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Validitas, reliabilitas dan adaptasi transkultural Dizziness Handicap Inventory dalam Bahasa Indonesia Jenny Bashiruddin; Widayat Alviandi; Brastho Bramantyo; D. Daneswarry
Oto Rhino Laryngologica Indonesiana Vol. 49 (2019): Volume 49, No. 2 July - December 2019
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v49i20.318

Latar belakang: Keluhan gangguan keseimbangan berupa dizziness sulit untuk diukur, sementara itu individu dengan keluhan dizziness sering mengalami kesulitan untuk beraktivitas dan terganggu kualitas hidupnya. Salah satu perangkat yang paling sering digunakan untuk menilai kecacatan (handicap) pasien gangguan keseimbangan adalah kuesioner Dizziness Handicap Inventory (DHI). Sampai sekarang, kuesioner ini belum pernah diadaptasi ke bahasa Indonesia. DHI versi adaptasi yang valid dan handal (reliable) dapat digunakan untuk mengukur kualitas hidup, dan sebagai modalitas untuk menilai efektivitas terapi pasien gangguan keseimbangan. Tujuan: Mendapatkan instrumen DHI adaptasi bahasa Indonesia dengan validitas dan reabilitas yang teruji. Metode: Desain potong lintang digunakan pada studi yang dilaksanakan di poliklinik THT Divisi Neurotologi Departemen THT RS Dr. Cipto Mangunkusumo sejak Agustus 2012 sampai Februari 2013, pada pasien gangguan keseimbangan usia dewasa. Kuesioner DHI yang terdiri dari 25 pertanyaan diterjemahkan ke bahasa Indonesia, kemudian dilakukan terjemahan balik dengan proses validasi dan juga adaptasi kultural. Hasil: Uji validitas dilakukan dengan uji korelasi Spearman dan mendapatkan korelasi yang bermakna pada seluruh butir pertanyaan pada tingkat signifikansi p < 0,1 dengan nilai r sebesar 0,409- 0,783. Uji reliabilitas mendapatkan hasil nilai Cronbach-α total 0,9265 yang sangat baik untuk semua skala. Kesimpulan: Instrumen DHI adaptasi bahasa Indonesia valid dan handal berdasarkan kaidah validasi transkultural WHO sehingga dapat digunakan sebagai instrumen psikometrik untuk menilai kualitas hidup pasien gangguan keseimbangan.Kata kunci: Dizziness Handicap Inventory, gangguan keseimbangan, kecacatanABSTRACT Background: Balance disorder symptoms, such as dizziness is difficult to be assessed, it could caused difficulties in doing daily activities, and declining the quality of life. The most frequent tools used to measure handicap in patients with balance disorder is Dizziness Handicap Inventory (DHI). This questionnaire has never been adapted to Indonesian language. A valid and reliable version of the DHI adaptation can be used to measure the quality of life and also as a modality for assessing the effectiveness of therapeutic outcomes in balance disorders patients. Purpose: To obtain an Indonesian adaptation of DHI instrument which is valid and reliable. Methods: A cross-sectional research design in Outpatient Clinic of Neurotology Division, Department of Otorhinolaryngology, Cipto Mangunkusumo General Hospital, from August 2012 to February 2013. Respondents were all adult patients with balance disorders. DHI questionnaire contained 25 questions was translated into Indonesian language and re-translated with validation process and cultural adaptation. Results: The validity test was carried out with Spearman correlation test and obtained a significant correlation on all questions at a significance level of p<0.1 with r value of 0.409-0.783. The reliability test obtained a Cronbach-α value of 0.9265 which was very good for all scales. Conclusion: The Indonesian adaptation of DHI instrument was valid and reliable based on WHO transcultural validation rules, therefore it can be used as a psychometric instrument to assess the quality of life of patients with balance disorders.

