Enriched Acoustic Environment Therapy (EAE): A Cost-Effective and Feasible Alternative to Tinnitus Retraining Therapy...

Background/Objectives: Tinnitus affects approximately 15% of the population and lacks a universally effective treatment. Tinnitus Retraining Therapy (TRT) is widely used but requires 6-8 h of daily sound exposure for 1-2 years, limiting accessibility and adherence. This study evaluated the clinical feasibility and therapeutic effectiveness of Enriched Acoustic Environment therapy (EAE), a streamlined alternative using individualized sound stimulation with a markedly reduced treatment burden, and compared its time efficiency with published TRT outcomes. Methods: 82 adults with chronic tinnitus received standardized counseling and completed one of two EAE protocols (continuous or sequential). Participants listened to their personalized stimulus for 1 h/day over four months. Tinnitus severity (THI, TFI) and time-efficiency metrics (improvement per 10 listening hours) were assessed and compared with TRT studies reporting baseline and post-treatment THI. Results: EAE produced clinically relevant and statistically significant improvements, with 51.6% THI and 49.8% TFI reduction (p < 0.001). Both stimuli achieved similar outcomes with high responder rates. EAE yielded ~2.3 THI-point improvement per 10 h (~4.3% relative gain), demonstrating substantially greater time efficiency-approximately 20 times higher than values reported for standard TRT protocols. Conclusions: EAE achieved robust symptom reduction with dramatically lower treatment burden, high adherence, and strong clinical feasibility. These findings support EAE as an accessible, time-efficient alternative to TRT. Controlled long-term studies are warranted.