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Tinnitus Treatment from Neuromod (lenire.com)
397 points by Mopolo on Oct 16, 2020 | hide | past | favorite | 167 comments



I've been following tinnitus research and the most promising treatment is FX-322 [1]. It's a drug that will treat hearing loss, but it could also help diminish tinnitus.

It's currently in phase 2a [2] and results come out next year [3].

[1] https://hear2tell.com/2020/09/29/frequency-therapeutics-fx-3...

[2] https://clinicaltrials.gov/ct2/show/NCT04120116

[3] https://www.hearinglosstreatmentreport.com/estimated-fx-322-...


>The researchers found that some body tissues regenerate much better than others. They studied the lining of the small intestine, which turns over roughly every four days, because it’s designed to absorb and distribute nutrients to other parts of the body. Drs. Karp and Langer saw the molecular pathways that signal the lining’s cells to turn over quickly and form new tissues.

>Around the same time, another scientific group found very similar cells in the cochlea – but with one big difference: in the cochlea, these cells weren’t active. They saw that the cochlea’s cells didn’t regenerate and form new sensory hair cells. “So that was the formation of Frequency,” LeBel explains. “And Frequency was asking, why is that the case? Why is it that the cochlea isn’t regenerating cells and the small intestine is?”

>This led to the discovery of two small molecules that make up FX-322, which targets these cells, called progenitor cells. Essentially, this process is meant to drive hair cell regeneration: The drug targets pathways to those cochlear cells, and when activated, they divide and form a new cell of themselves, called daughter cells. “And then most importantly, they form a new sensory hair cell,” LeBel says.

That sounds incredible. If it really can reliably do what they claim with no significant negative side effects, that'd seem like one of the most "miraculous" treatments I've heard of in a while, both in terms of the technique and what it could accomplish.


Yep. Frequency Therapeutics could make a tremendous medical breakthrough here. But some caution is warranted, even in light of their promising human trials: cochlear cell regeneration and subsequent hearing restoration is observed in reptiles and birds, so there is reason to believe that they can coax mammalian ears to do the same thing, but it may not be as generalizable a result across the human body. But damn will people start trying mightily if it succeeds in the ears. That said, even simply finding a cure for sensorineural hearing loss is nothing short of perhaps one of the top 10 medical breakthroughs in the last 50 years if you look at the cost to society and prevalence of it.


My baseless armchair speculative fear, with absolutely zero knowledge of this field or technology, is if some of the new hair cells could maybe somehow not fully "sync with" or complement the existing set and perhaps just make you hear "differently" but not necessarily better, and perhaps even worse in some contexts, depending on what % of your existing hair cells were healthy.

I have no clue if that has any remote basis in reality, though. And perhaps your brain would eventually learn to sort it all out, so maybe any increased sensory sensitivity would generally be a net plus either way, once enough time passes.


The cochlea is like a snail-shell shaped organ, lined with hairs. When the sound wave - or more specifically the vibration - reaches a bunch of hairs, they in turn fire a bunch of neurons.

The distance the sound wave travels into the organ is related to whether it is a high pitched or low pitched sound. The hairs are essentially "dumb", they only trigger the neuron firings when they detect the vibration.

So regenerating the hairs in the cochlea definitely won't change one's "natural" hearing, but for those that have had missing or damaged hairs for a long time, there'll definitely be an adjustment period where the brain has to re-learn how to interpret the new input. (About 2 weeks or so)


If I'm not mistaken, though, hair cells aren't really "fungible" / identical, right?

>Auditory hair cells are specialized along the length of the cochlea to respond to specific sound frequencies. ... Each of our roughly 16,000 hair cells is dedicated to a narrow frequency range. These cells are ordered along the basilar membrane according to the frequencies they detect. [1]

In that sense, they're dumb in terms of just encoding oscillation patterns, kind of like an electric guitar pickup, but even though a pickup is "dumb", you can get different results depending on the placement and type.

I'm just wondering if and how the newly generated hair cells somehow fit in where they're needed, and how general or controllable the process is.

[1] https://www.nih.gov/news-events/nih-research-matters/hearing...


they should be identical/fungible, it's the location that corresponds to the sound frequency, the nerves to be triggered are in the walls of the cochlea, underneath the hairs.


Ah, thanks, that makes sense, and makes me a lot less worried about potential negative consequences.


My fear would be that they see this product has a bigger market at targeting make hair loss than hearing loss. That said, I wouldn't hesitate to take it today if it would rid me of this wretched ringing.


Cochlear hair cells are fundamentally different types of cells than the hair follicles that produce the hair on your head; the name is more than a little misleading in this respect. Cochlear hair cells get their name from hair-like structures called stereocilia that project from the surface of the cells; they don't produce anything like the protein filaments that make up human hair.

A treatment that happened to have application to both male hair loss and hearing loss due to cochlear damage would be a really weird coincidence.


If that's true, you can almost guarantee a cottage industry of doctors writing off label scripts.


Carl LeBel (Chief Development Officer of Frequency) revealed on the Tinnitus Talk Podcast that several patients in the Phase I/II study reported "improved" tinnitus to their ENTs. How much improvement wasn't measured, but it's one of the reasons they're testing for tinnitus in the phase 2a study.