Words in noise audiometry in adult subjects with normal hearing Widayat Alviandi; Jenny Bashiruddin; Brastho Bramantyo; Farisa Rizky
Oto Rhino Laryngologica Indonesiana Vol. 50 No. 1 (2020): Volume 50, No. 1 January - June 2020
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v50i1.332

Background: Patients with hearing disturbance will generally undergo pure tone audiometry andspeech audiometry in a quiet room, but those examinations cannot evaluate the ability to understand speech in daily environment with a noisy background. Words in noise test will provide valuable informationregarding patient’s hearing problem in noise. Purpose: To evaluate the hearing threshold using wordsin noise test in adults with normal hearing. Method: This cross-sectional study was conducted in CiptoMangunkusumo Hospital from January to April 2017. All subjects who fulfilled the inclusion and exclusioncriteria underwent pure tone audiometry, speech audiometry, and words in noise test. Results: A total of71 individuals with normal hearing were recruited for this study. Words in noise test showed the medianvalue of 67 dB and 100 dB for Speech Recognition Threshold (SRT) 50% and Speech DiscriminationScore (SDS) 100%, respectively. The SRT 50% and SDS 100% were significantly higher in the age group40–60 years compared to the age group 18–39 years. There was also a statistically significant differencebetween males and females at SRT 50% assessed by words in noise audiometry. Conclusion: Wordsin noise test showed a statistically significant difference in SRT 50% and SDS 100% between two agegroups, but no difference was found between genders. The result of this study can be used as a referencefor SRT and SDS values of speech audiometry test in noise.Keywords: words in noise, speech audiometry, speech recognition threshold, speech discrimination score ABSTRAKLatar belakang: Pasien dengan gangguan pendengaran umumnya menjalani pemeriksaanaudiometri nada murni dan audiometri tutur di ruangan yang sunyi, tetapi pemeriksaan ini tidakdapat menggambarkan kemampuan pemahaman wicara di lingkungan sehari-hari yang ramai. Testutur dalam bising dapat mengevaluasi masalah pendengaran pasien dalam keadaan bising. Tujuan:Untuk mengevaluasi ambang pendengaran menggunakan tes tutur dalam bising pada orang dewasadengan pendengaran normal. Metode: Penelitian potong lintang ini dilakukan di Rumah Sakit CiptoMangunkusumo dari Januari hingga April 2017. Semua subjek yang memenuhi kriteria inklusi daneksklusi menjalani pemeriksaan audiometri nada murni, audiometri tutur, dan tes tutur dalam bising.Hasil: Sebanyak 71 orang dengan pendengaran normal diikutsertakan dalam penelitian ini. Tes tuturdalam bising menunjukkan nilai median masing-masing 67 dB dan 100 dB pada Speech RecognitionThreshold (SRT) 50% dan Speech Discrimination Score (SDS) 100%. SRT 50% dan SDS 100% secarasignifikan lebih tinggi pada kelompok usia 40–60 tahun dibandingkan dengan kelompok usia 18–39 tahun. Hasil pemeriksaan tes tutur dalam bising menunjukkan perbedaan yang signifikan antara laki-laki dan wanita pada nilai SRT 50%. Kesimpulan: Tes tutur dalam bising menunjukkan perbedaan yang bermakna secara statistik pada SRT 50% dan SDS 100% antara dua kelompok umur, tetapi tidak ada perbedaan signifikan diantara jenis kelamin. Hasil penelitian ini dapat digunakan sebagai acuan untuk nilai SRT dan SDS pada pemeriksaan audiometri tutur dalam bising.

Management of otosclerosis with obliterated footplate and round window involvement Priyono, Harim; Sari, Anita Amalia; Zizlavsky, Semiramis; Alviandi, Widayat; Ranakusuma, Respati W.
Oto Rhino Laryngologica Indonesiana Vol. 52 No. 2 (2022): VOLUME 52, NO. 2 JULY - DECEMBER 2022
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v52i2.448

