Problems with Tinnitus Retraining Therapy

December 5th, 2010 |

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What are the Problems with Tinnitus Retraining Therapy?

Tinnitus or the ringing ears syndrome is a phantom auditory perception that can be quite unbearable. It is a common disorder that affects nearly 17% of the people throughout the world. Several methods have been developed to deal with it.

Tinnitus Retraining Therapy or TRT is a method of treatment of tinnitus that has gained much popularity in the last decade. The conceptual basis of TRT has been described in 1990 as a form of tinnitus treatment that is based on the neurophysiologic model of tinnitus that was developed by Pawel Jastreboff and JWB Hazell. This model suggested that the treatment of tinnitus should focus on the autonomic nervous systems and the limbic system.

It has been claimed that TRT is currently the most effective therapy for tinnitus which obtains a success rate that exceeds 80%. However, there are some loopholes in the TRT such as the following:

• There are many centers around the world that claim to be treating tinnitus according to the method devised by Hazel and Jastreboff. However, the published literature shows that there are significant differences in the way the Hazel and Jastreboff model is applied in the different centers.

• The authors of the case reports that show the effectiveness of TRT claim to have a success rate ranging between 50-80%. However, the evidence that is provided by this research is inconclusive because of the unclear criteria of patient selection, unavailability of controls and the variability of the tinnitus methods that are implemented.

• The interaction between emotional and neuroacoustic processes that has been emphasized by Jastreboff is neither new nor adequately elaborated in terms of the underlying psychological factors.

• If the current state of evidence is taken into account then one can conclude that there is no realistic empirical support that proves TRT to be superior to other treatments due to lack of comparative studies.

So we find that methodological limitations in the research which has been published so far rule out any claims about the effectiveness of TRT at present.

Suggestions have been made to undertake randomized and controlled studies which include no-treatment and placebo conditions.

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