Lecture ("Tinnitus: Ear or Brain") by Dirk De Ridder in Belgium on April 22, 2019

Only glancing over this topic, but I notice only hearing loss / the cochlea is mentioned so far.

There are more ways to get tinnitus than through ear (mal)function. My case for example. Perfect health, but one day I slipped half-way down the stairs, barely managed to grab the support bar and then sled down to the bottom. Boom, I got tinnitus. First one sound, then up to 12 appeared in the months after.

I did not hit my head or something, it just appeared, without any trauma related to the hearing. The first ENT couldn't help me, but after a few months of searching, the conclusion is that the signals from my neck muscles are being mis-interpreted as sound. Though this diagnosis could not be confirmed by imaging, it did fit my symptoms perfectly (sounds differing with each posture etc.).

Physiotherapy helped a lot and eliminated six sounds, while reducing the others as well. Still got bad periods (have one right now), but there are stories and research articles online where it is shown that these cases can be fixed completely.

The only issue is our (lack of) understanding of tinnitus. Yes, the brain is related, but not necessarily the issue. Everyone with tinnitus has hearing loss, but so does every human alive: the fact alone does not tell us much. We all drink water as well, that does not mean it has to be related (although hearing loss makes more sense of course, it is often an issue).

Tinnitus is nothing other than a symptom, and it needs to be viewed in a broad picture. Determine the symptoms, find the underlying issue (or at least the one making the most sense in the patient's case). Try to fix that if possible.
That's definitely a source of frustration to me. It's always assumed unknown tinnitus is noise induced because everyone is exposed to traffic noise or construction noise or has been to a concert or has worn earphones.

As you pointed out, though, sometimes tinnitus can have non cochlear causes (like TMJ or neck issues) or even cochlear causes not usually addressed (like PLF or atypical Meniere's). ENTs need way more training on how to work up tinnitus and patients need to rule out the treatable causes before jumping to TRT.

It sounds like Susan Shore's device could really help you, but for me I don't have a somatic element to my tinnitus so I doubt it. As these treatments become available, the medical profession is going to have to get better at subtyping.
 
Ah! Good to get back to you. My tinnitus came on so faintly back in 1992 and got gradually louder and louder within the next days and weeks. I had good insurance back then, but my ENT sent me to the hospital somewhat late. You have to understand that at that time I didn't know what was wrong with me. A relation of mine in the medical field phoned me in hospital and told me the name was called tinnitus. He did his research -- he was one of the early ones into the internet --which was hardly known back then and read out something along the sound of the following sentence:

" A breakthrough occurred in the year 198* when the scientific community gave "ringing in the ear" the scientific term of "tinnitus" ". The exact year I don't know. Maybe 197* -- but it shows the lay of the land back then.

You might smile at this being described as a breakthrough -- But it really was! Just like the discovery of some tropical island in the age of exploration, (colonialism?) to be put on the scientific map like that with its very own name alerted the scientific academic community
What infusion therapy did I receive? I seem to recall some name such as Trental -- but that might be a German trade name -- Rogaine too, perhaps. The doctors chopped and changed the infusion drip throughout the two weeks that I was in hospital.

For many years it was a sore point with me that the ENT had not sent me to the hospital immediately. But I recall the first day in the hospital bed they tried the standard "Shtuff" on me in a precautionary allergy test and I failed it. So perhaps I was b*ggered from the start. German medical practice is to try to flush out the inner ear with plenty of some oxygen bearing infusion and to get the hair cells upright again. So to your question: I assume that I got a variety of the different infusion therapies which were fashionable in the 1990s. Trental and perhaps Rogaine... My memory is not all that good. It would not surprise me if they have improved or changed on them. Someone on Tinnitus Talk mentioned getting an intratympanic membrane injection of steroids or some such thing. Maybe that is a safer and more effective therapy than the German one for acute cases.

Back then I recall how my relation in the medical field was so enthusiastic about the internet and world wide web and wanted to get me enthused about it. He mentioned how back in the 80s and early 90s and before -- if you wanted to access some study or report done by a previous researcher, you had to catch a train or drive to some central archive and wait your turn and then real nicely ask the archivist in the library: "Please would you go down to the cellar and get photocopies of report nr whichever by doctors A and B (196*) and also report nr whatever by doctors C & D (197*) and etc., etc. and after about half an hour if you were lucky they came back up with the information.

Nowadays researchers have it all in a few mouse clicks -- and so do we if one can understand what it's all about.

An extreme version of this is the example of the Tinnitus Retraining Therapy. It seems to be getting a lot of stick now but it certainly helped me the most out of all the other therapies and cures doing the rounds.
The story goes that Pawel Jastreboff wrote his research paper and as with many research papers before it ended up in some archive gathering dust. A chance after-dinner conversation between the secretary of ENT Dr. Jonathan Hazell from London and Jastreboff in the US let to an enormous breakthrough:

The suggestion came up: "Why not put the theory into practice by testing it"!

