The Tinnitus Retraining Therapy Trial: Questions answered, questions raised

This presentation reviews the design, results, and clinical implications of the Tinnitus Retraining Therapy Trial (TRTT), which was conducted to evaluate TRT’s efficacy and to clarify the contributions of its components: directive counseling (DC) and sound therapy (ST). Three treatment arms included Full TRT (DC+ST), Partial TRT (DC + placebo ST generators), and a standard of care (SOC) control condition. The SOC encompassed participating centers’ usual tinnitus practices in a patient-centered protocol emphasizing: participants’ narratives, clinician empathy, shared decision making, and promotion of self-efficacy. Participants from US military hospitals (N = 151) were followed at 3, 6, 12, and 18 months post treatment. Outcome measures included the Tinnitus Questionnaire, Tinnitus Functional Index, Tinnitus Handicap Inventory and TRT visual analogue scales. Significant, comparable improvements were seen for all three treatment groups on all outcome measures; patterns of improvement were also comparable longitudinally. These results raise interesting questions:

  1. Is counseling sufficient to alleviate tinnitus distress?
  2. Is situational use of environmental sound sufficient for sound therapy?
  3. Is a patient-centered approach a reasonable, cost-effective alternative to TRT?
  4. On what basis should an audiologist choose tinnitus care for a specific patient?

This project was supported by NIH-NIDCD: U01DC007411 and U01DC007422.

Learning objectives:

  1. Participants will be able to describe the design of the Tinnitus Retraining Therapy Trial.
  2. Participants will be able to explain the components of the standard of care patient-centered tinnitus protocol.
  3. Participants will be able to describe the outcome of the Tinnitus Retraining Therapy Trial.