Analysis of the effects and predictors of tailor-made notched music therapy for chronic idiopathic tinnitus patients: Our experience with 70 patients

Efficacy of tailor-made notched music training (TMNMT) in the treatment of tinnitus: a systematic review and meta-analysis

INTRODUCTION

Numerous treatment modalities have been suggested for managing tinnitus. Tailor-Made Notched Music Training (TMNMT) is a viable strategy in music therapy for tinnitus management. Many research studies have examined the effectiveness and potential benefits of this intervention. This study aims to assess the effectiveness of TMNMT in treating chronic tinnitus.

METHODS

This systematic review and meta-analysis study used a research methodology that covered up until February 2023. The search was conducted across academic databases including Google Scholar, PubMed, Scopus, and Web of Science. A total of 234 papers were evaluated, and seven relevant clinical trials were included.

RESULTS

The meta-analysis, which included five studies using the tinnitus handicap inventory (THI), showed no statistically significant effect of TMNMT on tinnitus handicap after 3 and 6 months of intervention (dppc2: - 0.99, 95%CI - 2.94 to 0.96; I2 = 79.96%, p = 0.00), (dppc2 - 1.81, 95%CI - 5.63 to 2.01; I2 = 79.96%, p = 0.00). However, four out of five studies using the total Visual Analogue Scale (VAS) or its subscale showed positive effects of TMNMT on chronic tinnitus. Unfortunately, there were not enough articles to conduct a meta-analysis on this outcome.

CONCLUSION

Although the meta-analysis did not show a statistically significant effect of TMNMT on tinnitus handicap, the large effect size observed after at least 3 months of intervention suggests that this method may potentially decrease tinnitus handicap if more studies are conducted. Due to the limited number of studies, subgroup analysis could not be performed to analyze potential causes of heterogeneity. Therefore, further high-quality clinical trials are necessary to draw a definitive conclusion and evaluate the impact of different variables, techniques, and outcomes.

Efficacy of tailor-made notched music training for primary tinnitus: A systematic review and meta-analysis

OBJECTIVE

We systematically reviewed and meta-analyzed the efficacy of Tailor-Made Notched Music Training (TMNMT) for primary subjective tinnitus in adults. The main goal was to evaluate TMNMT's impact on tinnitus symptoms.

METHODS

Following PRISMA guidelines, we included randomized and non-randomized trials. Studies considered involved adults with primary subjective tinnitus treated with TMNMT alone or combined with other therapies. Bias risk was assessed using the Cochrane RoB 2 and ROBINS-I tools. Comprehensive database searches were conducted, and relevant data were extracted and analyzed.

RESULTS

Three studies (total: 99 TMNMT patients, 109 sound therapy) were meta-analyzed. Using THI scores, the Forest plot showed no significant difference in tinnitus distress between TMNMT and listening to music groups (p > 0.05), with low study heterogeneity (I2 = 0 %).

CONCLUSION

While TMNMT offers a non-invasive approach with a potential to reduce tinnitus distress, it did not significantly outperform the only listening to music. More research is needed to optimize TMNMT for tinnitus management and to better document its safety profile.

The effect of music therapy on tinnitus: A systematic review

OBJECTIVES

Tinnitus is a common otological symptom affecting almost all aspects of life, especially the quality of daily life. The present study aims to analyze music therapy effect on tinnitus patients. This paper mainly analyzes 3 kinds of music therapy: Heidelberg model of music therapy (HMOMT), standard music therapy (SMT), and tailor-made notched music training (TMNMT). To provide a reference for the follow-up treatment of tinnitus, whether to take and what kind of music therapy.

METHOD

A systematic literature search was performed in PubMed, Cochrane Library, EMBASE, Web of Science, and MEDLINE to obtain potential studies from their inception to May 2023 in all languages. Two researchers independently screened the studies, extracted data, and assessed the quality of the included studies. We included all randomized and non-randomized controlled trials that used music therapy to treat patients with tinnitus. We used fixed-effects and random-effect models to analyze data based on the heterogeneity results. The data analysis was performed by using Stata 12.0.

RESULTS

A total of 19 studies with 904 cases were included. Compared with before treatment, music therapy significantly reduces the tinnitus questionnaire score and tinnitus handicap inventory score. HMOMT, SMT, and TMNMT all significantly decrease tinnitus scores. Although the order of effectiveness of the 3 drugs is TMNMT > SMT > HMOMT, there is no statistical significance (P > .5).

