisms and heightened psychological stress. This presentation will discuss the impact of vaccination and pandemic-related factors (e.g., anxiety, stress) on the severity and clinical manifestations of tinnitus, focusing on changes in loudness, pitch, and interference with daily activities.
Between 2021 and 2024, a total of 778 participants from San Jose State University and the University of Arizona completed multiple survey instruments designed to assess tinnitus characteristics before and after COVID-19 vaccination or infection. Standardized tools included the Tinnitus Functional Index (TFI), a Visual Analogue Numeric Rating Scale, and the 12-Question Short Form Speech, Spatial, and Qualities of Hearing Scale. Survey items addressed perceived tinnitus loudness, pitch, anxiety, and the impact on speech perception in both quiet and noisy settings, as well as overall sound tolerance.
Preliminary findings suggest that COVID-19 vaccination is associated with both the exacerbation of established tinnitus and the emergence of new-onset cases. Participants reported significant increases in tinnitus loudness, pitch, and associated anxiety, with notable disruption to daily functioning, particularly regarding speech comprehension in challenging acoustic environments. Compared to respondents with pre-existing tinnitus, those reporting new-onset tinnitus frequently demonstrated higher severity scores. Significant decrements in sound tolerance were also observed post-vaccination and/or post-infection.
This investigation underscores a possible role of COVID-19 vaccination in intensifying tinnitus severity and triggering new cases in susceptible populations. The results highlight the need for dedicated clinical attention and further mechanistic studies on the interplay between immunological processes, psychological stressors, and auditory health in the context of the COVID-19 pandemic. By examining both infection and vaccination effects, this study delivers novel insights into tinnitus pathophysiology and presents evidence for developing targeted intervention strategies aimed at mitigating auditory-related burden in pandemic and post-pandemic scenarios.
Learning Objectives:
Upon completion, participants will be able to:
- Assess COVID-19’s impact on tinnitus: link vaccination to new cases and worsened symptoms
- Understand daily impact: how changes impair sound tolerance and speech perception.
- Highlight care needs: emphasize personalized treatment and research for post-COVID-19 tinnitus.
Anusha Yellamsetty, PhD, is an assistant professor in the Department of Audiology at San Jose State University. Her research focuses on digital health technologies, self-fitting hearing aids, and auditory neuroscience. She is also actively investigating the relationship between COVID-19, vaccination, and tinnitus severity, exploring its effects on auditory health, speech perception, and psychological well-being.
Dr. Yellamsetty has a strong background in clinical audiology, auditory signal processing, and real-world hearing aid outcomes. She collaborates with interdisciplinary teams to advance audiology research and is dedicated to mentoring students and contributing to evidence-based audiology practices.
There is an additional fee to attend the 2025 Pre-Conference Session. Please see the Conference Registration page for details and pricing.