Background: Chronic tinnitus significantly impacts patients' quality of life, with no consensus on the long-term efficacy of different interventions. This study aimed to evaluate the long-term effects of tinnitus retraining therapy (TRT) through a systematic review and meta-analysis. Methods: Following PRISMA guidelines, literature was searched across eight databases up to November 2024. Ten randomized controlled trials were selected. A random-effects model was used to calculate weighted mean differences (MD) and 95% confidence intervals (CI) for Tinnitus Handicap Inventory (THI) and Visual Analog Scale (VAS) scores. Results: Compared to control groups, TRT significantly improved THI scores (MD = -8.72, 95% CI: -16.65 to -0.79, P=0.03) and showed a trend toward improving VAS scores (MD = -2.78, 95% CI: -5.57 to 0.02, P=0.05). Heterogeneity was high (I²=90-96%), but sensitivity analysis confirmed stable results. Conclusion: TRT has a significant long-term therapeutic effect on chronic tinnitus. Future studies should increase sample sizes, standardize interventions, and optimize review processes to reduce heterogeneity and define optimal TRT strategies.

In Reference to "A Cure for Tinnitus After Tinnitus Retraining Therapy: Insights From a Large Case Series".

Treatment preferences and values in chronic tinnitus patients: A cross-sectional survey study.

Background and Aim: Tinnitus, the perception of sound without an external source, affects about 14.4% of the global population, often leading to sleep disturbances, anxiety, and depression. While sound therapy and tinnitus retraining therapy (TRT) are common treatments, their effectiveness varies. Bhramari Pranayama (BP), a breathing technique involving a humming sound, has been proposed as a potential therapy, but its efficacy remains underexplored. This study evaluates the impact of BP combined with sound therapy versus sound therapy alone on tinnitus severity and psychological distress. Setting and Design: A quasi-experimental study was conducted in an outpatient clinical setting with 30 participants divided into two groups: (1) sound therapy with white noise masking and (2) sound therapy combined with BP. Ethical guidelines were followed, and informed consent was obtained. Methods: Participants had chronic tonal tinnitus for at least 3 months and no prior treatment. Both groups received 15-minute white noise masking, relaxation exercises, and abdominal breathing, with the BP group performing additional BP exercises. Assessments included pitch and loudness matching, the Tinnitus Handicap Inventory, and the Hospital Anxiety and Depression Scale (HADS). Data were analyzed using SPSS. Results: Both groups showed significant improvement in tinnitus loudness perception. Loudness scores were significantly lower in the BP group. Anxiety improved in the sound therapy group, while the BP group showed a greater reduction in depression. Conclusion: BP combined with sound therapy may enhance tinnitus management by reducing loudness perception and psychological distress. Further research is needed to explore its long-term benefits.

Tinnitus is a highly prevalent and challenging neurotologic condition affecting over 740 million individuals worldwide. Despite the growing number of studies, treatment approaches remain fragmented and inconsistent. This umbrella review aims to aggregate results from systematic review to comprehensively synthesize the available evidence. Following PRISMA guidelines, we systematically searched CINAHL, COCHRANE Library, PubMed, and Scopus through April 2025. Systematic reviews with meta-analyses of primary tinnitus interventions were included. Outcomes focused on validated measures of tinnitus severity, distress, loudness, and quality of life. Study quality was assessed using AMSTAR-2. A total of 44 systematic reviews were included, covering 7 intervention domains. Cognitive behavioral therapy (CBT), hearing aids, tinnitus retraining therapy (TRT), and sound/music therapy consistently improved tinnitus-related outcomes (eg, THI reductions up to -14.50, P < .001). Cochlear implantation yielded the largest effects (eg, THI -29.97) but is reserved for patients with moderate-to-profound sensorineural hearing loss who are not adequately helped by hearing aids. Neuromodulation and acupuncture showed modest or inconsistent benefits with high heterogeneity. This umbrella review provides the current and comprehensive analysis of tinnitus treatments. CBT, hearing aids, TRT, and sound/music therapy show consistent benefit. Cochlear implantation offers the greatest effect in patients with moderate-to-profound hearing loss unresponsive to hearing aids. Other therapies show mixed evidence. These findings offer a much-needed evidence framework to guide treatment decisions and future research.

