title: Tinnitus retraining therapy:  mixing point and total masking are equally effective.
abstract: OBJECTIVE
  Habituation to tinnitus cannot occur with total masking, an argument made by proponents of "tinnitus retraining therapy." We also compared the effectiveness of retraining therapy with mixing-point masking, total masking, and with counseling alone.
  
  
  METHODS
  Forty-eight tinnitus patients were randomly assigned to one of three groups: counseling, counseling plus bilateral noise generators set to completely mask the tinnitus, or counseling plus bilateral noise generators with a focus on the mixing point (partial masking just below total masking). A picture-based counseling protocol was used to assist in providing similar counseling among all three groups. The Tinnitus Handicap Questionnaire was administered before and after about 12 months of treatment.
  
  
  RESULTS
  After 12 months, in the counseling group, three of 18 patients benefited significantly, in the mixing-point group, six of 19 patients benefited, and in the total masking group, four of 11 patients benefited from the treatment. The average decrease in the questionnaire was 16.7% for the counseling group, 31.6% for the retraining group, and 36.4% for the total masking group. No significant average differences among groups were observed.
  
  
  CONCLUSIONS
  One premise of retraining therapy is incorrect; a focus on mixing-point masking is not required for habituation.
authors.affiliation: Departments of Otolaryngology-Head and Neck Surgery, The University of Iowa, Iowa City, Iowa 52242, USA. rich-tyler@uiowa.edu
authors.forename: Richard S
authors.initials: RS
authors.lastname: Tyler
authors.forename: William
authors.initials: W
authors.lastname: Noble
authors.forename: Claudia Barros
authors.initials: CB
authors.lastname: Coelho
authors.forename: Haihong
authors.initials: H
authors.lastname: Ji
mesh_terms: D000161:Acoustic Stimulation / Q000379:methods*; D000368:Aged; D003376:Counseling / Q000379:methods; D005260:Female; D006185:Habituation, Psychophysiologic; D006801:Humans; D008297:Male; D008875:Middle Aged; D009622:Noise; D010470:Perceptual Masking; D011795:Surveys and Questionnaires; D014012:Tinnitus / Q000628:therapy*; D016896:Treatment Outcome