Abstract
Tinnitus retraining therapy (TRT), a tinnitus accommodation therapy advocated by Jastreboff, comprises counseling and sound therapy. Since the output noise level of a tinnitus control instrument (TCI) is essentially restricted to a maximum of approximately 70dB to prevent acoustic trauma, patients with profound hearing loss with a mean hearing of 70dB on the affected side tend to fail to hear the TCI noise; for these patients, TRT using sound therapeutic procedures other than TCI, including the use of a hearing aid, are recommended. Of the 183 tinnitus patients (102 men and 81 women) who received TRT at our hospital during the 5-year period from April 2004 to March 2009, 99 patients (54 men and 45 women) purchased a TCI and continued to use it following TRT. In this study, the therapeutic efficacy of TRT was investigated in 6 (1 man and 5 women) of the 99 patients with moderate or profound hearing loss who failed to show a remarkable improvement and received TRT with a hearing aid in addition to TRT with the TCI. Tinnitus patients with moderate or profound hearing loss are considered candidates for the use of a hearing aid for TRT as sound therapy; patients with lateral sensorineural hearing loss tend to resist the use of a hearing aid, since hearing on the healthy side is maintained, and they are more likely to use TCI instead of a hearing aid. When patients with moderate to profound lateral hearing loss received TRT with TCI followed by TRT with a hearing aid, the degree of subjective suffering from tinnitus improved significantly in the patients. These observations indicate that the use of TRT with a hearing aid in addition to TRT with TCI is an effective treatment for tinnitus in patients with moderate to profound lateral hearing loss.
