Electrical Stimulation of the Cochlea for Treatment of Chronic Disabling Tinnitus

This is quite surprising -- if the success rate figures turn out to be true?

Is it all about money? Sometimes, in medicine, it's fear of a bad outcome and a lawsuit... which comes down to money, too.

 

Let’s not forget to include the 22 participants from the 2022 study mentioned earlier in this thread. All 22 showed improvement. Reproducibility is key in validating these findings.

At this point, we should let Auricle proceed with its developments. Everyone involved should focus on accelerating progress.

Dr. Carlson has implanted nine patients at the Mayo Clinic, but we are still waiting for the results.

For the past year, I've pointed out that Med-El and Cochlear Ltd. are missing an obvious opportunity here.

 

...and Heidi Olze.

What is also worth bearing in mind is, the control. The device is installed into the test subject who has no idea whether or not it is switched on. This is true placebo control; none of that wishy-washy stuff we've all become so accustomed to wading through.

 

And how do we get them to move faster?

 

Identify the barriers that are impeding the process and work to remove them. Typically, these barriers involve either funding (such as for devices, staff, researchers, premises, and regulatory costs), a lack of partnerships (with tech companies, sponsors, facilities, and patients), or both.

 

60th birthday present? ;-)

 

That made me laugh, mate

 

Patents and Intellectual Property

This is an area where I am almost completely inexperienced, but it got me thinking. Dr. Hamid Djalilian has received significant donations from patients, which he has used to further his work on the implant.

Has he applied for or been granted a patent? If so, what are the implications?

There are limited human trials and approvals in Europe and other regions. Heidi Olze in Germany is progressing at a very slow pace. Could another manufacturer potentially produce these implants in Europe or Asia? Will there be multi-center trials outside the USA sponsored by UCI?

Take Otonomy, for example. They sponsored trials outside of Europe, and one of those sites was Sheffield Teaching Hospital, which is just up the road from me.

 

I just read about Heidi Olze, but the most recent article I found was from 2021. Is she still working on this? In the 2021 article, she mentioned it could take ten years before we see patients being treated, whereas I'm pretty sure Dr. Djalilian was hoping for 2027 with his implants. That's quite a difference!

 

This would be a good question to ask him at the upcoming Q & A event.

My main takeaway with Heidi Olze is that (as far as I know) she's one of the main players in Europe for this type of approach to cochlea stimulation. She's also competition, which is always a good thing.

Had I not encountered Hamid Djalilian (via the Tinnitus Talk Podcast with Brian Fargo), I wouldn't have known about his research. Also, the professional information online about him really only mentioned pharmacological approaches to tinnitus, CBT-like stuff, and an app, which was a bit puzzling because we know his situation is different.

Heidi Olze certainly cited the 5-10 years thing. Still, there's a reference to a device manufacturer being involved with her research, so who knows how various information and findings eventually feed into the network of tinnitus research? Positively, I hope.

 

I'm not sure how to ask this question in a politically correct way, but it's valid. It certainly seems that a fair number of tinnitus researchers have many irons in the fire, to the point where they likely can't devote enough time to fulfill all their responsibilities. It's hard not to speculate that they appear to jump from one potential revenue generator to another.

 

My new doctor actually recommended this to me. It was one of his first recommendations, and he's a young guy. I was pretty shocked. "Have you tried electrical cochlear stimulation?" I was like, "?????"

 

What did this look like and, if you looked into it, were there providers nearby?

 

If it were available, I'm sure there would be a big queue. Hats off to your doctor for even knowing about it.

I'm sure she said seven years in September 2022.

 

I can’t help but wonder, or even worry, whether any form of electrical stimulation would be suitable for someone with moderate to severe reactivity, or any reactivity, for that matter. Reactivity is the worst part of my condition. Perhaps I’m missing something, but I’ve tried Neuropuncture based on a study for tinnitus and tRNS, both of which involve sending electrical stimuli into the body. Unfortunately, these treatments made my tinnitus worse due to my heightened sensitivity to stimulation.

I realize these experiences are nothing compared to what’s being discussed here. Still, I’ve always felt that I needed something to counteract the already overstimulated nerves or possible central gain that cause my severe reactivity. This is especially problematic through the ears, where sound waves enter and exacerbate the issue.

