Repeated Modified Nerve Blocks and Auditory and Non-Auditory Nerve Stimulation

[Chinmoku]

Any other questions I should ask?

The indicative costs please. In the email they said $250-350 hundred dollars ($25,000-35,000 USD). We thought it was a mistake and they meant $250-350 per session. Putting some of their website answers (question 2) in Google translator I got this:

"The general treatment period is about 10-15 times, but in severe cases, it is very rare, but there are cases where treatment is 20-30 times or more, and there are patients who finish it within 10 times. The cost of one treatment is decided after consultation, but it is about 20-25 million won."

Note that 20-25 million won is currently circa $20 thousand USD, so I can't understand the costs. In a post above we thought it would be $250-350 USD per session, with a max of 18, say 20 to round up, so $7,000 USD max. I can't understand the costs really. This figure of 20-25 million won seems in line with $250 hundred dollars, i.e. $25,000. This would be prohibitive for most of us. Unless the FX rate has changed enormously since the date of that post.

 

[Chinmoku]

It may be of interest to see the other translations from their website posted above. This is through Google Translate. Some of the other answers are redundant so I post only these four.

1. The cause of tinnitus is often sensorineural, but there are various causes such as ligaments, tendons, and nerve abnormalities in the cervical spine or temporomandibular joint. In most cases, tinnitus and hearing loss that do not improve naturally within 1-2 months of onset last a lifetime even after receiving various treatments. The treatment using MTSneedle is a method that uses microneedles in various lesions that cause tinnitus and hearing loss and simultaneously uses nerve regeneration and ligament and tendon strengthening techniques. The effect on tinnitus of the treatment using the MTS needle treated at our hospital is recovered to the extent that 3 out of 10 people can't hear the sound, and 5-6 people out of 10 hear the sound very low, so they don't feel any discomfort in their daily life. However, 1 or 2 out of 10 cases depend on the severity of the patient's illness, personality (sensitive personality, obsessive personality, inability to tolerate even small pain, etc.), accompanying diseases, and the patient's ability to recover from disease Therefore, the effect may be reduced depending on various other causes. In addition, acute sudden hearing loss (within 2-3 weeks of onset) improves remarkably in most cases, and in the case of old hearing loss, the improvement is about 10-20 dB, and there may be more improvement in some cases.
   
   
2. Because dizziness has a very good prognosis compared to tinnitus or hearing loss, you can expect good results. The general treatment period is about 10-15 times, but in severe cases, it is very rare, but there are cases where treatment is 20-30 times or more, and there are patients who finish it within 10 times. The cost of one treatment is decided after consultation, but it is about 20-25 million won.
   
   
3. MTS needle is a microneedle and guide that was developed by Dr. Seo Heon-man and obtained domestic and US patents. It is a microneedle used for treatment using the MTS needle, which treats acute and chronic pain diseases as well as various intractable non-pain diseases (tinnitus, hearing loss, facial paralysis, gastrointestinal disease, skin disease, motor nerve disorder) without the use of steroids or surgery.
   
   
4. Since the cause of tinnitus is often sensorineural, treatment is mainly to regenerate the nerves involved, and other causes such as cervical spine or temporomandibular joint, ligaments, tendons, and nerve abnormalities are also treated. The treatment using the MTS needle performed at our clinic is a method that uses a microneedle to simultaneously regenerate nerves and strengthen the tendon ligaments in various lesions that cause tinnitus and hearing loss. The degree of improvement varies from individual to individual, depending on the degree of damage or regenerative ability, and the current living environment is different. -Some patients have more than 30 treatments, and some patients finish it within 10 treatments.

 

[David S]

Here they have some more questions and answers for their tinnitus treatment:

http://www.mtspain.co.kr/pg/bbs/board.php?bo_table=sub0701&page=3

Some of them discuss costs involved for the treatment.

 

[David S]

Kind of a bold statement on their website concerning the regeneration of nerves. The 0.3mm needle might trigger some micro healing?

