Efficacy differences and predictors of personalized mixed acoustic therapy in chronic tinnitus patients with and...

This study aimed to evaluate the efficacy of a personalized mixed acoustic therapy (narrow-band noise combined with music) in patients with chronic tinnitus, comparing those with and without hearing loss (HL vs. NHL), and to identify baseline predictors of treatment response.

A total of 111 patients with chronic tinnitus were enrolled (HL group, n = 51; NHL group, n = 60). At baseline, all participants underwent bilateral subjective tinnitus acoustic assessment and completed the HAMA, HAMD, PSQI, and THI scales. The same assessments were repeated after a 3-month mixed acoustic intervention.

At baseline, the NHL group was younger and had a higher prevalence of psychiatric history and insomnia than the HL group. After 3 months, both groups showed comparable improvements in tinnitus frequency, loudness, and PSQI scores (significant main effect of time, no group × time interaction). However, the NHL group showed significantly greater reductions in HAMA and THI scores (significant group × time interaction; both p < 0.05). Binary logistic regression identified NHL status, female sex, and lower baseline PSQI and HAMA scores as independent predictors of a favorable outcome (THI reduction ≥7).

Personalized mixed acoustic therapy improves tinnitus perception and sleep quality in both HL and NHL patients, but provides significantly greater psychological benefit in patients without hearing loss. The bilateral assessment protocol also accommodated patients with central "head noise" who could not lateralize their tinnitus. These findings support a stratified approach to tinnitus management based on audiometric and psychometric phenotypes.