The Effectiveness of Cognitive Behavioral Therapy versus Notched Sound Therapy in Adults with Chronic Subjective Tinnitus and Normal Hearing

Introduction Tinnitus can be distressing, and it affects the quality of life (QoL) through psychological and cognitive impairments. Cognitive behavioral therapy (CBT) and notched sound therapy (NST) are tinnitus management approaches aiming to reduce symptoms and improve QoL via two different mechanisms. The CBT attains the cognitive principle, whereas the NST initiates tinnitus habituation. Objective To evaluate the effect of CBT and NST and compare their results in the management of chronic subjective tinnitus. Methods The present prospective study involved 64 adults with normal hearing and chronic subjective tinnitus. They were subjected to history taking, basic audiological evaluation, and extended high-frequency audiometry at 10 and 12.5 kHz. The participants were divided into two equal groups, the first treated with CBT and the second treated with NST. The psychoacoustic measures of tinnitus and the Arabic Questionnaire for Tinnitus Reaction (Arabic-QTR) were used to monitor the outcomes of both therapies. Results Both groups showed significant reduction in tinnitus severity according to the Arabic-QTR and tinnitus loudness matching. Improvement in the Arabic-QTR was better in the CBT group, while tinnitus loudness improvement was better in the NST group. Conclusion Both CBT and NST are effective in the management of chronic subjective tinnitus. In a comparison of the effect of the two therapies, CBT was found to be more effective in decreasing tinnitus-related distress, whereas SNT was found to be more helpful in reducing tinnitus loudness.