Tinnitus Retraining Therapy

Tinnitus retraining therapy (TRT) is a clinical implementation of the neurophysiological model of tinnitus. The primary goal of TRT is the habituation of reactions evoked by bothersome tinnitus without attempting to remove tinnitus. Habituation is initiated, and further facilitated, using the method of modified passive extinction of conditioned reflexes and involves: (1) teaching/counseling aimed at reclassification of bothersome tinnitus signal (i.e., tinnitus-related neuronal activity) to the category of neutral stimuli and (2) sound therapy, which decreases the strength of the tinnitus signal by providing an enhanced sound background. Once a sufficient level of habituation of reactions is achieved, then habituation of perception occurs automatically. If present, the decreased sound tolerance is treated concurrently with tinnitus using specific protocols. Many centers reported an over 80% success rate of TRT in the treatment of tinnitus. Specific long-term studies, evaluating the stability of results after stopping of treatment, confirmed the persistence of positive effects with a tendency to further improvement.