Hyperbaric Oxygen Therapy

[joe]

Hi,

Has anyone tried Hyperbaric Oxygen Therapy?
http://www.tinnitusformula.com/library/hyperbaric-oxygen-therapy-for-tinnitus/

It has some good results, if done in early onset.

Any feedback welcome.

 

[Markku]

Yep, there's a Finnish "tinnitus clinic" ( http://www.tinnitus.fi/tinnitus/index.htm ) who do these:

In Finnish:
5. Ylipainehappihoito (Hyperbarinen oxygenatio, HBO) HBO-terapiasta on esitetty olevan hyötyä jopa yli 80 %:lla potilaista jos tinnitus on alkanut vähemmän kuin 6 viikkoa aikaisemmin. Erityisesti HBOlla on esitetty olevan tehoa, jos tinnituksen aiheuttaja on äkillinen altistuminen hyvin voimakkaille äänille (ns. akuutti akustinen trauma). Tällaista tapahtuu eniten rock/pop-konserteissa, ilotulitustapahtumissa ja ammuntaharrastuksen yhteydessä. Krooniseen tinnitukseen teho oli selvästi huonompi. On raportoitu, että alle kolmasosa potilaista hyötyisi hoidosta. Kontrolloituja tutkimuksia ei kuitenkaan ole suoritettu.

Roughly translated into English:
"It has been suggested that Hyperbaric oxygen therapy could benefit even over 80% of patients if the onset of tinnitus has been within the last 6 weeks. Especially it has been theorized that HBO is most effective, if the cause of tinnitus is sudden exposure to very loud noises (ie. acute acustic trauma). This happens most often in rock/pop-concerts, during fireworks and shooting sports. For chronic tinnitus HBO hasn't been nearly as effective. It has been reported that less than third of patients benefit from this treatment. Although controlled studies haven't been carried out.


I know from Finnish tinnitus groups that
a) at least in Finland this treatment is pretty expensive. Almost 1000€ (about $1300) with the recommended amount of sessions.
b) at least those anecdotal reports from single persons I've read have generally been fairly negative: no noticeable improvement, even if the tinnitus has started very recently, ie. within a week. There are some exceptions, I know a young lady (in 20s) who got tinnitus due to a rock concert, it was very bad in her own terms. Three weeks later she found out about HBO clinic in Finland and got the treatment. It helped her so much that she says she doesn't have tinnitus anymore. Sometimes acute tinnitus can go away on its own too, as we all know about disco tinnitus, but that usually happens within a few days. It's rarer for disco tinnitus to stay for a couple of weeks I think, but still it's possible that even without HBO that girl's tinnitus would have stopped.

Regarding b)
Many people on the internet report negative experiences and unsuccessful attempts at treating tinnitus.
It's completely possible that there are more positive experiences than what I've been able to discover.

Finland has quite great public health care system, yet HBO hasn't been shown effective enough for the public system to cover its expense.

It would be great if a larger study would be done on the effects of HBO for acute tinnitus.


But if anybody who has gone through HBO themselves read this thread, it would be most appreciated if that person came forward and shared their experience.

 

[joe]

I am on my 4th treatment of this, I have booked 20 sessions, if I had known about it earlier I would have done it sooner, however there still could be some improvement in reducing the tinnitus possibly up to 3 months of the onset of the trauma.

I will keep you posted of my progress, my tinnitus was onset by a loud noise, and I have had a high pitched pulsating ringing since.

Some people have reported after 8 sessions the high pitch to change into more of a hiss, which might be more manageable. I can only hope.

 

[Markku]

joe,

how expensive is it for you? 20 sessions? If you don't mind me asking.

How frequently you go in for a session? Twice a week, once?

Let me know how it goes, I hope it at least reduces your T.

 

[joe]

Hi Markku, it's 5 days a week for 1 hour session each, in total it's 5 hours. I pay £20 GBP for all week. There are quite a few of these tanks here in UK.

 

[exodus]

Hi Markku, it's 5 days a week for 1 hour session each, in total it's 5 hours. I pay £20 GBP for all week. There are quite a few of these tanks here in UK.

Hi joe,

Are you doing that in a public hospital or elsewhere? I would like to try it if possible.