ABSTRACTBackground: Otosclerosis with obliterated footplate describes a condition with an overgrowth of bone so that the oval window is almost indistinguishable from the surrounding area. The occurence of round window obliteration is uncommon. In such cases, surgery is more difficult to perform and the results are often unsatisfactory. Purpose: To find out the management option for obliterative otosclerosis. Case report: A 35-year-old-man with suspected bilateral otosclerosis. The patient underwent transcanal endoscopic stapes surgery of the left ear with large fenestra stapedotomy procedure. Clinical question: In adult patients with obliterative otosclerosis, does stapes surgery improve hearing function and reduce complication? Review method: Using PubMed, EBSCOhost, Scopus and Proquest to search for the evidence of randomised control trial (RCT), cohort and case-control studies. Critical appraisal was conducted using critical appraisal tools from Center for Evidence Based Medicine (CEBM), Oxford University and qFAITH for systematic review/meta-analysis. Result: The literature searching used eligibility criteria based on keywords from clinical question found one study regarding the evaluation of intra-operative factors in otoslecrosis surgery outcomes, which was relevant to our clinical question. Conclusion: Large fenestra stapedotomy or stapedectomy is the preferred surgical technique for the management of obliterative otosclerosis. The involvement of round window caused a sensorineural hearing loss (SNHL) component and has a worse prognosis of hearing outcome post operatively. A further study is required to assess the best management for obliterative otosclerosis. ABSTRAKLatar belakang: Otosklerosis dengan obliterasi footplate menggambarkan suatu kondisi pertumbuhan tulang yang berlebihan sehingga tingkap lonjong hampir tidak dapat dibedakan dengan daerah sekitarnya. Obliterasi sampai ke tingkap bundar jarang terjadi. Hal tersebut menyebabkan operasi lebih sulit dilakukan dan hasilnya seringkali tidak memuaskan. Tujuan: Untuk mengetahui pilihan tatalaksana otosklerosis obliteratif. Laporan kasus: Laki-laki 35 tahun dengan suspek otosklerosis bilateral. Pasien menjalani operasi stapes telinga kiri dengan pendekatan endoskopi transkanal menggunakan prosedur stapedotomi fenestra besar. Pertanyaan klinis: Pada pasien dewasa dengan otosklerosis obliteratif, apakah operasi stapes dapat memulihkan fungsi pendengaran dan mengurangi komplikasi? Telaah literatur: Pencarian bukti melalui database PubMed, EBSCOhost, Scopus dan Proquest. Untuk uji coba kontrol acak, kohort dan studi kasus-kontrol, penilaian kritis dilakukan dengan menggunakan penilaian kritis dari CEBM, Oxford University dan qFAITH untuk tinjauan sistematis/meta-analisis. Hasil: Penelusuran literatur berdasarkan kriteria dari pertanyaan klinis, didapati satu artikel mengenai evaluasi faktor-faktor intraoperatif yang relevan dengan pertanyaan klinis. Kesimpulan: Stapedotomi fenestra besar atau stapedektomi adalah teknik bedah yang lebih dipilih untuk tatalaksana otosklerosis obliteratif. Keterlibatan tingkap bundar menyebabkan komponen gangguan pendengaran sensorineural, dan memiliki prognosis hasil pendengaran pasca operasi yang kurang baik. Dibutuhkan studi lebih lanjut untuk menilai tentang penatalaksanaan terbaik untuk kasus otosklerosis obliteratif.

Financing hearing aids for patients with congenital deafness in Indonesia Zachreini, Indra; Bashiruddin, Jenny; Zizlavsky, Semiramis; Tamin, Susyana; Priyono, Harim; Mayangsari, Ika Dwi; Alviandi, Widayat; Supartono, Natasha; Soetjipto, Damayanti; Ranakusuma, Respati; Damayanti, Heditya; Alia, Dina; Hajar Haryuna, Tengku Siti; Harahap, Juliandi; Warto, Nirza; Fitria, Hidayatul
Oto Rhino Laryngologica Indonesiana Vol. 52 No. 1 (2022): VOLUME 52, NO. 1 JANUARY - JUNE 2022
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v52i1.550

