Personalized Alternative Therapies for Tinnitus: A Comprehensive Stud


Tinnitus, a condition characterized by the perception of ringing or buzzing sounds in the ears without any external source, is a symptom with a controversial origin.

Previous studies have suggested that tinnitus may be caused by insufficient blood flow in the tissues near the inner ear, leading to damage to the outer and inner hair cells.

Another proposed mechanism involves a thalamocortical lesion that results in decreased auditory stimulation. However, the exact cause of tinnitus cannot be confirmed for every patient, which complicates treatment planning and prognosis.

Some studies have associated the lack of peripheral blood flow in the inner ear not only with tinnitus but also with other symptoms such as vertigo and hearing loss. Sensorineural hearing loss, caused by microcirculatory insufficiency, can be the result of vascular occlusion due to various factors like embolism, hemorrhage, vasospasm, diabetes mellitus, or arterial hypertension.

Among these, diabetes mellitus is the most common condition associated with hearing disorders. Patients with diabetes often experience symptoms such as dizziness, tinnitus, and hearing loss.

Currently, there is no universally recommended treatment for tinnitus. Medications such as sedatives, antihistamines, antidepressants, local anesthetics, and antipsychotics are prescribed, but their outcomes vary. Some commonly prescribed drugs include flunarizine dihydrochloride and Ginkgo biloba.

Flunarizine dihydrochloride is a vasodilating drug used for balance disorders, dizziness, and labyrinth diseases, while Ginkgo biloba is used for vertigo and tinnitus caused by circulatory disorders. However, these medications only provide short-term relief and may have limited dosages due to potential side effects.

Due to the suggested role of microcirculatory insufficiency in tinnitus, alternative therapies aimed at increasing regional blood flow have been proposed. One such therapy is low-level laser therapy (LLLT), which has been used as an alternative treatment for tinnitus, cochlear dysfunction, and various muscle and skeletal disorders. LLLT involves the use of low-intensity lasers to stimulate biological tissues, promoting healing, angiogenesis, and pain relief.

Laser puncture, a specific type of LLLT, stimulates acupuncture points to restore the body’s energy balance. Vacuum therapy, also known as cupping therapy, is another non-invasive treatment option that uses suction cups to increase peripheral blood supply, leading to tissue repair and anti-inflammatory effects. Ultrasound therapy (US) is a non-invasive treatment that applies mechanical waves to promote tissue regeneration and decrease inflammation.

Several systematic reviews of randomized controlled trials (RCTs) investigating LLLT for tinnitus have shown mixed results. Some studies reported no significant differences between placebo and treated groups in terms of tinnitus scores. However, these studies used different treatment parameters, such as varying wavelengths and treatment application methods. Therefore, large-scale and well-designed studies are still needed to evaluate the efficacy of LLLT for tinnitus treatment.

To address the need for personalized and alternative treatments for tinnitus patients, this study aimed to investigate the effects of LLLT combined with vacuum therapy, US, or drug therapy. The study explored the outcomes of cochlear LLLT and transmeatal LLLT, using specific treatment parameters that were not extensively studied in previous research.

Additionally, the study evaluated the potential synergistic and antagonistic effects of combining LLLT with other therapies, such as vacuum therapy, US, Ginkgo biloba, and flunarizine dihydrochloride.

The short-term effects of these treatment modalities were monitored immediately after treatment and 15 days after treatment cessation.

The study hypothesized that the combined application of vacuum therapy or US with LLLT could enhance blood circulation and promote anti-inflammatory effects, leading to improved tinnitus symptoms. The therapeutic effects were assessed based on the improvement in tinnitus-related quality of life measured by the Tinnitus Handicap Inventory (THI) scores. The study also compared the treatment outcomes between different modalities and evaluated their efficacy in idiopathic and refractory patients.

The findings of the study demonstrated a superior treatment effect of transmeatal LLLT compared to placebos based on THI scores. The study also analyzed the synergistic and antagonistic effects of combining LLLT with vacuum therapy, US, Ginkgo biloba, and flunarizine dihydrochloride.

Furthermore, the short-term effects of different treatment modalities were assessed, providing valuable insights for future studies with larger patient populations.

In conclusion, tinnitus remains a symptom with a controversial origin, and there is currently no universally recommended treatment. However, alternative therapies such as LLLT, vacuum therapy, and US have shown promise in improving tinnitus symptoms by increasing blood flow, promoting tissue healing, and reducing inflammation. Further research is still needed to determine the optimal parameters and treatment combinations for personalized tinnitus management.


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