Efficacy of Tailor-Made Notched Music Training Versus Tinnitus Retraining Therapy in Adults With Chronic Subjective Tinnitus: A Randomized Controlled Clinical Trial

Abstract

Objectives: Chronic subjective tinnitus can have a serious effect on daily life, even causing serious psychological disorders. Currently there are no specific effective solutions or cures. Tailor-made notched music training (TMNMT) is a recently proposed sound therapy that has simpler processes and a higher compliance rate than tinnitus retraining therapy (TRT), a widely used treatment for chronic subjective tinnitus. This study explores the therapeutic effect of TMNMT in comparison to TRT to highlight its clinical value. Design: The study was a randomized controlled, single-blinded clinical trial. One hundred twenty eligible participants were randomly assigned to receive TMNMT (n = 60) or TRT (n = 60) for 3 mo with concurrent follow-up. It should be noted that the duration of sound treatment in TRT was modified to 2 hr per day for better feasibility in practice. The primary outcome was mean change in tinnitus handicap inventory (THI) measured at baseline (T0), 1 mo (T1) and 3 mo (T2) after intervention. Change in visual analog scale (VAS) was measured as a secondary outcome. A comparison of therapeutic effectiveness between TMNMT and TRT was evaluated by repeated measure analysis of variance. Results: One hundred and twelve (93%) of participants took part in the study, of which 64 were men and 48 women. Mean (SD) age was 42.80 (12.91) years. Fifty-eight were allocated to receive TMNMT and 54 to receive TRT. The between-group difference in primary outcome was −6.90 points (95% confidence interval [CI], −13.53 to −0.27) at T1 and −6.17 points (95% CI, −13.04 to 0.71) at T2. These results closely reached to clinical significance of tinnitus-related effective relief. For the secondary outcome, the mean value in the TMNMT group was 0.83 points (95% CI, 0.12 to 1.54), significantly lower than the mean value of the TRT group. The differences in THI and VAS between the two groups were statistically significant after intervention. Further analysis showed that age and baseline THI and VAS scores were associated with change in THI and VAS scores after interventions. Conclusions: Both TMNMT and TRT were able to alleviate chronic subjective tinnitus effectively after a 3 month intervention. When the two forms of therapy were compared TMNMT appeared to be more effective and consequently potentially superior to TRT for reducing tinnitus loudness and functional and emotional disturbance associated with chronic subjective tinnitus.

Recent Updates on Tinnitus Management

“…However, THI and visual analog scale (VAS) were similar. Similarly, in a comparison between TMNMT and TRT, both TMNMT and TRT significantly reduced THI scores over a 3-month treatment period [23]. A study comparing TMNMT, conventional music therapy, and counseling revealed that all three interventions contributed to decreased THI scores over time, but there were no significant differences [14].…”

“…However, the German guideline recommends that TMNMT should not be used in chronic tinnitus because it is no more effective than music and there is also potential harm [4]. In most recent studies, TMNMT did not differ in efficacy from other interventions, including conventional music or randomly removed frequency, counseling, and TRT [22][23][24][25].…”