Investigation of the Effectiveness of Sound Enrichment in the Treatment of Tinnitus Due to Hearing Loss

[Vadimus]

The results are very impressive. The program used in the study to create the therapy (Praat program) seems to be free and available for download.

Methods

A total of 96 patients with chronic tinnitus were included in the study. Fifty‐two patients in the study group and 44 patients in the placebo group considered residual inhibition (RI) outcomes and tinnitus pitches. Both groups received sound enrichment treatment with different spectrum contents. The tinnitus handicap inventory (THI), visual analog scale (VAS), minimum masking level (MML), and tinnitus loudness level (TLL) results were compared before and at 1, 3, and 6 months after treatment.

Results

There was a statistically significant difference between the groups in THI, VAS, MML, and TLL scores from the first month to all months after treatment (p < .01). For the study group, there was a statistically significant decrease in THI, VAS, MML, and TLL scores in the first month (p < .01). This decrease continued at a statistically significant level in the third month of posttreatment for THI (p < .05) and at all months for VAS‐1 (tinnitus severity) (p < .05) and VAS‐2 (tinnitus discomfort) (p < .05).

Conclusion

In clinical practice, after excluding other factors related to the tinnitus etiology, sound enrichment treatment can be effective in tinnitus cases where RI is positive and the tinnitus pitch is matched with a hearing loss between 45 and 55 dB HL in a relatively short period of 1 month.

Table 2 shows the VAS scores of the patients during the treatment and the statistical evaluation between the groups. There was a statistically significant difference between the groups for time‐dependent change of VAS scores (tinnitus severity, p < .001, tinnitus discomfort, p < .001, attention deficit, p < .001, and sleep difficulty, p < .001). VAS scores in the study group decreased statistically significantly during the treatment process (tinnitus severity, p < .001, tinnitus discomfort, p < .001, attention deficit, p < .001, and sleep difficulty, p < .001), whereas no statistically significant difference was observed in the placebo group (tinnitus severity, p = .74, tinnitus discomfort, p = .65, attention deficit, p = .57, and sleep difficulty, p = .63) during the treatment process.

Table 3 shows the THI scores of the patients during the treatment and the statistical evaluation between the groups. There was a statistically significant difference between the groups for the time‐dependent change of THI scores (p < .001). THI scores in the study group decreased statistically significantly during the treatment process (p < .001), whereas no statistically significant difference was observed in the placebo group (p = .59).

Investigation of the effectiveness of sound enrichment in the treatment of tinnitus due to hearing loss

 

[Tim Moore]

This is really interesting! It suggests that sound enrichment can be effective for people who have tinnitus specifically induced by hearing loss (like me). So, my next question is: how do I try it? How does someone go about obtaining the custom sounds needed for listening?

 

[Nick47]

This is really interesting! It suggests that sound enrichment can be effective for people who have tinnitus specifically induced by hearing loss (like me). So, my next question is: how do I try it? How does someone go about obtaining the custom sounds needed for listening?

Patients with positive RI, tinnitus pitch in the range of 45–55 dB HL hearing loss, and meeting both criteria were included in the study.

So those who experience residual inhibition and have hearing loss in the 45–55 dB range.

 

[Tim Moore]

So those who experience residual inhibition and have hearing loss in the 45–55 dB range.

From what I understand, I have a single notch of hearing loss at 45 dB in my left ear, specifically at 6000 Hz, with no loss in other areas. I suspect this is the source of my tinnitus, so I'm curious if this could help me!

 

[JRC1]

Can someone sort of "dumb this down" for me? Aren't these results really impressive?

 

[Vadimus]

I e-mailed the author of the study. I asked if I could send my audiogram and use it to prepare audio therapy based on his study. Or would I need to be there in person? I wrote that I am ready to pay for such a service, if it is possible. I also specified that my hearing loss is related to otosclerosis, i.e. I have a dysfunction in the middle ear. The author of the study lives in Turkey. I received a reply from him today.

Researcher's response:

Hello,

First of all, thank you for your kind thoughts. Since tinnitus is a symptom, it can be caused by many pathologies. When the underlying pathology is only hearing loss, the treatment we are working on can give very promising results. However, if tinnitus is accompanied by an etiology other than hearing loss, the results of the treatment may vary. For this reason, it would be better to examine first. I know it is not easy to come from another country, but it would not be right to make a treatment remotely.

 

[Tim Moore]

I e-mailed the author of the study. I asked if I could send my audiogram and use it to prepare audio therapy based on his study. Or would I need to be there in person? I wrote that I am ready to pay for such a service, if it is possible. I also specified that my hearing loss is related to otosclerosis, i.e. I have a dysfunction in the middle ear. The author of the study lives in Turkey. I received a reply from him today.

Researcher's response:

Hello,

First of all, thank you for your kind thoughts. Since tinnitus is a symptom, it can be caused by many pathologies. When the underlying pathology is only hearing loss, the treatment we are working on can give very promising results. However, if tinnitus is accompanied by an etiology other than hearing loss, the results of the treatment may vary. For this reason, it would be better to examine first. I know it is not easy to come from another country, but it would not be right to make a treatment remotely.

