Comparative effects of masking, music therapy, and tinnitus retraining therapy on tinnitus severity and depression: a multidimensional evaluation

Abstract Purpose This study aimed to compare the effectiveness of three therapeutic approaches (masking therapy, music therapy, and tinnitus retraining therapy (TRT)) in reducing complaints related to tinnitus. It also investigated whether the effectiveness of these therapies varied according to tinnitus frequency and degree of hearing loss. Method Fifty-two patients aged 18–65 with chronic tinnitus were recruited from the otolaryngology clinic at Harran University Hospital. Participants were randomly assigned to one of three therapy groups: masking ( n = 16), music therapy ( n = 17), or TRT ( n = 19). All participants completed the Tinnitus Handicap Inventory (THI) and Beck Depression Scale (BDS) before and after therapy. Therapy protocols were tailored based on tinnitus frequency and hearing thresholds. Data were analyzed using descriptive statistics, one-way ANOVA, paired t -tests, and Spearman correlation analysis. Results Significant reductions in THI scores were observed in all three therapy groups ( p = 0.001). Music therapy and TRT showed comparable improvements, while masking also demonstrated a substantial effect. Subgroup analyses based on tinnitus frequency and hearing loss degree did not yield statistically significant differences between therapies ( p > 0.05), although notable trends were observed in some subgroups. No participants remained in the “catastrophic” THI category after treatment. Conclusions All three therapeutic approaches yielded meaningful reductions in tinnitus-related distress, with differences in strengths: masking was simple and well-tolerated, TRT offered neurophysiological benefits through counseling, and music therapy improved patient compliance. Further studies with larger samples and long-term follow-up are recommended to validate these findings and explore underlying mechanisms.