 

[joe]

Hi exodus,

Can you tell me a little about your tinnitus, how did it come on and how long have you had it?

 

[exodus]

Hi exodus,

Can you tell me a little about your tinnitus, how did it come on and how long have you had it?

Hi joe,

It started in May 2008 after a nose surgery. I was often having headaches because of bones in nose wasn't letting me breath well. It seems I have giant frontal sinus which are giving me headaches if they don't have enough air.

So after that surgery I was often having feelings of my ears being blocked (no air was circulating) so my ENT told me to block nose and mouth and push air inside the ears, while doing that in May 2008, the tinnitus started and has never stopped since.

You know the whole story.

 

[joe]

Incredible, I am sorry to hear this, what about the tinnitus itself. Is it tonal? Is it chirping sounds? High-pitched? Or just a clicking sound.

 

[exodus]

It's a tonal one with high frequency (8000) see attached my tinnitus profile and what I'm hearing

By the way does anyone know how to build a tinnitus masker using those information?

 

[joe]

Ok, H.B.O.T therapy probably wouldn't work as test show that it's an only effective treatment if it's done within the first year of trauma or onset. Your tinnitus frequency is 8 kHz which is within the treatment threshold of the ANM CR 30, you could give it a try if it doesn't work within the first 8 weeks ANM will give you a refund on the unit.

Did you call Susan? Did you get an appointment?

 

[exodus]

I've called them this morning but I find the device quite expensive as they are charging about 6000 pounds when the device is costing half from Germany so let me think twice about that.

 

[Markku]

Hi Markku, it's 5 days a week for 1 hour session each, in total it's 5 hours. I pay £20 GBP for all week. There are quite a few of these tanks here in UK.

What the ... how on earth does 10 sessions cost almost £800 here?

Not fair...!

(It might very well be because of there aren't so many of these chambers/tanks in Finland I think, so the few can set their prices high...)

PS. Let's talk about the ANM device here: https://www.tinnitustalk.com/threads/acoustic-cr®-neuromodulation-a-new-treatment-for-tinnitus.219

 

[joe]

Yes Markku, a Local Hospital here in the UK has one and it hasn't been used since the hospital opened 23 years ago, when I asked them if I could use it, they said they had no one who could operate it. How shameful is that. It made my blood boil, for legal reasons I can't mention the hospital but it's totally sad.

 

[joe]

I've called them this morning but I find the device quite expensive as they are charging about 6000 pounds when the device is costing half from Germany so let me think twice about that.

Can I ask who made your tinnitus profile???

 

[exodus]

An audiologist outside the UK made my tinnitus profile.

 

[joe]

Ok, does the audiologist stock the ANM CR30 or maybe get it in??

 

[exodus]

Not my audiologist.

 

[joe]

Markku, I have had my 6th treatment of HBOT today, I have to be honest I haven't felt my tinnitus change in pitch or get any lower, it's the same??? The only thing I am experiencing is my ears are popping a lot, they get really tight to the point I have to swallow to reset them, do you have any idea why?? Or maybe what this symptom is...

 

[Markku]

Markku, I have had my 6th treatment of HBOT today, I have to be honest I haven't felt my tinnitus change in pitch or get any lower, it's the same??? The only thing I am experiencing is my ears are popping a lot, they get really tight to the point I have to swallow to reset them, do you have any idea why?? Or maybe what this symptom is...

http://en.wikipedia.org/wiki/Hyperbaric_oxygen_therapy

Possible complications and concerns

There are risks associated with HBOT, similar to some diving disorders. Pressure changes can cause a "squeeze" or barotrauma in the tissues surrounding trapped air inside the body, such as the lungs,[67] behind the eardrum,[68][69] inside paranasal sinuses,[68] or trapped underneath dental fillings.[70] Breathing high-pressure oxygen may cause oxygen toxicity.[71] Temporarily blurred vision can be caused by swelling of the lens, which usually resolves in two to four weeks.[72][73]
There are reports that cataract may progress following HBOT.[74] Also a rare side effect has been blindness secondary to optic neuritis (inflammation of the optic nerve).[citation needed]

Effects of Pressure

Patients inside the chamber may notice discomfort inside their ears as a pressure difference develops between their middle ear and the chamber atmosphere.[75] This can be relieved by the Valsalva maneuver or by "jaw wiggling". As the pressure increases further, mist may form in the air inside the chamber and the air may become warm. Increased pressure may also cause ear drums to rupture, resulting in severe pain.
To reduce the pressure, a valve is opened to allow air out of the chamber. As the pressure falls, the patient's ears may "squeak" as the pressure inside the ear equalizes with the chamber. The temperature in the chamber will fall. The speed of pressurization and de-pressurization can be adjusted to each patient's needs.



