TINNITUS THERAPY

Abstract

Tinnitus is the perceived sensation of sound in the absence of acoustic stimulation. In considering the treatment of tinnitus. it is important to consider the heterogeneity of both the aetiology and the experience of the patient. Thus, there exists no single treatment or regimen, management of tinnitus is based on an individual approach (Peifer, et al 1999), and no one treatment is likely to be effective for all patients. Moreover, significant effects of some treatments are missed in studies that enrol a heterogeneous group of patients (Baguley, 2000).

TRT is based on Jastreboff s model of tinnitus that uses a combination of low level, broadband noise and counselling to achieve the habituation of tinnitus. That is, the patient is no longer aware of their tinnitus, except when they focus their attention on it. and even then tinnitus is not annoying or bothersome. The idea is to block the TRNA from reaching the level of the cortex where it is perceived, and from activating the limbic and autonomic nervous systems - to habituate tinnitus perception and tinnitus­ induced reactions. The process of retraining takes 12 to 18 months. However, once tinnitus habituation is achieved. there is no need for continuing the treatment. Another important property of TRT is that it cannot create any harm. Since the habituation­ related modifications of the nervous system occur above the source of tinnitus, the aetiology of tinnitus is irrele'ant. and any type, as well as somatosounds. can be treated by inducing habituation (Jastreboff and Jastreboff, 2000).