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[TRT: results after one year treatment].
Rev Laryngol Otol Rhinol (Bord). 2007; 128(3):145-8.RL

Abstract

INTRODUCTION

Tinnitus Retraining Therapy (TRT) (which aims to induce changes in the mechanisms responsible for transferring signals from the auditory system to the limbic and autonomic systems) is a method for treating Tinnitus and decreased sound tolerance. An individualised explanation of Jastreboff's neurophysiological model allows greater insight and motivation on the part of the patient. Previous studies have demonstrated that daytime TRT is effective. As sleep forms a significant component of the distress associated with Tinnitus however, we hypothesised that night-time TRT could represent a useful tool in the treatment of this disabling condition.

MATERIAL AND METHODS

46 patients were studied (30 male, 16 female). Patients were selected from an ENT outpatient clinic. Patients with significant psychological disability were excluded. Patients were reviewed twice by their doctor and 5 times by a therapist over 12 months. Treatment consisted of 8 hours nighttime white noise stimulation, at progressively increasing intensity. Although several objective assessments of response were undertaken, patients' subjective testimonies were considered a more accurate signal of success.

RESULTS

In total, 80% of patients had a satisfactory response after 1 year of treatment. 20% had no response. Patients were subcategorised according to Jastreboff's categories as follows: 1. Tinnitus (n = 6), 100% improved; 2. Tinnitus with hearing loss (n = 16); 62% improved; 3. Hyperacusis (with or without Tinnitus) (n = 16), 88.5% improved; 4. Hyperacusis (with or without Tinnitus, exacerbated by noise) (n = 8), 75% improved.

CONCLUSION

Tinnitus is a symptom rather than an illness, and TRT gives patients greater control, allowing re-integration of normal perception. Night-time TRT is an effective treatment for Tinnitus and decreased sound tolerance. It has the potential advantage over day-time TRT of rapidly improving sleep and decreasing use of sedative hypnotics, a secondary effect noted in the personal testimonies of our cohort of patients. Further studies are needed to confirm this advantage, in view of the significant risks associated with long-term use of benzodiazepines. When investigating therapies for Tinnitus, it is necessary to measure success in terms of quality of life, as it is to this that the patient attaches the most importance.

Authors+Show Affiliations

Veranneman, Auxiliaire Acoustique, Galerie Ravenstein 35-37, 1000 Bruxelles, Belgique.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

18323325

Citation

Madeira, G, et al. "[TRT: Results After One Year Treatment]." Revue De Laryngologie - Otologie - Rhinologie, vol. 128, no. 3, 2007, pp. 145-8.
Madeira G, Montmirail Ch, Decat M, et al. [TRT: results after one year treatment]. Rev Laryngol Otol Rhinol (Bord). 2007;128(3):145-8.
Madeira, G., Montmirail, C. h., Decat, M., & Gersdorff, M. (2007). [TRT: results after one year treatment]. Revue De Laryngologie - Otologie - Rhinologie, 128(3), 145-8.
Madeira G, et al. [TRT: Results After One Year Treatment]. Rev Laryngol Otol Rhinol (Bord). 2007;128(3):145-8. PubMed PMID: 18323325.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [TRT: results after one year treatment]. AU - Madeira,G, AU - Montmirail,Ch, AU - Decat,M, AU - Gersdorff,M, PY - 2008/3/8/pubmed PY - 2008/4/26/medline PY - 2008/3/8/entrez SP - 145 EP - 8 JF - Revue de laryngologie - otologie - rhinologie JO - Rev Laryngol Otol Rhinol (Bord) VL - 128 IS - 3 N2 - INTRODUCTION: Tinnitus Retraining Therapy (TRT) (which aims to induce changes in the mechanisms responsible for transferring signals from the auditory system to the limbic and autonomic systems) is a method for treating Tinnitus and decreased sound tolerance. An individualised explanation of Jastreboff's neurophysiological model allows greater insight and motivation on the part of the patient. Previous studies have demonstrated that daytime TRT is effective. As sleep forms a significant component of the distress associated with Tinnitus however, we hypothesised that night-time TRT could represent a useful tool in the treatment of this disabling condition. MATERIAL AND METHODS: 46 patients were studied (30 male, 16 female). Patients were selected from an ENT outpatient clinic. Patients with significant psychological disability were excluded. Patients were reviewed twice by their doctor and 5 times by a therapist over 12 months. Treatment consisted of 8 hours nighttime white noise stimulation, at progressively increasing intensity. Although several objective assessments of response were undertaken, patients' subjective testimonies were considered a more accurate signal of success. RESULTS: In total, 80% of patients had a satisfactory response after 1 year of treatment. 20% had no response. Patients were subcategorised according to Jastreboff's categories as follows: 1. Tinnitus (n = 6), 100% improved; 2. Tinnitus with hearing loss (n = 16); 62% improved; 3. Hyperacusis (with or without Tinnitus) (n = 16), 88.5% improved; 4. Hyperacusis (with or without Tinnitus, exacerbated by noise) (n = 8), 75% improved. CONCLUSION: Tinnitus is a symptom rather than an illness, and TRT gives patients greater control, allowing re-integration of normal perception. Night-time TRT is an effective treatment for Tinnitus and decreased sound tolerance. It has the potential advantage over day-time TRT of rapidly improving sleep and decreasing use of sedative hypnotics, a secondary effect noted in the personal testimonies of our cohort of patients. Further studies are needed to confirm this advantage, in view of the significant risks associated with long-term use of benzodiazepines. When investigating therapies for Tinnitus, it is necessary to measure success in terms of quality of life, as it is to this that the patient attaches the most importance. SN - 0035-1334 UR - https://www.unboundmedicine.com/medline/citation/18323325/[TRT:_results_after_one_year_treatment]_ L2 - https://medlineplus.gov/tinnitus.html DB - PRIME DP - Unbound Medicine ER -