Round and Oval Window Reinforcement for the Treatment of Hyperacusis

[addot]

I do wonder whether this works for folks who have hyperacusis as a result of noise exposure (which is my case). The surgery focuses on the middle ear, but Dr. Silverstein describes it as a "permanent earplug", so it might work.

About two years ago I got in touch with a couple of patients who did the procedure. One of them improved, the other did not, though it had been less than a month since her surgery. I think I'll try to contact Dr. Silverstein's clinic and see if they can tell me more about the prospects of this procedure for folks with noise-induced hyperacusis.

 

[grate_biff]

I think I'll try to contact Dr. Silverstein's clinic and see if they can tell me more about the prospects of this procedure for folks with noise-induced hyperacusis.

Please do. Would be interesting to hear what they say!

 

[MattR]

I do wonder whether this works for folks who have hyperacusis as a result of noise exposure (which is my case). The surgery focuses on the middle ear, but Dr. Silverstein describes it as a "permanent earplug", so it might work.

About two years ago I got in touch with a couple of patients who did the procedure. One of them improved, the other did not, though it had been less than a month since her surgery. I think I'll try to contact Dr. Silverstein's clinic and see if they can tell me more about the prospects of this procedure for folks with noise-induced hyperacusis.

For some yes it has. You can watch videos from patients on Silvertein's website, and also on the Facebook group pertaining to the surgery. Some people had noise trauma (gunshots, a nail hit with a hammer very close to the ear, etc.). The only story I haven't seen a success case for yet is hyperacusis induced by medication. Doesn't mean there isn't one, but that's one I haven't seen, and have seen failed surgeries for.

 

[addot]

For some yes it has. You can watch videos from patients on Silverstein's website, and also on the Facebook group pertaining to the surgery. Some people had noise trauma (gunshots, a nail hit with a hammer very close to the ear, etc.). The only story I haven't seen a success case for yet is hyperacusis induced by medication. Doesn't mean there isn't one, but that's one I haven't seen, and have seen failed surgeries for.

Would you have the link for the Facebook group? I'm in 'Hyperacusis Support & Research', but this sounds like a different one.

 

[MattR]

Would you have the link for the Facebook group? I'm in 'Hyperacusis Support & Research', but this sounds like a different one.

It's a private group so it looks like I can't link directly to it. You can search hyperacusis surgery success and it will come up though.

 

[Daniel Lion]

I do wonder whether this works for folks who have hyperacusis as a result of noise exposure (which is my case). The surgery focuses on the middle ear, but Dr. Silverstein describes it as a "permanent earplug", so it might work.

About two years ago I got in touch with a couple of patients who did the procedure. One of them improved, the other did not, though it had been less than a month since her surgery. I think I'll try to contact Dr. Silverstein's clinic and see if they can tell me more about the prospects of this procedure for folks with noise-induced hyperacusis.

Any luck with chatting to the clinic?

 

[Frédéric]

From the same team (Dr. SiIverstein)

Minimally invasive surgery for the treatment of hyperacusis: New technique and long term results

Abstract
Objective
A minimally invasive surgery developed by the senior author has previously been reported to significantly improve sound tolerance after surgery. This report compares the new versus original surgical technique used and long-term results of all patients who have undergone minimally invasive surgery for hyperacusis.

Study design
A prospective, IRB approved clinical research trial at a single institution with surgery performed by the author (HS).

Setting
All patients were evaluated and treated at a tertiary level otologic referral center.

Subjects and methods
47 subjects were enrolled from 2014 through 2019, 40 met inclusion criteria including adequate follow-up in the analysis. All subjects underwent oval and round window reinforcement. 20 subjects underwent surgery before 2017 with the original technique of round window reinforcement. 20 subjects underwent new technique with additional oval window and stapes reinforcement.

Results
80% of subjects who underwent the new surgical technique had improvement in hyperacusis symptoms after surgery compared to 60% of subjects who underwent the original technique. Long term follow-up showed sustained results with both techniques with a mean follow-up of 2 years after surgery.

Conclusions
The most recent, newer technique employed appears to have an 80% success rate in improving sound tolerance with small changes to hearing. The improvement in hyperacusis symptoms after surgery is significant and now found to be sustainable with a mean follow-up of 2 years after initial surgery. Psychological measures of anxiety and depression also were found to be significantly improved after surgery in the newer technique group.

Source: https://www.sciencedirect.com/science/article/abs/pii/S0196070919309408

 

[Daniel Lion]

From the same team (Dr. SiIverstein)

Minimally invasive surgery for the treatment of hyperacusis: New technique and long term results

Abstract
Objective
A minimally invasive surgery developed by the senior author has previously been reported to significantly improve sound tolerance after surgery. This report compares the new versus original surgical technique used and long-term results of all patients who have undergone minimally invasive surgery for hyperacusis.

Study design
A prospective, IRB approved clinical research trial at a single institution with surgery performed by the author (HS).

