My Options for Treating My Tinnitus?

[Paulmanlike]

So not long have I been out of hospital with depression, due to tinnitus. Now that I've got that under control I was looking at my options to beat tinnitus.

I've been looking at the Tinnitus Clinic for some time, perhaps trying the expensive Desyncra therapy, my audiologist had said that the evidence base for this therapy was growing and they are very good.

Or with all the latest developments with these tinnitus treatments (Auris, Otonomy, Frequency Therapeutics, etc) do I wait for something better to come onto the market?

I have tonal tinnitus and I think I meet the criteria for this therapy, and they say they won't put me on it if they don't think I will respond.

I'm very much of a solutions person, if they can help me tone it down a notch or two I would be happy with that.

I'm in the UK by the way and they have a national Tinnitus Clinic here with the latest treatments for tinnitus, with expensive price tags.

 

[Ed209]

So not long have I been out of hospital with depression, due to tinnitus. Now that I've got that under control I was looking at my options to beat tinnitus.

I've been looking at the Tinnitus Clinic for some time, perhaps trying the expensive Desyncra therapy, my audiologist had said that the evidence base for this therapy was growing and they are very good.

Or with all the latest developments with these tinnitus treatments (Auris, Otonomy, Frequency Therapeutics, etc) do I wait for something better to come onto the market?

I have tonal tinnitus and I think I meet the criteria for this therapy, and they say they won't put me on it if they don't think I will respond.

I'm very much of a solutions person, if they can help me tone it down a notch or two I would be happy with that.

I'm in the UK by the way and they have a national Tinnitus Clinic here with the latest treatments for tinnitus, with expensive price tags.

I've always been dubious of the Tinnitus Clinic, but I've never been or used their facilities, so maybe I'm wrong. There's just something about their treatments that has always felt a bit exploitative to me, because their prices are really high for what are, effectively, unproven methods. Or we could say, clinically underwhelming.

To command the prices they want, I really believe the treatments should hold more clinical significance, and have data showing a high probability of real improvement. Personally, I wouldn't like to drop 5 grand on the likelihood of them helping me to habituate. We can do this for nothing.

Maybe I'm doing them a disservice, but this is based on what I know and have read about them and their treatments. They do their own version of TRT as well, but if you wanted to go down that route you'd be much better off getting it for free from the NHS.

 

[Ed209]

Specialist commentator comments

One specialist commentator stated that the clinical significance of the results from Tass et al. (2012) is unconvincing. The outcome measure of loudness as measured on a visual analogue scale is not clinically relevant, and neither is the 4‑point difference in Tinnitus Questionnaire scores between group 1 and placebo. Furthermore the adverse event rate in this study appeared unacceptably high. Further well‑designed studies that are independent of the device manufacturer are needed, and publication of the RESET2 study would provide valuable evidence on this technology.

The specialist commentators stated that Acoustic CR Neuromodulation is not suitable for many people with tinnitus because they have atonal tinnitus, tinnitus that is of too high frequency for the device to deliver good quality sound stimuli, or they have too much hearing loss around the region of their tinnitus pitch to be able to hear all the stimuli. The specialist commentators considered the treatment to be suitable for approximately 20–25% of people assessed. It is not clear how people who need a hearing aid would manage treatment with Acoustic CR Neuromodulation as it cannot be used at the same time as a hearing aid.

The effective selection of patients is an important consideration. A specialist commentator stated that people with 1 or at most 2 identified tinnitus tones, constant tinnitus perception with little improvement over the previous 3 months, and hearing loss no greater than 35 dB hearing level (dBHL) average in the best ear would respond best to the treatment. Another specialist commentator noted that there was not enough evidence to support this treatment protocol, and that reliable pitch identification can be difficult.

The device appears expensive compared with other equally effective if not better tinnitus treatment strategies, including CBT. Acoustic CR Neuromodulation is currently delivered (by a private provider) as a package including counselling and stress management; it is uncertain if NHS audiology services would offer the same level of service.

The current design of the device is suitable for a single use only. Acoustic CR Neuromodulation was used for 9 months in the RESET2 study (Hoare et al. 2013), rather than the 4–6 months suggested by the manufacturer.

One specialist commentator suggested that 6 hours of clinical time with a senior audiologist and or hearing therapist would be needed to fit binaural hearing aids. Another specialist estimated that 2 visits lasting 2.5 hours in total would be needed for fitting binaural hearing aids. The patient may have a follow‑up appointment or be followed up by telephone, depending on the department.

https://www.nice.org.uk/advice/mib5/chapter/technology-overview

 

[Michael Leigh]

I'm in the UK by the way and they have a national Tinnitus Clinic here with the latest treatments for tinnitus, with expensive price tags.

@Paulmanlike You will get the best help and long term aftercare for your tinnitus under the NHS. No private practice in the UK can match it. Try and get a referral to a hospital that practices TRT. I have had TRT twice and I'm still under the care of my hospital 20 years on. I agree with @Ed209 be very careful of the private practice that you intend on going to. I know two people that went there that had less than satisfactory results after parting with a lot of money. One of them complained and he was quickly shown the door.

Michael

 

[Paulmanlike]

Does trt help