HighlightsWhat are the main findings?EAE produced clinically meaningful and statistically significant tinnitus reduction (~50% improvement in THI and TFI) after just 1 h/day for 4 months.Both continuous and sequential EAE stimuli achieved comparable outcomes with very low non-response rates (3–8%), demonstrating robust and consistent clinical effectiveness.What are the implications of the main finding?EAE achieved tinnitus improvements similar to those reported for TRT while re-quiring over 90% less listening time, offering markedly greater time efficiency and higher treatment feasibility.The simplicity, accessibility, and low resource requirements of EAE support its in-tegration into routine and public healthcare settings, including tele-audiology and remote care models.Background/Objectives: Tinnitus affects approximately 15% of the population and lacks a universally effective treatment. Tinnitus Retraining Therapy (TRT) is widely used but requires 6–8 h of daily sound exposure for 1–2 years, limiting accessibility and adherence. This study evaluated the clinical feasibility and therapeutic effectiveness of Enriched Acoustic Environment therapy (EAE), a streamlined alternative using individualized sound stimulation with a markedly reduced treatment burden, and compared its time efficiency with published TRT outcomes. Methods: 82 adults with chronic tinnitus received standardized counseling and completed one of two EAE protocols (continuous or sequential). Participants listened to their personalized stimulus for 1 h/day over four months. Tinnitus severity (THI, TFI) and time-efficiency metrics (improvement per 10 listening hours) were assessed and compared with TRT studies reporting baseline and post-treatment THI. Results: EAE produced clinically relevant and statistically significant improvements, with 51.6% THI and 49.8% TFI reduction (p < 0.001). Both stimuli achieved similar outcomes with high responder rates. EAE yielded ~2.3 THI-point improvement per 10 h (~4.3% relative gain), demonstrating substantially greater time efficiency—approximately 20 times higher than values reported for standard TRT protocols. Conclusions: EAE achieved robust symptom reduction with dramatically lower treatment burden, high adherence, and strong clinical feasibility. These findings support EAE as an accessible, time-efficient alternative to TRT. Controlled long-term studies are warranted.

BackgroundTinnitus retraining therapy (TRT) promotes habituation in chronic tinnitus but is less effective in patients under psychological distress. Acceptance and commitment therapy (ACT) offers an alternative by enhancing psychological flexibility rather than targeting symptom reduction.Case PresentationFive patients with chronic tinnitus unresponsive to TRT completed the ACT program. Among them, four completed the 6‐month follow‐up and are presented in detail. While Case 1 was previously reported, this analysis includes all four to explore ACT's broader application. The intervention targeted ACT's six core processes. Outcomes were measured using the Tinnitus Handicap Inventory (THI), Cognitive Fusion Questionnaire‐7 (CFQ‐7), Valuing Questionnaire (VQ), and Hospital Anxiety and Depression Scale (HADS). After 6 months, three patients showed a clinically meaningful THI reduction. Those without hearing loss improved more in CFQ‐7 and HADS. VQ scores showed minimal change.ConclusionACT may help patients with TRT‐resistant tinnitus, particularly those without hearing loss.

Evidence synthesis of tinnitus treatment methods: An umbrella review.

In Europe, 14.7% of the population suffer from chronic tinnitus. Regarding pharmacological treatment of tinnitus, there is currently no evidence-based protocol recommendation. Tinnitus Retraining Therapy is the only effective method available in specialized multidisciplinary centers. By analyzing 116 patients who underwent rehabilitation in a multidisciplinary audiophonology center, we quantified the use of benzodiazepines before and after treatment. Among patients suffering from chronic tinnitus, there is an over-prescription of benzodiazepines, which can be reduced through proper care. Better awareness among frontline healthcare professionals about treatment in specialized multidisciplinary centers should be reinforced in order to enable quicker referrals and avoid therapeutic wandering or inappropriate use of benzodiazepines.

Tinnicare and Tinnipatch: A Smart Phone Integrated, Non-Occlusive, Bone-Conduction Platform for Personalized Digital Tinnitus Retraining Therapy

To identify the clinical features of sensorineural tinnitus patients who achieved complete symptom resolution or "cure" after tinnitus retraining therapy (TRT) and to determine significant factors that influence tinnitus resolution duration after TRT. A retrospective analysis of sensorineural tinnitus patients who underwent TRT and achieved a cure between January 2017 and January 2022 was performed. Cure of tinnitus was defined as patients experiencing symptoms for less than 5 minutes of awareness per day. Clinical information, including demographics, tinnitus duration, audiometric results, and therapeutic response, was examined. A total of 1,027 patients who achieved a cure for tinnitus were included, with more females (65.4%, n = 672) than males (35.6%, n = 355). The median age was 57 years (range, 12-92), with most having unilateral tinnitus (73.3%, n = 753). More than half had tinnitus with hearing loss (53.3%, n = 549), and the majority was under Jastreboff's tinnitus category 2 (38.7%, n = 397). The median duration of tinnitus before consult was 12 months in range (range, 1-480), whereas the median duration before tinnitus resolution after TRT was 17 months (range, 1-96). In Jastreboff's tinnitus categories, category 4 had the longest resolution time (median, 18 months) and category 1 the shortest (median, 15 months), but the difference was not statistically significant. A moderate correlation was observed between age and tinnitus resolution duration (Spearman correlation coefficient = 0.391, p < 0.05) and between tinnitus duration before consult and tinnitus resolution duration (Spearman correlation coefficient = 0.355, p < 0.05). TRT seems to be a promising treatment option for patients with sensorineural tinnitus. The time to achieve this cure may range from a few months to years after TRT, indicating the heterogeneity of the mechanism and therapeutic response. The younger patients and the earlier management after the onset of tinnitus seem to be good prognostic factors for a shorter tinnitus cure time after TRT.

