Tinnitus Retraining Therapy

TINNITUS RETRAINING THERAPY (TRT)

Tinnitus Retraining Therapy (TRT) is also known as habituation-oriented therapy. This type of therapy is based upon the Neurophysiological Origin of Tinnitus first studied in the 1980s and subsequently published in 1990 by Dr Pawel Jastreboff (Neurosci Res, 1990, 8:221-254). TRT has been suggested as one method to treat both tinnitus and hyperacusis. It does not claim to eliminate the tinnitus, but its goals are to block the neuronal activity from reaching the cortex and prevent it from being perceived by reducing the activation of the Limbic and Autonomic Nervous Systems. The features of TRT are that:

1.	There are no harmful side effects.
2.	It is suitable for all types of Tinnitus irrespective of the cause of the Tinnitus / Hyperacusis.
3.	Research worldwide has shown an effectiveness of over 80%, significantly above the placebo effect of 40%.
4.	TRT requires a limited treatment period but it is not a “quick-fix”.
5.	It does not require frequent visits and the treatment process easily accommodates out-of-town patients.
6.	It is the only treatment that is based upon a scientific model.

TRT uses a combination of sound therapy and informational counseling (teaching). The teaching component demystifies and explains the condition which will allow the brain to be rewired so that it can block the perception of tinnitus. The sound therapy component requires either the use of hearing aids or sound generators depending upon the individual’s symptoms. TRT aims to change first, the reaction to the tinnitus through its teaching component, and second, the perception of the tinnitus through the use of sound therapy. The expected outcomes are that the patient, even when perceiving tinnitus, is no longer annoyed by it and a gradual reduction in the amount of time a person is aware of the tinnitus. Patients can expect to be in treatment for 12 to 18 months following which there will be no further need to continue treatment. Jastreboff and his associates reported a significant improvement in over 80% of their patients (Am J Otology, 1996, 17:236-240). Data from our treatment outcomes reflect similar findings.

Since TRT is able to reduce and sometimes eliminate the perception of tinnitus, it is imperative that all patients be provided with clearance from an otolaryngologist verifying that there are no medically treatable or malignant conditions associated with their tinnitus. Such medical conditions must be treated prior to the commencement of TRT.

TRT is also the only method of treating hyperacusis and misophonia. The use of sound therapy serves to gradually desensitize a person to everyday environmental sounds by reducing the amount of amplification in the auditory system. The treatment of hyperacusis is very successful and the condition is considered to be curable after a treatment period of 12 – 18 months. The use of hearing protection is strongly contraindicated as this will increase the sound sensitivities and worsen hyperacusis.