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Tinnitus Library

Ask Barry - October 2011

Do you have questions about tinnitus, our products or specific treatments? Ask Barry. Arches President Barry Keate will select the most representative questions each month publication. Regardless all questions will receive a personal reply from Barry.

ASK BARRY Tinnitus expert, Barry Keate, answers your questions about Tinnitus Send your question to:  Ask Barry

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NOTE: Ask Barry is pleased to be able to answer your questions based upon the information we have available. Our answers to your email inquiries are not substitutes for a physician's advice nor are they reviewed by a physician. If you are under a physician's care, please share with your doctor any suggestions you have received from Ask Barry

This Month's Questions:

Football Follies and Tinnitus

Dear Barry, I've had moderate to severe tinnitus since a firecracker incident 40 years ago. I learned to live with it, and it would elevate at times but would eventually return to regular level.Last Fall, I went to a New England Patriots football game where I was sitting in 1st row, just behind these costumed revolutionary war "Patriots" who would fire [explode more like it] these huge muskets after each score. In the excitement I forgot to cover my right ear, and actually felt an eerie numbing thump in my eardrum and instantly knew my life would never be the same. The ringing has been at much higher level since.

Depression, lack of sleep and concentration soon followed. Hearing tests confirmed my going from moderate to severe. My doctor said there was still no cure, just treatments. I'm a recovering alcoholic the GABA family of drugs was NOT an option. He did mention EStimME with some degree of hope. He wasn't so sure ginkgo would help, except for the placebo effect. I've taken it for years ((Ginkgold), but now taking Arches). I'm not so sure it’s helping either, but I am tolerating my tinnitus better. My body and mind could just be adapting. Have you any opinion on EStimME.

Thank you for your time, Paul M.

Dear Paul, I’m very sorry for your experience. Personally, I think the noise in most stadiums is way too high and I try to stay away from them. I can’t imagine being next to exploding muskets at the same time.

EStimMe is a very small electrical stimulator, referred to as a neurostimulator, which is surgically implanted inside the ear drum. It is described as the size of a grain of rice. It sends an electrical signal to the auditory nerve in an effort to reduce tinnitus. An external unit powers and controls the stimulator. While the website doesn’t explicitly state this, there must be wiring from the controller to the stimulator to keep it powered. The control unit would apparently be carried in a pocket or case worn on the belt.

EStimMe Ltd. is an Israeli company founded in 2008. It is very clearly stated on their website that “The EStimMe system is an investigational device, limited to investigational use only.” It is not available for sale to the public.

A clinical trial evaluating the safety and efficacy of the unit is currently underway in Israel. Until such time as the trial is complete and published, we will not have any idea whether it works or not. Personally, I am not holding my breath. I’ve seen many small devices claim to control tinnitus but have not seen positive results. The concept of electrical stimulation is valid but the only major successes so far have been with total cochlear replacement with implants and with Dr. Seidman’s experiments with implanting electrodes directly into the brain. Both of these are very invasive surgeries and very expensive.

You mention the GABA family of drugs as not being an option. You can also get over-the-counter GABA supplements which are not addicting in any way. GABA supplements are known to be brain calming agents without the physical effects of benzodiazepine tranquilizers. GABA may be helpful, in combination with Arches Tinnitus Formula, for reducing depression and helping with sleep and concentration. It is found in most health food stores and is very inexpensive. It is typically taken in 500-750 mg doses, two or three times daily.

Wishing you quiet times, Barry Keate

Flight to Tinnitus?

Dear Barry, One of the question writers in the most recent issue of your newsletter mentioned his tinnitus occurring after a flight home from England. I'm 63 years old and have had tinnitus since traveling by air to Africa and back about a year ago.

In your answer to the traveler to England, you mentioned engine noise and air pressure. How can we protect ourselves from those factors in jet travel? Do noise-canceling headphones really protect the ears from the engine noises, or do they simply create the illusion of quiet while the inner ear is still being bombarded by the loud noise?

Also, before the trip to Africa, I took anti-malarial drugs, and in researching tinnitus I have seen those drugs mentioned as possible causes. True?

I've been to an ENT doctor, who recommended the Arches Formula; I used it for over three months, with no reduction of the high-pitched ringing. My tinnitus is not unbearable but has gotten worse in the year since it first occurred. I'd appreciate your insights and opinions on the possible causes of my tinnitus, and especially your advice on where I can go from here!

Thank you, Kristie F.

Dear Kristie, Engine noise and air pressure changes are the two challenges to flying for those with tinnitus. Noise-canceling headphones really do protect against outside noise. You can leave the sound off and fly in silence or turn it on to listen to music or movies that many airlines show. For more ideas read our article on Flying and Tinnitus.

Anti-malarial drugs may cause tinnitus. Many of them are quinine based or quinine derivatives. Quinine is a known cause of tinnitus.

I’m sorry our products weren’t more helpful for you. There are many other therapies to try from acupuncture and biofeedback to Neuromonics, an acoustic stimulator that desensitizes the brain to tinnitus in order to reduce both the perception and the annoyance.

These treatment therapies and more can all be found in our Tinnitus Library

Wishing you quiet times, Barry Keate

Dry Eye Connected to Tinnitus?

Hi Barry. I've had my tinnitus and TMJ dysfunction now for 2 years. The problem is not in the joint in my jaw. The pain is in front of the joint. I have a elongated coronoid process. My TMJ doctor wants me to have a coronoidectomy. Is there any link between an elongated coronoid process and tinnitus? If I press on the elongated bone, my tinnitus goes up and down. Another weird thing is I got hit with dry eye syndrome recently. Is there any connection here that you know of?

Thanks! Eric

Dear Eric, Elongated coronoid process is an elongation of a normal protrusion of the mandible, or jaw bone, that is in front of the temporomandibular joint (TMJ). It is a mechanical problem and can limit the opening of the mouth. This question is perplexing for me. I have found no references to elongated coronoid process causing tinnitus. I am sure there is a connection through TMJ dysfunction but there is not much information about it.

Hopefully, the surgery recommended can be helpful. However, I am always interested in finding a less invasive process if it can be effective. TMJ specialists know the surgical route but may not know of other potential therapies.

We published an article on somatic tinnitus, where tinnitus is modified by changes in the body rather than the cochlea. TMJ dysfunction is a major cause of somatic tinnitus. As you relate, pressing on the elongated bone affects your tinnitus. In the case of somatic tinnitus, nerve signals from the TM joint, mandible, or other head and neck areas are transmitted through the dorsal cochlear nucleus in the brain along with auditory signals. They can become involved in cross-talk with each other and the nerve signals can strongly influence tinnitus.

As outlined in the article, there are several treatment options for somatic tinnitus. These include the use of a bite guard, biofeedback training and Transcutaneous Electrical Nerve Stimulation (TENS). TENS units are portable and can be used at home. They relax the muscles and show promise in reduction of tinnitus.

TMJ dysfunction can appear in many different guises. It is frequently referred to as “the great imposter” because it can cause symptoms that mimic other conditions. Dry eye syndrome is definitely one of them.

I would try some of these less invasive options in the hope they can be helpful. If they are not, you can then go the surgical route.

Wishing you quiet times, Barry Keate

NOTE: "Ask Barry" is pleased to be able to answer your questions based upon the information we have available. Our answers to your email inquiries are not substitutes for a physician's advice nor are they reviewed by a physician. If you are under a physician's care, please share with your doctor any suggestions you have received from Ask Barry.