Threshold sound conditioning in the treatment of sensorineural hearing loss

Abstract

Objectives/hypothesisSensorineural hearing loss is one of the most common human disorders, with increasing incidence in elderly patients, severely restricting normal activities, and lowering quality of life. The introduction of sound conditioning has the potential to activate auditory pathway plasticity and improve basal frequency hearing. Our objective was to evaluate the safety and efficacy of threshold sound conditioning (TSC). The null hypothesis in this study was that TSC does not have a significant effect on auditory threshold amelioration.MethodsPure tone audiometry (PTA) was performed and hearing thresholds were measured once at baseline, and a second time following TSC intervention. Data were analyzed using an intention‐to treat design.ResultsThe TSC group (78%) significantly differed from the control group (44%) on auditory threshold amelioration; P = .008091 in DV1, P = .000546 in DV2 by Scheffe's post hoc test. Female subjects (77%) showed a significant difference in DV1 from male subjects (47%); P = .025468 in DV1 by Scheffe's post hoc test. Older subjects (75%) showed no significant difference from younger subjects (53%); P = .139149 in DV1, P = .082920 in DV2 by Scheffe's post hoc test.ConclusionsWe observed a significant improvement in a narrow band frequency threshold in this randomized controlled prospective clinical study in a broad range of subjects. These data have important clinical implications since there is no current long‐term therapy for this widespread and growing disability. Additional physiologic, mechanistic, and molecular studies are necessary to fully elucidate the pathophysiology and mechanism of action of TSC.Level of Evidence1a.

Stochastic Modeling of Tinnitus Loudness

“…TSC differs from other existing methods using bistable auditory streaming conducted at audible levels 45 . It is noticeable that two different studies on hearing threshold improvement using a notched sound 46 and a threshold sound 42 reported similar findings. The experimental results in both studies might have the same substrate on which stochastic impedance levels in deprived frequency regions may become a robust biomarker for both the reversibility of sensorineural hearing loss and the reducibility of tinnitus loudness.…”

“…One study reported that an increased listening effort could change functional connectivity in the central nervous system 41 . Another study focused on auditory threshold amelioration by an attention-free listening effort 42 . Although the behavioral modality in both studies was an active listening effort, the latter is not attention-involved.…”

Combined sound conditioning therapy and counseling for tinnitus treatment: proof-of-concept study in Colombia

“…27 Indeed, it is proposed that tinnitus spectrum fits within the region where there is hearing loss and tinnitus pitch might influence the outcome of acoustic stimulation treatments. [28][29][30] Therefore, having the possibility to identify high frequency tinnitus and using acoustic stimulation at the same frequency allows for a subjective decrease in loudness.…”

“…31 Similarly, in patients with sensorineural hearing loss the use of threshold sound conditioning generates an improvement in a narrow band frequency threshold in most of the subjects tested. 32 For patients with chronic tinnitus (>12 months), the use of transcutaneous vagus nerve stimulation paired with music therapy at the same tinnitus frequency resulted in improvement in tinnitus loudness and awareness. 33 In a randomized clinical trial, the use of tinnitus retraining therapy (TRT) using sound therapy and counseling also showed significant improvement in overall quality of life after 18 months of treatment.…”

Efectos de la Estimulación Acústica Personalizada en Pacientes con Tinnitus

“…Con respecto a la estimulación acústica pasiva, diferentes autores (Noreña & Eggermont, 2005), mencionan el uso de estrategias que podrían llegar a ser benéficas para el manejo sintomático del tinnitus. Entre algunos de los principios que han demostrado potencial uso para dichos fines, se encuentran los denominados en la literatura como "Enriched Acoustic Enviroments" (EAE) y "Sound Conditioning" (SC (Kwak & Kwak, 2020)) . EAE y SC son descritos como modalidades de estimulación acústica bajo parámetros de estimulación controlados, han sido investigados en gran variedad de mamíferos, llegando a conclusiones de que pueden ser usadas con propósitos terapéuticos de recuperación o protección de la función del sistema auditivo en los humanos (Harris, Bielefeld, Hu, & Henderson, 2006); (Kwak & Kwak, 2020).…”