Objective:

To evaluate the efficacy of personalized mixed acoustic therapy in chronic tinnitus patients with and without hearing loss, and to identify baseline predictors of treatment response.

Approach:

• Study Design: A prospective observational cohort study involving 111 patients with chronic tinnitus, classified into hearing loss (HL) and non-hearing loss (NHL) groups.
• Assessment Tools: Participants underwent bilateral subjective tinnitus acoustic assessment and completed HAMA, HAMD, PSQI, and THI scales at baseline and after a 3-month intervention.

Key Findings:

• Both HL and NHL groups showed comparable improvements in tinnitus frequency, loudness, and PSQI scores after 3 months (significant main effect of time, no group × time interaction).
• NHL group exhibited significantly greater reductions in HAMA and THI scores compared to HL group (significant group × time interaction; both p < 0.05).
• NHL status, female sex, and lower baseline PSQI and HAMA scores were identified as independent predictors of favorable treatment outcomes (THI reduction ≥7).

Interpretation:

Personalized mixed acoustic therapy improves tinnitus perception and sleep quality in both HL and NHL patients, with greater psychological benefits for NHL patients.

Limitations:

• The study's findings may not be generalizable beyond the specific demographic of middle-aged and older adults.
• Potential biases related to self-reported measures and the exclusion of patients on psychotropic medication.

Conclusion:

The study supports a stratified approach to tinnitus management based on audiometric and psychometric phenotypes.