Download PDF
J Am Acad Audiol 2000; 11(03): 162-177
DOI: 10.1055/s-0042-1748042
Original Article

Tinnitus Retraining Therapy (TRT) as a Method for Treatment of Tinnitus and Hyperacusis Patients

Pawel J. Jastreboff
Tinnitus and Hyperacusis Center, Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia
,
Margaret M. Jastreboff
Tinnitus and Hyperacusis Center, Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia
› Author Affiliations
› Further Information
  PDF Download  Permissions and Reprints

Abstract

The aim of this paper is to provide information about the neurophysiologic model of tinnitus and Tinnitus Retraining Therapy (TRT). With this overview of the model and therapy, professionals may discern with this basic foundation of knowledge whether they wish to pursue learning and subsequently implement TRT in their practice. This paper provides an overview only and is insufficient for the implementation of TRT.

Abbreviations: DPOAE = distortion product otoacoustic emission, IHC = inner hair cells, LDL = loudness discomfort level, OHC = outer hair cells, THT = Tinnitus Habituation Therapy, TRT = Tinnitus Retraining Therapy

Key Words

Habituation - hyperacusis - neurophysiologic model - tinnitus - Tinnitus Retraining Therapy - treatment


Publication History

Article published online:
07 April 2022

© 2000. American Academy of Audiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • REFERENCES

