Authors' objectives:

To determine the effectiveness of tinnitus retraining therapy (TRT) for the treatment of chronic tinnitus.

Authors' results and conclusions: Tinnitus retraining therapy (TRT) uses a neurophysiological model and aims to habituate a patient to the reaction and perception of subjective tinnitus. The core components of TRT are direct counseling, sound therapy, and follow-up consultations. TRT has been criticized for not clearly distinguishing the difference between counseling and cognitive therapy, not involving trained psychologists, and not using standard diagnostic and evaluation strategies. One prospective study has been conducted to evaluate the effectiveness of TRT. The Berry case series study found that baseline Tinnitus Handicap Inventory (THI) scores correlated with subjective tinnitus characteristics. Six months following TRT, the 32 patients in the study experienced significant improvement on the THI suggesting reduced disability. Due to the lack of comparison groups, the results of the study do not provide clear evidence that TRT effects disability related to tinnitus. Three retrospective studies have been published since 1997. The lack of baseline measurements, comparison groups, predetermined outcome measurements, and patient homogeneity prohibits the ability to draw conclusions on efficacy. Many alternative treatments for tinnitus exist. Systematic reviews suggest that evidence does not demonstrate efficacy for the following treatments: ginkgo biloba, carbamazepine, drugs for cardiac arrhythmias, melatonin, magnetic stimulation, and ultrasound. In contrast, the evidence suggests that patients may respond to benzodiazepines, masking, biofeedback, and psychotherapy. The author of the review states that the treatments generally produce clinically insignificant changes and that few well-established treatments exist.

Authors' recommendations: Due to the lack of prospective trials with comparison groups, the efficacy of TRT for subjective tinnitus has not been established. Therefore, TRT is considered investigational and controversial.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.lni.wa.gov/ClaimsIns/Files/OMD/TinnitusRetrainingTechAssessJune072004.pdf

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Washington State Department of Labor and Industries (WSDLI)

Contact Address: Box 44321, 7273 Linderson Way SW, Olympia, WA, USA 98504-4321. Tel: 1(360)902-5227

Contact Name: mojo235@LNI.wa.gov

Contact Email: mojo235@LNI.wa.gov

Copyright: Washington State Department of Labor and Industries