Enriched Acoustic Environment Therapy (EAE): A Cost-Effective and Feasible Alternative to Tinnitus Retraining Therapy (TRT).

Background/

Objectives

Tinnitus affects approximately 15% of the population and lacks a universally effective treatment. Tinnitus Retraining Therapy (TRT) is widely used but requires 6-8 h of daily sound exposure for 1-2 years, limiting accessibility and adherence. This study evaluated the clinical feasibility and therapeutic effectiveness of Enriched Acoustic Environment therapy (EAE), a streamlined alternative using individualized sound stimulation with a markedly reduced treatment burden, and compared its time efficiency with published TRT outcomes.

Methods

82 adults with chronic tinnitus received standardized counseling and completed one of two EAE protocols (continuous or sequential). Participants listened to their personalized stimulus for 1 h/day over four months. Tinnitus severity (THI, TFI) and time-efficiency metrics (improvement per 10 listening hours) were assessed and compared with TRT studies reporting baseline and post-treatment THI.

Results

EAE produced clinically relevant and statistically significant improvements, with 51.6% THI and 49.8% TFI reduction (p < 0.001). Both stimuli achieved similar outcomes with high responder rates. EAE yielded ~2.3 THI-point improvement per 10 h (~4.3% relative gain), demonstrating substantially greater time efficiency-approximately 20 times higher than values reported for standard TRT protocols.

Conclusions

EAE achieved robust symptom reduction with dramatically lower treatment burden, high adherence, and strong clinical feasibility. These findings support EAE as an accessible, time-efficient alternative to TRT. Controlled long-term studies are warranted.