Simplified tinnitus retraining therapy reduces tinnitus distress
4 December 2008
A simplified version of tinnitus retraining therapy (TRT) has been found to significantly reduce the perceived loudness, annoyance, and effect of tinnitus on life, for the majority of patients who took part in a new study.
The research was published this month in the journal BMC Ear Nose and Throat Disorders and carried out at Ealing Primary Care Trust Audiology Department, in conjunction with scientists at the University of Cambridge.
TRT was originally developed in the 1990s, with support from Deafness Research UK. The treatment uses counselling and sound therapy to alleviate tinnitus by removing negative associations from the condition. This is assumed to allow the tinnitus signal to decrease naturally, through a process known as habituation, which can help retrain people's beliefs about tinnitus so that they are able to ignore the symptoms.
Over the years, clinicians have customised the therapy to suit their practice and patients. The new version of TRT differs from the original in that it requires a shorter initial consultation of 30 minutes instead of 90, and does not include teaching about the basics of the auditory system, brain function, or the theory of habituation.
However, simplified TRT does include counselling to reassure patients that tinnitus-related distress declines over time following habituation, that reduced distress helps habituation to occur, that difficulty hearing is more likely to be caused by hearing loss than by tinnitus, and to suggest that patients avoid silence by using sound-generating machines.
Forty-three men and women with bothersome tinnitus were treated by audiologist Hashir Aazh at Ealing Hospital in Uxbridge, London. The patients each received between 2-7 counselling sessions over a period of 3-24 months.
In addition to studying the effect of simplified TRT on the patients' distress from tinnitus, the research team also analysed the scores by the participants' age (28-81) and duration of tinnitus (6 months-30 years). Results showed that these factors did not make a difference to the effectiveness of simplified TRT.
Finally, the team looked at the effect of sound therapy and hearing aids. Using a sound generator tended to improve the benefit from simplified TRT and hearing aids did not make the treatment any more or less effective for patients with mild hearing loss. However, further research is needed to determine their effectiveness with simplified TRT for those with more severe hearing loss.
Overall, the results suggest that using a shorter, simpler version of tinnitus retraining therapy is an effective way of significantly reducing the distress caused by tinnitus.
