Under periods of extreme stress, fatigue, or during bouts of otitis media, many people experience a "whoosh" or "beep" in the ear despite the absence of external noise. This phenomenon, known as tinnitus, is a common condition affecting approximately one in five people in Korea, according to the Korea National Health and Nutrition Examination Survey. Globally, the prevalence remains high at roughly 14%. Despite its frequency, treatment responses vary significantly, making it difficult for clinicians to predict outcomes.
A research team led by Professor Park Si-nae of the Department of Otolaryngology at Seoul St. Mary’s Hospital recently identified key factors that predict treatment success. The large-scale study followed 1,269 patients over a two-year period to evaluate the effectiveness of Tinnitus Retraining Therapy (TRT).
The Critical Twelve-Month Window
TRT, which has been utilized at Seoul St. Mary’s Hospital since 1999, combines structured educational counseling with sound therapy. The goal is to train the brain to stop interpreting tinnitus as a threat or significant signal.
The researchers tracked the Tinnitus Handicap Inventory (THI) scores of patients (mean age 53) at intervals of 3, 6, 12, 18, and 24 months. The analysis revealed that the most substantial improvements occurred within the first year of initiation. Specifically, tinnitus-related discomfort decreased most sharply during the first three months and continued to show meaningful improvement through the 12-month mark. After one year, however, the rate of improvement tended to plateau, suggesting that intensive management during the first 12 months is vital for long-term success.
Factors for Complete Resolution
During the study, 172 patients (13.6%) reported a complete resolution of their symptoms. The data highlighted several demographic and clinical trends:
Gender: Women were approximately 2.4 times more likely than men to achieve complete resolution.
Age and Hearing: Younger patients and those with minimal hearing loss showed higher rates of recovery.
Initial Severity: Patients with more severe distress at the start of treatment often saw the greatest overall improvement in their scores.
However, the study also noted that while patients with high initial THI scores saw significant progress, they were less likely to achieve total resolution within the two-year window. "This indicates that severe initial symptoms are not a reason to abandon treatment," the research team explained. "Instead, these cases likely require more intensive, long-term management to reach complete resolution."
Tailored Treatment Strategies
The findings were presented at the 72nd Academic Conference of the Korean Otological Society earlier this month, where the study received the Best Presentation Award.
"This study is significant because it uses large-scale data to confirm clinical clues for predicting patient response to TRT, which we have implemented for over 20 years," said Professor Park Si-nae. "Applying these findings—considering sex, age, hearing status, and initial psychological distress—will help us establish optimized, personalized treatment strategies for each patient."