Since the cause of tinnitus is often sensorineural, treatment is mainly to regenerate the nerves involved, and other causes such as cervical spine or temporomandibular joint, ligaments, tendons, and nerve abnormalities are also treated. The treatment using the MTS needle performed at our clinic is a method that uses a microneedle to simultaneously regenerate nerves and strengthen the tendon ligaments in various lesions that cause tinnitus and hearing loss. The degree of improvement varies from individual to individual, depending on the degree of damage or regenerative ability, and the current living environment is different. -Some patients have more than 30 treatments, and some patients finish it within 10 treatments.​

Here is how they explain their success rate:

In most cases, tinnitus and hearing loss that do not improve naturally within 1-2 months of onset last a lifetime even after receiving various treatments. The effect on tinnitus of the treatment using the MTS needle treated at our hospital is recovered to the extent that 3 out of 10 people can't hear the sound, and 5-6 people out of 10 can hear the sound very low, so they don't feel uncomfortable in their daily life. However, 1 or 2 out of 10 cases depend on the severity of the patient's illness, personality (sensitive personality, obsessive personality, inability to tolerate even small pain, etc.), accompanying diseases, and the patient's ability to recover from disease. , the effect may decrease depending on various other causes.​

 

[Chinmoku]

Here they have some more questions and answers for their tinnitus treatment:

http://www.mtspain.co.kr/pg/bbs/board.php?bo_table=sub0701&page=3

Some of them discuss costs involved for the treatment.

Yes, I found this:

"Injection therapy for the treatment of tinnitus is a safe injection treatment and there is no nerve damage. The one-time cost is around 25-26 million won, and the actual cost claim may be different for each individual insurance, so you should check it individually. thank you"​

So I'm afraid it's $20 thousand ($20,000) without insurance. We absolutely need some clarity about this.

 

[David S]

So I'm afraid it's $20 thousand ($20,000) without insurance. We absolutely need some clarity about this.

But here they say something else:

http://www.mtspain.co.kr/pg/bbs/board.php?bo_table=sub0701&wr_id=1681&page=3

"Tests for tinnitus are rarely performed, and after treatment 3 times a week for 2 weeks, the number of treatments is reduced depending on the degree of reaction. One-time cost is 25-60 thousand won. It is also possible to treat at Daegu A. Anesthesia and Pain Medicine. Thank you."​

Confusing...

 

[Uklawyer]

Note that 20-25 million won is currently circa $20 thousand USD, so I can't understand the costs. In a post above we thought it would be $250-350 USD per session, with a max of 18, say 20 to round up, so $7,000 USD max. I can't understand the costs really. This figure of 20-25 million won seems in line with $250 hundred dollars, i.e. $25,000. This would be prohibitive for most of us. Unless the FX rate has changed enormously since the date of that post.

I have asked them to confirm if it is US$200 - 300 per session.

 

[DimLeb]

Lol, it looks more and more like a sophisticated acupuncture technique, which we all know what that means...

 

[Chinmoku]

But here they say something else:

http://www.mtspain.co.kr/pg/bbs/board.php?bo_table=sub0701&wr_id=1681&page=3

"Tests for tinnitus are rarely performed, and after treatment 3 times a week for 2 weeks, the number of treatments is reduced depending on the degree of reaction. One-time cost is 25-60 thousand won. It is also possible to treat at Daegu A. Anesthesia and Pain Medicine. Thank you."​

Confusing...

Perhaps the translator messes up millions and thousands. Perhaps they are similar in Korean and something is lost in translation.

EDIT:
Their numbering system is complicated.

Lesson 130: Big Korean Numbers

Best to ask the question "$250 vs $20000, 1 session" rather than saying "$20 thousand" or "millions".

 

[Chinmoku]

Lol, it looks more and more like a sophisticated acupuncture technique, which we all know what that means...

I wouldn't say so. The needles go much deeper than in standard acupuncture, and they also inject substances for nerve blocks, so it's a combination of stimulation through _deep_ needle placements and nerve blocks. More like pain surgeon medicine than acupuncture.

I'm wondering what is doing the work here in reducing tinnitus from such different origins, even patients with very relevant hearing loss have been helped. From the forum posts, it even looks like some patients regained some hearing. The results seem so good for such a technique, what do the needles do? Are they even calming the dorsal cochlear nucleus through the nerves?

Also, I would like to understand how genuine the results are. What is the relationship between doctors and patients in South Korea? Is it impolite to tell a doctor their treatment is failing? Might people have been embellishing results to please doctors? I wish we had an objective measurement of tinnitus, so there would be less doubts. Have doctors been reporting all the cases where the treatment failed? But cases of 10 to 0... average 7 points drop... that's not just embellishing, that's close to a cure.

I think there's nothing else to do but trying, even though having statistics on the success of the therapy in 2019-2022 and an updated list of adverse effects would help in making a decision.

 

[GoatSheep]

I wouldn't say so. The needles go much deeper than in standard acupuncture, and they also inject substances for nerve blocks, so it's a combination of stimulation through _deep_ needle placements and nerve blocks. More like pain surgeon medicine than acupuncture.

