New Combo Approach May Ease Severe 'Ringing in the Ears'12/06/13
FRIDAY, Dec. 6, 2013 (HealthDay News) -- Patients suffering from
the intense, chronic and sometimes untreatable ringing in the ear
known as tinnitus may get some relief from a new combination
therapy, preliminary research suggests.
The study looked at treatment with daily targeted electrical
stimulation of the body's nervous system paired with sound
Half of the procedure -- "vagus nerve stimulation" -- centers on
direct stimulation of the vagus nerve, one of 12 cranial nerves
that winds its way through the abdomen, lungs, heart and brain
Patients are also exposed to "tone therapy" -- carefully
selected tones that lie outside the frequency range of the
troubling ear-ringing condition.
Indications of the new treatment's success, however, are so far
based on a very small pool of patients, and relief was not
"Half of the participants demonstrated large decreases in their tinnitus symptoms, with three of them showing a 44 percent reduction in the impact of tinnitus on their daily lives," said study co-author Sven Vanneste. But, "five participants, all of whom were on medications for other problems, did not show significant changes."
For those participants, drug interactions might have blocked the
therapy's impact, Vanneste suggested.
"However, further research needs to be conducted to confirm this," said Vanneste, an associate professor at the School of Behavioral and Brain Sciences at the University of Texas at Dallas.
The study, conducted in collaboration with researchers at the
University Hospital Antwerp, in Belgium, appeared in a recent issue
of the journal
Neuromodulation: Technology at the Neural Interface.
The authors disclosed that two members of the study team have a
direct connection with MicroTransponder Inc., the manufacturer of
the neurostimulation software used to deliver vagus nerve
stimulation therapy. One researcher is a MicroTransponder employee,
the other a consultant. Vanneste himself has no connection with the
According to the U.S. National Institute on Deafness and Other
Communication Disorders, nearly 23 million American adults have at
some point struggled with ear ringing for periods extending beyond
Yet tinnitus is not considered to be a disease in itself, but
rather an indication of trouble somewhere along the auditory nerve
pathway. Noise-sparked hearing loss can set off ringing, as can
ear/sinus infection, brain tumors, heart disease, hormonal
imbalances, thyroid problems and medical complications.
A number of treatments are available. The two most notable are
"cognitive behavioral therapy" (to promote relaxation and
mindfulness) and "tinnitus retraining therapy" (to essentially mask
the ringing with more neutral sounds).
In 2012, a Dutch team investigated a combination of both
approaches, and found that the combined therapy process did seem to
reduce impairment and improve patients' quality of life better than
either intervention alone.
Additional options include neural stimulation, hearing aids,
cochlear implants, dietary adjustments, and/or antidepressants and
anti-anxiety medications. But there is no known cure, and some
patients do not respond to any treatment.
Searching for a new approach, the investigators behind the new
study focused on a small group of just 10 Belgian patients, all of
whom had been struggling with severe ear-ringing for a minimum of
one year before enrolling in the study. Standard treatments had
failed to ease their symptoms.
Each patient was implanted with a stimulation electrode
connected directly to their vagus nerve. The research team noted
that electrical stimulation of the vagus nerve is already approved
by the U.S. Food and Drug Administration as a method for treating
both epilepsy and depression.
Throughout the 2.5 hours of daily treatment, electrical
stimulation levels remained below 1 percent of the FDA-approved
maximum, according to the study.
For the 20-day treatment period, vagus nerve stimulation was
paired with half-second pure tones that ranged in frequency from
170 hertz to 16,000 hertz (cycles per second). Tones were always at
least a half-octave above or below ear-ringing frequencies.
In the end, the researchers said the patients experienced few
side effects, and that the four patients who experienced relief
from their condition had maintained their improvements as much as
two months after therapy.
None of the four had been taking any medications during the
study period, the authors said. By contrast, the five patients who
failed to experience relief had been taking a range of
Dr. Donald Keamy Jr., a pediatric otolaryngologist (ear, nose
and throat specialist) at the Massachusetts Eye and Ear Infirmary,
said the effort addresses a real need for new tinnitus treatments.
He was not involved with the study.
"Many people try to ignore this condition when it arises, but this is a very prevalent problem," Keamy noted. "And while we have treatments, there's no one therapy that fits everybody. In fact, many sufferers, like the ones in this study, have tried everything and nothing has worked. Which means, frustratingly, that many people who seek help are told that they just have to live with it, even though they can't sleep and they can't perform their daily duties," he added.
"So this can be very debilitating, and have a really big impact on a patient's quality of life," Keamy explained. "The traditional treatments we have are not sufficient and a search for new approaches -- like this one -- is certainly necessary."
For more about tinnitus, visit the
U.S. National Institute on Deafness and Other
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