Sound therapy and tinnitus retraining therapy in patients with chronic subjective tinnitus

Misophonia in autism: A systematic review of prevalence, clinical features, and comorbidities.

Tinnitus, a subjective perception of sound without external stimuli, affects millions worldwide, impairing daily function and quality of life. The severity of tinnitus is influenced by associated symptoms such as stress, anxiety, depression, and insomnia. The Tinnitus Functional Index (TFI) is a validated tool for assessing tinnitus severity and treatment outcomes. Despite the lack of a definitive cure, multimodal treatments, including pharmacotherapy and Tinnitus Retraining Therapy (TRT), show promise in managing the condition. This ambispective cohort study aimed to evaluate treatment efficacy in chronic tinnitus patients without hearing loss, using the Tinnitus Functional Index (TFI) as an assessment tool. Forty patients were divided into two groups: Group A received pharmacological treatment alone, while Group B received both pharmacological treatment and tinnitus retraining therapy (TRT). TFI scores were recorded at baseline, 3, 6, and 12months. Statistical analyses revealed significant improvements in TFI scores in both groups over time, with Group B demonstrating greater improvement, indicating the efficacy of TRT. Our findings underscore the importance of multimodal treatment approaches, particularly TRT, in managing chronic tinnitus without hearing loss. Further research is warranted to refine treatment protocols and enhance patient outcomes.

This pilot study investigated the efficacy of a novel Tinnitus Retraining Therapy (TRT) device utilizing bone conduction white noise generation, in treating tinnitus in a normal hearing population. This study was designed as a prospective, single-arm, observational trial in an outpatient clinic at a tertiary referral center, with 30 consecutive normal hearing patients with tinnitus. Tinnitus-specific questionnaires, namely the Tinnitus Handicap Inventory (THI) and Tinnitus Functional Index (TFI), translated and adapted to European Portuguese were administered. Patients were categorized into Group A (tinnitus characteristics within the device's maximum output performance) and Group B (outside the device's maximum output performance). 69% of the participants showed improvement in their TFI scores, with Group A exhibiting a significant mean reduction of 10 points (p = 0.0004). The device was well-tolerated, with no adverse effects reported. The novel bone conduction tinnitus suppression device showed promise in reducing the impact of tinnitus, particularly in patients whose tinnitus profile is within the device maximum performance output. This improvement in TFI scores in the majority of the participants, observed after just a 30-day period, highlights the potential of specifically tailored sound therapy delivered via bone conduction in tinnitus management.

Background: Tinnitus can significantly impact a patient’s quality of life. As no evidence-based curative treatments exist, therapies such as cognitive behavioral therapy, tinnitus retraining therapy, acceptance and commitment therapy, and mindfulness-based interventions aim to minimize tinnitus severity and have been shown effective. Since traditional delivery can be costly and time-consuming and often has limited accessibility, therapies might also be provided via eHealth. This study investigates the change in tinnitus severity measured by the Tinnitus Functional Index (TFI) score after participation in an online self-paced tinnitus (“Still Tinnitus”) course. The secondary aim was to identify predictors for the clinically relevant improvement after participation in this course. Methods: This retrospective record study included patients from Still Tinnitus course between March 2023 and July 2024. Patients were recruited via the Still Tinnitus website. Differences in the TFI scores from baseline and after completing the fifth (last) module of the course were calculated to investigate the change in tinnitus over time. Multivariate logistic analyses were performed to identify the possible predictors for the clinically relevant improvement after completion of the Still Tinnitus course. Results: In total, 122 patients were included in the study. The analysis revealed a clinically relevant reduction in the TFI score of 27.2 points. Multiple regression analyses showed that the “duration of the tinnitus” (OR 5.0; 95%CI: 1.537–16.240; p = 0.007) and “female sex” (OR 1.9; 95%CI 0.111–7.637; p = 0.030) are predictors for a clinically relevant improvement. Conclusions: In a convenience sample of tinnitus patients, the Still Tinnitus course may contribute to a clinically relevant reduction in tinnitus severity. A shorter duration of tinnitus and female sex were identified as significant predictors.

