Using VR in Tinnitus Management

The second most frequent request I receive from patients, after improved hearing, is to make their tinnitus go away. While tinnitus is not dangerous, it can certainly diminish sufferers’ quality of life. Unfortunately, there is no known cure for tinnitus. Instead, the focus is on mitigating the impact on daily life. Studies show that amplification, sound therapy, dietary modifications and cognitive behavioral therapy (CBT) are all effective forms of tinnitus management. But are there any new tools to add to the arsenal? Perhaps! Researchers are beginning to explore the use of virtual reality (VR) in helping tinnitus patients, and the initial results are promising.

Sound Therapy

Sound therapy refers to the practice of having tinnitus patients listen to relaxing sounds to lessen the perceived annoyance caused by the tinnitus. Common stimuli can include white noise and nature sounds, such as waves. They are often presented through hearing aids. The stimulus sound masks the tinnitus; the brain focuses on the stimuli, rather than the bothersome tinnitus. It’s similar to putting on your headphones while trying to complete an assignment so you are not distracted by the noises around you. Sound therapy also promotes relaxation, which has been shown to reduce the perceived loudness of tinnitus.

Recently, researchers have looked to fractal tones for use in sound therapy. Fractal tones sound like wind chimes or singing bowls, which most people find inherently relaxing. However, their real benefit is their unpredictability. Because they do not follow a predictable pattern, the listener listens more passively, which promotes a more relaxed emotional state. Studies have shown that fractal tones can be as or more effective than other types of sound.

Virtual Reality

When hearing the words virtual reality, most people likely imagine video games or online communities. However, studies have shown it to be useful in the medical field as well. It can be used to help manage acute and chronic pain. It can also help with mental health conditions such as anxiety. Scientists believe the therapeutic benefit stems from VR’s effect on our limbic system, which helps to control emotional states and reactions. Since the limbic system is believed to be involved in our perception of tinnitus, VR offers an intriguing pathway to relief. Indeed, one study showed VR to be as effective as CBT in addressing tinnitus.

Happy Marriage

So, sound therapy and virtual reality have both proven themselves viable options for managing tinnitus. But what happens if the two are combined? Is the benefit even greater? Fortunately, we have an answer. A. K. Deshpande, et al. (2022) performed an experiment to explore this exact hypothesis.

The authors gathered 20 adult participants with tinnitus in one or both ears. They excluded those with head, neck or spinal injuries, or those who already had a tinnitus masker active in their hearing aids. They then had the participants undergo two treatment paradigms. One involved a session using a commercially available sound therapy in isolation. The second involved those same participants undergoing the sound therapy in conjunction with VR. The VR involved wearing goggles which presented different nature scenes. Each session was performed one week apart, with the order of the sessions (VR first or second) being randomized.

After each session, the effects of the therapies were determined using three self-assessments. However, for our purposes, we will focus on two: tinnitus loudness and Tinnitus Functional Index (TFI). Tinnitus loudness is the perceived intensity of the tinnitus. The TFI measures the perceived negative impact of the tinnitus on the person’s daily life. Both paradigms (sound therapy only and sound therapy with VR) were shown to help lower both the tinnitus loudness and TFI scores. However, there was a statistically significant difference between the two, which favored the inclusion of VR. In other words, the authors showed that combining the two therapies did make them more effective.

These results are obviously quite exciting. Audiologists have a possible new tool in the fight against tinnitus! However, anticipation must be tempered. As the authors discuss, their experiment did not study the long-term effects and efficacy of their treatment. Also, the setup was entirely experimental and designed solely for the study. There is no commercially available, self-contained device that you can buy to replicate this specific treatment. But such significant results in early experiments are encouraging. Contact your local audiologist to discuss currently available treatments and keep an eye on the horizon. QCBN

By Jeff Lane, Au.D.

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Dr. Jeff Lane is a doctor of audiology with a passion for improving the lives of others. Dr. Lane may be reached at 928-522-0500 or at audio@trinityhearing.net.