CONCLUSION

This meta-analysis of accumulated clinical trial data suggests that music therapy can relieve tinnitus symptoms and loudness. Among music therapies, SMT is recommended first for tinnitus based on cost, efficacy, and convenience. At the same time, TMNMT and HMOMT can be used as alternative therapies for specific cases.

Efficacy of Tailor-Made Notched Music Training Versus Tinnitus Retraining Therapy in Adults With Chronic Subjective Tinnitus: A Randomized Controlled Clinical Trial

OBJECTIVES

Chronic subjective tinnitus can have a serious effect on daily life, even causing serious psychological disorders. Currently there are no specific effective solutions or cures. Tailor-made notched music training (TMNMT) is a recently proposed sound therapy that has simpler processes and a higher compliance rate than tinnitus retraining therapy (TRT), a widely used treatment for chronic subjective tinnitus. This study explores the therapeutic effect of TMNMT in comparison to TRT to highlight its clinical value.

DESIGN

The study was a randomized controlled, single-blinded clinical trial. One hundred twenty eligible participants were randomly assigned to receive TMNMT (n = 60) or TRT (n = 60) for 3 mo with concurrent follow-up. It should be noted that the duration of sound treatment in TRT was modified to 2 hr per day for better feasibility in practice. The primary outcome was mean change in tinnitus handicap inventory (THI) measured at baseline ( T0 ), 1 mo ( T1 ) and 3 mo ( T2 ) after intervention. Change in visual analog scale (VAS) was measured as a secondary outcome. A comparison of therapeutic effectiveness between TMNMT and TRT was evaluated by repeated measure analysis of variance.

RESULTS

One hundred and twelve (93%) of participants took part in the study, of which 64 were men and 48 women. Mean (SD) age was 42.80 (12.91) years. Fifty-eight were allocated to receive TMNMT and 54 to receive TRT. The between-group difference in primary outcome was -6.90 points (95% confidence interval [CI], -13.53 to -0.27) at T1 and -6.17 points (95% CI, -13.04 to 0.71) at T2 . These results closely reached to clinical significance of tinnitus-related effective relief. For the secondary outcome, the mean value in the TMNMT group was 0.83 points (95% CI, 0.12 to 1.54), significantly lower than the mean value of the TRT group. The differences in THI and VAS between the two groups were statistically significant after intervention. Further analysis showed that age and baseline THI and VAS scores were associated with change in THI and VAS scores after interventions.

CONCLUSIONS

Both TMNMT and TRT were able to alleviate chronic subjective tinnitus effectively after a 3 month intervention. When the two forms of therapy were compared TMNMT appeared to be more effective and consequently potentially superior to TRT for reducing tinnitus loudness and functional and emotional disturbance associated with chronic subjective tinnitus.

Intervention of the Syndrome-Position Point Selection Method on Idiopathic Tinnitus of Phlegm-Fire Stagnation Pattern: A Randomized Controlled Study

Objective

To investigate the clinical effect of the syndrome-position point selection method on the intervention of idiopathic tinnitus of the phlegm-fire stagnation pattern.

Methods

One hundred patients with idiopathic tinnitus of phlegm-fire stagnation pattern who met the inclusion criteria were randomized into the treatment group and the control group by the random number table method, with 50 cases in each group. The treatment group (syndrome-position point selection method) was treated with acupuncture at the corresponding acupoints for tinnitus and associated symptoms and the corresponding acupoints located in Wernicke's area of scalp projection, while the control group (traditional acupuncture method) was treated with the combination of acupuncture points with the most frequent occurrence in the tinnitus research literature for acupuncture treatment. Both groups received acupuncture twice a week for 5 weeks. The efficacy was evaluated before and after treatment with the Tinnitus Severity Inventory (TSI), Sleep Spiegel Questionnaire, Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS).

Results

The 100 patients with idiopathic tinnitus of phlegm-fire stagnation pattern completed 5 weeks of clinical treatment and a month of follow-up with no loss of patients and no adverse event reports. Three patients recovered with the disappearance of the tinnitus symptoms in the treatment group after 5 weeks of treatment. After 5 weeks of treatment, obvious differences between the two groups were observed in the TSI scores (P < 0.05) and the Spiegel scores, with a better Spiegel score in the treatment group than in the control group (P < 0.05). Compared with the control group, the depression (SDS score) and anxiety (SAS score) of tinnitus patients in the treatment group were markedly improved (P < 0.05).

Conclusion

In line with the principle of symptomatic treatment and based on the modern imaging data, the syndrome-position point selection method is more accurate and effective compared with the traditional acupoint selection method, which significantly improves the symptoms, sleep quality, and psychological state of patients with idiopathic tinnitus of the phlegm-fire stagnation pattern.