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09.06.2015

Tinnitus ear or brain, ear nose and throat institute - How to DIY

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Constant noise in the head -- such as ringing in the ears -- rarely indicates a serious health problem, but it sure can be annoying. Tinnitus (pronounced tih-NITE-us or TIN-ih-tus) is sound in the head with no external source. Almost everyone has had tinnitus for a short time after being exposed to extremely loud noise.
While there's no cure for chronic tinnitus, it often becomes less noticeable and more manageable over time.
Sound waves travel through the ear canal to the middle and inner ear, where hair cells in part of the cochlea help transform sound waves into electrical signals that then travel to the brain's auditory cortex via the auditory nerve. Most people who seek medical help for tinnitus experience it as subjective, constant sound, and most have some degree of hearing loss.
Tinnitus can arise anywhere along the auditory pathway, from the outer ear through the middle and inner ear to the brain's auditory cortex, where it's thought to be encoded (in a sense, imprinted). Most tinnitus is "sensorineural," meaning that it's due to hearing loss at the cochlea or cochlear nerve level. Tinnitus that's continuous, steady, and high-pitched (the most common type) generally indicates a problem in the auditory system and requires hearing tests conducted by an audiologist.
If you're often exposed to loud noises at work or at home, it's important to reduce the risk of hearing loss (or further hearing loss) by using protectors such as earplugs or earmuff-like or custom-fitted devices.
In addition to treating associated problems (such as depression or insomnia), there are several strategies that can help make tinnitus less bothersome. There is no FDA-approved drug treatment for tinnitus, and controlled trials have not found any drug, supplement, or herb to be any more effective than a placebo.
In a revolutionary series of experimental surgeries, Michael Seidman, MD, and his team have now shown that an electrode array implanted directly into the auditory cortex area of the brain can control tinnitus levels. Author’s Note: This procedure is still very early in the discovery process and this procedure is not available as a treatment option. Author’s note: Neural hyperactivity in the auditory cortex has long been associated with tinnitus.
The cortical response to MEG imaging was stronger in the right ear so the right auditory cortex was implanted. It is important to note that initially the effect was greater for the opposing ear but subsequently it had effectively eliminated the tinnitus in both ears.
High resolution MRI revealed a microvascular compression at the entrance of her spine into the brainstem. Four months later, MV underwent transcranial magnetic stimulation, which suppressed her tinnitus by 20-50% but did not last for any appreciable time. Two patients underwent intracranial electrical stimulation of their auditory cortex in an attempt to reduce or eliminate tinnitus.
Author’s Note: The limbic system is the part of the brain responsible for pleasure, emotions, sexual arousal and fear.
In many ways, this is similar to the early work of William House with cochlear implantation. It has been suggested that tinnitus can be affected through cortical and auditory pathway stimulation, provided that reorganization of auditory signals has not yet reached the ultimate phase of irreversibility. Things that cause hearing loss (and tinnitus) include loud noise, medications that damage the nerves in the ear (ototoxic drugs), impacted earwax, middle ear problems (such as infections and vascular tumors), and aging. One of the most common causes of tinnitus is damage to the hair cells in the cochlea (see "Auditory pathways and tinnitus").
Pulsatile tinnitus calls for a thorough evaluation by an otolaryngologist (commonly called an ear, nose, and throat specialist, or ENT) or neurotologist, especially if the noise is frequent or constant. You may also be able to reduce the impact of tinnitus by treating depression, anxiety, insomnia, and pain with medications or psychotherapy.


