Low-Level Laser Therapy (LLLT) for Tinnitus — Efficacy Debate

[japongus]

http://www.ncbi.nlm.nih.gov/m/pubmed/25797186/

Lucky i had this treatment, H has not returned after i went to clinic. This combined with keppra could demolish my misophonia but keppra is also not tested properly, should i not try to take it? Hell no, same with LLLT, all possible treatments are nor yet tested; we are the lab rats and test it out selves.

What do you mean your misophonia? According to Jastreboff anything that isn't pure loudness reaching the brain, is misophonia. So the tensing of the muscles that may be what causes us pain, that we people with TTTS-like symptoms have, would according to Jastreboff, just be misophonia. But of course that's probably because Jastreboff never bothered exploring the ear to see if muscles were tensing or not because he was so preoccupied with the brain. Funnily enough, this definition of hyperacusis and misophonia may have also slipped into the laser camp...

 

[Koen]

Dr. Wilden mentioned at the end of his paper 'dangers of trt'. There was one thing I found interesting. He wondered how it can be that the introduced sound by a white noise generator does not get stuck in the brain after a 1/2 year treament? Just like the original tinnitus sound get's stuck in the chronical phase?

Sound like a good point, who can say why this is invalid?

 

[Reinier]

Sound like a good point, who can say why this is invalid?

I am not a doctor, but I would argue that tinnitus is there because we have damage in the inner ear and/or nerves.
(This is at least for 90% of tinnitus cases the reason, I read in several documents.)
That is where the tinnitus is originates from. That is also why it will not go away until this damage is repaired. (Assumption).
When you are lucky you habituate. The tinnitus is still there, but you are only used to it and forget about it most of the time.
Completely different from a sound introduced form outside the ear.
Apart form the odd song that sticks in your mind.
This can also sometimes drive you mad.
Just a thought.

 

[AAM]

Perhaps Dr Nagler could take the plunge and try LLLT. He might/might not be pleasantly/unpleasantly surprised!

Bless!

 

[linearb]

Just like the original tinnitus sound get's stuck in the chronical phase?

Sound like a good point, who can say why this is invalid?

Exposure to an external sound for 90% of your reading hours doesn't cause the sound to "get stuck" in your brain. If it did, everyone who has a small house work a refrigerator or HVAC system would have tinnitus...

 

[linearb]

To be clear I don't think TRT is a panacea, but I've read a lot of stories over the years from people who were helped by it, and only one or two who believed they were harmed. The biggest risk by far is to your wallet.

 

[Philip83]

4-prope Lucky Laser ordered from China.. here goes nothing(?)

 

[Reinier]

Today I received my Lucky Laser combi set.
Now I need to read through many posts to start a treatment regime

 

[Reinier]

I used the laser for a few times. I find it quite cumbersome to use.
The lasers are heavy so you won't hold them for 20 minutes when sitting upright.
The tips are painful when you accidentally move the laser.
I am trying to think of a way to be able to lay down and have the laser units positioned correctly. Not easy when the support of the laser is a bed. Makes it all unstable.

I used both wavelengths. Bot on full power 10 Hz pulse for 20 minutes each. I started on a much lower power setting, but did not notice anything. On the high power output there definitely is something happening. (tinnitus increase and vertigo).
My hyperacusis and distorted hearing today is bad. Using the saw bench, I needed earplugs plus earmuffs. Normally I only use earmuffs. I put this down to coincident. I find it very hard to believe this has got anything to do with the LLLT. Although perhaps in a negative way, I irritated my inner ear with the LLLT and that made the hyperacusis playing up more?

I do hope that I will be able to get a comfortable set-up with the laser units. That way I can look forward to a session and not be apprehensive to start one. Still years to go

 

[Bobby B]

@Reinier
what do you mean by full power ?
how much power in mw ?

you need to place the tips on pillows that are higher so that you don't have to hold the full weight but just lightly keep in place with your hand, or place a tee-shirt under it and you don't even have to hold it
I'm sure there are other ways to secure those probes to the side if you are a bit handy you ca build somthing but the quick and easy way is a set of pillows and towels under to make it more stable
I did file the edge of the glass tip just a little bit to make it a bit rounder as its sharp yes that's an issue

 

[Reinier]

@Bobby B Thanks for responding.
Full power for 808nm is: 900mW
Full power for 650nm is: 120mW
At the moment I am not using CW but a 10Hz pulse.
Also at the moment I am doing what you suggested. I am using insulation blocks where the laser units sit in. So the hight is just right for my ears when I lay down. I am still adjusting these blocks.

I am reluctant to file the tips. I would imagine this can change the beam. Also I did not realise they are not glass tips.
As I mentioned earlier my hyperacusis yesterday, after two LLLT sessions was very uncomfortable. Could have been a freak coincident, but I am still experimenting.
Therefore I will decrease the power setting for the following sessions and see if it has an effect on hyperacusis and distortion discomfort levels.
I am still intrigued that the laser has an effect on the middle or even inner ear (vertigo, increase in tinnitus). I "only" need to find a way to make this effect a positive one.

 

[Bobby B]

900mw is too much

Try 400

 

[Bobby B]

900 w generates too much heat on the tissue, this is laser not LED ! the laser can send a lot of energy in one straight direction and the tip of the probe is quite narrow - you don't want to heat tissue as it can cause damage.
If you have vertigo this is a typical symptoms of heat.

