EFFECTIVENESS OF PARTIAL AND COMPLETE TINNITUS MASKING

Jastreboff und Hazell [9] developed a neurophysiological approach to t innitus perception,including the important role of the central nervous system in the maintenance and intrusiveness of tinnitus. They introdu ced tinnitus-retraining therapy, consisting of four different strategi es:(1) directive and person-centered counseling;(2) hearing aids and/o r noise generators and/or environmental sounds; (3) psychological ther apy; (4) adjacent therapies. Tinnitus should not be masked as with a t innitus-masker, but must be able to be heard in addition to the noise! A noise generator or hearing aid should be worn at least 6-8 h per da y over a period of up to 18 months. In additions several clinical Visi ts are required in order to reinforce the counseling. The actual resul ts shaw complete tinnitus remission for about 20-30% and partial remis sion for 50-60% of the patients [6]. We report on a retrospective stud y in patients wearing hearing aids or tinnitus-maskers over a period o f 3 years. We compared the results of patients using partial tinnitus masking to those using complete masking. The tinnitus-related and gene ral psychological complaints were acquired by the 52-item tinnitus que stionnaire developed by Hallam et al. [4] and modified by Goebel and H iller [3]. To describe the dimensions of tinnitus-related distress the scales are labelled emotional distress, cognitive distress, emotional and cognitive distress, intrusiveness, auditory perceptual difficulti es,sleep disturbance and somatic complaints. Positive changes for the global tinnitus questionnaire score of more than 10 points are signifi cant in the dimensions of tinnitus-related distress and are described as partial tinnitus-reduction. The group with partial masking effects can be compared to those performing retraining therapy to day because directive and personal centered counseling were integrated for all pat ients. Patients reporting partial masking effects through their aids ( hearing aid or noise generator) showed more effective treatment result s (reduced or disappeared tinnitus) than those using complete masking effects (P<0.05). The reported results are improved by current investi gations in Germany showing about 20-30% tinnitus remission and 50-60% significant reduction after 1 year of treatment [1]. Further scientifi c investigations must be carried out to evaluate the appropriateness a nd effectiveness of the retraining therapy and with regard to unique q uality standards.