Tinnitus Treatment Case Study Shows Promise

Having spent more than 18 years in the audio business, and most of that time developing loudspeakers, I've spent my fair share of time listening to music at far too high a volume. Thankfully, I still retain most of my hearing. Unfortunately, though, I've had colleagues who have developed hearing loss and tinnitus. Tinnitus can be difficult to manage, and even more difficult to live with. Although there are a variety of treatments available for tinnitus, many have serious side effects, or marginal effectiveness. Many tinnitus sufferers have no choice but to take antidepressants for the rest of their lives to control the condition. A new case study shows a potential new drug-free therapy may be able to substantially reduce the symptoms of tinnitus with no side effects, although more substantial study is still required.

What is Tinnitus?

Before we get to a further discussion of the tinnitus treatment case study, let's discuss tinnitus itself. Tinnitus can be caused by many different things. According to the Mayo Clinic, a type of tinnitus called pulsatile tinnitus can be the result of any of a number of different circulatory system disorders or even a tumor exerting pressure in the region around the ear. Let's leave the discussion of pulsatile tinnitus for another time; I'd like to focus on the type of tinnitus associated with hearing loss. As we get older, most, if not all of us will experience a decline in our hearing. This typically starts with losing the ability to hear higher frequencies; the highest pitched sounds we can hear get lower and lower over time. When this progression gets into the normal range of vocal frequencies, we may have trouble understanding conversations and resort to a hearing aid.

Hearing loss can also be caused by excessive exposure to loud noise, like loudspeakers cranked up high to evaluate their performance. Both kinds of hearing loss are associated with damage to microscopic hairs in the chambers of the inner ear. These hairs normally trigger the sending of signals to the brain in response to the vibrations caused by sounds. Sometimes, when they are damaged, these hairs in the inner ear can end up sending constant signals, even in the absence of external sounds. The brain interprets these signals as a constant ringing. This ringing in the ear is called tinnitus. Hearing damage due to loud music or other loud noises is largely dosage related. In other words, you can turn the stereo all the way up for very short time with little or no damage, but depending upon the volume, the longer you listen, the more you are likely to do permanent damage to your hearing. We were taught these things and the workings of the inner ear in one of the audio companies for which I worked. They made sure we understood the dangers of listening to music at too high a volume, even if we were listening through our own dearly beloved loudspeakers. Hearing loss related tinnitus typically doesn't go away, ever. Your ears ring all day and all night for the rest of your life. Depending upon the severity of the tinnitus, the ringing in the ears can be so loud that it is nearly impossible to sleep or even think straight. Certain medications or structural changes to the inner ear bones can also be causes of tinnitus, but these are less common causes.

Typical Tinnitus Treatments

There are a number of medications commonly used to treat tinnitus associated with hearing loss, but most either have very limited effectiveness or have side effects that may make the tinnitus sufferer prefer to go without medication. Less severe tinnitus can be managed either by using a hearing aid so that real sounds outweigh the tinnitus or providing a background masking noise in the sufferer's room. Sometimes, it's just a matter of getting used to the constant ringing so it seems less distracting. Don't avoid seeking proper medical treatment. Some people do find effective relief from the available medications; the effectiveness tends to vary between individuals but you may be one of the ones for whom traditional treatments work very well. Discuss all available options with your doctor and make your decision based on his experience and advice.

Tinnitus Treatment Case Study

A case study (Mennemeier et al, 2008) published in the July issue of Laryngoscope was conducted at the University of Arkansas for Medical Sciences (UAMS). The study, led by Dr. Mark Mennemeier, Department of Neurobiology and Developmental Sciences at UAMS, cites as background for his study previous work showing that no medication is more effective than placebo treatments for tinnitus and showing that application of low frequency magnetic stimulation of a the auditory cortex has previously been effective in temporary relief of tinnitus in more than half of the subjects of such experimental treatment. Given this data, Mennemeier and his colleague sought to test whether the application of follow-up maintenance treatments of this magnetic stimulation might prolong the subject's relief from tinnitus.

Tinnitus Case Study Subject

The UAMS study used a subject with a 20 year history of exposure to loud music. The subject had suffered from tinnitus in both ears and a partial hearing loss (maximum reduction of 55dB at 4kHz for my audio-enthusiast friends), but was still able to understand normal conversational speech. Asked to rate the loudness of the ringing in his ears, the subject rated it as 44 out of 100.

Transcranial Magnetic Stimulation Case Study Results

Immediately after the magnetic stimulation therapy, the subject rated the loudness of his tinnitus at 20, a marked improvement. Over time the tinnitus returned to higher levels. 18 months later, the subject was invited back for maintenance treatments. Magnetic stimulation was applied again to the auditory cortex. Over the course of several weeks, treatment was applied each time the subject's tinnitus loudness rating reached 25 or higher. Four months after the last of three maintenance sessions, the subject reported the loudness of his tinnitus at 17, and according to the published case study said the tinnitus no longer bothered him on a daily basis. No side effects were observed or measured.

Tinnitus Case Study Conclusions

Clearly, a case study involving one patient is not grounds for statistically valid results of any kind. However, it does show that transcranial magnetic stimulation maintenance treatments may substantial prolong meaningful relief from tinnitus. The case study provides a basis for future, more rigorously controlled studies to quantify the effectiveness of this treatment for tinnitus. Such a further study cannot come too soon for those who suffer from tinnitus.

Sources:

Mennemeier et al.; Maintenance Repetitive Transcranial Magnetic Stimulation Can Inhibit the Return of Tinnitus. Laryngoscop; July, 2008.

Mayo Clinic Staff; Tinnitus; retrieved on July 10^th from www.mayoclinic.com/health/tinnitus/DS00365.