Portable
Tinnitus Devices
by Barry Keate
Many
of our readers have asked me to comment on a variety
of portable tinnitus instruments. There are a number
of these devices on the market and while I cannot address
all of them here, I will try to describe the most often
asked about devices, discuss the scientific theories
of the various treatments and relay my impressions as
to their effectiveness in this article. Ti-Ex
Tinnitus Therapy Device
This portable electromagnetic device was developed
by an Austrian electronics engineer named Gerald Neuwirth
in 1998. Mr. Neuwirth had suffered severe tinnitus
for many years and had not experienced relief with
any therapy. He developed a hand-held device that
directed electromagnetic energy into the cochlea and
reported that his tinnitus symptoms disappeared after
10 weeks of use.
The
scientific basis of this device is predicated on the
belief that electromagnetic waves will stimulate and
regenerate hair cells that have been damaged. A quote
from their website reads, “In order to understand
how ti-ex works, it is important to realize that the
hair cells in the inner ear can regenerate. If they
are damaged, they regenerate completely from the tip
to the root, creating a new hair cell in about two
days.”
This
dubious statement contradicts all scientific knowledge
to date. Hair cells in humans do not regenerate. If
they could, or if scientists could find a way to stage
the regeneration, hearing loss in humans would become
a thing of the past.
Certain
cold-blooded animals, such as sharks and frogs can
regenerate hair cells. More recently it has been found
that some birds can regenerate hair cells as well.
This has led to a surge of research into how to duplicate
this process in humans. It has not been accomplished
so far.
Mr.
Neuwirth also makes reference to repetitive Transcranial
Magnetic Stimulation (rTMS), as a rationale for the
therapy he claims for his instrument. rTMS has been
shown to be helpful for some tinnitus patients, and
we published an article on
rTMS, that is found in our Tinnitus
Info Center.
The
comparison between a portable electromagnetic device
designed for home use and rTMS is a very large stretch.
rTMS generators use capacitors that can generate 5,000
to 8,000 Amps. This amount of power is necessary to
induce a magnetic field inside the skull which can
effectively change the metabolic activity of the auditory
cortex. Even at this power level, many researchers
believe the magnetic field cannot extend deep enough
into the brain to affect tinnitus and that only implanted
electrodes will truly accomplish tinnitus relief.
Furthermore,
rTMS seems to be effective in interfering with the
neuronal changes in the auditory cortex, not by regenerating
hair cells.
Ti-ex
has not undergone clinical trials. It is available
in Europe and costs 290 to 490 Euros (approximately
$390.00 to $650.00 US dollars). The device can be
found at ti-ex.com/en.
Neuromonics
The Neuromonics Tinnitus Treatment consists of a new
model of acoustic therapy along with a six-month program
of education, support and monitoring from a qualified
audiologist. Its aim is to break the negative cycle
of tinnitus disturbance, rather than objectively lower
the sound level, which results in reduced awareness
of tinnitus and its associated disturbance.
Neuromonics
is based on the Neurophysiological Model for tinnitus
developed by Pawel Jastreboff, who devised Tinnitus
Retraining Therapy (TRT). Similar to TRT it is a long-term
treatment. Both treatments attempt to reprogram the
brain by de-sensitizing it to filter out the sounds
of tinnitus. An article on TRT
can be seen in our Info Center.
In
both TRT and Neuromonics, researchers believe that
the problem is not specifically the tinnitus itself
but the individual’s reaction to the perception
of tinnitus. This reaction involves the emotional
centers of the brain’s limbic system which controls
emotions and leads to disturbance. By removing the
negative association attached to tinnitus perception,
the disturbance of tinnitus will decrease.
Whereas
TRT utilizes sound generators and couples them with
education, emotional support and cognitive therapy,
Neuromonics adds advanced audio technology that can
reproduce frequencies up to 12,500 KHz. It combines
full-spectrum classical music with high frequency
sounds to make the sound therapy soothing. The result
is less intensive and faster conditioning than with
traditional TRT.
The
first step of this treatment is to perform a comprehensive
personalized assessment to determine an individual’s
tinnitus profile. This profile is used to program
the Neuromonics Processor, a small, lightweight device
about the size of a cell phone. The processor is coupled
with high-end headphones to produce acoustic stimulation
across a broad spectrum of sound. The theory is the
full-spectrum sound stimulates audio pathways in the
brain reducing the relative loudness of the single
frequency tinnitus. The patient is instructed to listen
to the device for at least two hours daily. The time
can be broken up to accommodate for work and daily
schedule but 2-3 hours daily is the recommended time.
The
program costs around $5,000 and takes 6 months to
complete. At the end of that period, patients may
continue to listen to the device, if desired, for
shorter periods or may elect to not use it at all.
They have results on their website on their own clinical
studies show positive results for this therapy but
none of them have been published in a peer-reviewed
publication.
I
have received many questions about Neuromonics but
have no personal experience of it. Nor have I communicated
with anyone who has used it. If anyone decides to
use this program, I will appreciate any feedback about
its effectiveness. There are numerous audiology clinics
across the US that are beginning to offer Neuromonics.
You can find the US locations online at neuromonics-usa.com.
