THURSDAY, May 24 (HealthDay News) -- One in five people suffers
from tinnitus, the annoying and sometimes severely debilitating
condition often referred to as "ringing in the ears," and new
research may offer some hope for relief for these patients.
Although the condition currently has no cure, researchers in the
Netherlands found that combining two existing therapies may help
more than either single therapy alone.
Their report is published in the May 26 issue of
The Lancet.
The strategies used in the study aren't new, noted Dr. Eric
Smouha, an associate professor of otolaryngology and director of
otology and neurotology at Mount Sinai School of Medicine in New
York City, who was not involved with the study. However, the
finding "shows hope for these people," he said.
Tinnitus can be incredibly frustrating for doctors and patients
alike, added another expert, Dr. Michael Seidman, director of
otologic/neurotologic surgery at the Henry Ford Health System in
Detroit, because there is no cure for the condition and even good
treatments are elusive.
Smouha also pointed out that doctors look for an underlying
cause but usually can't find one.
Finding a remedy -- if there is one -- is very much a
trial-and-error adventure, Seidman said. Dietary modifications
(such as cutting out caffeine or alcohol, herbs including Ginkgo
biloba), therapy, and even some drugs (such as anti-anxiety
medications to facilitate sleep) may help some patients.
Right now, clinicians often rely on one of two main treatments
for tinnitus. One, called "tinnitus retraining therapy," involves
exposing the patient to another, more neutral sound to mask the
tinnitus, along with counseling.
The second is "cognitive behavioral therapy," which includes
correcting distorted thought patterns, relaxation techniques and
mindfulness instruction.
To date, though, no one has investigated how the two work
together, said study authors Rilana Cima and colleagues, from
Maastricht University in the Netherlands.
For this study, about 500 adults with tinnitus were assigned to
the combination therapy group, or to "usual" care, which itself was
very intensive, involving more than two hours of initial testing
followed by multiple visits with a social worker.
Those assigned to the combination therapy, referred to as
"specialized care," showed more improvement in health-related
quality of life over the course of a year, a reduction in the
severity of the tinnitus, as well as less impairment from the
condition, the investigators found.
Specialized care included the same initial testing period as
usual care, followed by assessment by a clinical psychologist and
group sessions with movement therapists, physical therapists,
speech therapists and social workers.
In the end, it was the uber-intensive specialized care that
benefited people with both mild and severe tinnitus the most, the
study found.
This specialized combination care really was not a dramatic
departure from the tinnitus retraining therapy and cognitive
behavioral therapy used individually in the United States, Seidman
said.
And it's unclear if this intensive combination approach, which
relies on the expertise of many different specialists, could be
implemented in the United States with its different population and
vastly different health care system, Smouha said.
"What they did is very intensive, consisting of hours and hours
of counseling and coming back for sessions," Smouha pointed out.
And the combination therapy used in the study really "doesn't
differ much from what we refer to as tinnitus retraining therapy,"
he added.
In the United States, retraining therapy can cost $3,000 to
$5,000 and require a commitment of two years, Seidman noted.
More information
The U.S. National Institute on Deafness and Other Communication
Disorders has more on
tinnitus.