"'We cannot do anything about your tinnitus'. This is simply not true"

A.I. It is not really an act of faith then?

P.J.J. No, faith would only lead to unsustainable results, it would be nothing more than a placebo. You have to prove to patients that it is possible through real-life.

A.I. Sound is also very important in TRT. Is silence the greatest enemy?

P.J.J. Sound therapy is a very important part of TRT, but it must go hand in hand with good counseling. Studies have shown that using sound exclusively is only effective in 20% of cases. Sound therapy is very useful, but it is important to know exactly how to conduct it.

A.I. The success of the therapy has led to it being used throughout the world…

P.J.J. TRT is being used in 35 countries. In Spain, Dr Lorenzo Rubio, among many other professionals, has been using it. Some years ago, centers were established but now it is less present. I specialize in second opinions, so I sometimes see cases from Spain, and I must admit, I am not happy with what I see.

A.I. What elements of the approach used in Spain are wrong?

P.J.J. First of all, as in many other countries, the idea that we cannot do anything to help our patients still persists. Secondly, the use of hearing aids. Thirdly, the use of psychotropic medication.

A.I. Do you not approve of the use of hearing aids in tackling tinnitus?

P.J.J. In recent years we have developed very good hearing aids which integrate a sound generator, which can be very efficient and useful, but patients need to know how to use them. Even the hearing aids for tinnitus patients should be different from others.

In fact, in my clinic in Maryland I am using combined devices and we have had very good results. However, these should not be used as a stand alone solution but rather as part of a program. With hearing aids alone, the success rate is around 10%. When combined with TRT, this figure reaches up to 80%. Without a good understanding of how to use them and appropriate guidance, it is highly unlikely that they will provide satisfactory results