And hmm... I hope HBOT will help you, you do have some sessions still left I think you have a good attitude though, you know that it might not help but you are giving it a go nevertheless. I probably should have done it too (even with the high cost), but now it's too late.

The following is a discussion about HBO sourced from a Finnish bulletin board: http://keskustelu.suomi24.fi/node/935227

Sain äkillisen melualtistuksen vuoksi( viallinen varashälytin kerrostalomme vinttitiloissa) pahan tinnituksen. Kuulin ylipainehappi hoidosta vasta 3 viikon kuluttua onnettomuudesta, itse hoito alkoi n. neljän viikon päästä onnettomuudesta. Tinnitus hiljeni lähes kuulumattomiin, yliherkkyys korkeille äänille parani eli auttoi huomattavasti. Jos olet hiljattain saanut melualtistuksen vuoksi tinnituksen, toimi mahd.nopeasti, hoito toimii sitä paremmin mitä vähemmän aikaa onnettomuudesta on kulunut.

In English... "I was exposed to sudden loud noise (faulty burglar alarm in your apartment's attic) and got tinnitus because of that. I heard about HBO only 3 weeks after I got tinnitus, the treatment itself started within 4 weeks from the onset of tinnitus. Tinnitus quieted down to almost zero, hyperacusis was cured, so the treatment helped a lot. If you have recently been exposed to loud noise and got tinnitus because of that, act as fast as possibly, since the treatment works the better the less time it has been since the trauma."

Another one in the same discussion...

Ei auttanut minulla
Itselläni on ollut tinnitus vuodesta 2000. Olin jo oppinut elämään sen kanssa ihan hyvin, mutta uusi melualtistus (sinfoniaorkesterin konsertti) viime keväänä pahensi tilanteen. Tinnitus koveni ja lueskelin netistä tuosta happihoidosta ja kävijöiden kokemuksista. Osa oli saanut jonkinlaista apua, osa ei ollenkaan. Päätin sijoittaa 800 euroa ja kokeilla viiden kerran hoitosarjaa varmuuden vuoksi. Valitettavasti nollatuloksella. En saanut hoidosta siis minkäänlaista apua, en tinnitusääniin enkä ääniyliherkkyyteen, vaikka uudesta melualtistuksesta oli kulunut vain kolme viikkoa hoidon alkaessa. Tietysti tinnitustapaukset ovat yksilöllisiä ja joku voi hyvinkin saada apua happihoidosta. Kuten ketjun aloittaja. En halua siksi kyseistä hoitoa lytätä.

In English... "Didn't help me. I have had tinnitus since the year of 2000. I had already learned to live with it well, but new noise exposure (symphony orchestra) caused it to become worse. Tinnitus became louder and I read on the Internet about the HBO and experiences of those who've undergone the treatment. Some had got a bit of help, some nothing at all. I decided to invest 800€ and tried five sessions of HBO treatment just in case. Unfortunately without results. I didn't get any benefit from the treatment, not for tinnitus nor the hyperacusis, even though the new noise exposure had been only three weeks ago when starting the treatment. Of course tinnitus cases are different and somebody can very well be helped with HBO. Just like the original poster. That's the reason I don't want to call this treatment snake oil."


Best of luck!

 

[Markku]

A couple of studies:

http://www.ncbi.nlm.nih.gov/pubmed/10384896
In this study, we prescribed HBO to 20 patients who had had severe tinnitus for more than one year and who had already had other forms of tinnitus therapy with unsatisfactory results.
Six patients had a reduction of tinnitus and accompanying symptoms, eight patients did not notice any change and two patients experienced an adverse effect. Any outcome persisted with minor changes until one year after treatment. HBO may contribute to the treatment of severe tinnitus, but the negative effect on tinnitus should be weighed carefully.

