Round and Oval Window Reinforcement for the Treatment of Hyperacusis

[addot]

I consulted with Silverstein last March and asked about FX-322/intratympmanic injections. He said the procedure has been updated to leave the round window open, meaning the procedure wouldn't prevent you from having injections in the future. Whether leaving the round window open but reinforcing the rest lessens the effects of the surgery or not, I don't know.

Interesting! Thanks for sharing, I'm gonna send them an email asking about recent developments to the surgery too. I'm also curious if leaving the round window open would make the surgery less effective... judging by his research it seems Silverstein is really zeroing in on stapes hypermobility as the problem to fix.

 

[Brian Newman]

I consulted with Silverstein last March and asked about FX-322/intratympmanic injections. He said the procedure has been updated to leave the round window open, meaning the procedure wouldn't prevent you from having injections in the future. Whether leaving the round window open but reinforcing the rest lessens the effects of the surgery or not, I don't know.

I've been wondering that myself too. We need to find somebody who left the round window open. Only reason I haven't done the surgery yet is because of that very reason. Not gonna ruin my chances of getting the injections. I might be the first to try it unless you or @addot try it first. I will ask Dr. Nyack as well and see what he thinks. For me I definitely have a messed up stapes which needs to be reinforced, my tensor tympani probably needs to be cut too. One of us has gotta try it. I'm getting pretty close to cutting everything out of my left ear and be done with it.

I did more research on the round window. It regulates pressure it seems. Correct me if I'm wrong. So I don't think reinforcing it does much unless somebody has a perilymph fistula.

 

[addot]

I might be the first to try it unless you or @addot try it first. I will ask Dr. Nyack as well and see what he thinks.

Thanks, man! Let me know what he says, if you contact him, and I'll let you know what they say if I contact them.

Hopefully we can both find some manner of relief from this.

 

[Cory_]

I've been wondering that myself too. We need to find somebody who left the round window open. Only reason I haven't done the surgery yet is because of that very reason. Not gonna ruin my chances of getting the injections.

The surgery is reversible, I believe.

Of course, I still see the logic in not wanting 3 different operations to get it done, undone and redone.

 

[Brian Newman]

The surgery is reversible, I believe.

Of course, I still see the logic in not wanting 3 different operations to get it done, undone and redone.

Is it reversible? I talked to a guy who was one of the first patients and he asked another ENT to remove it because he's out of state and he said he was not sure if he could or not. Because it gets pretty attached to the cochlea. I would hope there was a way to just peel it off, but they use glue so who knows how stuck it would be, unless you know somebody who got it reversed. Safest way is definitely leaving the round window open. Yeah, getting a bunch of surgeries isn't worth it to have it removed later on.

 

[lymebite]

Is it reversible?

I had it done by Dr. Silverstein. Dr. Silverstein told me it is reversible, and he is willing to reverse, and my regular ENT says they are happy to reverse it at any time, I just need to say the word. The ENT said it probably would peel right off (they would use a hot laser) but if it was stubborn, they'd stop before risking any damage and sew me back up again.

I'm kind of waiting for something from Frequency Therapeutics to become available, before I'd bother reversing. But I'm ready to reverse as soon as there is a good reason to do that.

 

[addot]

I had it done by Dr. Silverstein.

How did it work out for you?

 

[lymebite]

How did it work out for you?

No changes for me, good or bad. I was essentially a non-responder. So if I could snap my fingers and have it reversed, I would.

 

[sakrt]

Should I put off surgery that could give me immediate relief for something that I'm not sure would help me? I truly, truly don't know the answer to that.

I wonder if PRP injections would be ideal to try first? To see if it helps regenerate weak RW/OW membranes and the supporting tissue to the ossicles before next steps to surgery? I wonder why the Silverstein Inst. does not provide PRP, or do they?

 

[Brian Newman]

I had it done by Dr. Silverstein. Dr. Silverstein told me it is reversible, and he is willing to reverse, and my regular ENT says they are happy to reverse it at any time, I just need to say the word. The ENT said it probably would peel right off (they would use a hot laser) but if it was stubborn, they'd stop before risking any damage and sew me back up again.

I'm kind of waiting for something from Frequency Therapeutics to become available, before I'd bother reversing. But I'm ready to reverse as soon as there is a good reason to do that.

Cool, thanks for the reassurance. I think for me to get to a livable level again, it will be a combo of the surgery and the regenerative meds. Might go ahead and do it and keep the round window open. Having it open as well for OTO-313 if my tinnitus gets worse and OTO-413 too.

Did the surgery help you much?

 

[addot]

No changes for me, good or bad. I was essentially a non-responder. So if I could snap my fingers and have it reversed, I would.

I'm sorry to hear that. Thank you for trying it and letting us know how it went.

I wonder if PRP injections would be ideal to try first? To see if it helps regenerate weak RW/OW membranes and the supporting tissue to the ossicles before next steps to surgery? I wonder why the Silverstein Inst. does not provide PRP, or do they?

Thanks for bringing PRP to my attention, I didn't know about it before. I don't think it would do much for the oval and round windows, like you're describing. Silverstein reinforces them, but hyperacusis isn't caused by weak RW/OW membranes, I'm pretty sure it would do nothing on that front. I also think it would be unlikely to help the stapes.