CBT uses techniques such as cognitive restructuring and relaxation to change the way patients think about and respond to tinnitus. Early experiments using DC current applied directly to the ear or mastoid bone showed promise in reducing tinnitus symptoms.
118 in March, 2008 with the title Direct Electrical Stimulation of Heschl’s Gyrus for Tinnitus Treatment by Michael D. Seidman begins by noting that tinnitus affects 50 million Americans and more than 300 million people worldwide. Seidman first experimented on animals to examine whether electrical stimulation of the auditory cortex suppresses tinnitus-related neural hyperactivity and found it to be effective. These determined the hearing levels at precise frequencies and pitch and loudness matching of their tinnitus. The skull was breached and electrodes were implanted in the opposing auditory cortex for the patient who had unilateral tinnitus and in the dominant ear of the patient who had bilateral tinnitus. Three months after surgery he reported his tinnitus was essentially gone when the electrode was active and recurred only several days after turning the device off.
Seven years after she developed her tinnitus, a microvascular decompression was performed and resulted in successfully treating her vertigo but failed to reduce her tinnitus. By altering the stimulation paradigm, she eventually had a 30% to 35% reduction in her tinnitus.
In patient one, the suppression of tinnitus was near complete, whereas in the other, it was moderate and did not last. The primary pitfall is determining which “structures” (areas of the brain) to target to minimize the perception of tinnitus. It is known that the limbic system plays a major role in the annoyance and aggravation of tinnitus. This implies that tinnitus should be treated as soon as possible, preferably within 5 years of onset.
This causes the middle ear mechanism (ossicles) to vibrate and send those waves on to the inner ear and brain.
Some medications (especially aspirin and other nonsteroidal anti-inflammatory drugs taken in high doses) can cause tinnitus that goes away when the drug is discontinued. This stimulates abnormal activity in the neurons, which results in the illusion of sound, or tinnitus. Tinnitus can also be a symptom of Mnire's disease, a disorder of the balance mechanism in the inner ear. If you have age-related hearing loss, a hearing aid can often make tinnitus less noticeable by amplifying outside sounds. The aim is to habituate the auditory system to the tinnitus signals, making them less noticeable or less bothersome. Audrey Maudoux found difference in the brain activity of tinnitus patients compared to the patients without tinnitus. Implanted electrodes used to control muscle spasms in Parkinson’s disease patients were found to reduce the sound of tinnitus, even though they were not implanted in the auditory cortex, where hearing occurs. The tinnitus would return when the electrode was off for 30-60 seconds and would decrease significantly when the electrode was active.
Several subsequent stimulation regimens applied over the succeeding 4 months failed to adequately diminish her tinnitus. However at her 2-year follow-up examination, her tinnitus had returned to its original levels. Whether this was due to the more longstanding nature of patient two’s tinnitus or to another reason is still unknown.
The main components of TRT are individual counseling (to explain the auditory system, how tinnitus develops, and how TRT can help) and sound therapy.


Individual studies have reported improvements in as many as 80% of patients with high-pitched tinnitus.
Two years after the accident, a sudden left-sided tinnitus developed and was associated with short-lasting spells of vertigo. Whether stimulation of the primary auditory cortex will have the greatest effect in alleviating the perception of tinnitus or whether stimulation of other structures, such as those within the limbic system, will have the greatest effect requires further study. Pulsatile tinnitus may be more noticeable at night, when you're lying in bed, because more blood is reaching your head, and there are fewer external sounds to mask the tinnitus.
Tinnitus can be a side effect of many medications, especially when taken at higher doses (see "Some drugs that can cause or worsen tinnitus"). A device is inserted in the ear to generate low-level noise and environmental sounds that match the pitch, volume, and quality of the patient's tinnitus. In a Cochrane review of the one randomized trial that followed Jastreboff's protocol and met the organization's standards, TRT was much more effective in reducing tinnitus severity and disability than a technique called masking (see below). But also less intense noise, when it is repeated or the patient is too close to the sound, can cause tinnitus. If amygdala an from it the sensory part of the brain is involved, the patients suffer more from their tinnitus even if they seem to have the same amount of tinnitus otherwise.
I discovered, that if I start trigger point treatment in the same day, most of the patients got rid of their tinnitus. Electrical stimulation of the skin near the ear, cochlea and brainstem has also provided some degree of tinnitus suppression. Many people worry that tinnitus is a sign that they are going deaf or have another serious medical problem, but it rarely is. If you notice any new pulsatile tinnitus, you should consult a clinician, because in rare cases it is a sign of a tumor or blood vessel damage. Noisy occupational environments are the most common causes of chronic tinnitus, that starts little by little during the years. Vagus nerve is used to ease tinnitus, there are different ways to do that and some results have been accomplished. A prior article discussing the early history of electrical stimulation can be found in our Tinnitus Library.
Also infections in the ear, like acute otitis media, can heal otherwise, but leave tinnitus in the ear. I myself have been working with muscles and their connections to the tinnitus network in the brain. Overuse of the masticatory and cervical muscles can cause tinnitus, sometimes even the shoulder area tensions can be connected to the ipsilateral tinnitus.
Autonomic neurons explain many phenomenon, that are connected to tinnitus like aural fullness and pain, sometimes hyperalgesia and hyperacusia. If we are quick enough, we are able to stop tinnitus from reaching the tinnitus networks of the brain and no tinnitus is formed. Most of them are used in severe diseases (cancer and deep infections) and they might save the patient’ s life but damage the inner ear. If tinnitus is combined to the hearing loss we should maybe give the patient an acute hearing aid fitting.
We do not know yet, but I have discussed with several tinnitus professionals in international congresses. A lot of work is to be done to find the best solutions in tinnitus treatment for everybody.



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