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Objective:To investigate the influential factors of the efficacy of tinnitus multivariate integrated sound therapy (T-MIST) in the treatment of subjective tinnitus.Methods:A total of 431 patients with subjective tinnitus who received treatment in The First Affiliated Hospital of Xiamen University from June 2019 to June 2020 were included in this study. A cross-sectional study method was used to conduct refined testing on tinnitus patients using the T-MIST matching platform. The severity of tinnitus patients was evaluated using the Tinnitus handicap inventory scale. SPSS software was used to analyze the factors affecting the effectiveness of the T-MIST for subjective tinnitus based on patients' basic characteristics.Results:Multivariate logistic regression analysis showed that compared with patients with short-term tinnitus, OR (95% CI) was 1.982 (1.033-3.804), P = 0.040, in patients with 3-12 months of disease duration, OR (95% CI) was 2.411 (1.322-4.396), P = 0.004 in patients with > 12 months of disease duration. With the increase in tinnitus handicap inventory score, the efficacy of T-MIST became better [ OR (95% CI) = 1.014 (1.004-1.024), P = 0.007]. The efficacy of T-MIST was better in the hearing compensation-effective patients [ OR (95% CI) = 0.133 (0.081-0.216), P < 0.001]. Conclusion:The course of the disease, tinnitus handicap inventory score, and effective hearing compensation are the influential factors of T-MIST. They can provide evidence for the treatment of subjective tinnitus.
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Objective@#The effectiveness of two different sound therapies in chronic subjective tinnitus was compared. The effectiveness of different degrees of hearing loss patients on two different sound therapies were analyzed preliminarily and the possible mechanisms were discussed.@*Methods@#This clinical trial was conducted in the Peking Union Medical College Hospital, China from January 2018 to April 2018. Patients were received sound therapy when they were diagnosed as subjective tinnitus. This was a double-blinded randomized controlled trial. In our clinical trial, we included 56 participants who were randomly divided into Groups A and B with different sound therapies by using a computer allocation sequence. Pure tone audiometry, tympanometry and tinnitus matching were performed. The patients were followed up for 2 weeks, 1 month, 2 months and 3 months. Tinnitus handicap inventory (THI) and visual analog scales (VAS) measuring were used to evaluate the handicap, loudness and anxiety of tinnitus. An analysis of variance (ANOVA) of 2×5 repeated-measures was conducted.@*Results@#With the prolongation of the treatment time, both groups showed significantly lower scores after 3 months training compared with baseline which were measured by THI scores. While there was no effect between the two groups. According to the degree of hearing loss, Group A and B were divided into normal to mild hearing loss group (26-40 dB HL, Group A1, Group B1), moderate to profound hearing loss group (41 dB HL group and above, Group A2, Group B2). In the patients with normal hearing and mild hearing loss, the THI (P=0.013), VAS loudness and annoyance scores (P<0.01) after 3 months in Group B1 was significantly lower than those at baseline and the sound therapy in Group B1 was effective. In patients with moderate to profound hearing loss, the THI, VAS loudness and annoyance scores (P<0.01) after 3 months in Group A2 was significantly lower than those at baseline and the sound therapy in Group A2 was effective.@*Conclusions@#Sound therapy may be effective for some patients. Sound therapy for patients with different degrees of hearing loss are different. The tinnitus of most patients could not disappear completely, but reduce or eliminate. Doctors should use appropriate and individualized acoustic parameters for different characteristics of tinnitus. Doing so would provide effective and specific sound therapy for patients and reduce or eliminate tinnitus.
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[Objective] To evaluate the efficacy of sound therapy and provide a kind of treatment for tinnitus patients with normal audiogram.[Methods] From the database of the Audiometric Center of the First Affiliated Hospital,Sun Yat-sen University,we identified 46 outpatients with normal hearing thresholds in the conventional pure-tone audiometry suffering subjective tinnitus over 3 months.The clinical information were collected with respect of age,gender,tinnitus severity,pitch,laterality and duration,comorbid symptoms.All the patients received the tinnitus test,including loudness and frequency of the tinnitus and residual inhibition,Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS) scores pre-and post-complex sound therapy.The complex sound were remixed with natural sounds and music materials,while the masking frequency of natural sounds is consistent with the tinnitus frequency of patients and the main frequency of music materials covers the tinnitus frequency.[Results] 32 of the 46 patients showed residual inhibition (RI) positive.The average THI score before treatment was 33.38±16.23 and the VAS score was 4.38±1.62.The THI score decreased to 21.75±11.67 and the VAS score was 2.97±1.06 after sound therapy.The rest 14 patients were residual inhibition (RI) negative.The THI score were 29.86±20.15 and 23.43±16.29 pre-and post-complex sound therapy,while the VAS score were 3.93±1.69 and 3.36±1.2.The THI and VAS scores were significantly decreased after the treatment in both RI positive and negative patients.The RI positive group showed better results than RI negative group.[Conclusions] Both RI positive and negative tinnitus with normal audiometry shown adaptation with complex sound therapy,RI positive patients acquired more benefits from tailor-made complex sound therapy.
