(917) 305-7751 tinnitus@lhh.org
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Frequently Asked Questions
HOW DOES THE LEAGUE TREAT TINNITUS?
Our treatment is called “Tinnitus Retraining Therapy” or TRT, created by Dr. Pawel Jastreboff, formally from the University of Maryland. It is also known as habituation-oriented therapy and is based on neurophysiological principles. It involves an extensive audiological, tinnitus, and hyperacusis evaluation along with several directive counseling sessions. Throughout the program sound is used from environmental sources or ear level devices. It does not involve surgery or drugs.
WHAT DOES RETRAINING THERAPY MEAN?
We try to retrain the subconscious (subcortical) parts of the brain to ignore the sound of tinnitus and to achieve the stage in which the client is no longer annoyed by the tinnitus. The achievement of this primary goal paves the way for the secondary goal in that once the tinnitus signal is no longer annoying, the period of time that tinnitus is perceived becomes less.
IS THE COUNSELING A FORM OF PSYCHOTHERAPY, COGNITIVE THERAPY OR BIOFEEDBACK?
No, directive counseling provides the client with extensive information regarding the structures and function of the auditory pathways and how this information pertains to tinnitus/hyperacusis. A great deal of time is spent explaining the habituation model and how retraining therapy works in reducing tinnitus annoyance and perception and eliminating hyperacusis. The counseling sessions are a fundamental part of the treatment process.
WHAT IS THE ROLE OF ENVIRONMENTAL SOUND?
Environmental sound from radios, TV’s, air purifiers, fans, air conditioners, or table top sound machines is used at low levels, not for the purpose of covering (masking) tinnitus but to help bring about changes in the lower levels of the brain and auditory system. It reduces the contrast between the tinnitus sound and complete silence and makes it harder for the brain to “keep track” of the sound of the tinnitus.
WHAT ARE THE DEVICES AND WHAT DO THEY LOOK LIKE?
The devices used in retraining therapy are called “sound generators”. They look similar to in the ear hearing aids. They are small instruments and are usually fit to both ears. They should not interfere with normal conversation, situations requiring concentration or talking on the telephone.
DO I NEED THE DEVICES?
Not everyone needs the devices. After the initial evaluation and the category of tinnitus or hyperacusis has been determined, each client will be given recommendations regarding individual treatment.
CAN I JUST BUY THE DEVICES?
The devices are used to speed up the process of habituation. Directive counseling is fundamental to the retraining process and therefore its success. If ear level devices are purchased alone it is unlikely the client will achieve improvement and without proper instruction tinnitus and hyperacusis may become worse.
I WAS USING TINNITUS MASKERS WITHOUT EFFECT. WHAT IS THE DIFFERENCE BETWEEN TINNITUS MASKERS AND NOISE GENERATORS?
Although in some cases masking can provide tinnitus relief, the goal of this approach is to cover tinnitus, making it inaudible. When the device is removed tinnitus often returns, sometimes requiring higher levels of masking noise which can be uncomfortably loud and potentially unsafe. In our program the devices are used to generate low level sound that does not cover the sound of tinnitus. In order for the brain to habituate to the sound of tinnitus, the tinnitus must be heard and not masked. Generating sound that mixes with the tinnitus will assist in removing the emotional response to tinnitus and then the perception of tinnitus itself .
I AM USING HEARING AIDS. HOW CAN I USE OTHER DEVICES?
Depending on the type of hearing aids that are being used it may be possible to work with your current amplification and that you will not need any other devices.
WHAT KIND OF AUDIOLOGICAL TESTS ARE PERFORMED? WILL IT HURT MY EARS? WHAT IF I DON’T HAVE TINNITUS WHEN I AM TESTED?
The tests include an audiogram and several specific tests which will help us assess the category of your tinnitus and/or hyperacusis. The testing begins at a low level, gradually increasing in loudness, therefore none of the tests will be painful. Great care is taken to not exceed individual tolerance levels. If tinnitus is not present on the day of testing it will NOT influence the success of the treatment.
HOW LONG DOES THE TREATMENT TAKE?
TRT can take up to 12-24 months. TRT is not a quick fix. However it may be possible to experience changes within six months.
WILL I BE CURED?
Tinnitus retraining therapyis a treatment, not a medical cure. You will no longer be bothered or annoyed by your tinnitus. However, if you concentrate in a quiet room it is possible that you will hear it. In addition, hyperacusis can just disappear.
WHAT IS THE GUARANTEE THAT I WILL GET BETTER?
There is no guarantee, however, an 80% success rate has been found at our Center and reported by various other facilities including the University of Maryland and Emory University’s Tinnitus and Hyperacusis Centers. This is a higher success rate compared to other treatments available.
HOW LONG IS THE AUDIOLOGICAL/TINNITUS EVALUATION?
This visit consists of a 2 hour audiological/tinnitus evaluation followed by a 1 hour counseling session. If sound generators are recommended, impressions are taken for devices and a 1 hour fitting session scheduled in approximately 2 weeks.
HOW FREQUENTLY DO I NEED TO RETURN TO THE CENTER?
There are several follow up visits and periodic telephone contact. Clients return in 3 weeks, at 2, 3 and 6 months and in 6 month intervals up to 2 years.
IS THIS TREATMENT COVERED BY INSURANCE?
In general no. Some insurers may cover part of the evaluation and sometimes the devices. Medicare does not cover it. You may call or write your insurance company and check with them as to your coverage and possible reimbursement.
