Tinnitus retraining therapy

  Jastreboff and Jastreboff  have developed a therapy technique called tinnitus retraining therapy, which has provided significant improvement for at least 80% of tinnitus sufferers. Tinnitus retraining therapy is based on strong neurophysiologic evidence that any person can habituate to acoustic, or acoustic-like, sensations in their environment. Tinnitus retraining therapy has two key elements: directive counseling and sound therapy. The counseling session is critical to the success of the program, and patients may actually achieve relief through counseling alone. The counseling process involves an in-depth discussion of the hearing physiology, which helps the patient understand why tinnitus occurs. Hearing only starts at the ear; from there, sound signals travel to the lowest
levels of the brain (brainstem) and pass upward to arrive eventually at the highest level of the brain, the auditory cortex. Random signals in these areas may be responsible for the perception of tinnitus. A strong negative emotional reaction to the tinnitus causes it to be a problem. An expanded discussion about the auditory process enlightens patients and helps
relieve their fears. In addition to counseling, most patients are fitted with ear-level white
noise devices. These look like small hearing aids and are comfortably worn during the day. The sound is set to a very low level, which never interferes with normal hearing, and after several weeks most patients do not hear the sound unless they really try to hear it. These devices help the brain to ignore the random signals of tinnitus, achieving auditory habituation. The initial evaluation and counseling process is quite extensive, usually
lasting 4.5 to 5 hours. Regular follow-up visits or telephone communication for out-of-town patients are absolutely necessary. Within 6 to 24 months many patients have eliminated or are no longer bothered by their tinnitus.