Tinnitus: the spontaneous auditory sensations perceived by a person that are not produced by external acoustic signals.

Not a disease or disorder — it is a symptom or component of the peripheral and/or auditory nervous system; a dysfunction, commonly described as ringing or buzzing or humming in the ears.

Head noise, or tinnitus, is very common. It may be intermittent or constant in character, mild or severe in intensity and vary from a low roar to a high pitch type of sound. Tinnitus may be accompanied by a hearing loss. It may cause sleeplessness, poor concentration and/or serious emotional complications.


Until now, most patients have been treated with lists of drugs and foods to avoid, stress reduction techniques, masking units (which did little more than cover one noise with another), vitamin therapies, sedatives or pharmacology.

In 1990, Dr. P. Jastreboff, Professor of Neurophysiology at Yale University, the University of Maryland and Emory College, proposed a new research approach to tinnitus patients aimed at habituation of tinnitus or Tinnitus Retraining Therapy (TRT).

The basic foundation of this approach is rooted in four principles:

  • The auditory system, including the sources of the tinnitus (cochlea) plays a secondary role in patients with clinically significant tinnitus.
  • The extent of tinnitus annoyance depends on the interaction of the limbic system with the auditory and autonomic nervous system.
  • Increased awareness of tinnitus by the patient produces an increase in the intrusiveness of tinnitus.
  • The brain has the capacity for “plasticity” which makes it possible to habituate to a sensory signal (e.g. tinnitus) if the signal does not have a negative implication to the patient.

The epidemiological data show that less than a quarter of the people who have tinnitus suffer from it, while the vast remaining majority experience it without any problems. It is very possible to find two people with identical loudness, pitch and even maskability of tinnitus and identical hearing, but one person will be able to ignore it, while the other will suffer profoundly.

Our TRT Program

The goal with TRT is to modify the way the brain responds to the tinnitus signal. Once the habituation of reaction is achieved, patients are no longer annoyed by tinnitus and the awareness of it decreases radically. Habituation is achieved by directive counseling combined with low-level broadband noise produced by wearable generators (not maskers) and environmental sounds. While we cannot always guarantee success, 84% of patients report a significant improvement with the full protocol involving counseling and use of noise generators — for this reason, patients with all degrees of tinnitus are excellent candidates for this therapy.

TRT is aimed at the reversal/retraining of the connections between the auditory, limbic and autonomic nervous system to achieve habituation.

All patients are reviewed for their candidacy by our audiologists and must be screened by ENT or neurology for medical clearance.

Patients are seen most frequently on referral. There are countless patients who have suffered for years and have tried any of a number of therapies or attempts to reduce or alleviate the tinnitus. We can provide your patients with reassurance and help to safely ameliorate or significantly reduce the tinnitus or the stress that arises from tinnitus.


In many cases hyperacusis is often associated with tinnitus. Hyperacusis is a hypersensitivity to sound that makes it difficult to tolerate moderate to loud noise. Tinnitus Retraining includes an extremely successful treatment to this disorder and is offered to our participating patient population.

Contact R Cohen Audiology Associates today to find out more:  rcohen2552@optonline.net or call us at 914-948-7070