Pulsed Radiofrequency of the Auriculotemporal Nerve to Reduce the Intensity of Tinnitus

→ Pulsed Radiofrequency of the Auriculotemporal Nerve to Reduce the Intensity of Tinnitus

 

This research was done by anesthesiologist, Dr. de Koning, who has a clinic in the Netherlands where he provides said treatment.

I've been contemplating an appointment, but I've been hesitant because 3% of the treated people also worsened because of it.

I used to go to Dr. de Koning's clinic for issues related to chronic nerve pain. He's a very kind and understanding doctor.

 

3% is ABSOLUTELY NOT SIGNIFICANT. There were more in Dr. Shore's trial that worsened. Worsening in such small numbers is subjective or just the variations tinnitus takes day to day, as many here know. It just happened they were worse when tested again.

I would like to see the full write-up as I'm sceptical of the efficacy.

Get in touch and ask him. Say you have seen the paper. Ask him how it works.

 

What an odd condition.

Reminded me of a talk Dr. De Ridder gave where he mentioned a lot of treatments have subclinical success, much like this one study would show 35% isn't enough to become a serious treatment.

 

What I'd be interested to know is, what inspires these various doctors to utilise a specific technology to treat tinnitus? Do they wake up one morning and think, "Pulsed radio waves would be a great idea to try out", or is that a certain treatment protocol eventually becomes the manifest end point to a broader mechanism of action they're working on?

 

There's a chance those patients could have worsened from something else not related to the treatment along the way, unless I'm missing something. The odds would definitely be in your favor, but as with anything, there is always a risk.

 

I'm getting an extended hearing test on April 10th, which is a prerequisite Dr. Koning requires before possibly undergoing this treatment. Once I have my audiogram, I'll likely make an appointment for more information.

On the positive side, nothing besides acoustic shock has ever worsened my tinnitus (alcohol, coffee, salt, drugs, etc). Perhaps that would be a good sign going into this.

 

Anyone know what this treatment entails - as in, how is this pulsed radiofrequency to this particular nerve done...? What is the supporting theory behind why this might help people?

I’m unclear if this treatment relies on the sufferer having a particular type of tinnitus that is somehow reliant on C2-C3 (and therefore open to treatment through C2-C3)? Or does everyone’s auditory nerves pass through that cervical canal...? I’m sorry I’m so ignorant!

 

It seems to me there is something fishy about Dr. De Koning.

Previous websites have been deleted:

• www.minderoorsuizen.nl
• www.pijnhoeftniet.nl

Why?

 

Pulsed Radio Frequency is a treatment for neuropathic pain. A special needle is shoved into you near the subject nerve and a pulsed radio frequency signal is generated at the tip at various frequencies. The idea is that, over time, the modulation of the radio frequency signal has various advantageous effects on the nerve. The extent of the beneficial effect is slightly dubious, but it has a scientific basis (it's by no means woo-woo nonsense).

For some reason, clinicians love to draw analogies between neuropathic pain and tinnitus - wrongly, in my opinion. However, the main hypothesis in this paper was that the Pulsed Radio Frequency therapy had an effect on excited fusiform cells in the DCN (i.e. it might work similarly to bimodal stimulation).

 

I don't know about those other websites, I've only ever known about this one:

• www.pijnkliniekdebilt.nl

Dr. Koning has helped me greatly in the past. He's currently working with his son, who'll take over when he retires.

Those other 2 websites appear to be pretty old. It could be he used them in the past to get traction for his clinic. Might have left them online, even after sunsetting them, for SEO purposes. They probably still generate traffic on those keywords (given that you found them, too).

 

Maybe this could help noxacusis.

 

Throwing mud to see what sticks? In all fairness, I think it's a case of looking at the literature on somatosensory involvement and stimulating nerves with electricity. There's so much research at the moment using sound and/or electrical stimulation compared to compounds. For example, the following all have one common denominator, electricity:

• tDCS
• tRNS
• HD-tDCS
• Extracochlear stimulation
• Lenire
• Auricle
• Neurosoft
• DBS
• TU Delft

Think quickly of drug compounds in development (until recently easy) and it becomes very limited now.

 

@Fields, if you know the doctor and live nearby, why wouldn't you consider this?

It sounds like this therapy is available and that he has a practice; it's not just a limited clinical trial.

 

I'm actually in the process of setting up an appointment. However, I need a GP referral and an extended audiologic evaluation first.

I got the referral yesterday and was supposed to have the evaluation two weeks ago, but unfortunately, it was pushed back to May.

 

It is hopefully successful.

 

I received the treatment two weeks ago. So far, I haven't noticed any changes.

I have a follow-up appointment in July to discuss further treatment.

I've been on a bit of an experimental spree lately. Things that haven't worked so far:

• Psilocybin
• MDMA
• Pulsed radio frequency
• Dahlia4
• Acupuncture
• Physical therapy

 

For the record, I contacted the provider, and he refused to consider scheduling an appointment because I am not local. He said, "It is quite busy with patients from the Netherlands, and we cannot see any opportunities to increase our capacity."

 

Do you really want to come all the way from the US to NL just for this?

You do know it costs more than 1000 EUR for a consult and a PRF treatment?

The guy will retire as a millionaire.

 

If it was effective, yes.

 

Botox should have the same effect, no?

 

He knows his treatment isn't effective for everyone. To this end, he's conducting further research in order to better assess efficacy based on specific markers.

For what it's worth, he also stays up-to-date with others in the field (Dr. Shore, Dr. Djalilian, Dr. de Ridder, etc).

If I'm not mistaken, there's an old thread on Tinnitus Talk made by someone who did experience a significant improvement.

Perhaps the treatment can be improved over time. My insurance covers the costs, so I'm open to trying one of his other approaches.

 

You wouldn't know without trying it. Nothing is effective for everyone. I'm not suggesting you should try it.

 

I know everything is a crapshoot, but it would help if there were patient-confirmed reports of efficacy.

 

Interestingly, the only testimonial I could find was on Tinnitus Talk.

It's for a different treatment, though. I'll ask for more information during my check-up in July.

 

Excuse the double post: unfortunately, the pulsed radiofrequency of the nervus vagus was unsuccessful. So, I'm going back next week for an alternative approach.

If I'm not mistaken, he'll target the facet joints this time. I'll share an update later.

 

Did you make any progress?

 

I had the second treatment last week: it didn't make it better, didn't make it worse.

It was worth a shot. There's one final procedure he can try. We'll discuss it in a couple of weeks in the follow-up call.