One of the most well known methods in treating Tinnitus is called the Tinnitus Retraining Therapy or TRT. It was first developed by a neurophysiologist named Pawel Jastrelboff and an otolaryngolotogist names JWP Hazell in the late 1980’s. It is a form of habituation therapy especially designed to help people who suffer from the Tinnitus condition.
So in this article, you are going to discover how TRT works and the two methods being used including Neurophysiologic Model and Rationale for TRT. At the end of this article, you will also discover how are the Tinnitus patients are being categorized and that time, you will be able to know more that TRT.
Let’s start with the Neurophysiologic model. This model suggests that the treatment of Tinnitus should focus mainly on the limbic and autonomic nervous systems. The attention should be given then to the Tinnitus sensation itself.
In the scientific term, neural signals are very important because they are they indicator to the brain when it comes to interpreting the meaning. Different types of sounds may bring in different meanings to many people. For example, if you and your friend heard a loud noise coming from the behind, you may perceive it was an action of thief and your friend may perceive something just fell off from the backyard.
When it comes to TRT, it has got a lot to deal with the emotional reaction and some sound do come and attach with emotional reaction. If a person’s Tinnitus is attached with an emotional response, any similar response in the future is likely to be activated when he hears a certain type of sound associated with whatever meaning it gives.
Now, the brain also plays a very big part in TRT because it must determine which of the environmental sounds will receive the person’s attention. The neural signals that come with pertinent auditory data are transmitted to the auditory cortex. However, the signals that are of lesser importance will be terminated before it reaches the consciousness of the patient. This process will take longer because it can only be done with habituation.
This is why, the neurophysiologic model proposes that it is not the ringing noise itself that brings problem to a person’s life but it has got so much to do with the auditory signal that has been conditioned to cause activation of the limbic or autonomic nervous system. The signal must go through a certain procedures in order for it to be processed differently as an unimportant signal. Therefore, TRT is meant to retrain the brain to habituate to the tinnitus signal that is or will be given to the patient himself.
The next model being discussed here is the rationale for TRT. The goal for this method aims to encourage patients to do habituation so that their Tinnitus condition may be treated. There are actually 2 strategies when it comes to rationale for TRT.
The first strategy can be implemented with the help of directive counseling which consists of a structured education program that teaches the patient to eliminate or at least a decrease in the annoying ringing noise in the ears. These teaching materials are meant to take away the fear or any negative perception attached with the patient’s mind.
The second strategy is an complementary treatment to the first strategy and this will only be implemented only when the first strategy is successful. The goal here aims to remove Tinnitus from the person’s conscious perception and the only way to do this is through the use of audio therapy. During the audio therapy, a constant low levels of background sound will be used to reduce the detectability of Tinnitus at the subconscious level. When this is achieved, the patient will be free from Tinnitus for a year or two.
Both strategies are equally effective when it comes to TRT. However, it should be taken into consideration that not every Tinnitus patient shall be encouraged to use TRT. In the rest of the article, you will find out the different types of categories of Tinnitus patients and only patients with more severe condition needs to be treated accordingly.
The first patient category is the number 0 category. This group of Tinnitus patients whose condition have really minimal problem and weak.They do not have significant hearing loss or hyperacusis and the condition has only been discovered less than 2 months. So in order to treat this group of patients, basic directive counseling and sound therapy without the need for wearable sound generators or hearing aids will be needed. There is no need for a lot of follow ups.
The second group of patient belong to category 1. To these patients, Tinnitus has been a significant problem but so far, they have not experienced significant hearing loss just yet. Directive counseling and audio therapy which includes tabletop sound machine and a wearable sound generator which is set at ‘mixing’ or blending point will be needed to do the TRT treatment.
The third group is the category 2 group. People from this group suffers a significant subjective hearing loss and Tinnitus problem, without hyperacurasis nor prolonged worsening of symptoms after sound exposure. Like category 0 and 1, directive counseling will be needed plus a combination instruments of hearing aids and sound generator.
The fourth group belong to the category 3 and these people are experiencing serious hyperacusis. Up to this point, Tinnitus and hearing difficulties have already become irrelevant to them. They even have the prolonged worsening of Tinnitus or hyperacusis. The way to treat them is very similar to the categories above, which is also using directive counseling, wearable sound generator or a combination instruments.
The final category is the category 4, which hyperacusis has become a dominant complain to them. Their condition shows worsening of Tinnitus or hyperacusis following the exposure to sound. People in this category are the most difficult ones to be treated because research shows that their responses are usually slow to the responses suggested for all the categories.
Now that you already know what Tinnitus Retraining Therapy is all about. It is time for you to consider whether you belong to any of the categories mentioned above and if TRT is one of the methods you would consider to undertake.
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