A Prospective Study Of Tailor-Made Notched Music Therapy On Chronic Idiopathic Tinnitus

Tinnitus is a sense of sound perception in one's ears or head without external sound source exists.It is divided into objective tinnitus and subjective tinnitus.Most of the subjective tinnitus is unexplained,it is also known as Idiopathic Tinnitus.It can be an isolated idiopathic symptom,but also may be accompanied by varying degrees of sensorineural hearing loss.After many years for the study and exploration,the medical intervention of the disease still faced many challenges.first,the pathogen is unknown;second,the evaluation means are limited;third,although the method is multiple,the effect is uncertain.The clinical feature of chronic idiopathic tinnitus is that its loudness,persistence,annoyance is difficult to self-mitigation.Due to the subjective characteristics of tinnitus symptoms,clinical diagnosis is mainly based on the patient's description of the condition.The perception of tinnitus is often different from patient's personal experience,psychological quality,occupation and social and family environment.Therefore,the lack of objective evidence is one of the main obstacles to tinnitus research.In recent years,based on the tinnitus mechanism of maladaptive auditory cortex reorganization,In 2010,Pantev first proposed the application of specially tailor-made notched music(TMNM)to individualize the treatment of tinnitus and carried out the relevant clinical trials So far,this kind of research is few,and mostly single center and small sample.Its clinical effect and application value evaluation is inconclusive and the relevant evidence-based medical evidence has yet to be expanded and enriched.In this paper,compared with the existing tinnitus treatment methods,we apply a randomized control and prospective design for the preliminary analysis of custom music for chronic idiopathic tinnitus in the near future effect and to explore its possible mechanism.Objective Compared with the existing tinnitus treatment methods,we apply tailor-made notched music to intervene in chronic idiopathic tinnitus and study the preliminary analysis and the possible mechanism of tailor-made notched music.Methods Subjects were recruited during June 2015-October 2016 from out-patients of our hospital otorhinolaryngology.These patients had chronic(longer than 6 months)and idiopathic tinnitus,with or not significant sensorineural hearing loss.In the prospective design,the patients with rigorous selection and exclusion criteria into the test were randomly divided into group A(treated with tailor-made notched music,N=20)and group B(treated with analogous sound masking,N=20)and group C(treated with analogous retraining therapy,N=20)to receive the treatment for 3 months.The tinnitus scale,tinnitus questionnaire and audiological findings were evaluated before treatment started and each of months after treatment started.Results After 1 month of regular treatment,the difference between groups is not obvious(38.9% vs 41.2% vs 41.2%)(x2=0.026,P= 0.987>0.05).After 2 months of regular treatment,The effective rate of group A(44.4%)was higher than that of group B(29.4%),but there was low than that of group group C(52.9%).The difference between groups is not obvious(x2= 1.979,P= 0.372 > 0.05).After 3 months of regular treatment,the effective rate of group A was better than that of other two groups(77.8% vs 23.8% vs 52.9%,x2= 10.317,P= 0.006 <0.05).With the passage of time,the effective rate of group A showed an increasing trend(?2=6.406,P=0.041),the effective rate of group B decreased in no evidence(?2=1.275,P=0.529),and the effective rate of group C showed an increasing trend in the short term but unchanged after two months remain(?2=0.628,P=0.713).the survival rate of group A increased with the treatment time.The results showed that A group showed obvious advantages on tinnitus handicap inventory(THI)(F=5.603,P=0.002),loudness visual analog scale(VAS)(F=13.780,P< 0.001)and tinnitus loudness(F=3.738,P= 0.027< 0.05).Conclusion Our results suggest that tailor-made notched music can be used for the treatment of chronic idiopathic tinnitus and long-term normalized listening to tailor-made notched music can significantly reduce the perceived tinnitus loudness in varying degrees and improve the quality of life of patients.The effects and possible mechanism of this method were discussed in this paper.