The study aimed to evaluate the effect of tinnitus masking on cognitive functioning and the efficacy of tinnitus retraining therapy in reducing the severity of tinnitus handicap. The study recruited 15 subjects (mean age = 47.1 ± 11.5) with unilateral chronic tinnitus (6 participants with right-ear tinnitus and 9 participants with left-ear tinnitus); and mild to moderate sensorineural hearing loss. Conducted in two phases, Phase 1 comprised case history, audiometric testing, tinnitus matching, and THI-Bangla assessment. Phase 2 involved P300 administration followed by a 60-session tinnitus retraining therapy (online-offline modality), concluding with post-therapy P300 and THI-Bangla assessments. Therapy outcomes were evaluated by improvements in P300 latency and amplitude and THI-Bangla scores. A significant improvement observed post-therapy, with reductions in mean P300 latency for both left (p < 0.001) and right (p < 0.001) ears. Mean P300 amplitude also increased significantly post-therapy for left (p < 0.001) and right (p < 0.001) ears. THI scores also declined substantially (p < 0.001), with a post-therapy mean THI score of 17.80 (SD = 4.64) for males and 12.20 (SD = 3.42) for females, revealing a significant difference (p = 0.033). These findings support the efficacy of tinnitus retraining therapy in reducing tinnitus related distress and enhancing cognitive processing, as evidenced by P300 improvements.

This study compares the outcomes of traditional face-to-face tinnitus retraining therapy (TRT) with mobile-based TRT in India. TRT, comprising directive counseling and sound therapy, aims to help patients habituate to tinnitus. Traditional TRT involves extensive in-person sessions, whereas mobile-based TRT employs interactive applications for weekly video counseling. The Tinnitus Handicap Inventory (THI) was used to assess tinnitus severity in two cases: Case 1 received conventional face-to-face TRT, while Case 2 received mobile-based TRT. Results indicate that mobile-based TRT is as effective as the traditional approach. After two months of therapy, Case 2 showed significant improvements in tinnitus and quality of life (QOL) due to convenient followups and self-monitoring. Mobile-based TRT is a promising alternative to face-to-face therapy.

Abstract Background: Tinnitus has no definitive treatment to date. Sound therapy can be given as tinnitus retraining therapy. Aims and Objectives: Our study is aimed to study the outcomes of a novel one-time tinnitus masking for nonpulsatile subjective tinnitus. Materials and Methods: All patients who presented with tinnitus which is subjective nonpulsatile without any treatable causes of tinnitus are included in the study. Results: Out of 16 patients, tinnitus matching was done by 15 patients, and 13 patients had complete masking of tinnitus with a single time. Eight patients who had more than moderate hearing loss developed recurrence of symptoms on follow-up. Tinnitus Handicap Index pre- and posttreatment with questionnaire showed a significant improvement (P &gt; 0.001) in analysis. Conclusion: The origin of tinnitus central or peripheral is unsettled, as people with normal hearing also had tinnitus and people with hearing loss had recurrence of tinnitus. They were further managed by hearing aids with tinnitus maskers. This method is individual operatable and can be used in apps as self-curing treatment.

This review aims to explore the influences of tinnitus retraining therapy (TRT) on patients with tinnitus. PubMed, MEDLINE, EMBASE, CINAHL, PEDro, SCOPUS, and Web of Science were screened for randomized controlled trials (RCTs) that explored the effects of TRT on patients with tinnitus from inception to June 30, 2024. The methodological quality of the included RCTs was evaluated using the physiotherapy evidence database (PEDro) scale. Fifteen studies met our eligibility criteria. A total of 2069 patients with tinnitus (mean age 52.93years; 66% male) were involved in the present review. The quality of the selected studies ranged from 5 to 8 on the PEDro scale, with a median score of 7. TRT did not provide superior effects in treating patients with tinnitus compared to tinnitus masking (TM), tinnitus educational counselling (TED), TRT with open ear hearing aids, Tailor-made notched music training (TMNMT), partial TRT, usual care, and smart TRT. TRT intervention is considered a treatment option for patients with tinnitus. Combining TRT with other interventions, such as cognitive-behavioral therapy, pharmacotherapy, or tDS, may show even greater efficacy. Additional studies are strongly required to recognize the long-term effects of TRT on tinnitus, determine who most likely would benefit from the intervention regarding tinnitus type and severity, and identify the optimal treatment protocol.