ABSTRACTBackground: The appropriate management of patients with congenital deafness is installing hearing aids, either external hearing aids or implanted in the ear (cochlear implant), aiming to reduce the medical and social burden, besides improving the quality of life of the sufferers. Objective: To ascertain the cost of hearing aids in patients with congenital deafness, in the form of external hearing aids or cochlear implants. Method: A descriptive study with cross-sectional design using questionnaires through interviews. The sample size was 535 mothers whose children had congenital deafness at 24 hospitals with facilities for establishing a diagnosis of congenital deafness in 17 provinces in Indonesia. Result: Most respondents were aged 30-39 years (55%), occupations were housewives (71.8%), and education level was high school (52.5%). The type of hearing aid used mostly was external (92.7%), with 45.9% paid by personal expense. The surgically planted hearing aids in 22 children was mostly cochlear implants (95.5%), which were financed by the Indonesian Healthcare and Social Security Agency (BPJS) plus personal costs (50%). Discussion: This study found that the most common type of hearing aid used by children with hearing impairments was external hearing aids (92.7%) through independent financing (45.9%). Only 7.3% of patients chose surgery in hearing habilitation, and 95.5% were cochlear implants. The small percentage of surgery were due to the high-priced of cochlear implants, and the government did not cover all financial expenses. Conclusion: Most external hearing aids were paid independently-out-of-pocket, while cochlear implant surgeries were funded by BPJS, plus extra costs independently. ABSTRAKLatar belakang: Penatalaksanaan terbaik untuk penderita tuli kongenital adalah pemasangan alat bantu dengar (ABD), baik berupa ABD eksternal maupun ABD yang ditanam dalam telinga (implan koklea), dengan tujuan untuk mengurangi beban medis dan sosial, serta meningkatkan kualitas hidup penderita. Tujuan: Untuk mengetahui seberapa besar biaya pemasangan ABD pada penderita tuli kongenital, baik berupa ABD eksternal maupun implan koklea. Metode: Penelitian deskriptif dengan rancangan cross sectional study menggunakan kuesioner melalui wawancara. Besar sampel 535 ibu yang anaknya menderita tuli kongenital pada 24 rumah sakit yang memiliki fasilitas penegakkan diagnosis tuli kongenital di 17 provinsi di Indonesia. Hasil: Sebagian besar responden berusia 30-39 tahun (55%), pekerjaan terbanyak adalah ibu rumah tangga (71.8%), dan tingkat pendidikan SMA (52.5%). Jenis ABD yang terbanyak adalah ABD eksternal (92,7%) dengan pembiayaan secara mandiri 45,9%. Pemasangan ABD dengan tindakan operasi dilakukan pada 22 anak, yang terbanyak adalah implan koklea (95,5%) yang dibiayai oleh Badan Penyelenggara Jaminan Sosial (BPJS) ditambah dengan biaya sendiri (50%). Diskusi: Penelitian ini mendapati bahwa ABD yang terbanyak digunakan oleh anak dengan gangguan pendengaran adalah ABD eksternal (92,7%) dengan biaya mandiri (45,9%). Habilitasi pendengaran dengan tindakan operasi hanya dilakukan pada 7,3% pasien, berupa implantasi koklea 95,5%. Kecilnya persentase habilitasi bedah dikarenakan tingginya harga implant koklea, dan bantuan dari BPJS tidak meliputi keseluruhan biaya. Kesimpulan: Sebagian besar pembiayaan alat bantu dengar eksternal secara mandiri, sedangkan operasi implan koklea menggunakan biaya BPJS ditambah biaya sendiri.

Efektivitas Tinnitus Retraining Therapy (TRT) sebagai Upaya Meningkatkan Kualitas Hidup Pasien Tinitus: Laporan Kasus Berbasis Bukti Ramadhany Fikri Setiawan; Kemal Akbar Suryoadji; Brastho Bramantyo; Widayat Alviandi
Cermin Dunia Kedokteran Vol 50 No 5 (2023): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i5.890

