A 70-year-old retired factory worker complains of constant high-pitched bilateral tinnitus and sensorineural hearing loss greatest at 4 kHz. Tinnitus Retraining Therapy (TRT) uses which principle to achieve habituation?

• A Complete masking of tinnitus with broadband noise louder than the tinnitus
• B Cognitive behavioral therapy alone targeting catastrophic thinking
• C Transcranial magnetic stimulation to reduce auditory cortex excitability
• D Partial sound enrichment (mixing point) combined with directive counseling to reclassify tinnitus as neutral, allowing neuroplastic habituation ✓

Explanation

TRT (Jastreboff neurophysiological model) aims to reclassify tinnitus from a negative to a neutral signal through two components: sound therapy using low-level broadband noise generators set at the 'mixing point' (just below the tinnitus loudness, not masking it) to decrease contrast and promote auditory cortex adaptation; and directive counseling to explain the neurophysiological model and remove emotional/autonomic associations. Complete masking is avoided because it prevents habituation. CBT targets the emotional response but not the auditory pathway retraining.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.