Tinnitus Retraining Therapy (TRT)

Constant, unrelenting tinnitus (ringing in the ears) is a very common problem affecting somewhere around 20% of the population. This constant ringing in the ears can cause significant sleep deprivation and can negatively affect one's ability to concentrate recreationally or professionally. This ringing deprives millions of Americans every year of ever experiencing "silence"

Prior to 10 or 12 years ago, there was no really effective treatment for tinnitus. Over the past 10 or 12 years, however, an extremely effective treatment option has developed -- this is referred to as Tinnitus Retraining Therapy (TRT).

Tinnitus Retraining Therapy (TRT) is based on the natural, ongoing physiologic process of "habituation" that keeps us from being aware of common, recurrent sounds in our environment -- like hearing the refrigerator go on and off while sitting in the kitchen, or hearing the constant flow of traffic passing by our houses. TRT harnesses this natural process of "habituation" and causes us to be unaware of the tinnitus just as we are unaware of the refrigerator and traffic in the above example. This is accomplished through the use of sound generators (instruments the size of small hearing aids) which are fitted to the ear and which produce a very comfortable broadband noise -- a low-level background sound -- which immediately decreases the awareness and the discomfort of the tinnitus and ultimately leads to habituation. There are now multiple studies supporting this treatment option.

Recently a study by Herraiz et al. (Otolaryngology -- Head and Surgery --2005 --133: 774 --779) has provided more evidence of the success of this treatment. Using previously validated measures of tinnitus severity and looking at 158 patients with tinnitus over a 12-month period, they found that 82% of subjects undergoing Tinnitus Retraining Therapy (TRT) experienced a statistically significant decrease in their tinnitus. This is one of the first studies to compare two groups -- a treated group versus a nontreated group.

A second, very current study (Folmer & Carroll, Otolaryngology -- Head and Surgery --2006 --134: 132-137) also demonstrated a statistically significant decrease in tinnitus severity in patients using this same process of habituation through the use of both sound generators and hearing aids. This study included 150 patients over 18 months of treatment. Fifty of these patients were treated with sound generators bilaterally --50 were treated with hearing aids bilaterally and 50 were treated with counseling alone. All three groups exhibited significant reductions in their tinnitus, but those patients using either the sound generators or the hearing aids reported greater improvement than the third group (counseling only) which used neither sound generators or hearing aids. The perception of tinnitus involves complex mechanisms which are gradually becoming better understood. In the meantime what is remarkable is that relatively simple interventions can make a tremendous difference for many of those patients who suffer from tinnitus.

Another point strongly made by this second article is that too many patient care providers tell their patients that "nothing can be done" for their tinnitus and that "you just have to learn to live with it". Our experience in this office and the results reported in both of these articles agree that this advice is both erroneous and counterproductive to patients with such a potentially disabling problem.