Clinical trial to compare tinnitus masking and tinnitus retraining therapy.
CONCLUSIONS
Both tinnitus masking (TM) and tinnitus retraining therapy (TRT) can be effective therapies for amelioration of tinnitus. TM may be more effective for patients in the short term, but with continued treatment TRT may produce the greatest effects.


OBJECTIVE
Although TM and TRT have been used for many years, research has not documented definitively the efficacy of these methods. The present study was a controlled clinical trial to prospectively evaluate the clinical efficacy of these two methods for US military veterans with severe tinnitus.


METHODS
Over 800 veterans were screened to ensure that enrolled patients had tinnitus of sufficient severity to justify 18 months of individualized treatment. Qualifying patients (n=123) were placed quasi-randomly (alternating placement) into treatment with either TM or TRT. Treatment was administered at 0, 3, 6, 12, and 18 months. Outcomes of treatment were evaluated primarily using three self-administered tinnitus questionnaires (Tinnitus Handicap Inventory, Tinnitus Handicap Questionnaire, Tinnitus Severity Index).


RESULTS
Findings are presented from the three written questionnaires with respect to three categories of patients: describing tinnitus as a 'moderate,' 'big,' and 'very big' problem at baseline. Based on effect sizes, both groups showed considerable improvement overall. In general, TM effects remained fairly constant over time while TRT effects improved incrementally. For the patients with a 'moderate' and 'big' problem, TM provided the greatest benefit at 3 and 6 months; benefit to these TRT patients was slightly greater at 12 months, and much greater at 18 months. For patients with a 'very big' problem, TM provided the greatest benefit at 3 months. For these latter patients, results were about the same between groups at 6 months, and improvement for TRT was much greater at 12 months, with further gains at 18 months.
Henry
J A
JA
VA RR&D National Center for Rehabilitative Auditory Research, VA Medical Center (VAMC), Portland, OR, USA. james.henry@med.va.gov
Schechter
M A
MA
Zaugg
T L
TL
Griest
S
S
Jastreboff
P J
PJ
Vernon
J A
JA
Kaelin
C
C
Meikle
M B
MB
Lyons
K S
KS
Stewart
B J
BJ
D000161:Acoustic Stimulation / Q000295:instrumentation / Q000379:methods; D003376:Counseling; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D010470:Perceptual Masking / Q000502:physiology*; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014012:Tinnitus / Q000175:diagnosis* / Q000534:rehabilitation*; D016896:Treatment Outcome