Effect of Counseling, Amplification and Fractal Tones in Tinnitus Management

Introduction: Educational counseling, sound stimulation and stress reduction have been shown to be effective in reducing tinnitus distress. Hearing aids that include a sound generator capable of producing relaxing fractal tones and amplification seem to be an ideal solution for managing tinnitus patients. This study aimed to investigate the effectiveness of counseling, amplification and fractal tones applied sequentially. Method: 35 subjects with hearing loss and Tinnitus Handicap Inventory (THI) scores >18 participated in the study. Their mean age was 57 (±8) years. The tinnitus management had three phases: educational counseling, amplification and sound stimulation by use of fractal tones. Each phase lasted two months on average. The intervention period was six months. Most subjects initially reported tinnitus to have a moderate to severe negative impact on their quality of life. Subjects were instructed to use the hearing aids several hours per day and listen to the fractal tones for a minimum of two hours per day. THI questionnaires were applied at baseline, after each phase of the protocol (i.e., counseling, amplification and sound stimulation) and 12 months post-treatment. Additional questionnaires regarding hearing aid and sound stimulation experiences were also collected. Results: The majority of subjects showed a clinically and statistically significant reduction in perceived tinnitus-related distress after six months and 12 months post-treatment(p<0.001). Improvements were seen after counseling (p<0.001), and after hearing aids and sound stimulation (p<0.003). The vast majority of subjects were very satisfied with the hearing aids and evaluated the sound stimulation as being either satisfactory or very satisfactory. The average use of the hearing aids was 9 hours a day. Conclusion: Overall the findings show that a combined approach with counseling and hearing aids that include a sound generator capable of producing fractal tones is a successful tool in tinnitus management.