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Author: admin | 10.04.2015 | Category: Relieve Tinnitus

According to the Mayo clinic, tinnitus is a common problem that affects approximately 1 in 5 people. Tinnitus treatment begins by first determining if there are any underlying conditions that can be treated. Noise suppression is another form of treatment that may make the tinnitus sounds less troublesome.
The effect of surgery for vertigo on tinnitus was evaluated in 90 patients who underwent surgery for disabling vertigo for Menieres disease. Tinnitus is an integral component of most neurotological disorders, particularly Meniere's disease. A retrospective review of 110 patients with Meniere's disease who underwent surgery for the control of disabling vertigo between July 1984 and November 1994 was undertaken. The patients were asked to grade their tinnitus severity from 1 to 5, (1 = worst and 5 = best) before, and a minimum of 2 years after their surgery.
The tinnitus response rate was then correlated with the different surgical procedures and submitted for statistical analysis.
A regression analysis comparing tinnitus outcome between the labyrinthectomy and the neurectomy groups yielded no significant differences (p = .9).
An analysis of maximum likelihood estimates comparing the shunt and the neurectomy groups also confirmed that the neurectomy group did significantly better (p = .04). The results of this investigation revealed a few salient points that were statistically significant.
The superiority of the vestibular neurectomy over the endolymphatic sac surgery in the control of vertigo has been widely described.
A destructive labyrinthectomy offers no advantage over the vestibular neurectomy with regard to tinnitus control, and should be reserved to patients who have already lost their hearing beyond possible help from amplification.
We believe that the ultimate control of tinnitus will come from the discovery of a pharmacotherapeutic agent.
The effect of surgery for vertigo in patients suffering from Meniere's disease on their tinnitus was evaluated in this retrospective study of 90 patients. In our experience, tinnitus for otosclerosis may be due to the following: poor vibration of the inner ear fluids, fixation of the footplate, destruction of the Corti hair cells by the proteolytic enzymes, acoustic trauma, or to poor inner ear blood supply due to the hyalinization of the spiral ligament of the stria vascularis.
Otosclerosis is first of all a regrowth of pseudohaver- sian bone fixing the footplate of the stapes.
The following formula shows the acoustic impedance of the annular ligament of the footplate. When the fixed stapes is replaced by a piston and a piece of vein graft the vibration of the part of the piece of vein graft located between the piston, replacing the stapes crura, and the edge of the hole made in the footplate, plays the role of sort of a new annular ligament. When the elastic band is replaced by bone, the resistance increases and the elasticity decreases, leading to an increase in the acoustic impedance of the ossicular chain. When less information gets to the brain, the brain has the tendency to increase the information to the external Corti hair cells located near the hair cells which are destroyed (border line),3 leading to excessive muscular action on the membranes. When the fixed stapes is properly replaced by a piston, with an interposition of a piece of vein graft to enhance the good elasticity of the system,1 the vibration of the inner ear fluids is good, and this bio-feedback vicious circle stops immediately; the tinnitus is completely released. When surgery allows a good vibration of the inner ear fluids, it will stop low tone tinnitus. When the reconstruction of the middle ear is followed by fibrous tissue formation located between the long process of the incus and the promontory, the piston pushes into the vestibule. Acoustic traumas are able to damage the inner ear hair cell structures, all the more so since the proteolytic enzymes have already partially destroyed the protein structure of the Corti hair cells.
Prevention against acoustic trauma is considered of paramount importance to an otosclerotic patient. Poor inner ear blood supply, due to the hyalinization of the spiral ligament of the stria vascularis by the proteolytic enzymes,12 leads to a lack of glucose and oxygen to the Corti hair cells.
Experience shows that tinnitus in otosclerotic patients when it is low tone is likely to be decreased following stapes surgery. We have performed a statistical retrospective study, comparing pre-operative and post-operative tinnitus patients one year after surgery. We studied the tinnitus in otosclerotic patients according to their frequency and intensity. The intensity and frequency were assessed by the audiometrist the day before and one year after surgery, by comparing the tinnitus with a pure tone sound emitted by the audiometer and heard by the opposite ear of the patient.
As far as intensity, the tinnitus patients before surgery were at the level of the hearing loss, or 5 to 15 dB above that threshold. As far as the disappearance of the tinnitus one year after surgery, and in order to avoid excessive subjectivity of the patients, the complete disappearance of the tinnitus was the only criterion for success. The patient reports improvement in the low frequency tinnitus as soon as the wick is removed a few days after surgery. What have you found to be the correlation between the tinnitus recovery to the extent of the otosclerosis? There is no correlation between the fixation of the footplate compared to the loudness of the tinnitus. What percentage of patients experience complete tinnitus relief one year following surgery? In our experience, surgery for tinnitus due to otosclerosis can help tinnitus of the low tones. SoundCure ® Quote “For the tinnitus patient, living with this persistent condition requires changing the way he or she thinks about health care and daily life.