I'm wondering what is doing the work here in reducing tinnitus from such different origins, even patients with very relevant hearing loss have been helped. From the forum posts, it even looks like some patients regained some hearing. The results seem so good for such a technique, what do the needles do? Are they even calming the dorsal cochlear nucleus through the nerves?

Also, I would like to understand how genuine the results are. What is the relationship between doctors and patients in South Korea? Is it impolite to tell a doctor their treatment is failing? Might people have been embellishing results to please doctors? I wish we had an objective measurement of tinnitus, so there would be less doubts. Have doctors been reporting all the cases where the treatment failed? But cases of 10 to 0... average 7 points drop... that's not just embellishing, that's close to a cure.

I think there's nothing else to do but trying, even though having statistics on the success of the therapy in 2019-2022 and an updated list of adverse effects would help in making a decision.

I wondered the same about doctor/patient relationship and if reporting negative results is viewed through a certain lens. @Will Sedley, in his post, mentioned socio-cultural factors. I wish he would have clarified what he meant exactly because I am inferring a negative connotation from it.

 

[Uklawyer]

I'm wondering what is doing the work here in reducing tinnitus from such different origins, even patients with very relevant hearing loss have been helped. From the forum posts, it even looks like some patients regained some hearing. The results seem so good for such a technique, what do the needles do? Are they even calming the dorsal cochlear nucleus through the nerves?

Hi @Chinmoku. Hope you are hanging in there. Nice to see you on here looking into this.

It's hard to see what the miracle mechanism is. It does, indeed, seem a little odd that you have the combination of nerve block plus needle stimulation to ameliorate signalling problems in the auditory pathway. It is almost like a resetting exercise. Also, the relationship between cranial nerves 5 and 7 and the vestibulocochlear nerve is not abundantly clear. Some hypothesis around the method of action would be helpful.

Still no response to my email.

 

[Chinmoku]

Hi @Chinmoku. Hope you are hanging in there. Nice to see you on here looking into this.

It's hard to see what the miracle mechanism is. It does, indeed, seem a little odd that you have the combination of nerve block plus needle stimulation to ameliorate signalling problems in the auditory pathway. It is almost like a resetting exercise. Also, the relationship between cranial nerves 5 and 7 and the vestibulocochlear nerve is not abundantly clear. Some hypothesis around the method of action would be helpful.

Still no response to my email.

Thank you, Uklawyer, I try to come back when I can, the tinnitus is excruciating and all my fuel is on surviving hour by hour.

I agree, they definitely stumbled upon something but why it works is not entirely clear. Hopefully they might refine it in the future. The point is this should be immediately studied by medical scientists abroad, but I'm sure very little will happen. If this had been COVID-19 two years ago, everyone would be on it. Sadly we have low priority for the medical community.

@GoatSheep, I think Will Sedley was referring to the relationship patients-doctors with socio-cultural aspects. Is it impolite to tell a doctor his treatment does not work? This is where a Korean forum member would be invaluable. Unfortunately South Korea seems to be a separate planet.

 

[DimLeb]

Some guy's comment from Reddit. I definitely see the points he makes. It was too good to be true...

Guys, this study is of very low quality. I won't go into all of the problems with it, but it's basically a promotion for the lead author's clinic where he does a bunch of other inefficacious treatments for tinnitus, like acupuncture. The "new, integrative protocol" he's describing here is also basically acupuncture, plus lidocaine injection in some cases. The "nerve blocks" are also not actually nerve blocks. This is the same old snake oil in a shiny new bottle.

The design is a retrospective chart review of some of the patients at this dude's private pain clinic. Even the inclusion/exclusion criteria in the paper are kind of a problem, not to mention all the selection biases that lead someone to this guy's practice in the first place. You have to read the methods somewhat carefully to realize that the nerve blocks are not nerve blocks but acupuncture. (The first clue is that you would never bilaterally block the facial nerve for real, that's pretty crazy. You know those Botox disasters? That but your whole face. You never really block the facial nerve at all, because it's all motor.) There is no blinding or randomization (there is no control group at all). The effect size is crazy, the whole mechanism they postulate about how acupuncturally stimulated CN7 will somehow stimulate CN8, this is all very suspect.

Do this prospectively, blinded, in a more representative population and we can talk. Tinnitus remains an intractable problem and this dude's personal "data" from his proprietary rebranded acupuncture contributes nothing to the field. This is marketing.

