Multiple Electrostimulation Treatments to the Promontory for Tinnitus

Perez, Ronen; Shaul, Chanan; Vardi, Michael; Muhanna, Nidal; Kileny, Paul R.; Sichel, Jean‐Yves

doi:10.1097/mao.0000000000000309

Cited by 9 publications

(24 citation statements)

References 25 publications

(16 reference statements)

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“…The tinnitus severity improved in 5 patients, but turned to the original status 4 weeks after treatment. Also the audiological tests could not reveal any changes – the authors postulate that this therapy might be useful for some patients; further it has no side effects [78]. The authors consider as effective a suppression of the tinnitus by the (peripheral) stimulation but not masking.…”

Section: Neuromodulation – Instrument-based Medical Interventionsmentioning

confidence: 99%

Evidence and evidence gaps in tinnitus therapy

Hesse¹

2016

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 15:Doc04

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Section: Neuromodulation – Instrument-based Medical Interventionsmentioning

confidence: 99%

Evidence and evidence gaps in tinnitus therapy

Hesse¹

2016

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 15:Doc04

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“…Perez et al (6) used a transtympanic needle electrode to deliver charge-balanced pulsatile stimulation to the promontory in 10 chronic tinnitus subjects. The Perez study differed from previously-described work in two aspects: they delivered 3 consecutive 30-minute stimulation sessions, every other day, and 7 of their 10 subjects had normal or mild hearing loss (PTA≤40 dB HL at 0.5, 1, 2 and 4 kHz).…”

Section: Existing Evidencementioning

confidence: 99%

Tinnitus treatment with precise and optimal electric stimulation

Zeng

Djalilian²,

Lin³

2015

Current Opinion in Otolaryngology & Head and Neck Surgery

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Purpose of review Electric stimulation is a potent means of neuromodulation that has been used to restore hearing and minimize tremor, but its application on tinnitus symptoms has been limited. We examine recent evidence to identify the knowledge gaps in the use of electric stimulation for tinnitus treatment. Recent findings Recent studies using electric stimulation to suppress tinnitus in humans are categorized according to their points of attacks. First, non-invasive, direct-current stimulation uses an active electrode in the ear canal, tympanic membrane or temporal scalp. Second, inner ear stimulation uses charge-balanced biphasic stimulation by placing an active electrode on the promontory or round window, or a cochlear implant array in the cochlea. Third, intraneural implants can provide targeted stimulation of specific sites along the auditory pathway. Although these studies demonstrated some success in tinnitus suppression, none established a link between tinnitus suppression efficacy and tinnitus-generating mechanisms. Summary Electric stimulation provides a unique opportunity to suppress tinnitus. Challenges include matching electric stimulation sites and patterns to tinnitus locus and type, meeting the oftentimes-contradictory demands between tinnitus suppression and other indications, such as speech understanding, and justifying the costs and risks of electric stimulation for tinnitus symptoms.

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“…Third, electric stimulation is not optimized to achieve the greatest efficacy for tinnitus treatment. For example, charge-balanced alternating-current stimulation is safe and has been shown to suppress tinnitus in about 50% of patients (Hazell, Jastreboff, Meerton, & Conway, 1993; Kuk, Tyler, Rustad, Harker, & Tye-Murray, 1989; Perez et al., 2015; Rubinstein et al., 2003; Shulman, Tonndorf, & Goldstein, 1985; Vernon & Fenwick, 1985). However, these previous studies showed a wide range of stimulus parameters used for tinnitus suppression, with occasionally contradictory suggestions.…”

Section: Introductionmentioning

confidence: 99%

“…(1985) used amplitude-modulated sinusoids. The level of stimulation ranged from below audibility threshold (Shulman et al., 1985) to a 2-mA hardware limit (Perez et al., 2015). The duration of stimulation ranged from minutes (Rubinstein et al., 2003) to days (Shulman et al., 1985).…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies either used stimulators for pain management (e.g., Vernon & Fenwick, 1985) or customized equipment for research purposes only (e.g., Hazell et al., 1993; Shulman et al., 1985). In addition, stable electrode contact is difficult with either tympanic or transtympanic stimulation (e.g., Kuk et al., 1989; Perez et al., 2015). Although commercially available cochlear implants have been modified for tinnitus treatment (Hazell et al., 1993; Rubinstein et al., 2003; Wenzel et al., 2015), the invasive nature and the likelihood of damaging hearing limit their clinical utility because, after all, most tinnitus sufferers have significant residual or even normal hearing.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Tinnitus Treatment Using Noninvasive and Minimally Invasive Electric Stimulation: Experimental Design and Feasibility

et al. 2019

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Noninvasive transcranial or minimally invasive transtympanic electric stimulation may offer a desirable treatment option for tinnitus because it can activate the deafferented auditory nerve fibers while posing little to no risk to hearing. Here, we built a flexible research interface to generate and control accurately charge-balanced current stimulation as well as a head-mounted instrument capable of holding a transtympanic electrode steady for hours. We then investigated the short-term effect of a limited set of electric stimulation parameters on tinnitus in 10 adults with chronic tinnitus. The preliminary results showed that 63% of conditions of electric stimulation produced some degree of tinnitus reduction, with total disappearance of tinnitus in six subjects in response to at least one condition. The present study also found significant side effects such as visual, tactile, and even pain sensations during electric stimulation. In addition to masking and residual inhibition, neuroplasticity is likely involved in the observed tinnitus reduction. To translate the present electric stimulation into a safe and effective tinnitus treatment option, we need to optimize stimulation parameters that activate the deafferented auditory nerve fibers and reliably suppress tinnitus, with minimal side effects and tolerable sensations. Noninvasive or minimally invasive electric stimulation can be integrated with sound therapy, invasive cochlear implants, or other forms of coordinated stimulation to provide a systematic strategy for tinnitus treatment or even a cure.

show abstract

Multiple Electrostimulation Treatments to the Promontory for Tinnitus

Abstract: Multiple sessions of electrostimulation to the promontory seem to be safe and may be beneficial for some tinnitus patients. Further clinical trials are warranted.

Cited by 9 publications

References 25 publications

Evidence and evidence gaps in tinnitus therapy

Evidence and evidence gaps in tinnitus therapy

Tinnitus treatment with precise and optimal electric stimulation

Tinnitus Treatment Using Noninvasive and Minimally Invasive Electric Stimulation: Experimental Design and Feasibility

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