Tinnitus treatment

Treatment for tinnitus

Can be effective in many defined pathologies: when treatment of tinnitus is given to a medical conditions that have a known diagnostic procedure by objective means (such as audiograms, imaging and blood tests) and may respond to Surgery tinnitus treatment, Antibiotic medications or removal of medications that may cause tinnitus as side effect.tinnitus treatment

Metabolic approach

The metabolic approach is an important part of Internal Medicine.

It can be very helpful to sufferers who need treatment for tinnitus. The obstacle exists in the Text-Books of "Otolaryngology". The message is very pessimistic and ignore this field of medicine.

More details about treatment for tinnitus by the metabolic approach (that is my contribution to the severely affected sufferers) will be discussed at the end of this page.

Few words about the terminology and classification of forms of tinnitus that may respond to tinnitus treatment:

What is tinnitus?

Tinnitus is a sensation of sound when such ambient sound does not exist outside the head of the sufferer or may come from a structure near the ear of the patient, inside the head or neck.

Possible origins are: (1) contraction of a muscle, (2) turbulent blood flow inside a blood vessel.

Objective versus Subjective tinnitus

The subjective type of tinnitus is heard only by the sufferer, while the objective tinnitus can be heard also by others. The objective tinnitus can be detected by a mini-high quality treatment for tinnitusmicrophone and amplified, transferred to a speaker in real time or recorded, and transferred to an amplifier and a speaker after the recording.objective tinnitus

Such tinnitus is typically a pulsating sound that can have the same counts per minute as the heart rate (when a blood vessel disease is the origin), or a different number then the heart rate of the sufferer (when involuntary muscle contraction makes the noise).

For these two sub-types the medical approach to the treatment of tinnitus is different.

Acute tinnitus versus chronic tinnitus

When the duration of the tinnitus is less then 6 months it is called acute tinnitus. Tinnitus that lasts more then 6 months is considered chronic tinnitus. The duration of the tinnitus is not related to the tinnitus treatment when the metabolic approach is used (see later in this article: more about metabolic approach).

"Acute on chronic" and "relapse of tinnitus"

A sufferer of tinnitus may have prolonged and low grade tinnitus that he can tolerate. Such a sufferer (usually) would not seek help.

When the intensity of the tinnitus becomes louder and annoying, it is called "acute on chronic". It is different from "relapse of tinnitus". If the sufferer experienced disappearance of his tinnitus for prolonged duration, and then a new onset of tinnitus started, it is a "relapse of tinnitus". In order to start treatment for tinnitus, the expert should start the medical evaluation from the beginning in the two types of patients.

Tinnitus severity

Tinnitus can be classified according to the severity. Mild or moderate levels of this condition are not known enough in the out patient clinics of hospitals and audiological clinics because most of those who have it are non-help seekers. They may say: "I can live with that", "I can ignore it" or "I do not need medical help".

Severe tinnitus

When a sufferer is experiencing disturbance to his sleep-waking cycle (irregular biological clock), anxiety, irritability, hyperacusis (noise intolerance), Depression, less productivity at work, inability to derive pleasure from social life, sport, movies and family life – it is a severe medical condition.

Treatment for tinnitus (with the metabolic approach) is very effective for severe tinnitus patients.

Help seeker versus non help seeker

When the patient have a severe tinnitus (called also: intractable tinnitus or intolerable tinnitus), he is seeking for help. This is the common sense. Many times there are exceptions. A help seeker can be a victim with acute onset, or someone who was non help seeker for long time, and recently became a sufferer of severe tinnitus.

This medical condition was mentioned above as acute on chronic. A tinnitus sufferer may refuse to have medical help for many causes. Examples are: frustration from ineffective tinnitus treatment that he had before, fear of the tinnitus treatment, the patient is in the middle of a process of litigation and he does not want to loose the opportunity to sue his insurance company, the sufferer has inability to finance the treatment or low expectations from the outcome.

Mission impossible: tinnitus treatment when there is litigation

When the patient have plans to start in legal processes against any medical insurance, the probability that effective tinnitus treatment will help him is very low. After the litigation process is over, there is a chance that the treatment will help, or even will become a "cure tinnitus treatment".