  • Boettcher FA, Salvi RJ. (1993). Functional changes in the ventral cochlear nucleus following acute acoustic overstimulation. J Acoust Soc Am 94:2123–2134.
  • Borsook D, Becerra L, Fisherman S, Edwards A, Jennings SL, Stojanovic M, Papinicolas L, Ramachandran VS, Gonzales RG, Breiter H. (1998). Acute plasticity in the human somatosensory cortex following amputation. NeuroReport 9:1013–1017.
  • Brooks CM. (1987). Autonomic nervous system, nature and functional role. In: Adelman G, ed. Encyclopedia of Neuroscience. Boston: Birkhauser, 96–98.
  • Chen GD, Jastreboff PJ. (1995). Salicylate-induced abnormal activity in the inferior colliculus of rats. Hear Res 82:158–178.
  • Coles RRA. (1987). Epidemiology of tinnitus. In: Hazell JWP, ed. Tinnitus. Edinburgh: Churchill Livingstone, 46–70.
  • Coles RRA. (1996). Epidemiology, aetiology and classification. In: Vernon JA, Reich G, eds. Proceedings of the Fifth International Tinnitus Seminar, 1995. Portland, OR: American Tinnitus Association, 25–30.
  • Coles RRA, Sood SK. (1988). Hyperacusis and phono-phobia in tinnitus patients. Br J Audiol 22:228.
  • Drukier GS. (1989). The prevalence and characteristics of tinnitus with profound sensori-neural hearing impairment. Am Ann Deaf 134:260–264.
  • Fallon BA, Nields JA, Burrascano JJ, Liegner K, DelBene D, Liebowitz MR. (1992). The neuropsychiatric manifestation of Lyme borreliosis. Psychiatric Q 63:95–117.
  • Feldmann H. (1988). Pathophysiology of tinnitus. In: Kitahara M, ed. Tinnitus: Pathophysiology and Management. Tokyo: Igaku-Shion, 7–35.
  • Gerken GM. (1992). Central auditory temporal processing: alterations produced by factors involving the cochlea. In: Dancer A, Henderson D, Salvi R, Hamernik R, eds. Effect of Noise on the Auditory System. Philadelphia: Mosby, 146–155.
  • Gerken GM. (1993). Alteration of central auditory processing of brief stimuli: a review and a neural model. J Acoust Soc Am 93:2038–2049.
  • Hallam RS, Rachman S, Hinchcliffe R. (1984). Psychological aspects of tinnitus. In: Rachman S, ed. Contribution to Medical Psychology. Vol. 3. Oxford: Pergamon Press, 31–34.
  • Hazell JWP, Sheldrake JB. (1992). Hyperacusis and tinnitus. In: Aran J, Dauman R, eds. Tinnitus 91. Proceedings of the TV International Tinnitus Seminar. Amsterdam: Kugler, 245–248.
  • Heller MF, Bergman M. (1953). Tinnitus in normally hearing persons. Ann Otol 62:73–93.
  • Jakes SC, Hallam RS, Rachman S, Hinchcliffe R. (1986). The effects of reassurance, relaxation training and distraction on chronic tinnitus sufferers. Behav Res Ther 24:497–507.
  • Jastreboff PJ. (1990). Phantom auditory perception (tinnitus): mechanisms of generation and perception. Neurosci Res 8:221–254.
  • Jastreboff PJ. (1995). Tinnitus as a phantom perception: theories and clinical implications. In: Vernon J, Moller AR, eds. Mechanisms of Tinnitus. Boston: Allyn & Bacon, 73–94.
  • Jastreboff PJ. (1998). Tinnitus; the method of. In: Gates GA, ed. Current Therapy in Otolaryngology Head and Neck Surgery. St. Louis: Mosby, 90–95.
  • Jastreboff PJ, Gray WC, Gold SL. (1996a). Neurophysio-logical approach to tinnitus patients. Am J Otol 17:236–240.
  • Jastreboff PJ, Gray WC, Mattox DE. (1998). Tinnitus and hyperacusis. In: Cummings CW, Fredrickson JM, Harker LA, Krause CJ, Richardson MA, Schuller DE, eds. Otolaryngology Head & Neck Surgery. St. Louis: Mosby, 3198–3222.
  • Jastreboff PJ, Hazell JWP. (1993). A neurophysiological approach to tinnitus: clinical implications. Br J Audiol 27:1–11.
  • Jastreboff PJ, Hazell JWP, Graham RL. (1994). Neurophysiological model of tinnitus: dependence of the minimal masking level on treatment outcome. Hear Res 80:216–232.
  • Jastreboff PJ, Jastreboff MM, Kwon O, Shi J, Hu S. (1999). An animal model of noise induced tinnitus. In: Hazell JWP, ed. Proceedings of the Sixth International Tinnitus Seminar, Cambridge, UK. London: 198–202.
  • Jastreboff PJ, Jastreboff MM, Sheldrake JB. (1996b). Utilization of Loudness Discomfort Levels in the treatment of hyperacusis, tinnitus, and hearing loss. Assoc Res Otolaryngol 19.
  • Konorski J. Integrative Activity of the Brain. Chicago: University of Chicago Press, 1967.
  • Kuk FK, Tyler RS, Russell D, Jordan H. (1990). The psychometric properties of a tinnitus handicap questionnaire. Ear Hear 11:434–445.
  • Liberman MC, Kiang NYS. (1978). Acoustic trauma in cats. Acta Otolaryngol Suppl 358:1–63.
  • Liberman MC, Mulroy MJ. (1982). Acute and chronic effects of acoustic trauma: cochlear pathology and auditory nerve pathophysiology. In: Hamernik RP, Henderson D, Salvi R, eds. New Perspectives on Noise-Induced Hearing Loss. New York: Raven Press, 105–136.
  • McFadden D. (1982). Tinnitus: Facts, Theories, and Treatments. Washington, DC: National Academy Press.
  • Moore BCJ. (1995). An Introduction to the Psychology of Hearing. San Diego: Academic Press, 1–350.
  • Muhlnickel W, Elbert T, Taub E, Flor H. (1998). Reorganization of auditory cortex in tinnitus. Proc Natl Acad Sci USA 95:10340–10343.
  • Newman CW, Wharton JA, Jacobson GP. (1995). Retest stability of the tinnitus handicap questionnaire. Ann Otol Rhinol Laryngol 104:718–723.
  • Ramachandran VS, Rogers-Ramachandran D. (1996). Synaesthesia in phantom limbs induced with mirrors. Proc R Soc Lond Β Biol Sci 263:377–386.
  • Ruggero MA, Rich NC, Recio A, Narayan SS, Robles L. (1997). Basilar-membrane responses to tones at the base of the chinchilla cochlea. J Acoust Soc Am 101:2151–2163.
  • Salomon G. (1989). Hearing problems and the elderly. Dan Med Bull 33(Suppl 3): 1–22.
  • Salvi RJ, Wang J, Powers N. (1996). Rapid functional reorganization in the inferior colliculus and cochlear nucleus after acute cochlear damage. In: Salvi RJ, Henderson D, Fiorino F, Colletti V, eds. Auditory System Plasticity and Regeneration. New York: Thieme, 275–296.
  • Sataloff J, Sataloff RT, Lueneburg W. (1987). Tinnitus and vertigo in healthy senior citizens without a history of noise exposure. Am J Otol 8:87—89.
  • Sheldrake JB, Jastreboff PJ, Hazell JWP. (1996). Perspectives for total elimination of tinnitus perception. In: Vernon JA, Reich G, eds. Proceedings of the Fifth International Tinnitus Seminar. Portland, OR: American Tinnitus Association, 531—536.
  • Stouffer JL, Tyler RS. (1990). Characterization of tinnitus by tinnitus patients. J Speech Hear Disord 55:439–453.
  • Stouffer JL, Tyler RS, Kileny PR, Dalzell LE. (1991). Tinnitus as a function of duration and etiology: counselling implications. Am J Otol 12:188–194.
  • Swanson LW. (1987). Limbic system. In: Adelman G, ed. Encyclopedia of Neuroscience. Boston: Birkhauser, 589–591.
  • Tonndorf J. (1987). The analogy between tinnitus and pain: a suggestion for a physiological basis of chronic tinnitus. Hear Res 28:271–275.
  • Vernon JA. (1987). Pathophysiology of tinnitus: a special case—hyperacusis and a proposed treatment. Am J Otol 8:201–202.
  • Vernon J, Press L. (1998). Treatment for hyperacusis. In: Vernon JA, ed. Tinnitus Treatment and Relief. Boston: Allyn and Bacon, 223–227.