title: Effectiveness of sound therapy in patients with tinnitus resistant to previous treatments: importance of adjustments.
abstract: BACKGROUND
  The difficulty in choosing the appropriate therapy for chronic tinnitus relates to the variable impact on the quality of life of affected patients and, thus, requires individualization of treatment.
  
  
  OBJECTIVE
  To evaluate the effectiveness of using sound generators with individual adjustments to relieve tinnitus in patients unresponsive to previous treatments.
  
  
  METHODS
  A prospective study of 10 patients with chronic tinnitus who were unresponsive to previous drug treatments, five males and five females, with ages ranging from 41 to 78 years. Bilateral sound generators (Reach 62 or Mind 9 models) were used daily for at least 6h during 18 months. The patients were evaluated at the beginning, after 1 month and at each 3 months until 18 months through acuphenometry, minimum masking level, the Tinnitus Handicap Inventory, visual analog scale, and the Hospital Anxiety and Depression Scale. The sound generators were adjusted at each visit.
  
  
  RESULTS
  There was a reduction of Tinnitus Handicap Inventory in nine patients using a protocol with a customized approach, independent of psychoacoustic characteristics of tinnitus. The best response to treatment occurred in those with whistle-type tinnitus. A correlation among the adjustments and tinnitus loudness and minimum masking level was found. Only one patient, who had indication of depression by Hospital Anxiety and Depression Scale, did not respond to sound therapy.
  
  
  CONCLUSIONS
  There was improvement in quality of life (Tinnitus Handicap Inventory), with good response to sound therapy using customized settings in patients who did not respond to previous treatments for tinnitus.
authors.affiliation: Health Sciences, Department of Otolaryngology and Head and Neck Surgery, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil. Electronic address: flavia_fabs@yahoo.com.br.
authors.forename: Flavia Alencar de
authors.initials: FA
authors.lastname: Barros Suzuki
authors.affiliation: Health Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil.
authors.forename: Fabio Akira
authors.initials: FA
authors.lastname: Suzuki
authors.affiliation: Health Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil.
authors.forename: Fernando Kaoru
authors.initials: FK
authors.lastname: Yonamine
authors.affiliation: Health Sciences, Department of Otolaryngology and Head and Neck Surgery, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil.
authors.forename: Ektor Tsuneo
authors.initials: ET
authors.lastname: Onishi
authors.affiliation: Health Sciences, Department of Otolaryngology and Head and Neck Surgery, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil.
authors.forename: Norma Oliveira
authors.initials: NO
authors.lastname: Penido
mesh_terms: D000161:Acoustic Stimulation / Q000379:methods*; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014012:Tinnitus / Q000628:therapy*; D016896:Treatment Outcome
keywords: Sound therapy; THI; Terapia sonora; Tinnitus; Tratamento; Treatment; Zumbido