Curable tinnitus according to the underlying medical conditions

1) Tinnitus due to infectious disease. (I) in the ear: (1) acute otitis media. (2) Inner ear infection: Labyrinthitis (vestibular neuritis) (II) in the brain: encephalitis (very rare) or meningitis.auditory neuromaAcoustic neuroma
2) Tinnitus due to a benign tumor: I) Cholesteatoma (tumor like). (II) Auditory neuroma. (III) Other cerebellopontine angle tumors.
3) Intracranial hemorrhage (rare): (I) Intra-axial hemorrhage, that is bleeding within the brain itself, and can be in the tissue of the brain or in the ventricles. (II) Extra-axial hemorrhage that can be in the skull. Epidural, subdural or subarachnoid.
4) Transient side effect of substance: (I) medications. (II) Drugs. (III) chemicals (Heavy metal poisoning: lead, mercury).
5) Endocrinopathy such as: (I) Diabetes mellitus. (II) Hypothyroidism. (III) Hyperthyroidism.
6) Normal pressure hydrocephalus (NPH).
7) Avitaminosis.
8) Palatal myoclonus.
9) Turbulent blood flow: (1) Carotid arteries. (2) Blood vessels disease in the brain such as A-V malformation. (3) Haemangioma. (4) Aneurism.
10) Anemia.

Resistant tinnitus

Types of tinnitus that are considered as resistant to treatments, but may be cured by the metabolic approach are: 1) Chronic tinnitus without any known disease. 2) Tinnitus due to noise hazards: (I) Acute noise (explosion, shooting), acoustic shock. (II) prolonged exposure to noise (loud music, motorized machines).

In patients with tinnitus that is considered treatable, but did not respond to the medical treatment: It means that if a sufferer has one of the above medical conditions and the medical treatment (with western approach) does not help him, he or she should be referred to a treatment with the metabolic approach (which is also a western medicine).

The metabolic approach

The metabolic approach is considered a treatment for tinnitus cure. This treatment is not suitable for every patient with tinnitus.

Medical examination

The first step is a medical examination of a qualified expert. Usually the expert is a specialist of Otolaryngology (Ear Nose and Throat). In most of the patients with sever tinnitus the expert is taking the anamnesis (medical history), examining the patient (ear nose & throat and Neurological examination) and referring him to objective tests (audiogram, ABR or BERA, MRI of the temporal bone and brain or fMRI).

The expert should do re-assessment of the general health of the patient and his intra-cranial auditory pathways. When the interpretation of the objective tests is that there is no evidence for pathology that may cause tinnitus, it is possible to apply the metabolic approach.

The basis for the metabolic approach

The basis for the metabolic approach is that our body can cure itself. In many mild traumas such as small cut-wounds, miniature burns, or even obstruction of small vessels in the heart – the curative mechanisms of the body can cure the damage.

Even in a group of people who are exposed to phonal trauma (such as high energy explosion, shooting of cannons, loud sound of speakers in rock concert) only few of them remain with chronic tinnitus.

What happened to the majority of the victims?

All the people who are exposed to phonal trauma suffer from tinnitus. After the beginning of the tinnitus, the curative mechanisms of the individual start to repair the damage. Soldiers who are exposed to the noise of shells report of having tinnitus that lasts few seconds to several hours.

What is the explanation for the cure without any tinnitus treatment?

The curative mechanisms of the body succeeded to repair the damage. The principle of applying the metabolic approach is to identify the systems that failed to take part in the repair of the damage and enable them to take part in the healing process.

Medical workup

This medical workup include many aspects of the western Internal Medicine. When the blood tests are completed there are two types of abnormal results:
1) Results that deviate from the normal range.
2) Results that are within the normal range, but when compared to other results, they are considered abnormal.
3) The tinnitus treatment starts with correction of the results type (1) and later the focus is on correction of the results type. (2) Continuous monitoring of the symptoms is important part in the tinnitus treatment.