However, it is important to take precautions before you begin taking any medications since they can cause side effects.

For instance, some individuals who suffer from phantom noises wear masking devices that are worn in the ear just as hearing aids would be. This form of treatment involves wearing a device that produces tonal music that works to mask the sound frequencies that you hear due to tinnitus. The three procedures studied included a destructive labyrinthectomy, endolymphatic sac decompression and shunt, and vestibular neurectomy. Most reports in the literature regarding surgery for Meniere's disease have focused on the success in vertigo control. The 4 patients dropped, included 2 patients who had undergone a shunt and subsequently a vestibular neurectomy, and another 2 who had revision shunt surgery. However there was a significant difference between the neurectomy and the shunt groups, the neurectomy group showing a better outcome (p = .04). Despite significant interest from the medical and scientific communities and the pressures from tinnitus sufferers, a cure or solution to this vexing problem continues to evade us.
Patients who underwent a vestibular neurectomy had a better tinnitus response rate when compared to those who underwent a shunt (50% vs 22.7%).
Until basic research in this field can yield a clue, continued clinical research on the medical and surgical management of tinnitus is necessary and helpful in guiding patients through their options. The results of this study revealed that: 1) Patients who underwent either a labyrinthectomy or a vestibular nerve section had a 50% positive outcome (cured or improved). The aim of this article is to suggest some explanations to enhance future research work carried out by other authors on this important issue, and to show what are the results of surgery in our experience, as far as tinnitus is concerned. The annular ligament of the footplate is the only part of the ossicular chain which is involved by the otosclerotic foci (Fig.
This increase in the resistance of the acoustic vibration of the annular ligament of the stapes footplate makes the inner ear fluids vibrate less, mainly for the low tones. The resultant increase in pressure of the labyrinthine fluids may, as in a hydrops, create low tone tinnitus. Sodium fluoride is able to arrest the activity of the proteolytic enzymes,8-10 but will not help to rebuild the structures of the destroyed hair cells.
Thus, an acoustic trauma will put an otosclerotic patient in greater danger than a normal person.
Acoustic trauma may disconnect the attachment between the cilia of the external Corti hair cells, as explained in the theory of Tonndorf (1980)3 leading to an epilepsy-like message to the brain.
The same theories as applied to the degeneration of the Corti hair cells by acoustic trauma, help to understand the mechanism of the tinnitus due to poor inner ear blood supply.
Only if the tinnitus is of the low tones, will the patient have a real chance to have tinnitus disappear. Why not say this experience reflects the clinical impression that there are different clinical types of tinnitus of which the low frequency tinnitus in otosclerosis is a cochlear type? But, as a matter of fact, they are mechanical as the poor vibration of the inner ear fluids gives a poor vibration of the internal inner ear hair cells leading to probable extra-stimulation of the external Corti hair cells. The more the tinnitus is of low pitched frequencies before surgery, the more effective will surgery be for tinnitus relief. Causse JR, Shambaugh GE, Causse JB, Bretlau P: Enzymology of otospongiosis and NaP therapy. Pujol R, Puel JL, Gervais D'aldin C, Eybalin M: Pathophysiology of the glutamatergic synapses in the guinea pig cochlea. Remind patients that tinnitus is different for every individual and that there is much we are still learning about tinnitus. Tinnitus may be a sign of hearing loss in which case a hearing aid may be helpful.  Additional tinnitus causes may include vascular conditions that may be alleviated with surgery, medications, or other forms of treatment. These masking devices produce “white noise” that helps to suppress the symptoms of tinnitus. Patients who underwent a vestibular neurectomy had a significantly better tinnitus outcome than those who underwent shunt surgery (50% vs 22.7%). In addition to the disabling vertigo, patients with Meniere's disease are quite distraught with tinnitus and commonly ask about the chances of their tinnitus improving following their surgery. Ninety (90) of these patients had chart information and follow-up data allowing inclusion in this study. The tinnitus response categories were then grouped into 2 main categories: cured or improved and same or worse. While some patients with severe tinnitus are ready to sacrifice their hearing to stop their tinnitus and regain their quiet existence, the unpredictability of the response prevents us from pursuing such therapy in the presence of serviceable hearing.
A destructive labyrinthectomy provided a similar tinnitus response rate to a neurectomy (50%). 2) With hearing conservation surgery, the vestibular neurectomy offers a significantly better chance of tinnitus cure or improvement when compared to endolymphatic sac surgery (50% vs 22.7%).
Only complete release of the tinnitus one year after surgery is taken into account to assess the results. If the tinnitus at the time of the revision surgery is still of the low tones only, it will disappear completely after revision surgery of the middle ear. Sodium fluoride will help to avoid an increase in tinnitus located about the 2 KHz but will not help diminishing its intensity. The external Corti hair cells are not able to buffer the message sent to the internal Corti hair cells.