So in that study HBO was tried for patients who had had tinnitus for more than one year. Six of 20 had a reduction of tinnitus, 8 of 20 had no effect and 2 of 20 experienced an adverse effect.


Another one: http://www.ncbi.nlm.nih.gov/pubmed/17159373

INTRODUCTION:
The standard treatment of subjective tinnitus hardly reaches the level of placebo controls. Though the effectiveness of hyperbaric oxygenation (HBO) for subjective tinnitus has never been objectified, it is still advocated by some institutions. We analyzed the effectiveness of hyperbaric oxygen treatment in the context of accompanying factors.


PATIENTS AND METHODS:
We randomized 360 patients suffering from tinnitus into 2 HBO treatment protocols (group A: 2.2 bar for 60 min bottom time and group B: 2.5 bar for 60 min bottom time once a day for 15 days). All patients were asked to fill in a questionnaire (social and medical history, tinnitus characteristics, pre-HBO duration of tinnitus, prior therapy, pretreatment expectation, accompanying symptoms). A subjective assessment of the therapeutic effect was obtained.


RESULTS:
Twelve patients (3.3%) experienced complete remission of tinnitus, in 122 (33.9) the intensity lessened, and 44 (12.2%) had a subjectively agreeable change of noise characteristics. No change was found in 157 cases (43.6%) and 25 (6.9%) experienced deterioration. There was no statistically significant difference between groups A and B (p > 0.05). Out of 68 patients with a positive expectation of HBO effects, 60.3% stated that the tinnitus had improved whereas only 47.2 and 19%, respectively, out of patients who underwent therapy with an indifferent (n = 271) or negative expectation (n = 21) reported an improvement. The influence of subjective expectation on the outcome was statistically significant (p < 0.05).


CONCLUSION:
The therapeutic effects of HBO on subjective tinnitus may be substantially influenced by psychological mechanisms.


From that second study it's interesting that the influence of subjective expectation was statistically significant.



Then finally a review: http://www.ncbi.nlm.nih.gov/pubmed/18225611

OBJECTIVE:
To assess the effect of hyperbaric oxygenation on tinnitus.


METHODOLOGY:
A Medline search from 1960-2007 yielding 22 studies.


RESULTS:
No significant effect could be demonstrated in four prospective studies. Retrospective studies indicate greater improvement in tinnitus in acute cases (49-85%) compared with tinnitus episodes exceeding three months (34-38%). One study, however, showed significantly more improvement in patients with positive expectations before therapy (60.3%) compared with those with negative expectations (19%).


CONCLUSIONS:
There are no significant data about the effect of hyperbaric oxygenation for tinnitus, but there are indications of a better effect in acute cases. However, a major psychological component and a low risk of enhancement of the tinnitus should be considered.

 

[joe]

I will keep going, my next one's tomorrow morning at 10:30am, I read on an American forum someone noticed changes after the 8th session, he had tried HBOT 6 months after tinnitus onset? I am only 3 months in? Who knows...

But for the sake of this debilitating tinnitus I will go through with it and report my progress.

As we all need to know the truth about HBOT and if it still works at 3 months after onset or not, it's horrible going into a chamber for an hour with a door locked shut. The best part of it is when the hour is over and they open the door, only 14 more to go... Hey ho!!!

 

[Markku]

I will keep going, my next one's tomorrow morning at 10:30am, I read on an American forum someone noticed changes after the 8th session, he had tried HBOT 6 months after tinnitus onset? I am only 3 months in? Who knows...

But for the sake of this debilitating tinnitus I will go through with it and report my progress.

As we all need to know the truth about HBOT and if it still works at 3 months after onset or not, it's horrible going into a chamber for an hour with a door locked shut. The best part of it is when the hour is over and they open the door, only 14 more to go... Hey ho!!!

Indeed. At least HBO has some (albeit small) trials behind it for tinnitus. "there are indications of a better effect in acute cases. However, a major psychological component and a low risk of enhancement of the tinnitus should be considered."