Setting
All patients were evaluated and treated at a tertiary level otologic referral center.

Subjects and methods
47 subjects were enrolled from 2014 through 2019, 40 met inclusion criteria including adequate follow-up in the analysis. All subjects underwent oval and round window reinforcement. 20 subjects underwent surgery before 2017 with the original technique of round window reinforcement. 20 subjects underwent new technique with additional oval window and stapes reinforcement.

Results
80% of subjects who underwent the new surgical technique had improvement in hyperacusis symptoms after surgery compared to 60% of subjects who underwent the original technique. Long term follow-up showed sustained results with both techniques with a mean follow-up of 2 years after surgery.

Conclusions
The most recent, newer technique employed appears to have an 80% success rate in improving sound tolerance with small changes to hearing. The improvement in hyperacusis symptoms after surgery is significant and now found to be sustainable with a mean follow-up of 2 years after initial surgery. Psychological measures of anxiety and depression also were found to be significantly improved after surgery in the newer technique group.

Source: https://www.sciencedirect.com/science/article/abs/pii/S0196070919309408

Thanks for the post, I've been raving about this surgery and the pioneering doctor behind it for some time. "Small changes in hearing" is an issue, but dwarfed by the newfound freedom and life of patients who have had a successful treatment. Great news for chronic hyperacusis sufferers...

 

[GoatSheep]

"Small changes in hearing" is an issue, but dwarfed by the newfound freedom and life of patients who have had a successful treatment. Great news for chronic hyperacusis sufferers...

I wonder what those changes are?

 

[Daniel Lion]

I wonder what those changes are?

Hearing loss, put simply... it tends to be minor.

Post note... what I read most of the hearing loss was "minor" and patients' lives were transformed from being housebound to being able to go freely outside without fear of noise. I have contemplated this surgery.... I need to send them my audiogram. I am not housebound, just handicapped...

 

[GoatSheep]

Hearing loss, put simply... it tends to be minor.

Post note... what I read most of the hearing loss was "minor" and patients' lives were transformed from being housebound to being able to go freely outside without fear of noise. I have contemplated this surgery.... I need to send them my audiogram. I am not housebound, just handicapped...

Hearing loss in what frequency range?

 

[Daniel Lion]

Hearing loss in what frequency range?

I don't know... I will have to read through documents again... didn't sound serious, or they downplayed it... hmmmmm.

 

[GoatSheep]

I don't know... I will have to read through documents again... didn't sound serious, or they downplayed it... hmmmmm.

The paper from 2016 said patients experienced no change in hearing. So I'm curious why an improved technique would cause changes to hearing.

"Postoperatively, the patients reported no change in hearing and improved quality of life after the procedure."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100801/

 

[Juan]

I don't know... I will have to read through documents again... didn't sound serious, or they downplayed it... hmmmmm.

Hearing loss is harder to measure than people think, and can be very bothersome, depending on what you do for a living, and your lifestyle.

 

[Daniel Lion]

The paper from 2016 said patients experienced no change in hearing. So I'm curious why an improved technique would cause changes to hearing.

"Postoperatively, the patients reported no change in hearing and improved quality of life after the procedure."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100801/

The new procedure involved reinforcing the stapes, they found this really helped because they were to mobile.

My impression was the hearing loss was not a huge issue... how this relates to tinnitus... I don't know. But for hyperacusis it's a godsend and life changer. I need to write them again and ask some of these questions...

 

[GoatSheep]

The new procedure involved reinforcing the stapes, they found this really helped because they were to mobile.

My impression was the hearing loss was not a huge issue... how this relates to tinnitus... I don't know. But for hyperacusis it's a godsend and life changer. I need to write them again and ask some of these questions...

Please do. I wonder how low your LDL's have to be for the procedure. If you have tinnitus and this reduces hearing like you said, what does that mean for your tinnitus?

 

[GoatSheep]

The new procedure involved reinforcing the stapes, they found this really helped because they were to mobile.

My impression was the hearing loss was not a huge issue... how this relates to tinnitus... I don't know. But for hyperacusis it's a godsend and life changer. I need to write them again and ask some of these questions...

So is this for all forms of hyperacusis, even pain?

 

[Daniel Lion]

Please do. I wonder how low your LDL's have to be for the procedure. If you have tinnitus and this reduces hearing like you said, what does that mean for your tinnitus?

The procedure is for chronic hyperacusis, by that, I mean debilitating... as in house bound.
Having said that I will write back, I am waiting for my audiogram to send them.

My hyperacusis is up and down. I avoid noise, so I avoid pain. At one point I was really gunning for the surgery, now I am kind of in limbo and financially can't consider it.

I did read that they can reverse the surgery, or remove the packing and it's a fast operation and not considered highly invasive.

That being said, all surgeries are scary... it's the nature of the beast.