The higher the tinnitus frequency the less chance we have seen for tinnitus to disappear after surgery. As the cause can be treated by surgery, that is the reason why the low tones tinnitus disappear.

Tinnitus in itself is not a medical condition, but a sign of an underlying condition that a doctor who specializes in ear problems in Sydney can address.
Playing a CD that includes ocean sounds or any other white noise sounds often help people with chronic tinnitus sleep at night or focus during the day. The customers feedback can engage you a great of the value and uppercase satisfaction of the product.
The purpose of this paper is to review the tinnitus outcome in patients who had undergone surgery for the control of disabling vertigo from Meniere's disease.
A trans-mastoid labyrinthectomy was performed in 12 patients who had no serviceable hearing.
Patients were also asked to rate their postoperative tinnitus response according to a scale of 1-4. Twelve patients in the neurectomy group responded to a question grading the degree of their improvement. However when the shunt group was compared to the neurectomy group, the neurectomy appeared to be more effective in tinnitus control (p = .064, borderline significant). A surgical solution for severe tinnitus has been proposed 'and investigated by multiple authors.
The severity of the preoperative hearing loss as measured by the PTA and the SDS did not affect the ultimate tinnitus response. 3) The severity of the preoperative hearing loss as measured by the PTA and the SDS showed no correlation with the tinnitus outcome. Otosclerosis and footplate fixation results in poor vibration of the inner ear fluids and contributes to tinnitus. This excess biofeedback message leads to low tone tinnitus most of the time, compared by the patient to a buzzing or an enginelike noise. If the tinnitus is located in the high pitched frequencies 6 and 8 kHz, the Corti hair cells degeneration is most of the time an irreversible damage. As a matter of fact, the Carhart notch about the 2 kHz is only partly due to the enzymatic process. This is the reason why surgery for otosclerosis will not relieve the tinnitus located in the high tones.
According to Remy Pujol,11 there is an increase in the amount of glutamate neuro-transmitter at the synapse between the internal Corti hair cell and the first neuron. By reducing or halting the use of the medication or finding a medication alternative, symptoms may be reduced. The severity of the preoperative hearing loss did not correlate with the tinnitus outcome in all groups.
While the indications for surgery in these patients were the control of vertigo and not tinnitus, it is helpful to recognize the different tinnitus response rates comparing the three main procedures reviewed, namely, the destructive labyrinthectomy, the endolymphatic sac decompression and shunt, and the vestibular neurectomy.
Of those patients with serviceable hearing, 56 patients underwent a vestibular neurectomy and 22 patients a mastoid endolymphatic sac decompression and shunt.
Dandy in 1941 reported a 50% improvement in tinnitus following VIIIth nerve sections for Meniere's disease. The degree of decompression of the endolymphatic sac is not believed to play a role in the tinnitus outcome since the extent of exposure and decompression of the endolymphatic sac and surrounding posterior fossa dura we perform in sac surgery is similar to the exposure in retrolabyrinthine vestibular neurectomy.
The JB Causse schematization of inner ear function2 proposes that the internal inner ear Corti hair cells carry the message to the brain, whereas the external ones bring the message from the brain to the inner ear in order to help select the "keynotes", amplifying the message or buffering it (Fig.2). If a few days after revision surgery, no results are shown for the disappearance of the tinnitus then it is too late to hope for a further disappearance of the tinnitus.
The increase in the amount of glutamate is not only the cause of the tinnitus, but is also the cause of the destruction of the synapse, leading to deafness. The disappearance of the tinnitus must be compared to the improvement of the bone conduction on the low and mid frequencies after surgery. Patients who have serviceable hearing and require surgery for disabling vertigo appear to have a better chance of tinnitus control with the vestibular neurectomy rather than an endolymphatic sac decompression and shunt.
The availability of such data could play a role in the choice of surgery when tinnitus is a major symptom. The choice of the surgical procedure in the hearing preservation group was not determined by the severity of the vertigo, but rather by the age of the patient, bilaterality of the disease, and the patient's preference. This is the reason why post-operatively, in two-third of the cases, the tinnitus, located about mid-frequencies, are much less after surgery. The bone conduction improves because of a better vibration of the inner ear fluids, and thus better vibration of the inner ear hair cells. Only 12 patients responded to that question, rating their improvement as either significant or mild. Such procedures however are not widely embraced particularly due to the inability of future cochlear implantation of these patients should they become candidate for an implant at some point. There is no reliable test before surgery that may indicate if the tinnitis is predominantly due to a poor vibration of the fluids or if they have an enzymatic origin.
That is the reason why Itard and Val salva by inflating the middle ear produced a better function of the ossicular chain and could also decrease the low tone tinnitus in some patients.

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