Latar Belakang: Tinnitus retraining therapy (TRT), yang terdiri dari counseling therapy dan acoustic therapy, menjadi salah satu alternatif terapi tinitus. Namun, efektivitas TRT belum diketahui pasti. Tujuan: Mengetahui efektivitas TRT dalam meningkatkan kualitas hidup pasien tinitus. Metode: Laporan kasus berbasis bukti dengan mencari literatur dari pertanyaan klinis pada database Cochrane Library, Embase, ProQuest, PubMed, ScienceDirect, dan Scopus, dengan kata kunci sesuai pertanyaan klinis. Seleksi berdasarkan kriteria eligibilitas dan kesesuaian PICO, menghasilkan satu artikel kajian sistematik dan meta-analisis. Studi telah lolos telaah kritis sesuai pedoman Centre for Evidence-Based Medicine (CEBM) University of Oxford. Hasil: TRT memiliki overall response rate lebih tinggi dibandingkan terapi standar pada pasien tinitus (OR=7,01; IK 95%=5.16,9.53; p<0,00001; I2=0%; p=0,82). TRT memiliki skor tinnitus handicap inventory (THI) lebih rendah dibandingkan dengan terapi standar pada pasien tinitus (MD=-14.50; IK 95%=-16.65,-12.36; p<0,00001; I2= 8%; p=0,30). Simpulan: TRT efektif memperbaiki response rate terhadap tinitus dan menurunkan skor THI. Background: Tinnitus greatly affects daily activities, which can interfere with the quality of life. Tinnitus retraining therapy (TRT) which consists of counseling therapy and acoustic therapy, is an alternative therapy for tinnitus. However, its effectiveness is not yet known. Objective: To determine the effectivity of TRT in improving the quality of life of tinnitus patients. Methods: This study is an evidence-based case report that searches the literature from clinical questions in databases from Cochrane Library, Embase, ProQuest, PubMed, ScienceDirect, and Scopus, using keywords that matched the clinical question. Studies were selected based on the PICO and eligibility criteria. The result is one systematic review and meta-analysis article. The study has been critically appraised using the Center for Evidence-Based Medicine (CEBM) University of Oxford instruments. Result: TRT has a higher overall response rate than standard therapy in tinnitus patients (OR=7.01; CI 95%=5.16, 9.53; p<0.00001; I2=0%, p=0.82). TRT has a lower tinnitus handicap inventory (THI) scale than standard therapy in tinnitus patients (MD=-14.50; CI 95%=-16.65,-12.36; p<0.00001; I2= 8%; p=0.30). Conclusion: TRT effectively improves response rate to tinnitus and lowers THI score.

Perbaikan Pendengaran Pasien Otitis Media Efusi yang Autoinflasi: Laporan Kasus Berbasis Bukti Ugiadam Farhan Firmansyah; Kemal Akbar Suryoadji; Jenny Bashirudin; Brastho Bramantyo; Widayat Alviandi
Cermin Dunia Kedokteran Vol 51 No 6 (2024): Cardiology
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i6.1024

Background: Otitis media with effusion (OME) is the presence of middle ear fluid without acute ear infection signs or symptoms. OME is one of the causes of hearing loss. Chronic asymptomatic OME could be managed by careful waiting for 3 months because it is a self-limiting disease. During surveillance, autoinflation is a beneficial intervention with minimal side effects and high adherence. Objective: To evaluate the effectiveness of autoinflation to improve hearing in otitis media with effusion and hearing loss. Methods: Literature searching was conducted through PubMed, Cochrane, ScienceDirect, Scopus, and EBSCOHost with inclusion and exclusion criteria. The articles were selected and underwent critical appraisal using rapid critical appraisal of systematic review and level of evidence by the Oxford Centre for Evidence-based Medicine in 2011. Result: One systematic review and meta-analysis, or RCT, met the criteria. This article revealed a pooled estimate of RR 1.74; 95% CI [1.22-2.50] with a Z-score of 3.02 (p=0.0025). This result showed substantial significant (p=0.01) heterogeneity (I2=69%). Conclusion: OME patients with hearing loss who performed autoinflation >1 month had a 1.74 times greater chance of achieving hearing improvement than controls. Autoinflation with the Politzer method gives significant results in improving hearing loss. Large-scale RCT research is recommended to evaluate the effectiveness of autoinflation with the Politzer method or other available methods in OME patients with hearing loss.

Perbaikan Pendengaran Pasien Otitis Media Efusi yang Autoinflasi: Laporan Kasus Berbasis Bukti Firmansyah, Ugiadam Farhan; Suryoadji, Kemal Akbar; Bashirudin, Jenny; Bramantyo, Brastho; Alviandi, Widayat
Cermin Dunia Kedokteran Vol 51 No 6 (2024): Cardiology
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i6.1024

