Current Status and Problems Associated with Tinnitus Treatment at Municipal Hospitals

Based on a series of studies including brain function tests, we reinforced and improved treatment for tinnitus by developing a tinnitus retraining therapy (TRT) that incorporates the “tinnitus pain model”; our laboratory subsequently introduced this therapy in 2013. This model provides a clinical explanation that tinnitus manifests and worsens through nerve synchronization of the auditory path and the non-auditory path with the pain network. Therefore, the target of tinnitus therapy based on this model is the auditory path generating the tinnitus and the pain network that worsens the tinnitus. The therapy mainly uses “acoustic therapy” and “directive counseling”, which are the same as the original TRT. What characterizes this method is the central use of a hearing aid in the “acoustic therapy” targeting tinnitus patients with hearing loss. TRT incorporating the “tinnitus pain model” would be ideal for the establishment of an outpatient department dedicated to hearing loss and tinnitus. In actual practices, however, many hospitals avoid offering “directive counseling”, as it is often difficult to provide sufficient counseling in a general outpatient setting.