Tinnitus retraining therapy (TRT) is a procedure that aims to alleviate the suffering from tinnitus. Tinnitus aurium (ringing in the ears) is the term used to describe an acoustic sensation or ringing in the ears that exists without an external source of noise. Tinnitus is chronic when it has lasted for 3-6 months. The therapy is based on the neurophysiological tinnitus model of Pawel Jastreboff (USA) and Jonathan Hazell (England). In the early 1990s, the two scientists investigated and substantiated a treatment approach based on the assumption that processes occurring in the central nervous system (brain) during auditory perception are responsible for tinnitus.
The procedure
Tinnitus is perceptible as a disease when the inhibitory systems of the brain fail and disturbing, unpleasant sounds permanently penetrate the consciousness. These noises can have a variety of causes. Human auditory perception in the brain is connected, among other things, to the so-called limbic system, which controls the emotional world of each individual. This connection explains the amplification of tinnitus in negative moods such as anxiety or stress. Usually, a habituation to sounds takes place, which is called habituation. The sound of a streetcar passing by the office every day is “tuned out” after some time. The tinnitus noise, on the other hand, is evaluated negatively and attention increases. Tinnitus retraining therapy counteracts this process by desensitizing the patient. The goal is a reduced perception up to the complete fading out of the disturbing ear noise. The term “retraining” can best be translated as “unlearning”.
Prior to the actual therapy, an audiological diagnosis (examination of the auditory system) is carried out. If necessary, further clarification by neurologists, orthopedists or internists is useful.
The first element of the actual tinnitus retraining therapy is the tinnitus counseling. This is a counseling session, the contents of which are as follows:
- Information transfer about tinnitus
- Discussing current symptoms and complaints
- Reduce anxiety
- Discussing coping strategies (strategies to deal with the problem).
- Discussing personal developments and circumstances
This is followed by the so-called tinnitus conference. This is a meeting between the patient, the ENT physician and an acoustician. The goal is to create an individual treatment plan that guarantees the patient the physical and psychological support he needs.
The second major element is the use of a noise device (noiser). This device offers the patient a quieter, not so disturbing sound. The goal is for the patient to learn to pay less attention to the tinnitus and to later overhear the external, non-negative noise. The device externally resembles a hearing aid and should be worn for about 2-6 hours a day when there is as little ambient noise as possible. Complementary relaxation techniques and self-help methods are taught. Education and counseling to help mitigate stress reactions are recommended. If the tinnitus has an organic cause, this will of course be treated.
Benefits
Tinnitus retraining therapy is an effective behavioral therapy that provides lasting reduction of the tinnitus condition. The constant ringing in the ears affects the patient both physically and psychologically. The therapy counteracts this and restores his quality of life.