Edit: They are not using electrical stimulation, my mistake. It's just plain old acupuncture.

Edit 2: Also, not clear what their "modified nerve block" technique is. They say clearly that it's not a conventional nerve block, but then later they describe a totally conventional nerve block (injecting lidocaine near the nerve, exactly what I said is crazy if using main trunk of facial nerve) and say it often produced facial palsy (paralysis) for 5-15 minutes, which is shorter than a lidocaine block should last. So their modified block technique appears to be what we would call "a shitty nerve block" because it doesn't always produce visible block at all, and then only weakly.

Anyways it's acupuncture plus lidocaine in the general area of some nerves. This is not totally insane but needs to be properly studied before anyone gets excited.

 

[ajc]

I'm now convinced a major driver was the location. The patient-doctor relationship in Korea is probably very different from what we are used to.

Was the price confirmed yet?

 

[Uklawyer]

Shit. I should have asked how nerve blocks to cranial nerves 5 and 7 help stimulate cranial nerve 8. But Will Sedley did not raise these questions. I don't know...

 

[Gb3]

Some guy's comment from Reddit. I definitely see the points he makes. It was too good to be true...

Some random guy's comment on Reddit lol.

Will Sedley, who peer reviewed the study, is supposedly going to speak on it.

 

[Aussie Lea]

Will Sedley, who peer reviewed the study, is supposedly going to speak on it.

Did he say he is going to speak more on it, than what he already wrote here?

I thought it would be a good idea to post on here briefly, as this is clearly a very interesting study, and it is understandable that this should generate a lot of interest... and questions.

I was a reviewer on the study, meaning I had no hand in any aspect of it, and also have no current or prior connection with the team conducting the research.

The fact that the study appears in a scientific journal indicates that I, and the other reviewer, felt that it contained findings that would be of interest to the tinnitus research community, and had no obvious flaws that clearly undermined its findings and needed to be addressed before publishing the work.

Like many of you, I found the apparent benefits to tinnitus symptoms quite astonishing. Particularly as this technique appears 'brand new' almost, being first published in a fully functioning form, rather than from a gradual series of studies and techniques each making advances on the last.

I would consider that it is, however, very premature to be making any recommendations about this being adopted into routine medical practice, or indeed any practice outside of a research setting. Firstly, it absolutely must be tested in a randomised controlled clinical trial, against a sham or placebo treatment. I do very much accept that the apparent responses obtained seem beyond that which we would expect for a placebo treatment, but the size of placebo effects can vary with many factors, including the methods of response recording, and socio-cultural factors. Ideally, this trial would be first conducted by the team leading this research, as it does seem a highly specialised method, rather than something that other medical specialists in related areas would simply be able to perform from their existing skills. If this showed a similar benefit, then larger-scale trials in different locations would be needed to inform decisions about when/how/whether to fund the technique, and training for specialists in order to be able to perform it. There are also considerations of safety, particularly as some of the injections involve placing needles very close to delicate and easily damaged nerve structures. There is a lot involved in any new treatment's journey from initial development to widespread use, and in this case it seems particularly complicated.

That said, if the technique does prove successful in robustly conducted trials, then it would obviously become a huge priority to try and get it into widespread use. The desperate need for effective tinnitus treatments is well-recognised.

Will Sedley

 

[StoneInFocus]

What's quite interesting is that most sufferers seem to have nothing like pure tone tinnitus. The majority in the study had crickets, escaping steam, buzzing. I find that very encouraging.

Why do you think this is encouraging if I may ask?

If I read their mails correctly, they believe this would also help with hyperacusis?

According to the emails posted here it would, but we might have to take that information with a grain of salt since it was not included in the study. They also do not specify which type of hyperacusis it might help.

 

[David S]

Why do you think this is encouraging if I may ask?

I just thought there already are more options for tonal tinnitus, like notched sound treatments.

I have a number of friends with stable, but quite loud tonal tinnitus, meaning they have no problem hearing it in the car or on the street but they are all well habituated.

 

[DebInAustralia]

I spoke to Soo Ji (the doctor) today.

$200 - 300 USD per treatment.

Tinnitus reduction usually seen in around 4 - 6 treatments (the clinic does X3 treatments per week). May require further treatments (up to 10 - 15) if the tinnitus is not resolved sooner.

They have been using this technique for 20 years!!!

I asked if it works for hearing loss. Poor prognosis, but has seen it help (English limited).

They are looking at starting trials as soon as possible. Maybe a good time for those who are able, to reach out and participate? They will be hiring interpreters to assist with the process.

