It is no secret that ENTs and audiologists are far from saviors of tinnitus patients when it comes to their suffering. Often, we are told that, in all cases with cilia loss, the tinnitus is permanent and there is nothing that can be done. You have all seen my rage at such news, to be told in a seemingly unempathetic way that there is nothing this specialist can do and all you're left to do is cope. Yet their answer is understandable. Currently, medical science offers little hope in terms of curing tinnitus, let along treating it. Often, the underlying symptoms that accompany this disorder (depression, stress, anxiety, and insomnia) are readily treated without any regard for the very thing that is causing it. The purpose of this post is to explore why we are seemingly stuck in this stage of little hope of frustration.
1. Tinnitus is a "symptom" and not a "disease". It is often the case that many academic and medical professionals regard tinnitus as a symptom rather than an actual affliction. Indeed, the tinnitus is usually indicative of hearing loss, TMJ, or other medical issues. However, such professionals sometimes fail to identify what this is specifically a "symptom" of. I think its high time for medical and academic professionals to regard tinnitus as a disease rather than just a symptom. The very manor in which we approach the affliction is first defined by how we classify it. Nobody wants to cure a "symptom", even though ironically it is the associated symptoms of tinnitus that are often treated instead of the tinnitus itself.
2. Research is complicated by money. Like most things in life, money is what makes the world go round. We don't develop chemotherapy drugs because we want to treat cancer per se, but because the company overseeing its development has profit potential. In the case of tinnitus, there is an influx of literature this century compared to the previous century. However, there is still a severe lack of it compared to other afflictions. And who can blame the government and other grant providers? After all, why spend millions to cure an affliction people are expected to cope or "habituate" to while diseases like cancer, diabetes, and heart disease afflict and kill millions every year? You can say its because depression and suicide are consequences of tinnitus, but statistics show that the this is only a small minority of the community. These sufferers do matter (to me anyways), but again, science will simply prescribe to treat the depression, anxiety, and insomnia because such treatments exist. Scientists are just as lazy as regular people are, and the less work they have to do, the better (f0r them).
3. Current treatments have a conflict of interest. Whether its audiologists and ENTs getting kickbacks for prescribing expensive and somewhat helpful devices like hearing aids and cochlear implants, to CBT and TRT specialists charging a small fortune for the dozens of sessions said to be required before relief is "found", to the endless prescriptions of antidepressants, antipsychotics, and other useless medications (with the exception of sedatives and glutamate antagonists), professionals may feel the need to guard their cash cow businesses by promoting their treatments over research for a cure.
4. Research knows little about tinnitus and results in disagreements about pathology. Finally, of the research that is being done, there is often a conflict over how tinnitus develops, what brain changes occur because of it and nothing else, and fights over whether the so-called "gate keeping" theory of tinnitus purposed by Rauschecker provides any insight or not. A 2014 meta analysis paper concluded that current neuroanatomical evidence fails to substantiate the theory, though does not reject it. In the end, research seems to have stalled, and hedges off its chips on higher brain regions for treatment with preexisting drugs (like SSRIs) instead of targeting the commonly know burst firing areas in the brainstem's Dorsal Cochlear Nucleus.
I don't want to think this fight is hopeless, but it is hard to feel this way. Professionals, even those afflicted themselves, don't seem to care. Wanting to boost mood and promoting coping over addressing the problem causing chronic distress anyways. What do you guys think we, as a community, should do to promote a cure over coping, depression treatments, and talk therapies? How can we convince the government, medical professionals, etc. to actually fight for a cure rather than using preexisting drugs and therapies to address symptoms of what is increasingly seen as an affliction rather than a mere "symptom" of a greater problem.
1. Tinnitus is a "symptom" and not a "disease". It is often the case that many academic and medical professionals regard tinnitus as a symptom rather than an actual affliction. Indeed, the tinnitus is usually indicative of hearing loss, TMJ, or other medical issues. However, such professionals sometimes fail to identify what this is specifically a "symptom" of. I think its high time for medical and academic professionals to regard tinnitus as a disease rather than just a symptom. The very manor in which we approach the affliction is first defined by how we classify it. Nobody wants to cure a "symptom", even though ironically it is the associated symptoms of tinnitus that are often treated instead of the tinnitus itself.
2. Research is complicated by money. Like most things in life, money is what makes the world go round. We don't develop chemotherapy drugs because we want to treat cancer per se, but because the company overseeing its development has profit potential. In the case of tinnitus, there is an influx of literature this century compared to the previous century. However, there is still a severe lack of it compared to other afflictions. And who can blame the government and other grant providers? After all, why spend millions to cure an affliction people are expected to cope or "habituate" to while diseases like cancer, diabetes, and heart disease afflict and kill millions every year? You can say its because depression and suicide are consequences of tinnitus, but statistics show that the this is only a small minority of the community. These sufferers do matter (to me anyways), but again, science will simply prescribe to treat the depression, anxiety, and insomnia because such treatments exist. Scientists are just as lazy as regular people are, and the less work they have to do, the better (f0r them).
3. Current treatments have a conflict of interest. Whether its audiologists and ENTs getting kickbacks for prescribing expensive and somewhat helpful devices like hearing aids and cochlear implants, to CBT and TRT specialists charging a small fortune for the dozens of sessions said to be required before relief is "found", to the endless prescriptions of antidepressants, antipsychotics, and other useless medications (with the exception of sedatives and glutamate antagonists), professionals may feel the need to guard their cash cow businesses by promoting their treatments over research for a cure.
4. Research knows little about tinnitus and results in disagreements about pathology. Finally, of the research that is being done, there is often a conflict over how tinnitus develops, what brain changes occur because of it and nothing else, and fights over whether the so-called "gate keeping" theory of tinnitus purposed by Rauschecker provides any insight or not. A 2014 meta analysis paper concluded that current neuroanatomical evidence fails to substantiate the theory, though does not reject it. In the end, research seems to have stalled, and hedges off its chips on higher brain regions for treatment with preexisting drugs (like SSRIs) instead of targeting the commonly know burst firing areas in the brainstem's Dorsal Cochlear Nucleus.
I don't want to think this fight is hopeless, but it is hard to feel this way. Professionals, even those afflicted themselves, don't seem to care. Wanting to boost mood and promoting coping over addressing the problem causing chronic distress anyways. What do you guys think we, as a community, should do to promote a cure over coping, depression treatments, and talk therapies? How can we convince the government, medical professionals, etc. to actually fight for a cure rather than using preexisting drugs and therapies to address symptoms of what is increasingly seen as an affliction rather than a mere "symptom" of a greater problem.
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(but that's not because of tinnitus but their weak mindset!!!)
