by Barry Keate There is exciting news from The Tinnitus Control Center in New York City. This independent company is offering Phase Shift Tinnitus Reduction (PSTR) therapy, pioneered by Daniel Choy, MD and Arpad Fejos, MD. An independent study was conducted at the Mount Sinai School of Medicine which confirmed the results of Dr. Choy’s study. This new therapy is available only for those people who perceive their tinnitus at a single pitch, known as mono-frequency tinnitus and is not effective for people who have changing frequencies or multiple tone tinnitus. In a recent study, 77% of tinnitus patients described their tinnitus as a relatively pure tone.
Prior to treatment, patients must have their auditory system examined by an ENT to rule out conditions that can be treated through surgery or other medical procedures. A recent audiogram is also required.
The treatment consists of “sound-typing” patients to accurately determine their tinnitus characteristics. Their tinnitus is matched to frequency and volume using highly accurate electronic equipment. This tinnitus sound is then reproduced and phase-shifted to produce sound cancellation therapy that is similar to noise reducing headphones and industrial noise reduction technologies. The sound cancellation therapy is then presented to the patient for a period of 30 minutes.
The process is repeated three more times on an out-patient basis at the Tinnitus Control Center. If the therapy is successful, the patient is offered a custom made CD of the specific sound cancellation for their tinnitus. This CD can be played on any high quality stereo system.
A clinical study has been conducted and written and is ready for publication. It has not yet been published, so the authors were unable discuss it in detail until after publication. However, they report that 83% of patients demonstrated a positive response and there have been no complications in two years of testing. They claim that after only one session, most patients experience a significant reduction in their perception of tinnitus. This reduction has been shown to last one week on average. Some study participants have experienced residual inhibition lasting several weeks.
I spoke with Dr Choy at the Center about their success rate and what it means in context. He said that success was determined as a decrease of 3.5 decibels (dB) or more. He noted that most people experienced a greater decibel decrease than 3.5 dB. Decibel rating is logarithmic, meaning it is an exponential in configuration. Therefore lowering the sound output by 50 percent equates to a reduction of approximately 3 dB. Lowering sound output by 90 percent would mean a reduction of 10 dB. The Tinnitus Control Center report of 83 percent of their patients demonstrating a positive response means they experienced a decibel output reduction of at least 50%.
The center employs sophisticated electronic pitch and loudness matching equipment, both before and after therapy, in order to determine the amount of tinnitus reduction. They then calculate the amount of reduction their equipment has recorded. What the Center determines as a 50 percent decrease may or may not be the patient’s subjective perception of what they consider cutting their sound level by half.
In one study on zinc therapy for the reduction of tinnitus, it was determined that clinical success was a reduction of 10dB or more. The zinc study had a clinical success rate of 46%. This is considerably more reduction than that claimed by the Tinnitus Control Center although the percentage of success was lower. I doubt that 46% of the participants in the zinc study perceived their tinnitus to be reduced by 90% even though that is what the equipment may have recorded. The complete zinc study can be found here under Studies in our Informaition Center.
The Tinnitus Control Center is offering their services to the public. Their fee schedule is:
- Initial Evaluation $350.00 .
- In-office Treatment Sessions $500.00 (Includes up to four visits).
- Treatment CD $1,500.00 (Includes 3 follow-up visits).
They also provide patients with all necessary, completed forms for submission to insurance companies for reimbursement. They do not accept direct payments from insurance companies nor do they participate in Medicare.
The extent to which insurance companies cover tinnitus treatment programs varies by the company and plan. The Tinnitus Control Center provides the CPT codes (Current Procedural Terminology) so the insurance company will recognize the procedures.
For more information: The Tinnitus Control Center, 170 East 77th Street Ste 1C, New York, NY 10021 (212) 535-6160.