AND the BIG one IMO...

Soo Ji confirmed that they would be willing to teach international doctors their technique either in person or via video conferencing. So, reach out to your research facilities and see if you can gather some interest. The needles used at the clinic would need to be purchased from Korea.

 

[InNeedOfHelp]

They have been using this technique for 20 years!!!

Thanks for speaking with him.

That was the last piece of credibility going away. If it was successful all these 20 years, tinnitus shouldn't have been a problem anymore in Korea.

But obviously it is because there is quite some research coming out of Korea regarding tinnitus.

If it would have worked the last 20 years, all Koreans with tinnitus would have been cured/aware of this. Sounds like snake oil to me.

 

[Uklawyer]

hunman0405@naver.com

@Freerunner, are you sure this is the email address? I have received nothing back.

@DebInAustralia, did you get the email address? I had a number of questions for them to respond to in writing.

@UKlawyer, what about the Lidocaine? I had to use a small amount recently (topically) and it spiked me. Should that be a concern for us? Does Lidocaine have to be used for this?

@Jerad, I will ask if they get back to me. I might have to call.

 

[UKBloke]

$200 - 300 USD per treatment.

Total treatment cost would then roughly align I think with that of current various clinically delivered tinnitus treatments in the West. Circa $2k-$5k (similar in Sterling too).

 

[Padraigh Griffin]

I spoke to Soo Ji (the doctor) today.

$200 - 300 USD per treatment.

Tinnitus reduction usually seen in around 4 - 6 treatments (the clinic does X3 treatments per week). May require further treatments (up to 10 - 15) if the tinnitus is not resolved sooner.

They have been using this technique for 20 years!!!

I asked if it works for hearing loss. Poor prognosis, but has seen it help (English limited).

They are looking at starting trials as soon as possible. Maybe a good time for those who are able, to reach out and participate? They will be hiring interpreters to assist with the process.

AND the BIG one IMO...

Soo Ji confirmed that they would be willing to teach international doctors their technique either in person or via video conferencing. So, reach out to your research facilities and see if you can gather some interest. The needles used at the clinic would need to be purchased from Korea.

Excellent. Thank you so much for all this information.

I have an appointment with Dr. Brendan Conlon (Lenire) in June and will be highlighting this to him. Maybe he will show interest. In the meantime we need people from the boards here to give it a try. It is unfortunate that Seoul is such a long flight from most English speaking nations. I presume after reading Markku's earlier post we don't have many non-English speaking members.

A few guinea pigs would be great.

 

[Freerunner]

@Freerunner, are you sure this is the email address? I have received nothing back.

Yes, this is the correct email address I have also been in contact with - hunman0405@naver.com

 

[Uklawyer]

@Freerunner - sorry, I thought you mentioned you had sent a text and not an email.

It's too late to call now. Time zone not great for their working hours and our time zone (and my waking hours).

I have sent a follow up email. If anyone in the West or East wants to pass on my questions in writing, let me know.

I will try calling tomorrow if I can and if I have received no response.

 

[Reed19]

That was the last piece of credibility going away. If it was successful all these 20 years, tinnitus shouldn't have been a problem anymore in Korea.

But obviously it is because there is quite some research coming out of Korea regarding tinnitus.

If it would have worked the last 20 years, all Koreans with tinnitus would have been cured/aware of this. Sounds like snake oil to me.

I'm wondering about this too. You would think there would be more parts in Korea that offer this service at least.

 

[AfroSnowman]

Thanks for speaking with him.

That was the last piece of credibility going away. If it was successful all these 20 years, tinnitus shouldn't have been a problem anymore in Korea.

But obviously it is because there is quite some research coming out of Korea regarding tinnitus.

If it would have worked the last 20 years, all Koreans with tinnitus would have been cured/aware of this. Sounds like snake oil to me.

So a quick show of hands, any South Koreans here? Maybe they have all been cured and didn't bother emailing you.

 

[DimLeb]

Thanks for speaking with him.

That was the last piece of credibility going away. If it was successful all these 20 years, tinnitus shouldn't have been a problem anymore in Korea.

But obviously it is because there is quite some research coming out of Korea regarding tinnitus.

If it would have worked the last 20 years, all Koreans with tinnitus would have been cured/aware of this. Sounds like snake oil to me.

Agreed. It is probably one of those clinics who advertise "alternative healing methods" that do acupuncture, laser and such crap. Nothing more than relaxation/habituation/placebo stuff.