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Hope for ear problem treatment

Friday May 25th, 2012

A combination of cognitive behaviour therapy and sound-based retraining therapy is a significantly more effective treatment for the hearing condition tinnitus than existing therapies, a new study has found.

Research published in this week’s Lancet show that a specialised care programme was beneficial to those with mild and severe tinnitus, which causes a constant ringing in the ears.

Rilana Cima and Johan Vlaeyen from Maastricht University in the Netherlands, who led the research, described their findings as “highly relevant for clinical practice because best practice for tinnitus has not been defined, and current treatment strategies are fragmented and costly”.

Tinnitus affects up to 21 per cent of adults at some point in their lifetime, but there is very little evidence about which treatments work most effectively and few studies have been carried out to compare them.

The Dutch study examined 492 adults with tinnitus. Of these, 245 were randomly assigned to stepped specialised care, which allows for health care based on individual needs, and 247 were offered the usual care stratified by tinnitus severity and hearing ability in blocks of four. Validated questionnaires were used to measure health-related quality of life, tinnitus severity, and tinnitus impairment.

After 12 months, patients in the specialised care group reported improved quality of life, as well as decreased tinnitus severity and impairment, compared with those receiving standard treatment.

“We showed the effectiveness of specialised care compared with usual care not only after the first three months of first-step treatment, but also after the more intensive second-step treatment approach ended and four months of no treatment,” write the authors.

“Our findings could lead to consensus in policy about best practice in treatment of tinnitus, standard choices in referral trajectories, and the implementation of standardised tinnitus assessment and thereby more easily comparable outcomes.”

In a linked Comment, Berthold Langguth from the University of Regensburg in Germany says: “The results of this trial are especially convincing and relevant for clinical practice… Although the stepped care approach involved only a short intervention for most patients, specialised care was significantly better than usual care for the whole sample.”

Specialised treatment based on cognitive behaviour therapy versus usual care for tinnitus: a randomised controlled trial. Cima R et al. Lancet. May 26 2012. Lancet 2012; 379: 1951–59

Tags: Europe | General Health | Hearing

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