Abstract #186, Date 2/14/99, Session E7, Poster (B154)

Outcome of Tinnitus Retraining Therapy (TRT) for patients with hyperacusis versus tinnitus only

*P.J. Jastreboff, M.M. Jastreboff (University of Maryland School fo Medicine)

Patients treated by Tinnitus Retraining Therapy are divided into 5 categories, and for each category a different variant of counseling and sound therapy is used. One of the main factors for differentiation is the presence of hyperacusis and / or phonophobia, which accompanies tinnitus in approximately 40% of the cases. If hyperacusis is present, then it is treated first and a different variant of sound therapy is used. Of special interest are patients exhibiting "kindling" and "winding up" phenomena. These phenomena describe prolonged enhancement of tinnitus and / or hyperacusis as a result of sound exposure (Category 4). While in many patients it is possible to observe worsening of their symptoms for minutes or hours after sound exposure, in patients from this category the effect persists until at least the next morning after exposure.       Improvement in 163 cases was analyzed, with the criteria of improvement the same as described in an accompanying poster. 119 patients had tinnitus only, and 44 patients had tinnitus accompanied by hyperacusis. TRT resulted in significant improvement in 78% of patients with tinnitus only, and in 95% of patients where hyperacusis was present. The average success rate of significant improvement was 83%. While the average results from patients with hyperacusis showed a higher success rate, TRT was less effective on patients from Category 4 who exhibit prolonged worsening of their problem. Significant changes in quality of life, tinnitus awareness, annoyance, and severity were observed for all categories.       In conclusion, although a larger sample size for each category is needed for a firm conclusion, these data indicate that patients with hyperacusis have at least as good, if not better, chance of achieving significant improvement.