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Objective To compare the efficacy of sound therapy and conventional medical treatment in the treatment of chronic tinnitus.Methods CNKI,Wanfang database,Weipu database (VIP),Chinese biomedical literature database (CBM),Pubmed,Embase,OVID,SciVerse ScienceDirect and Cochrane library were used.The data were retrieved up to May 2017,and the relevant literature was screened according to the inclusion and emission standards.The quality of the literatures were analyzed and the data was extracted.Meta analysis was carried out by using Revman 5.2 software with total effective rate,tinnitus handicap inventory(THI) value and visual analogue scale(VAS) value.Results A total of 16 articles (1 594 patients) were included in the literature,including 14 articles in Chinese and 2 articles in English.The total effective rate in the sound therapy group were 86.42 ％ (by patients) and 80.50％ (by ears),while in conventional medical treatment group were 60.62％ (by patients),and 48.10％ (by ear),respectively[P＜0.01 (by patients),P＜0.01 (by ear)].The changes of THI value were analyzed before and after treatment,the difference was statistically significant(P＜0.01).The changes of VAS value were analyzed before and after treatment,the difference was statistically significant (P＜0.05).Conclusion Compared with conventional medical treatment,sound therapy can significantly improve the clinical efficacy of tinnitus treatment and reduce the symptoms in tinnitus patients.
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ABSTRACT INTRODUCTION: The difficulty in choosing the appropriate therapy for chronic tinnitus relates to the variable impact on the quality of life of affected patients and, thus, requires individualization of treatment. OBJECTIVE: To evaluate the effectiveness of using sound generators with individual adjustments to relieve tinnitus in patients unresponsive to previous treatments. METHODS: A prospective study of 10 patients with chronic tinnitus who were unresponsive to previous drug treatments, five males and five females, with ages ranging from 41 to 78 years. Bilateral sound generators (Reach 62 or Mind 9 models) were used daily for at least 6 h during 18 months. The patients were evaluated at the beginning, after 1 month and at each 3 months until 18 months through acuphenometry, minimum masking level, the Tinnitus Handicap Inventory, visual analog scale, and the Hospital Anxiety and Depression Scale. The sound generators were adjusted at each visit. RESULTS: There was a reduction of Tinnitus Handicap Inventory in nine patients using a protocol with a customized approach, independent of psychoacoustic characteristics of tinnitus. The best response to treatment occurred in those with whistle-type tinnitus. A correlation among the adjustments and tinnitus loudness and minimum masking level was found. Only one patient, who had indication of depression by Hospital Anxiety and Depression Scale, did not respond to sound therapy. CONCLUSION: There was improvement in quality of life (Tinnitus Handicap Inventory), with good response to sound therapy using customized settings in patients who did not respond to previous treatments for tinnitus.
Resumo Introdução: A dificuldade em escolher a terapia apropriada para zumbido crônico encontra-se nas suas diversas formas de impacto sobre a qualidade de vida dos pacientes e requer a sua individualização. Objetivo: Avaliar a eficácia do uso do gerador de som com ajustes individuais para aliviar o zumbido em pacientes sem resposta aos tratamentos anteriores. Método: Um estudo prospectivo em 10 pacientes, 5 homens e 5 mulheres, na faixa etária de 41 a 78 anos com zumbido crônico e resistente a tratamentos medicamentosos. Foram utilizados geradores de som bilaterais nos modelos Reach 62 ou Mind 9 por no mínimo 6 horas diárias durante 18 meses. Os pacientes foram avaliados no início, depois de 1 mês e a cada 3 meses até 18 meses através da acufenometria, Minimum Masking Level (MML), Tinnitus Handicap Inventory (THI), Escala Visual Analógica (EVA) e Hospital Anxiety and Depression Scale (HADS). Os geradores de som foram ajustados em cada visita. Resultado: Houve uma redução do THI em 9 pacientes usando-se um protocolo com uma abordagem personalizada, independente das características psicoacústicas do zumbido. A melhor resposta ao tratamento ocorreu naqueles pacientes com zumbido do tipo apito. Encontramos uma correlação entre os ajustes e a intensidade do zumbido e o MML. Apenas um paciente com indicação de depressão HADS não respondeu à terapia sonora. Conclusão: Houve uma melhora na qualidade de vida (THI) com boa resposta a terapia sonora com ajustes personalizados em pacientes resistentes a tratamentos anteriores para o zumbido.