With LLLT you need to start with low power, then increase a bit maybe over time.
The max I did was 600mw at 3-4 cm from the ear and that was already hot enough on 808nm

 

[Pleasure_Paulie]

Hi All,

I'm pretty new here. If I wanted to start LLLT, where would I start?

 

[Bobby B]

Start by reviewing if you are a good candidate or not

 

[Pleasure_Paulie]

Start by reviewing if you are a good candidate or not

Thanks for your reply!

I'm almost 1 month since onset, have T only in the right ear. Possibly noise related but trying to clarify with another audiologist who is doing above 8khz (I have normal hearing under 8khz from extensive testing).. But could be from Pneumonia recently, or drug related from extensive SSRI and other meds taken over the years... I honestly have no idea about this ridiculous condition!

Do I need to go somewhere, or is it a matter of buying the lucky laser?

Appreciate all your help

 

[Bobby B]

What kind of noise damage do you have ? Gives us more details

 

[Pleasure_Paulie]

What kind of noise damage do you have ? Gives us more details

My onset was the day after being in a loud bar. I've had 2 audiograms which state no loss whatsoever up to 8000hz. I'm getting a 3rd audiogram done next week at high frequencies.

 

[Reinier]

This is my laser set-up. This is so much better. I am even looking forward to a session. It relaxes me.
Need to do some final "tweaking" to get it even better. I can even read

 

[lymebite]

This is my laser set-up. This is so much better.

Very nice!

One thing I did with my Lucky Laser was to take a wine bottle cork, cut it in half, then drill a hole down the center of each half the same size as the glass laser tips. Then I slide them onto the laser tips. This decreases the effective length of the glass tips from about 33 mm to about 15 mm and thereby reduces the chances I might accidentally push the laser tips too far into the ear canal.

 

[Reinier]

Good idea!

 

[Bobby B]

With this setup you cannot change the angle easily - you need to hit the ear at various angles during the session
I do 20 minutes and change the angle frequently to limit exposure time to one spot only and make sure all zones are covered . This is what Wilden and Anne is doing as well

 

[Bobby B]

My onset was the day after being in a loud bar. I've had 2 audiograms which state no loss whatsoever up to 8000hz. I'm getting a 3rd audiogram done next week at high frequencies.

LLLT is a solution to a problem you don't have
With no hearing loss and no hyperacusis not sure what you want to achieve .

LLLT is not a chronic tinnitus cure

 

[Pleasure_Paulie]

LLLT is a solution to a problem you don't have
With no hearing loss and no hyperacusis not sure what you want to achieve .

LLLT is not a chronic tinnitus cure

Thanks for your reply. I have acute tinnitus but no hearing loss. Would it be wise to try LLLT?

 

[Bobby B]

Don't think so - unless you have serious hearing loss above 8khz and hyperacusis

Sounds like your T is due to the other causes you mentionned - unless you sticked your head into those bar speakers for hours

 

[Reinier]

With this setup you cannot change the angle easily - you need to hit the ear at various angles during the session

True. Although on the horizontal plane you can. But vertically is not so easy. Than I need to change the angle in which I drill the holes. Not impossible, but a lot of experimenting. Insulation material is cheap and I can make new angles, heights etc.. quit easily. Also not so easy is the soft bed. This makes it a bit unstable.

 

[linearb]

Sounds like your T is due to the other causes you mentionned

I wouldn't be so sure of that! I have essentially perfect hearing up to 8khz, and only a 10-15db deficit at 14khz on one side - but my tinnitus is absolutely, unquestionably the result of an acoustic incident.

 

[Bobby B]

Since 1999. Worse since 2011.


some mixture of noise and drugs, probably.

13-14khz EEEEE noise like a CRT monitor; some other quieter sounds that are less bothersome.

It was stable until a further noise trauma combined with a panic attack in 2011 that significantly worsened it. I believe it has been stable since.

Meditation, exercise, sex.

You mention a mixture of drugs , panic and noise as a cause for your T....probably
15 Db is no hearing damage unless you are a teenager.

 

[linearb]

You mention a mixture of drugs , panic and noise as a cause for your T....probably
15 Db is no hearing damage unless you are a teenager.

I'm sure the anxiety didn't help, but the noise trauma was ~120db for a couple hours. I didn't have any difference between ears prior to that, and everyone I was at the event with had significant tinnitus for ~24h. The others recovered; I had prior damage and minor tinnitus already, and payed a higher price...

 

[Alue]

Don't think so - unless you have serious hearing loss above 8khz and hyperacusis

Sounds like your T is due to the other causes you mentionned - unless you sticked your head into those bar speakers for hours

You mention a mixture of drugs , panic and noise as a cause for your T....probably
15 Db is no hearing damage unless you are a teenager.

Okay, don't take this wrong I know you mean well, but where are you getting your information from? You can diagnose people over the internet for NIHL based on self reported audiograms?

I believe I recall you posting a link to the done by Charlie Liberman and Sharon Kujawa on cochlear nerve degeneration after 'temporary' noise induced hearing loss. To sum up the major points, progressive nerve degeneration can happen after a temporary threshold shift from loud noises, this degeneration can cause 'hidden' hearing loss that is not detected in a normal audiogram. More than that you can damage "high threshold" nerves and leave the normal threshold nerves in tact thus giving you a normal audiogram.