The International Tinnitus Journal

Tinnitus, Use and Evaluation of Sound Therapy, Current Evidence and Area of Future Tinnitus Research

Tinnitus is one of the otologic symptoms seen in persons with ear pathologies. It is defined as an acoustic sensation in the ear without a corresponding external acoustic stimulus. Tinnitus is said to be generated from the higher auditory centres because of reduced feedback from the peripheral or neural component but can be an outcome of irritation at different levels of the auditory system. Several treatment modalities have been tried in the management of tinnitus, either as a single treatment or as part of combination therapy. They range from lifestyle or dietary modification, medications, surgery, to Tinnitus Retraining Therapy (TRT), use of sound generating devices, hearing aids and cochlear implants. Current literature has shown that the prevalence of tinnitus is highly variable and reflects the difference in symptom criteria and patient selection for the various treatment modalities. This variability is also visible in the outcomes of cases where the various treatment modalities have been used. In the presence of an augmented hearing, the brain can focus on the meaningful sound generated externally while suppressing or even aborting the tinnitus. Future tinnitus research needs to apply the highest level of randomization and blinding, in line with the high subjectivity of tinnitus and the possibility of a response with control. The natural sequence of tinnitus is characterized by the conditioning or habituation and possible gradual attenuation of symptom, this implies that there is a limit to which the benefits observed was due to our intervention rather than a natural process of this symptom.