Pawel Jastreboff in Brazil for 25th anniversary of TRT


In 2015, Tinnitus Retraining Therapy (TRT) celebrates its 25th year and Brazil has been one of the destinations of the pioneer of this method to talk about its principles and train local professionals. Invited by Sivantos Brazil, Pawel J. Jastreboff and his wife, scientist Margaret M. Jastreboff, were among the international lecturers who attended the 12th Hearing Aids International Meeting (EIPA). Held every year in São Paulo, the EIPA is the most significant event for Brazilian hearing aid specialists.

Following the EIPA, the Jastreboff couple also headed a one-day workshop dedicated to Sivantos’s Brazilian partners and lectured in Rio de Janeiro.

In his EIPA talk, Dr Jastreboff highlighted that TRT is a method aimed at habituation to tinnitus-evoked negative reactions. Habituation of tinnitus perception is achieved through brain habituation to all unimportant stimuli.

TRT mainly consists in counseling and sound therapy, both based on the neurophysiological model of tinnitus proposed by Jastreboff in the 1980s, which considers that the auditory system effect is not dominant in clinically relevant tinnitus since psychoacoustic characterization of tinnitus is not related to the severity of the disorder. Two patients with a similar characterization of tinnitus may show dramatically different levels of distress. On the contrary, the neurophysiological model of tinnitus points out that brain mechanisms are preponderant.

Based on this model, “TRT aims at inducing changes in the mechanisms responsible for transferring tinnitus-related neuronal activity from the auditory system to the limbic and autonomic nervous systems, and therefore remove tinnitus-induced reactions,” says Jastreboff.

According to Jastreboff, TRT is used in 33 countries, mainly the US and in Europe. The TRT protocol requires that professionals be trained in order to apply its methods. Mr and Mrs Jastreboff have provided two courses per year since 1996 and have offered additionally 60 courses all around the world.

In the current state of knowledge on tinnitus, the main drawback of TRT is that etiology is not addressed. Habituation seeks to alleviate distress, however it does not provide a cure.

Stéphane Davoine, editor in chief of Audiology Infos Brazil