Thank you for following up on this! I also emailed who I believe is the author, though I haven't received a response yet. I think the person's name is Eser Sendesen? Would you mind sharing who you emailed? Thank you!

 

[Vadimus]

Thank you for following up on this! I also emailed who I believe is the author, though I haven't received a response yet. I think the person's name is Eser Sendesen? Would you mind sharing who you emailed? Thank you!

Yes, I wrote to him in both English and Turkish. He replied to me in Turkish, but it took about a week for him to respond.

ResearchGate: Eser Sendesen

He is a young scientist specializing in tinnitus who has published several scientific papers on the subject, referenced by other researchers, and conducted a case study with very encouraging results. Perhaps he would be a good candidate for a Tinnitus Quest grant?

Can someone sort of "dumb this down" for me? Aren't these results really impressive?

I think the results are extremely impressive, even if they only worked for a narrow group of patients. As far as I know, such significant tinnitus volume reduction has never been confirmed in a double-blind, placebo-controlled trial before. Additionally, the treatment is simple, affordable, and non-invasive, which makes it even more remarkable.

 

[JRC1]

Thank you for your response. I'm still wondering why this study isn't getting more attention. I don't quite understand the concept of residual inhibition, although I can look up the term to read the definition. You mentioned a "narrow group of patients"—does this mean the treatment wouldn't work for most people? Since most cases of tinnitus are due to hearing loss, would this treatment be effective for the majority?

I also have another question: the patients in the study initially used the treatment for hours each day. Do you think using the Susan Shore Device for hours daily might yield similar dramatic results?

 

[Furetto]

Does this mean that the treatment only works for those who experience residual inhibition, or does it also work for those who don't?

 

[Dizzyhead888]

I read the paper.

This chart summarizes it:

The criteria are as follows:

• Absence of pathology or tumors (presumably, this refers to patients whose tinnitus is due to hearing loss).
• Hearing loss of 45-55 dB.
• Residual Inhibition (RI): This means that your tinnitus temporarily stops after playing narrow-band noise for one minute that matches your tinnitus perception or frequency. Presumably, your tinnitus frequency corresponds to the frequency at which you have hearing loss, though it's unclear if this is always the case or if tinnitus perception can differ from the hearing loss frequency. A narrow-band noise refers to a limited range of frequencies around your tinnitus frequency.

It has been shown that if you meet these criteria, sound enrichment around the frequency of your hearing loss can reduce tinnitus.

As for whether people with no hearing loss, hidden hearing loss, or milder hearing loss benefit, we don't yet know.

The promising aspect of this paper is the placebo comparison: they used a placebo that involved playing a frequency far from the hearing loss frequencies. The placebo group showed no improvement, while the treatment group experienced significant improvements.

 

[UKBloke]

Perhaps he would be a good candidate for a Tinnitus Quest grant?

Disclaimer: I haven't read the paper as I'm maxed out reading tinnitus research for now!
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At the very least, I think where any tinnitus treatment study is concerned , particularly where the researcher is a young scientist, we should consider trying to pair the study team with the Bionics Institute.

If the Bionics Institute is currently looking to build its own fNIRS device to "collect data from more sites," then the addition of an objective tinnitus measurement in these studies would be hugely significant.

 

[MichaelBull]

I'm quite intrigued by this research. As someone who experiences temporary residual inhibition when using a specific neuromodulation tinnitus video I found online, I'm interested in possibly trying this approach. I don't have hearing loss based on my last hearing test (though it only tested up to 8 kHz, so I might have hearing loss in higher ranges). I'm not entirely sure how relevant this is for my situation.

I remember seeing a post a while back about someone who claimed a friend cured their tinnitus by playing the frequency of their tinnitus almost constantly for a couple of weeks. Perhaps there's some logic in reinforcing residual habituation to the point where the brain stops sending the tinnitus signal altogether.

However, I'm hesitant because I've come across rare posts from people saying their tinnitus worsened after excessive neuromodulation.

I'll think it over. I mostly work from home, so I could easily play these sounds throughout my workday during the initial month, as specified in the paper (for about 6 hours).

 

[RunningMan]

• Residual Inhibition (RI): This means that your tinnitus temporarily stops after playing narrow-band noise for one minute that matches your tinnitus perception or frequency. Presumably, your tinnitus frequency corresponds to the frequency at which you have hearing loss, though it's unclear if this is always the case or if tinnitus perception can differ from the hearing loss frequency. A narrow-band noise refers to a limited range of frequencies around your tinnitus frequency.

Residual inhibition could occur due to other sounds, including a single tone sound. I can can experience it most easily using single tone pulses. Also, residual inhibition could mean the tinnitus only temporarily "reduces in intensity" rather than temporarily stopping completely.

 

[withintention]

Reading the paper, it seemed like creating a specific sound for each person is somewhat of an audio engineering challenge. It requires various filters and audio mixing techniques. I'd be very interested in trying this at home, but I'm not sure my relatively basic audio engineering skills are up to the task.