Background: Otitis media with effusion (OME) is the presence of middle ear fluid without acute ear infection signs or symptoms. OME is one of the causes of hearing loss. Chronic asymptomatic OME could be managed by careful waiting for 3 months because it is a self-limiting disease. During surveillance, autoinflation is a beneficial intervention with minimal side effects and high adherence. Objective: To evaluate the effectiveness of autoinflation to improve hearing in otitis media with effusion and hearing loss. Methods: Literature searching was conducted through PubMed, Cochrane, ScienceDirect, Scopus, and EBSCOHost with inclusion and exclusion criteria. The articles were selected and underwent critical appraisal using rapid critical appraisal of systematic review and level of evidence by the Oxford Centre for Evidence-based Medicine in 2011. Result: One systematic review and meta-analysis, or RCT, met the criteria. This article revealed a pooled estimate of RR 1.74; 95% CI [1.22-2.50] with a Z-score of 3.02 (p=0.0025). This result showed substantial significant (p=0.01) heterogeneity (I2=69%). Conclusion: OME patients with hearing loss who performed autoinflation >1 month had a 1.74 times greater chance of achieving hearing improvement than controls. Autoinflation with the Politzer method gives significant results in improving hearing loss. Large-scale RCT research is recommended to evaluate the effectiveness of autoinflation with the Politzer method or other available methods in OME patients with hearing loss.

Efektivitas Tinnitus Retraining Therapy (TRT) sebagai Upaya Meningkatkan Kualitas Hidup Pasien Tinitus: Laporan Kasus Berbasis Bukti Setiawan, Ramadhany Fikri; Suryoadji, Kemal Akbar; Bramantyo, Brastho; Alviandi, Widayat
Cermin Dunia Kedokteran Vol 50 No 5 (2023): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i5.890

Latar Belakang: Tinnitus retraining therapy (TRT), yang terdiri dari counseling therapy dan acoustic therapy, menjadi salah satu alternatif terapi tinitus. Namun, efektivitas TRT belum diketahui pasti. Tujuan: Mengetahui efektivitas TRT dalam meningkatkan kualitas hidup pasien tinitus. Metode: Laporan kasus berbasis bukti dengan mencari literatur dari pertanyaan klinis pada database Cochrane Library, Embase, ProQuest, PubMed, ScienceDirect, dan Scopus, dengan kata kunci sesuai pertanyaan klinis. Seleksi berdasarkan kriteria eligibilitas dan kesesuaian PICO, menghasilkan satu artikel kajian sistematik dan meta-analisis. Studi telah lolos telaah kritis sesuai pedoman Centre for Evidence-Based Medicine (CEBM) University of Oxford. Hasil: TRT memiliki overall response rate lebih tinggi dibandingkan terapi standar pada pasien tinitus (OR=7,01; IK 95%=5.16,9.53; p<0,00001; I2=0%; p=0,82). TRT memiliki skor tinnitus handicap inventory (THI) lebih rendah dibandingkan dengan terapi standar pada pasien tinitus (MD=-14.50; IK 95%=-16.65,-12.36; p<0,00001; I2= 8%; p=0,30). Simpulan: TRT efektif memperbaiki response rate terhadap tinitus dan menurunkan skor THI. Background: Tinnitus greatly affects daily activities, which can interfere with the quality of life. Tinnitus retraining therapy (TRT) which consists of counseling therapy and acoustic therapy, is an alternative therapy for tinnitus. However, its effectiveness is not yet known. Objective: To determine the effectivity of TRT in improving the quality of life of tinnitus patients. Methods: This study is an evidence-based case report that searches the literature from clinical questions in databases from Cochrane Library, Embase, ProQuest, PubMed, ScienceDirect, and Scopus, using keywords that matched the clinical question. Studies were selected based on the PICO and eligibility criteria. The result is one systematic review and meta-analysis article. The study has been critically appraised using the Center for Evidence-Based Medicine (CEBM) University of Oxford instruments. Result: TRT has a higher overall response rate than standard therapy in tinnitus patients (OR=7.01; CI 95%=5.16, 9.53; p<0.00001; I2=0%, p=0.82). TRT has a lower tinnitus handicap inventory (THI) scale than standard therapy in tinnitus patients (MD=-14.50; CI 95%=-16.65,-12.36; p<0.00001; I2= 8%; p=0.30). Conclusion: TRT effectively improves response rate to tinnitus and lowers THI score.

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