Characteristics and treatment outcomes of musical tinnitus: a prospective study

Tinnitus, the perception of sound without an external source, affects millions worldwide. Although its origin may be organic or psychological, musical tinnitus (hearing music in the absence of external stimuli) presents a distinct challenge. This study investigated musical tinnitus, focusing on its clinical profile, treatment outcomes, and associated psychiatric symptoms. The demographics, auditory perceptions, psychiatric history, and treatment response of 20 patients with musical tinnitus were prospectively evaluated. Sound therapy using hearing aids and tinnitus counselling were administered. Data were collected using the Tinnitus Handicap Inventory (THI), Visual Analogue Scale (VAS) for tinnitus loudness and distress, Self-Rating Depression Scale (SDS), and the State-Trait Anxiety Inventory (STAI). Of the 20 patients who underwent these tests every year until the 2-year follow-up, 15 were able to follow a sound therapy treatment regimen with hearing aids for > 2 years. The results revealed the prevalence of musical tinnitus in older women with hearing loss, emphasising its association with aging and the female sex. Patients reported varied musical content, predominantly nursery rhymes and melodies originating from the ear or head. No significant psychiatric symptoms were observed; this contrasts with previous reports linking musical hallucinations and psychiatric disorders. Sound therapy using hearing aids and counselling led to significant improvements in THI, VAS, and STAI-state scores at 1-year and 2-year follow-ups, suggesting the efficacy of this approach. However, no significant changes were noted in SDS or STAI-trait scores, indicating a lack of prominent depressive tendencies and stable anxiety traits. Musical tinnitus primarily affects older women with hearing loss and responds favourably to sound therapy. Understanding its clinical characteristics and treatment outcomes is crucial for optimising patient care and enhancing quality of life.