Their home website in Australia is neuromonics.com.
TinniTool
The TinniTool makes use of the theory behind Low Level
Laser Therapy (LLLT) developed by Dr. Lutz Wilden
in Germany. The theory is that auditory processes
require energy in the form of ATP (adenosine tri-phosphate).
ATP is considered by biologists to be the energy currency
of life. It is the high-energy molecule that stores
the energy we need to do just about everything we
do. It is produced by the mitochondria in the cells
of the inner ear and throughout the body. The mitochondria
are considered to be the powerhouse energy producing
units in each cell.
If
the cochlea is over-strained, its sensory cells are
affected as well and they inevitably lose part of
their functional capacity due to a lack of ATP. Using
LLLT, Dr. Wilden has been able to produce a biological
reaction, the end result of which is ATP production,
even in damaged cells. This therapy may be more beneficial
in patients in the early stages of tinnitus as it
may have more benefit in damaged cells than in dead
ones.
In
my opinion, the jury is still out on the effectiveness
of LLLT, especially for long-term chronic conditions.
While I have heard some encouraging results from people
who were treated by Dr. Wilden, I have not heard anything
positive coming from anyone who visited LLLT clinics
in the US. We previously published an article on LLLT
which is in our Tinnitus Info Center.
To
my knowledge, there has been only one published study
relating to LLLT and tinnitus. Unfortunately, the
study encompassed three treatment methods, all of
which were used simultaneously. It appears that 73%
of the people in the LLLT study were using Ginkgo
biloba for their tinnitus as well and others were
using ginkgo and also undergoing cranio-physical manipulation.
It is unclear which part of the therapy was helpful
and it may well have been the Ginkgo biloba.
Dr.
Wilden uses two separate laser beams on the mastoid
bone that are calculated to penetrate into the cochlea
from behind the ear. He also simultaneously uses a
third beam aimed down the ear canal. Typical treatment
sessions are 60 minutes and there are 10 session over
a period of 10-14 days.
The
TinniTool is a portable, home-use device that produces
a single beam. It is not aimed through the mastoid
bone but down the ear canal. It is difficult for me
to believe that this device would be helpful for people
with chronic tinnitus.
The
TinniTool has not undergone clinical trials. It is
available from the United Kingdom at a cost of 270
British Pounds, about $540 US dollars. It is sold
through on-line shopping markets in the UK and can
be found at bizrate.com.uk.
Tinnitus Phase-Out System
This
is a tinnitus treatment therapy more than an actual
scientific instrument although the therapy can be
accomplished at home. It was developed by Daniel S.J.
Choy, MD and is offered through the Tinnitus Control
Center in New York City. The Tinnitus Phase-Out System
utilizes recent advances in industrial sound cancellation
principles to produce a sound that results in significant
Residual Inhibition (RI). Residual Inhibition refers
to the inhibition of tinnitus that occurs after a
tinnitus masking session. In the great majority of
cases RI lasts only seconds. Using the Tinnitus Phase-Out
System, researchers claim to have produced RI lasting
hours and, sometimes, days.
We
published an article about this under the heading
Sound-based
Tinnitus Therapy.
This
therapy is available for patients with pure-tone tinnitus
where the frequency of the sound does not vary even
though loudness can vary. Each patient is first given
a thorough medical examination to eliminate the possibility
of a serious condition. Their tinnitus is then evaluated
and matched to both frequency and loudness. The individual
tinnitus tones are then reproduced and processed through
a proprietary computer program. The program shifts
the phase of the sound through 360 degrees in 6 degree
increments every 30 seconds. In this manner the sound
is completely phase-shifted every 30 minutes and is
effectively totally out of phase with the person’s
tinnitus for 1/3 the total time. During this out of
phase period, the sound cancels out the tinnitus sound
and tinnitus is not heard.
The
phase-shifted sound is then burned into a CD and played
for the patient at the Tinnitus Control Center. There
are four sessions after which the patient decides
if it is helpful in reducing tinnitus. If it is, the
patient can purchase the CD and use it at home on
any high-quality audio system.
The
cost of the program is $850.00 for the evaluation
and four office treatment sessions. If successful,
the cost of the CD is an additional $1,500.00.
There
have been several research papers presented at medical
symposiums but as yet there are no published studies.
One paper was presented at the Osteopathic College
of Ophthalmology and Otolaryngology in 2006. It stated
that the company’s research found that 46% of
their patients demonstrated complete residual inhibition
for 1-7 days.
Another
paper presented at the 8th Annual International Tinnitus
Seminar in Pau, France in 2005 found that 82% of patients
experienced a reduction of tinnitus symptoms. It did
not state for how long the reductions lasted.
The
Tinnitus Control Center is actively seeking to license
the technology to medical clinics throughout the US
and the world. So far it is only offered in New York
City and Erie, PA. For further information, visit
their website at tinnituscontrol.com.
Arches
Tinnitus Formulas can be used with any of the therapies
discussed in this article and will enhance results.
We have discussed combining our products with the
Tinnitus Phase-Out System using a combination therapy
and anticipate that this will be forthcoming.
I
am very interested to hear from anyone who uses any
of these therapies. Let me know of your experience,
pro or con. Send comments to
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