[Tinnitus retraining therapy in Ménière disease].

OBJECTIVE

To evaluate the response of tinnitus in Meniere's disease patients (MD) using the Tinnitus Retraining Therapy (TRT). This management includes a wide cognitive medical counselling and natural or prosthetic sound therapies (hearing aid or noise generator).

DESIGN

Descriptive prospective study (EBM level 3).

PATIENTS

Twenty-five patients diagnosed as definitive MD (AAO-HNS 95 criteria) were enrolled in our tinnitus protocol.

MAIN OUTCOME MEASURES

Tinnitus changes were reported according to patient's self-evaluation, a visual analogue scale on tinnitus intensity (EVA) and the Tinnitus Handicap Inventory (THI).

RESULTS

Seventy-three percent of the patients improved their tinnitus after 6 months of treatment (p < 0.05). THI scores were reduced from the initial 47% to 24% (p < 0.05) and EVA from 6.6 to 5.2 (p < 0.05). After 12 months, the response was slightly worse: 68% improved according to their self-evaluation (p < 0.05), THI score reached 20% (p < 0.05) but EVA did not improve significantly (6.4). Patients that refused prosthesis adaptation (hearing aid or noise generator) did not improved and the THI score (48%) and EVA score (6.6) did not change.

CONCLUSIONS

TRT has proved to be an effective method for tinnitus treatment in MD that improves patient's self-evaluation, tinnitus loudness and handicap scores. Individualized medical counselling and an exhaustive prosthesis adaptation are crucial to guarantee satisfactory results.