Are there any treatments that have been proven to cure tinnitus? If not, what treatments has research suggested to be the most helpful for tinnitus patients? And are there any new or exciting developments on the treatment front?
Tinnitus Retraining Therapy protocols
Over the past couple decades, tinnitus retraining therapy has become one of the most comprehensive protocols for managing tinnitus. Created in the late 1990s by Dr. Pawel Jastreboff, tinnitus retraining therapy is now taught every year to a handful of audiologists and is considered the ultimate neuroplasticity program for tinnitus. It has continued to be improved and tweaked over time using modern technology and research.
Neuroplasticity refers to changing the brain. Changing the relationship between tinnitus, our brain, and our ears and hearing system takes time. The major downside of tinnitus retraining therapy as a treatment is that it takes a lot of time. Patients will often undergo therapy for six months since it takes that long before we can consider bringing back some of the protocols, whether that’s sound therapy, ear devices, or certain counseling or education techniques. A six-month period of committing to that protocol is recommended and, if followed, is rather effective.
The goal of tinnitus retraining therapy is typically described as habituation. What does habituation mean for tinnitus? Simply put, it means that we are rarely aware of tinnitus. It may become only a background perception and sometimes the volume itself gets softer. The patient might still hear tinnitus but may not categorize it as bothersome. Many people with tinnitus hear it if they stop and listen for it; even if it’s loud and they’re living their life, they might still hear it but not be bothered by it.
Thus, tinnitus retraining therapy involves counseling and education, followed by a dedicated sound therapy plan typically between a period of nine to 12 months. While there’s no proven cure for tinnitus in terms of eradication of the symptoms, tinnitus retraining therapy remains a very effective treatment.
Cognitive Behavioral Therapy and Mindfulness
Cognitive-behavioral therapy and mindfulness are other helpful supplemental approaches to sound therapy, proper education, and proper counseling in treating tinnitus.
Regeneration of cells in the cochlea
An exciting development in the tinnitus treatment space involves regeneration of certain cells in the cochlea, the main hearing organ in the ear. There’s two specific bio-pharmaceutical projects that are worth knowing about so that you’re properly equipped in your tinnitus treatment journey.
First, there’s a company called Frequency Therapeutics that has developed a drug called FX-322 to target regeneration of cochlear cells. While initially showing promising results in restoring hearing loss and combating tinnitus, recent clinical trials of the drug have shown diminishing returns. Therefore, it appears that this project is unlikely to help people with tinnitus in the immediate future.
Next, there’s a company called Otonomy that has developed a drug called OTO-313. Unlike FX-322, OTO-313 does not aim to regenerate cells in the cochlea. Instead, it uses a more complicated approach in order to help with the brain’s reaction to tinnitus in the cortex. Similar to FX-322, clinical results haven’t shown much promise.
Research developments aimed at alleviating tinnitus are welcome and encouraged. And we’re thankful for the researchers who are trying to fix a very hard problem. That said, while these drugs have been cited as some of the most promising in the last few years, neither has seemed to accomplish any breakthroughs at this point. And, frankly, neither seem to be worth the wait based on their recent track record.
Another new treatment for tinnitus is bimodal stimulation. Typically, sound therapy is played through the ears, and would be considered one mode of auditory stimulation. It can come in multiple forms, such as listening to music through an app or speaker or simply listening to your surroundings.
So pairing a second mode of stimulation somewhere else in the nervous system—like in the skin, tongue, or neck—would make this kind of treatment a type of bimodal stimulation, as it involves two modes. There’s neuroscience that suggests that pairing two modes together with certain protocols or strategies can change the brain’s tinnitus in a positive way.
There’s a group called Neuromod based in Ireland that has developed the Lenire device, which pairs stimulation on the tongue with stimulation in the ears. They’re showing positive results, and while it’s not a complete breakthrough and is certainly not going to completely eliminate tinnitus, it does seem promising. It is available in Europe, but is not available in the U.S. yet. There’s another company called Neosensory, which was started by a Stanford neuroscientist. They created a device called Neosensory Duo, which is a wristband that transmits vibrations through the wrist into what is called our somatosensory system. It pairs this neural input at the same time that you’re hearing certain sounds. Thus, you’re getting two inputs—sound and vibration—traveling through the somatosensory system.
Research suggests that when the brain gets these kinds of inputs, it can make changes to recognize that the phantom sound of tinnitus is not actually there. This enables the phantom sound of tinnitus to be recategorized and restructured in certain ways.
There’s many different angles to managing tinnitus, and I see bimodal stimulation as a potential supplemental therapy. That said, I don’t recommend it to my patients as the only method of treatment. There’s more traditional protocols like tinnitus retraining therapy that are often more fruitful, so I recommend not fixating on the idea that some device will completely fix your tinnitus. Still, it may help, and I hope it does for anyone who uses it.
To learn what may help you manage your tinnitus, please download our free 10-page e-book, The Ultimate Guide to Tinnitus Relief. Dr. Thompson offers Tinnitus Retraining Therapy via telehealth. Please contact our team at Pure Tinnitus to learn more.