Tinnitus Management 2014: Part One
Fagelson (2014) reports that tinnitus affects some 10 to 15 percent of the population. He reports that there is no relationship between the distress/severity of the perceived tinnitus and auditory sensitivity and indeed, some 50 percent (or more) of tinnitus sufferers have a comorbid psychological injury or illness such as post-traumatic stress disorder (PTST), depression, anxiety, obsessive compulsive disorder, stress, and more.
He underscores the difference between tinnitus cures (not likely), tinnitus treatment (to substantially decrease or eliminate the perception of tinnitus), and tinnitus management (improving the way the patient reacts to their tinnitus). Fagelson notes that the Cochane Reports indicate that none of their 14 reviews on tinnitus interventions (including reviews of biofeedback, tinnitus retraining therapy, antidepressants, hyperbaric oxygen treatment, ginkgo biloba, or hearing aids) showed performance better than placebo.
Fagelson states that the management strategy selected should be tailored to the specific patient’s needs (for example, cognitive behavioral therapy, self-efficacy training, or other patient-centered approaches. Some approaches include various therapeutic sounds with counseling. Others, such as tinnitus retraining therapy and neuromonics tinnitus treatment use sound enrichment and a "more thorough, although not necessarily individualized" counseling program.
Sound-based interventions (in general) are used to promote the patient’s ability to manage their response to their tinnitus. Further, sound therapy without counseling is less effective than sound therapy with counseling. In accordance with progressive tinnitus management (PTM), specific sounds selected are most often chosen based on one of three presumptions: (1) masking to reduce the contrast between tinnitus and the acoustic environment thereby promoting habituation, (2) soothing or relaxing sounds are used to promote relief from stress or anxiety, (3) interesting sounds that distract the patient away from their tinnitus. PTM encompasses multiple steps from triage to sound based interventions used in tandem with counseling.
For More Information, References, and Recommendations:
Beck DL. (2011) Hearing Aid Amplification and Tinnitus: 2011 An Overview. The Hearing Journal 64(6).
Fagelson M. (2014) Approaches to Tinnitus Management and Treatment. Seminars in Hearing.35(2):92-104.