I'll keep you posted on what info I get. Have a look at Dr. Silverstein's testimonials and clinical trial data... you might find something I missed.

 

[Daniel Lion]

Please do. I wonder how low your LDL's have to be for the procedure. If you have tinnitus and this reduces hearing like you said, what does that mean for your tinnitus?

Follow up question...
Is your hypercusis or tinnitus driving you nuts, or both?

The operation you mentioned before was for middle ear stuff, correct?

What's up GoatSheep?
What's giving you the most grief now pertaining to your ears?

 

[GoatSheep]

Follow up question...
Is your hypercusis or tinnitus driving you nuts, or both?

The operation you mentioned before was for middle ear stuff, correct?

What's up GoatSheep?
What's giving you the most grief now pertaining to your ears?

Inner ear osteoma. Both are giving me grief really.

 

[Daniel Lion]

Inner ear osteoma. Both are giving me grief really.

Sorry, I recall you spoke with a doctor at Silverstein clinic.

Write them a letter, explaining everything and your ideas about what to do and request that Dr. Silverstein looks your case history over. I bet he will.

What does your local doctor think, who you like and trust?

 

[Daniel Lion]

Inner ear osteoma. Both are giving me grief really.

Inner ear osteoma, I know little about. But if surgery can help... then maybe go for it, talk to your doctor again. Hyperacusis is a different beast, I have it and know a little more about.

Surgery would depend on severity in my mind, but I need to talk to doctors about that. Just a hunch, hyperacusis can come and go... if it's debilitating and you are housebound, cars, noises are killing you... then surgery... I have no doubt.
That's how I am gonna play it, now it limits me to where I can go, but I wouldn't describe it as chronic.
If it was chronic, I'd be setting up an appoint in Florida right now.

At present it is annoying and restrictive, but manageable... does that make sense?

You need to consult with the professionals... follow your instinct... and keep communicating with your doctors.

Why was your doctor not "keen" on the osteoma surgery?

 

[GoatSheep]

Inner ear osteoma, I know little about. But if surgery can help... then maybe go for it, talk to your doctor again. Hyperacusis is a different beast, I have it and know a little more about.

Surgery would depend on severity in my mind, but I need to talk to doctors about that. Just a hunch, hyperacusis can come and go... if it's debilitating and you are housebound, cars, noises are killing you... then surgery... I have no doubt.
That's how I am gonna play it, now it limits me to where I can go, but I wouldn't describe it as chronic.
If it was chronic, I'd be setting up an appoint in Florida right now.

At present it is annoying and restrictive, but manageable... does that make sense?

You need to consult with the professionals... follow your instinct... and keep communicating with your doctors.

Why was your doctor not "keen" on the osteoma surgery?

Originally he said he was afraid of damaging my hearing.

 

[Daniel Lion]

Originally he said he was afraid of damaging my hearing.

Well, that's a big deal... I guess he assumes you are ok without the surgery?
Or that you can heal up somehow over time?

 

[GoatSheep]

Well, that's a big deal... I guess he assumes you are ok without the surgery?
Or that you can heal up somehow over time?

Eh I had the surgery today.

 

[GoatSheep]

Bottom pic shows osteoma. The white circle. Top pic shows it removed.

Currently I still have tinnitus. Can't tell if it's any better cause heads wrapped so it's not like normal. Could be lesser. Hell could be worse for all I know. Doc said give it up to three months to improve which is what @GregCA said before too.

 

[Daniel Lion]

View attachment 32650
View attachment 32649

Bottom pic shows osteoma. The white circle. Top pic shows it removed.

Currently I still have tinnitus. Can't tell if it's any better cause heads wrapped so it's not like normal. Could be lesser. Hell could be worse for all I know. Doc said give it up to three months to improve which is what @GregCA said before too.

Congratulations my brave friend.

Good call.

Don't listen or worry about your tinnitus now, just heal up.
Surgery is a bid deal, so chill... give it three months.
You are going to be better for it Champ... awesome.
Now take it slow... think good... no stress.
Take good care and stay in touch.

Sincerely,
Daniel

PS. It's going to be better... I just read up on osteoma... good call. Your tinnitus will get better.
Stay well bud.

 

[Juan]

View attachment 32650
View attachment 32649

Bottom pic shows osteoma. The white circle. Top pic shows it removed.

Currently I still have tinnitus. Can't tell if it's any better cause heads wrapped so it's not like normal. Could be lesser. Hell could be worse for all I know. Doc said give it up to three months to improve which is what @GregCA said before too.

Keep us updated! I hope everything goes fine with post-surgery!

 

[GoatSheep]

Keep us updated! I hope everything goes fine with post-surgery!

Ok I will. Thanks to you and Daniel.

 

[lapidus]

Someone over at chat-h posted about the Silverstein surgery today.
https://www.chat-hyperacusis.net/post/surgery-dr-siversteoin-10346071?pid=1309997343