Maybe these newer types of inner ear stimulation are so advanced that one might eventually say, "If you no longer have tinnitus, or if it’s significantly reduced, reactivity becomes a non-factor." That’s my hope, at least. Essentially, I just really hope that reactivity won’t interfere with the potential success of this treatment avenue.

On a related note, I checked the ClinicalTrials.gov page for Matthew Carlson’s study to see if there were any updates on the completion date. It appears to have been pushed back to mid-to-late 2026.

 

Dr. Polley at Harvard/Mass Eye and Ear follows a similar approach. He is less focused on finding a cure and more interested in discovering ways to "hack" the feedback loop that causes our issues. In fact, they have conducted some of their own research, with findings released in the spring of 2024. This research suggested that a 20-minute treatment could potentially lead to a week or more of tinnitus inhibition.

 

A 20-minute treatment of the electrical stimulation?

Yeah, I am worried about this as well, since I cannot tolerate hearing aids. If I can’t tolerate hearing aids, how would I tolerate this implant?

 

The data for this is probably already out there.

When first learning about an electrical tinnitus implant, one of my initial concerns was the long-term effect of applying current to the hearing system. A feasibility paper (I can't remember which, I'm afraid) mentioned exactly this, but in the context of cochlear implant patients. It concluded that tests on CI users > 5 years post-op showed no negative effects on residual hearing, alleviating my concerns.

I'm pretty sure that among the cohort of CI users who also experience tinnitus, there must be some with hyperacusis. Parsing that data to learn about their experience would likely be difficult but not impossible. Perhaps this is where projects like Tinnitus Quest can help.

 

Can you please post a link to this trial? I googled, but I can’t find anything mentioning 2026, only something for 2025.

 

December 2026. Fuck.

 

I know. I was very bummed when I saw this, too. A delay of almost a year and a half to two years from what was last stated? Good grief.

Sure, here's the link.

 

Opening lines to a tinnitus study like the above leave me gobsmacked.

 

Thank you! So strange. They started in August 2023 and say it lasts a year, but the trial won’t finish until 2026!

 

They technically started in August 2021, as the starting date is listed as 2021-08-23. So, it's even longer. But they just closed the study, I want to say, a little over a year ago, so their latest participant may have just been added in 2023.

 

Very good point, @ErikaS.

In addition to sound that exacerbates tinnitus, how could electrical stimulation of the inner ear help reduce tinnitus that reacts to somatosensory input, such as jaw movement (TMJ disorder), cracking of the eustachian tubes, tension in the tensor muscle of the soft palate, or movement and tension in the neck muscles (sternocleidomastoid)?

In my case, for example, my tinnitus worsened significantly due to these non-auditory factors. Could this type of stimulation potentially help me?

Lastly, could it also reduce loudness and pain hyperacusis?

 

He is also one of those working in 'their ivory tower.'

Yes, I nearly vomited when I saw that. WTF?

 

Given that we recently learned that Dr. Shore's device won't be on the market for years, the new hype seems to be focused on this subject.

Seriously, guys, are you really ready to have a device implanted in your ears to alleviate tinnitus?

Honestly, it would freak me out. I'm more interested in a non-invasive device.

Of course, it's good to see that some researchers are working hard to find something useful.

 

Yes.

No, I would not be freaked out in the slightest! People have cochlear implants, hip replacements, cataract surgeries, etc. Why would a middle ear implant freak anyone out?

 

I’d rather try Dr. Shore’s device first and see what happens with it than have an implant fitted. From everything I’ve read, I believe Dr. Shore’s device will hit the market before any of these electrical stimulation devices anyway.

 

If it works, why not?

When they first became available, cochlear implants were dismissed. Now, imagine how many hundreds of thousands of people could have heard from a young age if they had access to this technology sooner.

I'm increasingly convinced that cyborg-like adaptations are more likely to be the future of treatment in our lifetime than any biological cure. The issue is highly complex and involves the brain. This is what experts at Mass Eye and Ear have been suggesting — that it's more likely we'll find ways to "hack" our existing biological structures to eliminate the perception of tinnitus than to discover a complete cure. There are too many barriers to funding and research for Tinnitus-specific solutions, especially when other diseases with potential cures might offer broader benefits.

We just don't have the firepower.

However, electronic devices not only have a proven history of success, as seen with cochlear implants, but they also have the backing of doctors, such as audiologists and ENTs, when they work. If you think about it, it makes a lot of sense.