Digging Deeper into Tinnitus Management
Tyler et al (2012) compared the effectiveness of retraining therapy for tinnitus management with regard to "mixing point masking" as compared to "total masking" therapy, as compared to counseling alone. Tyler and colleagues note that traditional tinnitus retraining therapy (TRT) advocates mixing point (i.e., partial masking) masking, as total masking was previously believed to not allow the brain to habituate (to tinnitus it could not perceive). In contrast to "historically" accepted ideas and protocols, Tyler et al state that they do not agree that all tinnitus patients should avoid silence or that silence may be bad (for tinnitus patients). Likewise, they do not agree that "hearing aid use without providing background sound" is not beneficial (that is, they state that hearing aid use offers great potential for tinnitus management). They do not agree that group therapy is not beneficial for tinnitus patients (that is, they state group therapy is often beneficial).
Tyler et al report on 48 patients randomly assigned into one of three groups (mixing point, total masking, counseling), each of whom was evaluated pre and post (one year) treatment via the Tinnitus Handicap Questionnaire (THQ, for information on THQ see Tyler, Haskell et al, 2008 and see Searchfield, Kaur, Martin, 2010). The average decrease in THQ scores was 31.6 percent for the mixing point group, 36.4 percent for the total masking group and 16.7 percent for the counseling group.
Tyler et al state, "We believe that, for some patients of tinnitus, all forms of masking therapy, including those that use total masking and low-level partial masking might provide relief…."
For More Information, References, and Recommendations
Baigi A, Oden A, Almlid-Larsen V, Barrenas ML, Holgers KM.(2011) Tinnitus in the General Population With a Focus on Noise and Stress—A Public Health Study. Ear & Hearing 32(6):787–789.
Beck DL. (2011) Hearing Aid Amplification and Tinnitus:2011. Hearing Journal 64(6):12-14.
Kochkin S, Tyler R, Born J. (2011) MarkeTrak VIII: The Prevalence of Tinnitus in the United States and the Self-Reported Efficacy of Various Treatments. Hearing Review 18(12):10–26.
Newman CW, Sandridge SA. (2012) A Comparison of Benefit and Economic Value Between Two Sound Therapy Tinnitus Management Options. Journal of the American Academy of Audiology 23:126–138.
Parazzini M, Del Bo L, Jastreboff M, Tognola G, Ravazzani P. (2011) Open Ear Hearing Aids In Tinnitus Therapy - An Efficacy Comparison with Sound Generators. International Journal of Audiology 50:548-553.
Searchfield GD, Kaur M, Martin WH. (2010) Hearing Aids As An Adjunct to Counseling—Tinnitus Patients Who Choose Amplification Do Better Than Those That Don't. International Journal of Audiology 49(8):574-579.
Tyler RS. (2012) Patient Preferences and Willingness to Pay for Tinnitus Treatment. Journal of the American Academy of Audiology 23:115–125.
Tyler RS, Haskell GB, Gogel SA, Gehringer AK. (2008) Establishing a Tinnitus Clinic in Your Practice. American Journal of Audiology 17(1):25–37
Tyler RS, Noble, W, Coelho CB, Ji H. (2012) Tinnitus Retraining Therapy – Mixing Point and Total Masking are Equally Effective. Ear & Hearing 33(5):588-594.