Tinnitus retraining therapy may be effective

Clinical question: 
How effective is tinnitus retraining therapy (TRT) in the treatment of tinnitus?
Bottom line: 
A single, low-quality randomised controlled trial suggested TRT is more effective as a treatment for patients with tinnitus than tinnitus masking (use of “white noise” generators). In this study, outcome data for tinnitus severity were presented using three instruments, the Tinnitus Handicap Inventory, Tinnitus Handicap Questionnaire, and Tinnitus Severity Index, for patients in three groups (participants’ tinnitus being a “moderate problem”, a “big problem” or a “very big problem”). Patients with a “very big problem” showed much greater benefit from TRT at 18 months compared with those whose initial tinnitus problem was “moderate” or “big”. No side effects of treatment were reported.
Caveat: 
Although this study suggested considerable benefit for TRT in the treatment of tinnitus, the study quality was insufficient to draw firm conclusions. The study was not blinded but issues regarding incomplete data were addressed appropriately and all data were presented in full. The authors of the study used a non-specified form of random allocation for the first patient, followed by alternation between assignment to treatment and control groups. The study population was drawn from a veterans’ hospital and may not have been representative of the general tinnitus population in terms of age distribution, the preponderance of men and the frequency of a history of acoustic trauma.
Context: 
A wide range of therapies have been proposed for the treatment of tinnitus symptoms, including cortisone, vasodilators, benzodiazepines, lidocaine, spasmolytic drugs, anticonvulsants, antidepressants, ginkgo biloba, hyperbaric oxygen, cognitive behavioural therapy, transcranial magnetic stimulation, tinnitus masking, music therapy, reflexology, hypnotherapy, and traditional Chinese medicine, including acupuncture. TRT involves a combination of directive counselling and sound therapy in a strict framework, and is one of the most commonly used treatment modalities for tinnitus.
Review CD#: 
CD007330
PEARLS No: 
277
Date: 
June, 2010
Authored by: 
Brian R McAvoy