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Humans , Male , Female , Adult , Middle Aged , Aged , Tinnitus/therapy , Acoustic Stimulation/methods , Quality of Life , Severity of Illness Index , Chronic Disease , Prospective Studies , Surveys and Questionnaires , Treatment OutcomeABSTRACT
According to the Jastreboff's neurophysiological model of tinnitus, if negative associations are attached to the tinnitus signal, tinnitus is perceived to be a threat or a danger and it activates the autonomic nervous and limbic systems. Consequently patient's awareness of tinnitus is heightened and so patient perceives it to be louder and more persistent. Jastreboff and Hazell started tinnitus retraining therapy (TRT) based on the neurophysiological model of tinnitus. The purpose of TRT is blocking tinnitus from activating the sympathetic nervous and limbic systems (habituation of reaction) and from reaching the cerebral cortex (habituation of perception). TRT is composed of two components directive counseling that tries to reclassify tinnitus into the meaningless stimuli and sound therapy that decreases the relative strength of the tinnitus signal. Physicians try to put patient's tinnitus into the territory of meaningless stimuli through retraining the brain (habituation of reaction). Because the brain habituates all unimportant stimuli, if habituation of reaction is fully achieved, habituation of perception will follow automatically. In most clinical results, clinical success rates of TRT approach or exceed 80% improvement. Early improvement can be achieved during the first few months, followed by additional progressive improvement. It should be recommended that the patient continue treatment at least 18 months.
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Humans , Brain , Cerebral Cortex , Directive Counseling , Limbic System , TinnitusABSTRACT
Objective To investigate the clinical effects of sound therapy and psychological counseling on chronic tinnitus .Methods Two hundred and thirty - two cases of chronic tinnitus patients were treated with sound therapy and psychological counseling in this study .The time course of treatment was 12 months .Tinnitus Evalua‐tion Questionnaire(TEQ) was filled out before sound therapy ,3 ,6 and 12 months after the therapy to evaluate the effects .Results After the therapy ,the patients had a significant improvement in tinnitus symptoms .Before the therapy ,178 patients had severe tinnitus ,while after the therapy ,this number decreased obviously .In the end of treatment there were only 36 cases ,with severe tinnitus(15 .52% ) .After the 6 months treatment ,the effective rate was 79 .31% ,after 12 months the effective rate was 86 .21% .Conclusion Sound therapy and psychological counse‐ling are effective treatments for chronic tinnitus ,and the effects are stable and durable .
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BACKGROUND AND OBJECTIVES: The long-term effect of tinnitus retraining therapy (TRT) is excellent while its short-term effect is known to be inferior to tinnitus making (TM). In this regard, we mixed TRT (mTRT) by combining TRT and TM to improve the short-term effect of TRT. This study evaluated the short-term effect of the mTRT and also compared the clinical efficacy between mTRT and TM. SUBJECTS AND METHOD: Twenty patients who underwent mTRT due to chronic subjective tinnitus were included in this study. Sound therapy of the mTRT was performed with mixed noise of broadband noise and narrow band noise. The broadband noise was used for TRT and the narrow band noise was used for TM. During the first month of mTRT, sound therapy was mainly composed of narrow band noise. During the second month, the proportion of broadband noise was gradually increased to 2/3. After 3 months, only the broadband noise was applied. Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS) on annoyance and the tinnitus awareness duration (hr/day) was checked as the outcome measures. The outcome was also compared between mTRT and TM. RESULTS: The THI score decreased significantly from 41.8+/-24.3 to 27.3+/-25.6 after mTRT. The VAS (from 5.9+/-1.4 to 4.7+/-1.8) and the tinnitus awareness duration (from 18.5+/-8.2 to 12.6+/-10.7) also showed a significant improvement after treatment. When the treatment outcome was compared between mTRT and TM, there was no significant difference. CONCLUSION: mTRT seems to be effective in relieving the discomfort of tinnitus. Similar short-term outcomes can be expected from mTRT as they did in TM.
Subject(s)
Humans , Noise , Outcome Assessment, Health Care , Tinnitus , Treatment OutcomeABSTRACT
OBJECTIVE: Subjective tinnitus is heard only by the patient and is usually considered to have no acoustic source. Treatments of subjective tinnitus include medication, Tinnitus retraining therapy (TRT), psychological treatment, and electrical suppression. TRT is one of the most effective treatment for subjective tinnitus. However, TRT is not commonly done in Korea. The aim of this study was to investigate the effect of TRT on subjective tinnitus. METHODS: A case-control study was conducted between March 2010 and October 2011. A total of 148 patients who were diagnosed as subjective tinnitus were included in this study. In TRT group, TRT was given with hearing aids or sound generator and medications. The result of Tinnitus was evaluated by tinnitus handicap inventory (THI), visual analogue scale (VAS) and tinnitogram. RESULTS: At 3 months, TRT group showed significantly improvement at 15.2+/-14.2 of THI, 8.1+/-2.1 by emotional score of THI, and 18.1+/-15.5 by length of noticeable time. CONCLUSION: TRT group showed better result than medication group according to THI and VAS. TRT showed good effect on emotional score of THI and length of noticeable time. However, TRT needs more time and effort of physician.