Noise Induced Hearing Loss with Tinnitus: Does TRT Help?

Main Article Content

Nidhi Vohra Maggon
Ashwani Sethi
Atul Gupta

Abstract

Introduction


To determine if hearing augmentation and tinnitus retraining therapy (TRT) helps in cases of Tinnitus with Noise induced hearing loss (NIHL) and does degree of hearing loss, severity or duration of tinnitus affect recovery 


Materials and Methods


A prospective study was done on 100 patients of NIHL with tinnitus from Jan 14-Jul 15. Degree of hearing loss was assessed. Tinnitus severity was scored on Tinnitus handicap inventory (THI) scale as Slight, Mild, Moderate, severe or catastrophic and patients were subjected to TRT. Patients scored after 1 year of TRT. A relation between tinnitus severity, duration and degree of hearing loss on recovery from tinnitus was analysed.


Result


62 of the 100 patients improved following TRT.


Discussion


In 100 patients THI scores improved from a mean of 63.12 (SD-21.12) to 38.16 (SD-18.21). Mean difference between pre and post-intervention THI scores was 24.96 (SD-17.97). Improvement was significant in severe or profound hearing loss (P<.001).


Tinnitus severity was slight, mild, moderate, severe or catastrophic on THI. Following TRT, 82.35% with Catastrophic, 70.96% with severe, 52.63% with moderate, 20% with mild tinnitus improved. 1 patient with slight tinnitus did not improve.


Based on duration of tinnitus three groups made; 0-6 months, 6-12 months and >12 months. All groups showed improvement. Reduction in Post-TRT THI was significant but did not show any difference among groups.


Conclusion


TRT helps in tinnitus with NIHL particularly if hearing loss is severe. Severe or catastrophic tinnitus patients experience greater improvement. Duration of tinnitus has no impact.

Article Details

How to Cite
1.
Vohra Maggon N, Sethi A, Gupta A. Noise Induced Hearing Loss with Tinnitus: Does TRT Help?. BJOHNS [Internet]. 2017Apr.30 [cited 2024May18];25(1):39-45. Available from: https://www.bjohns.in/journal3/index.php/bjohns/article/view/110
Section
Main article
Author Biographies

Nidhi Vohra Maggon, Assistant Professor, Army College of Medical Sciences, Base Hospital, Delhi Cantonment, New Delhi 110010

Assistant Professor,

Dept of Otorhinolaryngology

Ashwani Sethi, Army College of Medical Sciences, Base Hospital, Delhi Cantonment, New Delhi 110010

Dept of Otolaryngology

Associate Professor

Atul Gupta, Senior Resident Army College of Medical Sciences Base Hospital, Delhi Cantt -110010

Senior Resident
Army College of Medical Sciences
Base Hospital, Delhi Cantt -110010

References

Stephens SDG. The treatment of tinnitus-A historical perspective. Journal of Laryngology and Otology.1984;98:963-72

Davies A, Rafaie EA. Epidemiology of tinnitus. In: Tyler R S (ed.) Tinnitus Handbook. Singular, San Diego, CA, 2000:1-23

Smith P, Coles R. Epidemiology of tinnitus: An update. In: FeldmannH(ed.). Proceedings of the third international tinnitus seminar, Munster. Karlsruhe: Harsch Verlag,1987:147-53

Axelsson A. Causes of tinnitus. In: Aran JM, Dauman R (eds). Tinnitus 91. Proceedings of IV international tinnitus seminar, Bordeaux. Amsterdam/New York: Kugler publications, 1992:275-7

Nicolas Puel C, Faulconbrodge RL, Guitton M, Puel JL, Mondain M, Uziel A. Characteristics of tinnitus and etiology of associated hearing loss: a study of 123 patients. International Tinnitus Journal. 2002; 8:37-44

Dias Adriano, Cordeiro Ricardo, Corrente José Eduardo, Gonçalves Cláudia Giglio de Oliveira. Association between noise-induced hearing loss and tinnitus. Cad. Saúde Pública [Internet]. 2006 Jan [cited 2017 Jan 16] ; 22( 1 ): 63-68

Newman CW1, Jacobson GP, Spitzer JB. Development of the Tinnitus Handicap Inventory.

