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Tinnitus Retraining Therapy
At EAR CARE Medical Center

``Tinnitus is the perception of sound when no actual external sound is present``.

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Tinnitus is the perception of sound when no actual external noise is present. While it is commonly referred to as “ringing in the ears,” tinnitus can manifest many different perceptions of sound, including buzzing, hissing, whistling, swooshing, and clicking. In some rare cases, tinnitus patients report hearing music. Tinnitus can be both an acute (temporary) condition or a chronic (ongoing) health malady.

In general, there are two types of tinnitus:

Subjective Tinnitus: Head or ear noises that are perceivable only to the specific patient. Subjective tinnitus is usually traceable to auditory and neurological reactions to hearing loss, but can also be caused by an array of other catalysts. More than 99% of all tinnitus reported tinnitus cases are of the subjective variety.

Objective Tinnitus: Head or ear noises that are audible to other people, as well as the patient. These sounds are usually produced by internal functions in the body’s circulatory (blood flow) and somatic (musculo-skeletal movement) systems. Objective tinnitus is very rare, representing less than 1% of total tinnitus cases.

There is currently no scientifically-validated cure for most types of tinnitus. There are, however, treatment options that can ease the perceived burden of tinnitus, allowing patients to live more comfortable, productive lives.  We at Ear Care Medical Center are leading the way in the ongoing search for a suitable tinnitus cure.

Tinnitus Retraining Therapy (TRT)

It is a process of learning to cope with your tinnitus on a conscious and subconscious level. This technique performed in Ear Care Medical Center has helped a lot of our patients.

This therapy can be compared to the sound of raindrops falling on a roof being noticed when it first starts raining, but going unnoticed and put out of mind after some time.

Tinnitus Retraining Therapy requires close co-operation with hearing professionals. The therapy is employed at the perceived source of the tinnitus and aims to teach the brain to ignore it.

At Ear Care Medical Center Tinnitus Retraining Therapy combines three significant therapeutic steps:

  • Extensive collection of information about the patient, including patient history and daily living habits.
  • Psychological therapy teaching the patient to ignore the tinnitus noise. This is combined with deep relaxation exercises and stress management. The object is the elimination of the patient’s anxiety, so that the tinnitus is no longer perceived as a danger, thus diverting the concentration away from the tinnitus noise. The counselling part of TRT, as a generalized type of psychological and behavioral counselling, has also been used by itself in the management of tinnitus.

Hearing aids: If tinnitus is associated with hearing loss, a tuned hearing aid that amplifies sound in the frequency range of the hearing loss (usually the high frequencies) may effectively mask tinnitus by raising the level of environmental sound, in addition to the benefit of restoring hearing.

Masking/Tinnitus masker: White noise generators or environmental music may be used to provide a background noise level that is of sufficient amplitude that it wholly or partially ‘masks’ the tinnitus (tinnitus masker). Composite hearing aids that combine amplification and white noise generation are also available. Use of devices worn behind the ear and generating broad-band noise to divert attention of the patient away from the tinnitus.

lifestyle and support Things like loud noise, alcohol, caffeine, nicotine, quiet environments and psychological conditions like stress and depression may exacerbate tinnitus. Reducing or controlling these may help manage the condition.

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Over the years, many methods of tinnitus treatment have been introduced, but very few survived the test of time. More than a decade has passed since the introduction of the neurophysiological model of Tinnitus and Tinnitus Retraining Therapy(TRT). TRT is used successfully now in more than 20 countries.

TRT reflects the practical implementation of the neurophysiological models of Tinnitus. It is a method aimed primarily at habituating tinnitus – evoked reactions of the brain and body, and secondarily at habituation of Tinnitus perception. Successful TRT patients are not bothered by their tinnitus, even though they are aware of it.

The two main components of TRT are:
(1) Educational Counselling
(2) Sound Therapy

Counselling sessions are aimed at the reclassification of tinnitus into a category of neutral signals. During the sessions, tinnitus is demystified and patients are taught about physiological mechanism of tinnitus and its distress, as well as the mechanisms through which tinnitus habituation can be achieved.

Sound therapy- constant low level broad band sound decreases the difference between tinnitus-related and background neuronal activity. Consequently, the strength of activation of the limbic and autonomic nervous systems, which at the behavioral level is reflected by a decrease in tinnitus evoked annoyance is reduced.

TINNITUS Clinic Test Protocol

  • Audiometric Tests
  • Tinnitus Tests

Audiometric Tests

All patients received routine audiometric evaluation including discrete-tone threshold testing and speech audiometry. For most of the patients, HL- hearing level (in dB) were determined at 8 frequencies.

Tinnitus Tests

Development of standardized methods for measuring methods for measuring the pitch, loudness, and other characteristics of tinnitus was completed. The basic test protocol involved measurement of four tinnitus parameters:

  • Pitch
  • Loudness match
  • Maskability
  • Residual inhibition