Outcome of audiometric masking therapy on subjective tinnitus patients in different age groups

Prabina Rashmi Mohanty, Basavaraj N. Walikar, Satish M. Rashinkar, Ashfak R. Kakeri, Milind V. Watwe, Wasifa S. Biradar


Background: Theoretical consideration suggests an impact of the age at tinnitus onset influencing tinnitus distress. The use of masking for tinnitus is a primary method of treatment of tinnitus. The objective was to study effectiveness of masking by introducing audiometric reference signal in treatment of subjective tinnitus.

Methods: The 90 patients (45 males and 45 females) were assessed by pure tone audiometer. Patients were divided into 6 age group sets for evaluation. The reference signal (90 to 100 dB SPL for 2-3 minutes in tinnitus ear of frequency 1000 Hz) was used for masking therapy. Outcome of the study was measured by using the tinnitus handicap inventory (THI) score and awareness time (tinnitus perception) before and after audiometric reference signal masking therapy. Success rate was measured to measure therapeutic efficacy.  

Results: Our results depict improvement in subjective tinnitus by 57.78% (in males), 55.56% (in females) and overall 56.67% success in patients aged between 21 to 60 years by using our audiometric reference signal masking therapy. Regarding gender, the finding of THI score, Awareness time and Success rate in our study showed females being affected more than males. Our study also evidenced a highest percentage of tinnitus after the age of 70 followed by the decades 61–70 and 51–60.

Conclusions: Our new economically viable approach to subjective tinnitus patients by audiometric reference signal seems to be an effective in improv­ing the patient’s distress in age group 21 to 60 years. Before taking decision for selection of high cost hearing aids, we can use it for poor people.


Subjective tinnitus, Audiometer, Masking therapy

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Crummer RW, Hassan GA. Diagnostic approach to tinnitus. Am Fam Physician. 2004;69:120-6.

Henry JA. Measurement of Tinnitus. Otol Neurotol. 2016;37:276-85.

Langers DR, de Kleine E. Tinnitus neurophysiology according to structural and functional magnetic resonance imaging. Scientific foundations of audiology: Perspectives from physics, biology, modeling, and medicine. San Diego, CA, USA: Plural Publishing Inc; 2016: 351.

Saha AK. Otology and Middle Ear Surgery. 1st ed. New Delhi, India: JP Medical Ltd; 2016: 252-258.

Tunkel DE, Bauer CA, Sun GH, Rosenfeld RM, Chandrasekhar SS, Cunningham ER, et al. Clinical practice guideline tinnitus. Otolaryngol Head Neck Surg. 2014;151(2):1-40.

Langguth B, Kreuzer PM, Kleinjung T, De Ridder D. Tinnitus: causes and clinical management. Lancet Neurol. 2013;12(9):920-30.

Sereda M, Hoare DJ. Self-Help Interventions for tinnitus. Tinnitus: Clinical and research perspectives. San Diego, CA, USA: Plural Publishing Inc; 2015: 227.

McCombe A, Baguley D, Coles R, McKenna L, McKinney C, Windle‐Taylor P. Guidelines for the grading of tinnitus severity: the results of a working group commissioned by the British Association of Otolaryngologists, Head and Neck Surgeons, 1999. Clin Otolaryngol Allied Sci. 2001;26(5):388-93.

Kim BJ, Chung SW, Jung JY, Suh MW. Effect of different sounds on the treatment outcome of tinnitus retraining therapy. Clin Exp Otorhinolaryngol. 2014;7(2):87-93.

Shrestha BL, Amatya RM, Shrestha I, Pokharel M. Analysis of etiological factors of tinnitus in patients attending Kathmandu University Hospital. Indian J Otol. 2012;18:196-9.

Cooper JC Jr. Health and nutrition examination survey of 1971-75: Part II. Tinnitus, subjective hearing loss and well-being. J Am Acad Audiol. 1994;5:37-43.

Pinto PC, Sanchez TG, Tomita S. The impact of gender, age and hearing loss on tinnitus severity. Braz J Otorhinolaryngol. 2010;76:18-24.

Palmer KT, Griffin MJ, Syddall HE, Davis A, Pannett B, Coggon D. Occupational exposure to noise and the attributable burden of hearing difficulties in Great Britain. Occup Environ Med. 2002;59(9):634-9.

Fabijanska A, Rogowski M, Bartnik G, Skarzynski H. Epidemiology of tinnitus and hyperacusis in Poland. In: Hazell J, editor. In: Proceedings of the 6h International Tinnitus Seminar; 1999; London, UK. The Tinnitus and Hyperacusis Centre; 1999: 569-571.

Schlee W, Kleinjung T, Hiller W, Goebel G, Kolassa IT, Langguth B. Does tinnitus distress depend on age of onset? PLoS ONE. 2011;6(11):e27379.

Andersson G, McKenna. The role of cognition in tinnitus. Acta Otolaryngol. 2006;556:39-43.