Tinnitus Treatments 1/3: Sound Therapies
Since the causes of tinnitus are so diverse, treatments end
up being just as varied. That’s why the success of any given treatment depends
largely on how treatable the underlying cause of the tinnitus is.
In this series of three posts, I’ll describe the main
treatments for (subjective) tinnitus currently available, both in conventional
and alternative medicine. It could be said that most of them have had relative
success—usually temporary and with very different results from person to
person—which is why there’s still no definitive cure for tinnitus.
Sound Therapies
This approach—along with Cognitive Behavioral Therapy—is one
of the most widely used tinnitus treatments today, offering positive results
for many people. It involves a type of sensory (auditory) retraining therapy
designed to help the ear ignore the presence of tinnitus, either through
masking or habituation.
Tinnitus Retraining Therapy (TRT) was developed by
neurophysiologist Pawel Jastreboff and is one of the best-known sound
therapies. It uses white or pink noise, but without completely covering the
tinnitus sound, with the goal of helping the patient gradually get used to it.
TRT also includes counseling sessions, since its main objective is to influence
the limbic system (which processes emotions) to promote beneficial neural
plasticity and reverse the problem.
Sequential Sound Therapy (TSS), similar to TRT, also
uses white noise but transitions gradually from masking to habituation.
Sound enrichment is a practice that involves
surrounding oneself with ambient sounds—whether natural or electronic—over
time. In cases of mild to moderate tinnitus, one way to mask it at night is by
using bedside sound generators that play soothing environmental sounds.
Music-based sound therapy, on the other hand, uses
specially filtered classical music.
There’s also a therapy that combines modified classical
music (based on findings by Dr. Alfred Tomatis) with the use of antioxidant
supplements for the ears such as ginkgo biloba, garlic, zinc, vitamins A, C and
E, grape seed extract, pine bark extract, curcuminoids (from turmeric root),
and more. These supplements help remove free radicals from auditory cells and
nerves, which can interfere with their ability to recover important nutrients
after noise overexposure.
Sound masking aims to cover the tinnitus sound using
another sound—typically white noise.
The Neuronomics program uses a small device called Oasis,
which plays relaxing music combined with a wide-band acoustic stimulus (similar
to white noise). A variation of this program is a device called Tinnitus
Terminator, developed by Timothy Seaton.
The SoundCure Serenade device was created from
research at the University of California, Irvine. It uses what’s known as an S-Tone—a
pleasant low-frequency tone played at a lower volume than the tinnitus.
According to its distributors, this acoustic therapy can quickly and
significantly reduce tinnitus perception in some patients.
Notched sound therapy (ambient, white noise, or
music*) uses audio where the specific frequency that matches the patient’s
tinnitus has been intentionally removed, in order to encourage habituation and
possibly eliminate the perception of the sound altogether. This approach is
based on psychoacoustic principles.
Another treatment involves targeted auditory stimulation
using specific frequencies (often high frequencies) to increase inhibitory
activity in certain groups of nerve cells, thereby suppressing some types of
tinnitus.
Auditory Discrimination Therapy (ADT) also uses sound
stimulation to enhance the cortical response to specific sound frequencies,
especially those linked to cochlear damage that may have caused incorrect
tonotopic representation in the brain. This therapy also aims to reduce the
response in nearby brain areas that may have become overactive.
Some hearing aids have been designed to help people
with both hearing loss and tinnitus by including a built-in masking sound (such
as white noise). One such device is called Xino Tinnitus.
Widex Zen therapy uses a program of relaxing music
(called Zen) based on unpredictable fractal tones. It’s designed for
tinnitus patients who also have hearing loss.
MuteButton is a personal-use treatment device that
combines sound therapy through headphones with mild electrical stimulation of
the tongue using an intraoral device. It’s designed to treat tinnitus caused by
hearing loss, whether age-related or noise-induced. A similar and more recent bimodal
stimulation device is called Lenire. Another device, developed by a
research team at the University of Michigan (USA) led by Dr. Susan Shore, sends
electrical pulses to the neck or jaw using electrodes.
The Levo System is an iPad/iPod app developed by the
company Otoharmonics. It uses the principle of habituation to reduce
tinnitus perception. The app maps the specific sound the patient hears and
creates a therapy based on that sound, which the patient then listens to
overnight. Another recently developed app is the one used alongside the Duo
device, which applies neuromodulation by stimulating the wrist. There’s
also a publicly available, free-use app called Fudan Tinnitus Relieving
System (FTRS), designed to help users manage their tinnitus and related
symptoms.
* In the case of music, this is known as Notched Music
Therapy. Based on this method, in 2014 the German company Sonormed launched a
web app called Tinnitracks, now also available on smartphones.
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