Short Term Effect of Mixed Tinnitus Retraining Therapy / 대한이비인후과학회지

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.

Tinnitus Masking Effects Using Various Kinds of Sound and Music / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Even though various methods have been tried to diagnose and treat tinnitus, researchers have fallen short of providing the accurate characteristics since most tinnitus are presented as a subjective symptom. A few researchers have tried to assimilate tinnitus using computer and music synthesizers, however, their efforts have not yet been developed as generalized treatment modalities. In this study, we attempted to induce not only tinnitus masking but also psychological stability with various kinds of sound and music and to analyse its treatment effects. The aim of this study is to make a step toward developing tinnitus treatment. MAERIALS AND METHODS: The subjects were 28 patients with constant tinnitus, who visited the otolaryngology department of Seoul Paik Hospital, Medical College of Inje University from June to December of 1997. We tried to objectify the tinnitus as close to the actual sound as possible by synthesizing the modulation of the broad band noises and recording not only the existing pure tones and broad band noises but also the natural and artificial sounds which the patients could easily hear from their surroundings. And then we tried to mask tinitus with various natural, artificial and synthetic sounds, including its frequency band. We also let them hear the tapes for contemplation and various music. RESULTS: The results were as follows. 1) As for the quality of tinnitus, 13 patients reported similarity to the pure tone (46.4%), seven to narrow band noise (25%), eight to natural environmental sounds (21.4%), one each to artificial environmental sound and white noise (3.6%) and no one to synthetic sound. 2) The sound that masked tinnitus well was three octave broad band noise including the tinnitus frequency. 3) Twenty four patients (85.7%) chose music as the most comfortable sound to listen to. 4) Three patients (10.7%) replied that their tinnitus were decreased in amplitude and 15 patients (53.6%) reported that it was easier to stand the tinnitus even though their tinnitus persisted. CONCLUSION: Based on these results, it can be concluded that music therapy provides psycological stability in addtion to inducing masking effect, even though it can't directly decrease nor completely remove tinnitus. Thus we believe that a more effective result can be obtained if music therapy is implemented on a gradual basis as a part of the whole treatment process.