Mild sarcasm alert here.
Well it helped me back in the 90s but now that my tinnitus is getting worse since 2016 it doesn't seem to work any more. I guess I must have graduated to some additional form of cochlear damage. :depressed:

On the little matter of money and research. That is real important. And getting the politicians to direct the funding in our direction will accelerate the advent of a cure or therapy enormously. One story related to the Jastreboff/Hazell incident is that Reagan was in power then. He suffered from tinnitus from a gunshot wound. He asked the top medical people in Washington if they could do anything it and they answered that "Sadly Mr President, we can put a man on the moon but we can't cure tinnitus." When Nancy heard this she took the matter in hand and ordered them to go and find something. And that's how Jastreboff and Hazell got the attention and research funding. That's the urban legend anyway. I'm sure it's at least 50% true. (I flipped a coin).

So cynical me is of the opinion that perhaps one of the main reasons for the increased interest and nr of clinical trials is simply because of the nr of army veterans suffering from hearing damage and the enormous cost burden on the Veterans Medical Funding.

Curiously, when I think of my own case, back in the nineties I must have taken wheelbarrow loads of blood-thinning tablets and magnesium powder prescribed by my doctor. He knew that they weren't working, the pharma people knew they weren't working, I knew they weren't working, but the elements of the machine were happy to continue to roll. The doctor got his fee, the pharma company got their sale and I happily paid my insurance which I needed anyway. Only thing was that I was suffering from the tinnitus.

Ups. Maybe I talk a bit too much. End of lecture. I seem to be all over the shop in my reply covering so many different topics and maybe not posted in the right thread. Well copy and paste as you like.
End of rant.
For me, that really puts it into perspective how far we have come. Crazy to think tinnitus wasn't even on the radar of the health field until recently.
 
For me, that really puts it into perspective how far we have come. Crazy to think tinnitus wasn't even on the radar of the health field until recently.
Well it ain't that simple. Please understand that my background knowledge that I gleaned and gathered about tinnitus was for the most part from back in the 90's. So my answer might or should be spread over some of the other threads if I was to be following the technically correct procedure.

1]. Records of tinnitus go way back to the times of the ancient Pharaohs in Egypt. There is some Papyrus scroll dealing with it and the various remedies prescribed to deal with it. Almonds and honey (mixed with whiskey and tobacco ;) Ha! -- my own addition). I seem to recall reading of one other source on a clay tablet from ancient Syria or Sumeria which would put the record back further.

Of course it was a medical condition well known to the medical practitioners right up till the present day. Beethoven suffered from it, the chap from Star Trek, William Shatner and Ronald Reagan. So we are all in good company. But the Doctors kind of cordoned it off. They knew that they couldn't cure it and most of the patients were pretty old anyway would soon die off. So the kind of put it on the back shelf so to speak.

Acknowledging it as a topic for medical study and giving it the Scientific name of Tinnitus instead of "ringing in the ear" was one of the first big steps is bringing it off the back shelf to where it is today. Myself, I'm gob-smacked at the multiplicity of all the studies that are being published on the topic. Research really has come a long way since when I first got it.

2]. One or two miscellaneous points:
This topic of the Hough pill and whether it might have a bad effect on other organs if it is to reach the Cochlea. Well that ain't necessarily so. I need only mention Aspirin or the Salicylates (correct spelling?) like Basil, Thyme, Rosemary and those other herbs. They can have a noticeable effect on your tinnitus but they are common household items we might take every so often.

3] One of the pieces of advice that I was given by the ENTs back in the 90s was to try and accustom myself to noise. "Don't lock yourself away" was the rule. I'm now at the stage of wondering was this advice good. Now that my tinnitus has got worse and doesn't respond to the TRT treatment as before I am thinking that perhaps I should have relocated to a quiet village somewhere where my OHC and IHC and ribbon synapses might have withstood the noise better. Perhaps I should have kept taking the magnesium powder as some French Military study from back then maintained that it does provide protection from noise.

But if Santa Claus is arriving soon with the Hough and Frequency discoveries... Well that would be a life-changer.
I only hope that it's not going to cost a fortune.
 
After some success with TRT I tried to live as normal a life as possible. That meant getting used to everyday noise, avoiding the loud noise as much as possible. That's not easy living in a city. Every so often I would be subjected to something such as a police or ambulance siren, or a loud motor-bike or around New Year Christmas etc., a firecraker. If I had my hands free on time I would try and block my ears. But if I was caught by some loud noise exposure, it would sent my tinnitus up for the next week or two. My strategy then was just hope that it would subside. That seemed to work reasonably well for a a few years. But not any more. The last three years my tinnitus has gone one way... louder and shriller. Perhaps I should have kept taking the magnesium powder, perhaps I should have gone and lived in a quiet small town.

Hoping now that some of these research efforts bring a cure or an effective treatment.
 

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