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Tinnitus Retraining Therapy The goal of TRT is that the patient will habituate to the tinnitus sound. We habituate to sound everyday, for example, we do not hear the sound of our refrigerator motor whilst watching television, that is we can effectively "tune out" to it. Therefore, patients who have undergone successful treatment with TRT often report that they can only hear their tinnitus if they concentrate on hearing it, and if they do hear their tinnitus they are not bothered by it. The tinnitus is then treated as a "neutral" signal. Habituation will occur with two conditions:· Removal of negative associations of the tinnitus using education and counseling and avoiding silence via low-level "neutral" sounds. What can be done? Firstly, an extensive tinnitus assessment is performed by one of our specialist tinnitus audiologists. The results are then clearly explained and the patient is counseled on techniques which they themselves can implement immediately to help reduce the awareness of the tinnitus. Some of our patients do not need a full TRT management program following this first assessment. That is, with positive counseling and appropriate information, they feel confident enough to self manage their tinnitus. However, for those whose tinnitus is intrusive throughout the day and they feel it interferes with their concentration, sleeping patterns, workplace performance and/or hearing clarity a TRT program tailored to their individual needs is discussed. This could include the fitting of noise generators, which are small units which sit neatly in the ear and produce a very low level ambient sound to partially mask the tinnitus signal. The ambient noise is in no way intrusive as it is set only slightly above the threshold of hearing and it does not interfere with communication. The patient regulates the level of the ambient noise to their tinnitus level each day. The noise generators are worn approximately 6-8 hours each day, which most of our patients find very easy. In fact, most forget they are even wearing the devices. The audiologist works very closely with each patient to ensure they are managing the devices well and they are tuned accurately to the patient’s tinnitus. Alternatively, if the patient’s tinnitus is associated with a hearing loss, hearing aids (fitted under the TRT protocol) are generally recommended. Tinnitus patients who also have a hearing loss often complain of poor hearing clarity in group situations such as meetings, listening in background noise eg restaurants, and over a distance. As the tinnitus frequency is often at the same frequency as the measured hearing loss, tailored amplification of the speech sounds will again partially mask the tinnitus signal, thereby both improving the overall hearing clarity and reducing the tinnitus awareness. The newest hearing aid technology includes the Open-Ear hearing aids which have proved immensely successful for this group of tinnitus patients.
Once the TRT program is underway and the patient feels comfortable with the use of their devices, the patient is reviewed after 6-12 months depending on the progress. If you would like any further information on tinnitus, TRT, or hearing loss contact Western Hearing Services and Tinnitus Management on (08) 9321 4999.
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Unfortunately, in the past a common response to a complaint of tinnitus was "nothing can be done" or "you'll have to learn to live with it". However, presently there is an exciting new treatment for tinnitus called Tinnitus Retraining Therapy (TRT). Dr Pawel Jastreboff (from the United States ) developed TRT based on over 10 years of tinnitus research.