Arch Otolaryngol Head Neck Surg. 1996 Feb;122(2):143-8

Henry JA, Jastreboff MM, Jastreboff PJ, Schechter MA, Fausti SA. Guide to conducting tinnitus retraining therapy initial and follow-up interviews. J Rehabil Res Dev. 2003 Mar-Apr;40(2):157-77

LeDoux JE, Sakaguchi A, Reis DJ. Sub cortical efferent projections of the medial geniculate nucleus mediate emotional response conditioned to acoustic stimuli. Journal of Neuroscience. 1983;4:683-98

Caspary DM, Salvi RJ, Helfert RH, Brozoski TJ , Bauer CA. Neuropharmacology of noise induced hearing loss in brainstorm auditory structures. In: HendersonD, Prasher D et al(eds). Noise induced hearing loss: Basic mechanisms, prevention and control. Noise Research Network Publications, London, 2001:169-83

Eggermont JJ .Physiological mechanisms and neural models. In: TylerR (Ed.). Tinnitus Handbook. San Diego : Singular, 2000:85-122

Wang J, Ding D, Salvi RJ. Functional reorganization in chinchilla inferior colliculus associated with chronic and acute cochlear changes. Hearing research. 2002;168:238-49

Komiya H, Eggermont JJ. Spontaneous firing activity of cortical neurons in adult cats with reorganized tonotopic map following pure tone trauma. Otolaryngologica. 2000;120:750-6

Zacharek MA, Kaltenbach JA, Mathog TA, Zhang J. Effects of cochlear ablation on noise induced hyperactivity in the hamster dorsal cochlear nucleus: implication for the origin of noise induced tinnitus. Hearing Research.2002; 172:137-44

The Cochrane Library/Ear Nose Throat disorders/Ear/Inner ear/Tinnitus. John S Phillips,

Don McFerran. First published: 17 March 2010. Editorial Group: Cochrane ENT Group

DOI: 10.1002/14651858.CD007330.pub2

Martin FW, Colman BH. Tinnitus : A double blind cross over controlled trial to evaluate the use of lignocaine. Clinical Otolaryngology. 1980; 5:3-11

Laurikainen EA, Johansson RK, Kileny PR. Effects of intratympanically delivered lidocaine on the auditory system in humans. Ear and Hearing. 1996; 17:49-54

Dobie RA. A review of randomized clinical trial in tinnitus. Laryngoscope.1999; 109:1202-11

Hallam RS, RachmanS, Hinchcliffe R. Psychological aspects of tinnitus. In: Rachman S (ed). Contribution to medical psychology, Vol 3. Oxford: Pergamon Press, 1984:31-4

Anderson G, Lyttkens L.A meta- analytic review of Psychological treatments for tinnitus. British Journal of Audiology. 1999;33:201-210

Cima RF, Andersson G, Schmidt CJ, Henry JA. Cognitive-behavioral treatments for tinnitus: a review of the literature. J Am Acad Audiol. 2014 Jan;25(1):29-61. doi: 10.3766/jaaa.25.1.4

Vernon JA, Meikle MB.Tinnitus masking. In: Tyler R(ed)Tinnitus handbook .San diego :Singular, 2000:313-76

Vernon JA. Pathophysiology of tinnitus: A special case—hyperacusis and a proposed treatment. Am J Otol 1987;8: 201-2

E M Khedr, J C Rothwell, M A Ahmed, A El-Atar. J Neurol Neurosurg Psychiatry 2008;79:212-215

Jasterboff PJ, Hazell JWP. A neurophysiological approach to tinnitus: Clinical implications. British journal of Audiology. 1993;27:7-17

McKinney CJ.An evaluation of the TRT method. In: Hazell JWP(ed) Proceedings of the sixth international tinnitus seminar, Cambridge, UK. London: The tinnitus and hyperacusis Centre,199:99-105

Bartnik G, Fabijańska A, Rogowski M. Effects of tinnitus retraining therapy (TRT) for patients with tinnitus and subjective hearing loss versus tinnitus only. Scand Audiol Suppl. 2001 ; ( 52):206-8

Phillips JS1, McFerran D. Tinnitus Retraining Therapy (TRT) for tinnitus. Cochrane Database Syst Rev. 2010 Mar 17;(3):CD007330. doi: 10.1002/14651858.CD007330.pub2

Baracca GN et al (2007) Results of tinnitus retraining therapy after 18 months: Our experience. Int J Audiol 46(5):217-222

Henry JA, Schechter MA, Zaugg TL, Griest S, Jastreboff PJ, Vernon JA, Kaelin C, Meikle MB, Lyons KS, Stewart BJ. Clinical trial to compare tinnitus masking and tinnitus retraining therapy. Acta Otolaryngol Suppl. 2006 Dec;(556):64-9.