👂 Tinnitus Retraining Therapy & Sound Masking Simulator

Reclassifying the Tinnitus Signal Through Directive Counseling

Counseling teaches the brain that tinnitus is neutral, not dangerous.

• 4–6: Counseling sessions (typical initial course)
• Limbic: Neural target (threat-reclassification pathway)
• ~60 min: Session length (initial directive session)
• Jastreboff: Model basis (neurophysiological model)

Directive counseling mechanism

Placeholder: clinician explains auditory pathway and reframes signal meaning.

Placeholder: reclassification is the cognitive entry point of TRT.

Low-Level Broadband Sound Generator Masking

Steady soft noise partially masks tinnitus without full coverage.

• Sub-mix: Output level (below tinnitus loudness)
• Ear-level: Device type (wearable generator)
• ≥8 hrs: Daily use target (recommended exposure)
• Broadband: Signal type (unstructured noise)

Partial masking principle

Placeholder: sound lowers contrast between tinnitus and background.

Placeholder: full masking is avoided to preserve habituation.

Limbic System Emotional Response Reduction

Emotional reactivity to the tinnitus signal weakens over repetition.

• Amygdala: Target structure (threat-response hub)
• Autonomic: Response type (stress/arousal linkage)
• Weeks 4–8: Reduction onset (typical early change)
• Extinction: Mechanism (conditioned response fading)

Emotional decoupling process

Placeholder: repeated neutral pairing extinguishes conditioned distress.

Placeholder: distress drop often precedes loudness change.

Gradual Neural Habituation Over Months

Auditory cortex slowly filters the signal from conscious perception.

• 12–24 mo: Typical course (full habituation window)
• Plasticity: Mechanism (cortical gain adaptation)
• Daily use: Adherence factor (strongest predictor)
• Low: Relapse risk (with sustained practice)

Habituation timeline dynamics

Placeholder: salience fades gradually, not as a sudden switch.

Placeholder: consistency of use accelerates habituation slope.

Long-Term Perception Reduction Outcome

Most patients reach durable, clinically meaningful relief over time.

• ~80%: Improvement rate (reported clinical benefit)
• 12–24 mo: Full habituation (average completion time)
• Possible: Relapse under stress (usually re-habituates faster)
• Long-term: Outcome durability (stable after completion)

Sustained outcome maintenance

Placeholder: perceived loudness and distress remain low long-term.

Placeholder: outcome depends on completing the full course.