However, I AM really curious about it potentially helping middle ear muscles. If Noreña's acoustic shock model is correct, than a chronically weak tensor tympani (or stapedius) might contribute to both pain and susceptibility to setbacks. It's like injuring one of your tendons; even after they heal, they remain forever weakened and sensitive to further insults. I've done some reading and it seems PRP really helps some people with joint and tendon pain. Might it help hyperacusis too? Obviously none of this has been proven conclusively, but nothing yet has for hyperacusis. I'd try in in a heartbeat if I could find someone to do it.

 

[grate_biff]

I'm sorry to hear that. Thank you for trying it and letting us know how it went.

Thanks for bringing PRP to my attention, I didn't know about it before. I don't think it would do much for the oval and round windows, like you're describing. Silverstein reinforces them, but hyperacusis isn't caused by weak RW/OW membranes, I'm pretty sure it would do nothing on that front. I also think it would be unlikely to help the stapes.

However, I AM really curious about it potentially helping middle ear muscles. If Noreña's acoustic shock model is correct, than a chronically weak tensor tympani (or stapedius) might contribute to both pain and susceptibility to setbacks. It's like injuring one of your tendons; even after they heal, they remain forever weakened and sensitive to further insults. I've done some reading and it seems PRP really helps some people with joint and tendon pain. Might it help hyperacusis too? Obviously none of this has been proven conclusively, but nothing yet has for hyperacusis. I'd try in in a heartbeat if I could find someone to do it.

Search for @JohnAdams and read his posts on PRP.

 

[addot]

Search for @JohnAdams and read his posts on PRP.

Beat you to it! I'm doing that right now lmao. Thanks for pointing me towards it though!

 

[Brian Newman]

I'm sorry to hear that. Thank you for trying it and letting us know how it went.

Thanks for bringing PRP to my attention, I didn't know about it before. I don't think it would do much for the oval and round windows, like you're describing. Silverstein reinforces them, but hyperacusis isn't caused by weak RW/OW membranes, I'm pretty sure it would do nothing on that front. I also think it would be unlikely to help the stapes.

However, I AM really curious about it potentially helping middle ear muscles. If Noreña's acoustic shock model is correct, than a chronically weak tensor tympani (or stapedius) might contribute to both pain and susceptibility to setbacks. It's like injuring one of your tendons; even after they heal, they remain forever weakened and sensitive to further insults. I've done some reading and it seems PRP really helps some people with joint and tendon pain. Might it help hyperacusis too? Obviously none of this has been proven conclusively, but nothing yet has for hyperacusis. I'd try in in a heartbeat if I could find someone to do it.

That does make sense. It definitely feels like I broke a tendon in my ear too. Besides the inner ear pain I definitely broke something in my middle ear. I'm curious too if regenerative medicine can heal it.

 

[addot]

That does make sense. It definitely feels like I broke a tendon in my ear too. Besides the inner ear pain I definitely broke something in my middle ear. I'm curious too if regenerative medicine can heal it.

It's possible. Although it's also possible that the pain has become centralized and treating the ear may no longer be effective. Who knows! I just wish there was something out there for hyperacusis that wasn't so uncertain.

Search for @JohnAdams and read his posts on PRP.

I went down that rabbit hole for a while today, and just ended up more conflicted than before. Let's just say Dr. Shim didn't exactly gave me a great first impression. I won't say more since I know there's a member of this forum who is currently in treatment with him. Hoping it all goes well for him!

 

[ajc]

I went down that rabbit hole for a while today, and just ended up more conflicted than before. Let's just say Dr. Shim didn't exactly gave me a great first impression. I won't say more since I know there's a member of this forum who is currently in treatment with him. Hoping it all goes well for him!

You are too nice. Honestly anyone who reads the Dr. Minbo Shim thread must eventually realize he's a class a charlatan. I feel bad for scotty03874 thinking he is going to get better from Mumbo Jumbo's "treatment"...

We shouldn't look past that, we need to alert people about poo "doctors" and not hand our hard-earned money to them.

 

[Philip83]

It's possible. Although it's also possible that the pain has become centralized and treating the ear may no longer be effective. Who knows! I just wish there was something out there for hyperacusis that wasn't so uncertain.

I went down that rabbit hole for a while today, and just ended up more conflicted than before. Let's just say Dr. Shim didn't exactly gave me a great first impression. I won't say more since I know there's a member of this forum who is currently in treatment with him. Hoping it all goes well for him!

I know I've posted it in this thread before, but anyone with hyperacusis should try regular hearing aids, even though you do not require them to improve your hearing. I had crippling hyperacusis after a noise trauma 1.5 years ago, and hearing aids gave me my life back. Hyperacusis down like 80%. Check out my full explanation / review here:

https://www.tinnitustalk.com/posts/630620/

 

[lymebite]

The Silverstein Institute is hosting a free online webinar about hyperacusis on Wednesday 9 November 2022 at noon Eastern Time. Advance registration is required and can be done here:

https://interland3.donorperfect.net/weblink/WebLink.aspx?name=E115182&id=40

 

[HighleyTall]

If these findings are correct (hyperacusis caused by acoustic trauma), the Round and Oval Window Reinforcement could be a good choice.

Does anyone know if the operation is performed in Belgium?

Thank you!