I. Preface
According to incomplete statistics, there are at least 129 treatment methods for tinnitus, ranging from the traditional tinnitus masking method to the recent laser treatment method, and as far as the signals used in tinnitus treatment are concerned, they can be divided into three categories: first, sound therapy based on various acoustic characteristics, including conventional sound masking therapy, low-intensity sound therapy (Xi-sui therapy), low pitched sound treatment, ultrasound therapy (HiSonic), white noise therapy, etc. The second is the use of other signal sources as treatment, including low level laser therapy, transcranial magnetic stimulation (rTMS) and microcurrent therapy, etc. The third is the use of natural sounds and music to treat tinnitus. In this paper, we will briefly introduce the characteristics of the two types of acoustic signals and clinical application of the first type of therapy.
Masking therapy
Masking therapy uses a second sound to reduce the intensity of the original sound, or complete masking, when the masked sound frequency must contain a specific critical frequency band close to the original sound; for some patients, almost all frequencies of sound can mask tinnitus, while for others, only masked sounds that match the frequency of their tinnitus sound will work. Optimal masking signal.
Hearing Special? TinniTest? provides individualized masking sounds, such as synthetic carrier sounds, speech sounds and various natural sounds, as shown in Figures 2 through 5.
The simplicity and safety of this therapy make it the preferred method of tinnitus treatment. Changes in tinnitus pitch, loudness, etc. should be noted during the treatment period, and the treatment plan should be adjusted in a timely manner. The masking intensity should not be too high, just enough to cover the tinnitus, or 5-10 dB above the minimum masking threshold.
Three, the habitual service therapy
To reduce or eliminate tinnitus and the symptoms associated with it by breaking the association between tinnitus and bad mood and the vicious cycle chain.
Acoustic therapy can be done by adding ambient sound, using sound generators and hearing aids, or hearing-assisted sound generating devices. Treatment takes 1.5 to 2 years, and tinnitus patients are required to wear a sound generator for an extended period of time until treatment is completed.
III. Comparison.
The same use of sound to treat tinnitus differs between conventional and masked sound therapy, as shown in Table 1. masked sound therapy aims to use sound to provide immediate relief of tinnitus. Masked sound is used to eliminate or diminish the perception of tinnitus by selecting a specific sound that matches or best masks the tinnitus sound through a rigorous objective determination of the tinnitus.
The goal in habituation therapy is to use sound to help develop long-term adaptation to tinnitus. The sounds used for adaptation do not need to completely or partially mask the tinnitus, no specific sound is required, and any safe sound can be used as a background sound for treatment. Habilitation is the retraining of the neural connections to the perceived tinnitus sound. If the tinnitus sound is completely suppressed by the masked sound and is not perceived, it cannot be relearned and adapted.
Masking therapy
Appropriation therapy
Purpose of acoustic therapy
Quickly reduce or mask the tinnitus sound
Promote long-term adaptation to tinnitus
Patient expectations
Immediate relief from the disturbance of tinnitus
Short-term effects are not obvious and require long training to gradually adapt to the tinnitus
Interaural devices used for acoustic therapy
Various tinnitus masking devices, hearing aids, hearing aid type tinnitus therapy devices
Sound generators, hearing aids (open earmolds)
Selection criteria for interaural devices
Repeated trials to select the most effective device according to the patient’s specific situation
Selection according to patient type
Device use
Monaural or binaural
Binaural
Treatment time requirements
Before tinnitus is most annoying
Worn daily for long periods of time
Type of sound
Sound of any frequency band that provides the most effective masking, individualized and customized sound
Broadband noise, rich sound environment
Sound adjustment
Adjusts to the patient’s changing tinnitus at any time
After adjusting to the “mixing point” before use, no further adjustments are made during use.
Duration of use of the sound therapy device
There is no limit, and it can be used for as long as it helps
Usually 1 to 2 years, after adaptation, the device is discontinued.
IV. Conclusion
Tinnitus acoustic information therapy is a symptomatic treatment method based on sound. In the process of diagnosis and treatment, we should first conduct a medical examination and evaluation to exclude underlying diseases that may cause tinnitus, and grasp the indications and contraindications of tinnitus acoustic information therapy, so as to determine an individualized tinnitus acoustic information therapy program for tinnitus patients. Obviously, masking therapy and habituation therapy have their own merits, and the decision of which method is appropriate should be made according to the specific situation of the patient.