Using Therapeutic Sound With Progressive Audiologic Tinnitus Management

Abstract

Management of tinnitus generally involves educational counseling, stress reduction, and/or the use of therapeutic sound. This article focuses on therapeutic sound, which can involve three objectives: (a) producing a sense of relief from tinnitus-associated stress (using soothing sound); (b) passively diverting attention away from tinnitus by reducing contrast between tinnitus and the acoustic environment (using background sound); and (c) actively diverting attention away from tinnitus (using interesting sound). Each of these goals can be accomplished using three different types of sound—broadly categorized as environmental sound, music, and speech—resulting in nine combinations of uses of sound and types of sound to manage tinnitus. The authors explain the uses and types of sound, how they can be combined, and how the different combinations are used with Progressive Audiologic Tinnitus Management. They also describe how sound is used with other sound-based methods of tinnitus management (Tinnitus Masking, Tinnitus Retraining Therapy, and Neuromonics).

Clinical Practice Guideline: Tinnitus

“…Some individuals experience residual inhibition following total or partial masking (ie, tinnitus suppression or temporary disappearance of the tinnitus sensation after exposure to an external sound). Sound therapy may promote habituation to the tinnitus by reducing the contrast between the tinnitus and environmental sound, 131,132,135 provide sounds that are soothing to induce a sense of relief from stress or tension caused by tinnitus, 136 or provide sounds that are interesting with the goal of distracting the patient's attention away from the tinnitus (active attention diversion). 136 The specific parameters of sound therapy that optimally provide tinnitus benefit are not yet established.…”

Auditory and vestibular dysfunction associated with blast-related traumatic brain injury

“…Therefore, it is necessary to implement a hierarchical program of tinnitus management that is designed to be maximally efficient and have the least impact on clinical resources, while still addressing the needs of all patients who complain about tinnitus [42]. A hierarchical program has been developed-Progressive Tinnitus Management (PTM)-that involves five levels of clinical services: (1) triage, (2) audiologic assessment, (3) group educational counseling, (4) interdisciplinary evaluation, and (5) individualized support (repeated appointments to implement one-on-one care) [43][44]. The majority of tinnitus patients have their needs met by receiving the Level 2 audiologic assessment (including hearing aids, if necessary) and Level 3 group education, which ideally consists of group sessions conducted by an audiologist and additional sessions conducted by a psychologist.…”

Tinnitus in Patients with Sensorineural Hearing Loss : Management, Quality of Life and Treatment Strategies

“…Initial evidence suggests that TRT can be an effective treatment for patients suffering from tinnitus (Henry et al, 2008). To implement TRT in clinical practice, clinicians use a combination of sound therapy within a strict framework and educational counseling according to a detailed procedure (Jastreboff & Hazell, 2004).…”