Relatively low-risk & improvements may occur. I don't expect in my lifetime for there to be a magic bullet for tinnitus that cures all cases. It will be hit and miss I think!

I'm not very fond of "treatments" that don't have any kind of scientific backing behind them (ie. homeopathy, different kinds of other alternative therapies...), but I'm willing to try almost anything that is at least being studied and trialed and positive effects have been noted.

I wish you all the best for every day when you go into the chamber. It's over sooner than you think!

 

[joe]

Thanks Markku

 

[joe]

Ok guys I have had my 8th Session, today, I have made some discoveries.

If I breathe the oxygen through the mask with no pressure in the chamber, the tinnitus is the same, no change. Soon as they compress us to 16 ft my tinnitus goes away, it's completely silent for the whole hour, at 16 ft (4.87 m).

As soon as we are decompressed to normal atmospheric pressure my tinnitus comes back, full on.

Has anyone else experienced this, are there any divers who dive 4.87 meters with tinnitus and get silence.

 

[Markku]

Ok guys I have had my 8th Session, today, I have made some discoveries.

If I breathe the oxygen through the mask with no pressure in the chamber, the tinnitus is the same, no change. Soon as they compress us to 16 ft my tinnitus goes away, it's completely silent for the whole hour, at 16 ft (4.87 m).

As soon as we are decompressed to normal atmospheric pressure my tinnitus comes back, full on.

Has anyone else experienced this, are there any divers who dive 4.87 meters with tinnitus and get silence.

Wow, that's very interesting. I don't remember reading about that kind of effect ever. I only know that some tinnitus can be caused by diving (ie. descent/ascent and perforating ear drum, or something...). Common Ear Injuries While Diving.

But the other way around, no, this was new to me.

 

[joe]

9th session today, had 1 hour treatment in the chamber I read my book and enjoyed an hour of pure silence However it ended soon as we were back at normal atmospheric pressure.

New to me also Markku, the only logic I can think of is our inner ear is made up of some tiny bones and membranes and with pressure on these the noise comes down to silence?

Trauma may have sent them into a state of shock or thrown them of course which could possibly cause these sound bones to vibrate emitting a phantom noise in which we hear as ringing or tinnitus.

I don't have enough knowledge about ear anatomy to back this, but I think it's the only logical explanation based on what I know???

Who should I approach about this? My E.N.T???

 

[Markku]

9th session today, had 1 hour treatment in the chamber I read my book and enjoyed an hour of pure silence However it ended soon as we were back at normal atmospheric pressure.

New to me also Markku, the only logic I can think of is our inner ear is made up of some tiny bones and membranes and with pressure on these the noise comes down to silence?

Trauma may have sent them into a state of shock or thrown them of course which could possibly cause these sound bones to vibrate emitting a phantom noise in which we hear as ringing or tinnitus.

I don't have enough knowledge about ear anatomy to back this, but I think it's the only logical explanation based on what I know???

Who should I approach about this? My E.N.T???

Tinnitus stops while diving
Any Divers with Tinnitus? (Ringing in the ears)

You might want to read those two discussions above.

Indeed it looks like you're not the only one.

 

[Jim]

9th session today, had 1 hour treatment in the chamber I read my book and enjoyed an hour of pure silence . However it ended soon as we were back at normal atmospheric pressure.

Hi Joe, I have had a similar experience. A few years back I was doing some scuba diving and noticed that my tinnitus had completely subsided while submerged. When I surfaced it came right back. I had the same thing happen while snorkeling. Dive down it goes away, come back up, it comes back. This effect continued for some time. Unfortunately for me that effect does not happen anymore. Fortunately my tinnitus is not nearly as bad now as it was back then.
Good luck with the HBOT, I hope it works for you. Keep us posted.

 

[joe]

Hi, Jim and Markku thanks for pointing that out, I thought I was the only one to experience this, well Jim looks like you did your own H.B.O.T the natural way, your way sounds much interesting I can imagine the nature you would have seen along with your dives. I love coral and all the colours. It sure beats being in a boring chamber!

However my 10th session today and still no changes, I have another 10 to go... Phew half way there..