Duration-dependent associations of sound therapy on tinnitus in hearing loss: A cross-sectional analysis of treatment duration cohorts

Am J Otolaryngol. 2026 May-Jun;47(3):104850. doi: 10.1016/j.amjoto.2026.104850. Epub 2026 Apr 28.

Abstract

Background: This cross-sectional observational study analyzed data from routine clinical practice to compare outcomes across independent treatment duration cohorts (3, 6, and 9 months).

Methods: This retrospective cohort study analyzed data from 85 patients with chronic tinnitus (≥6 months) and hearing loss who received hearing aid-based sound therapy. Patients were grouped by treatment duration (3, 6, or 9 months) based on clinical circumstances. Pure-tone audiometry, tinnitus psychoacoustic matching, and Tinnitus Handicap Inventory (THI) were assessed at baseline and post-treatment.

Results: Post-treatment assessments showed significant reductions in THI scores and tinnitus loudness versus baseline (P < 0.05). Repeated-measures ANOVA revealed a significant time × group interaction for THI changes (F = 5.856, P = 0.004), but Bonferroni-corrected pairwise comparisons showed no significant between-group differences. Multivariate ordinal regression identified longer treatment duration as an independent factor associated with better outcomes: the 3-month cohort showed a lower likelihood of improvement compared with the 9-month cohort (OR = 0.141, 95% CI: 0.038-0.513, P = 0.003), while no difference was found between 6- and 9-month cohorts. Hearing loss severity was not associated with efficacy.

Conclusion: In this observational cohort, hearing aid-based sound therapy was associated with reductions in tinnitus-related handicap and loudness. Longer treatment duration was associated with a higher probability of clinical improvement. Patients showed continued improvement up to 9 months, although causal inference is precluded by the observational design.

Keywords: Acoustic therapy; Chronic idiopathic tinnitus; Hearing aids; Sensorineural hearing loss; Sound treatment.

Publication types

  • Observational Study

MeSH terms

  • Acoustic Stimulation* / methods
  • Adult
  • Aged
  • Audiometry, Pure-Tone
  • Chronic Disease
  • Cohort Studies
  • Cross-Sectional Studies
  • Duration of Therapy*
  • Female
  • Hearing Aids*
  • Hearing Loss* / complications
  • Hearing Loss* / therapy
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Time Factors
  • Tinnitus* / complications
  • Tinnitus* / diagnosis
  • Tinnitus* / etiology
  • Tinnitus* / therapy
  • Treatment Outcome