Otonomy's OTO-413 drug (to fix the ribbon synapses in the cochlea) also seems really promising (results are due out next month). However, for their phase I/II study they're not testing for tinnitus and are actually excluding patients with "bothersome tinnitus". I'm hoping they see the same thing as Frequency and that some patients report improved tinnitus. These two drugs together (regrowing hair cells and ribbon synapses) seem like they could be a good one-two punch against hearing loss and tinnitus.


I get it when my right ear has way too much earwax. J lose some hearing and the ringing wont stop. Just a bit annoying so Im usually wearing headphones with nice soothing music until I can get that wax out.


Are you using cotton swaps in your ears? What might be happening is that you shove wax in, clogging your ears and giving you tinnitus. That used to happen to me - the ear wax wasn't the problem, trying to clean it was.


To clean your ears yourself you need something like this: https://www.japantrendshop.com/coden-ear-scope-13000-standar...

I thought it was ridiculous when I first saw it but I took a chance on it and it is actually a great product. You can clearly see everything and clean without damaging your ear. If you've ever had to go to the doctor to clear a blocked ear, you need one of these. With occasional use (~once/month) your ears will never be blocked again.


Man, I wish I had that a month ago- had a random hair from a haircut rubbing against my eardrum, and could. not. get. it. out. Thankfully have a physician friend who was able to scope my ear and remove the offender in about a minute, but it sure would have been nice to have been able to do so at home. Thanks for posting this.


Yes, I have used it for this exact purpose as well.


Drops seem safer to me. I've had good success with Debrox, but there are a variety of brands.

https://www.debrox.com/products/debrox-earwax-removal-kit


The drops have not been shown to be any more effective than plain water. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...

I dislike flushing my ear with a syringe or squeeze bulb as it is uncomfortably loud and it seems possible to damage the eardrum with overpressure. It is also difficult to tell if it is working or how long you should continue doing it to ensure a clean ear, especially if the ear is not completely blocked.

The endoscope is faster, easier, more comfortable, and lets you see exactly how clean your ear is so there's no guesswork.


I'd not seen that Cochrane study, that's interesting, thanks for sharing.

Sticking something pointy in your ear seems to carry its own risks. How do you ensure you don't puncture your eardrum?


Same way you don't cut yourself when using a knife, by watching and being careful. The endoscope makes it possible to see.


I've sworn off Debrox after damaging my ear recently. The instructions say to leave it in for "several minutes"; I waited ~10. My hearing was impacted for several days afterward. In the one ear I got high-pitched feedback when watching TV, it sounded like someone was running sound through a guitar distortion pedal. It went back to normal after ~5 days but I was very scared that it would be a permanent effect.


The reviews are pretty mixed

https://www.amazon.co.jp/%E3%82%A4%E3%83%A4%E3%83%BC%E3%82%B...

But more interesting all the recommendations listed on Amazon. Tons of them, many 1/2 the price of the one above, but use your phone as the display


I find Amazon reviews fairly useless these days. Most good ratings are just because of fake or paid reviewers or other scams like switching the product while keeping the reviews, combining two products in one listing, and probably others I don't know about. Amazon seems powerless to fix it, or maybe they just don't think they need to care.

I haven't tried any of the phone based endoscopes but I expect the latency and reliability to be bad. When I'm controlling something that's deep in my ear canal I don't want latency or dropped frames.


How would a camera to smartphone connector add appreciable latency?


I don't know, but I am constantly amazed at the ingenuity of the people who manage to add latency to pretty much all modern hardware and software.


Oh wow that is amazing

I also get mild tinnitus for the last 6 or so years due to earwax (once it got completely blocked and I had to go to the doctor to have them irrigate it back out).

I don't use cotton or any scraping right now, but I do use the same stuff the doctor used to irrigate it every once in awhile, to middling effect.

Maybe I'll try out that ear scope thing.


I've had great success with the ~$20 ear pump devices available at your local drug store. They look like a normal squirt bottle with a tube tip, you fill it up with warm water and just keep squeezing. I'm not sure what the scope would do for me... I can hear the ear is clogged, I don't need a visual confirmation.


I have been using these at least twice a month since high-school (20+ years) after having multiple dramatic ear infections that rendered me temporally unable to hear due to clogging. I was just at the ENT doc last week and he confirmed that my ears 1) look and function great and 2) there is no damage, at all, from using these mini turkey baster like devices when they are used correctly. I highly recommend them, but your own experience may differ and you should probably check with an ENT doc just to be sure.


I find that process uncomfortably loud, and I worry about damaging my ear with too much pressure. I also find it difficult to tell if it's working or if it's finished, especially if the ear is not plugged all the way yet, which I want to avoid.

The endoscope is faster, easier, more comfortable, and makes it possible to clean when the ear is not actually plugged and verify that it worked.


Yea that's pretty similar to what I'm currently using.


In India a common practice is to go to a doctor (G.P.) who uses a foot-long syringe to irrigate your ears with warm water. It is supposed to soften the wax which then either comes out by itself when you tilt your head (lying down) after the syringing, or can be removed easily by earbud etc.


> In India a common practice is to go to a doctor

The vast majority of poor and lower middle class Indians dont go to a doctor, they just go to an ear cleaner who sit on the streets and will do the job for you in 5 to 10 minutes for a dollar or two.


I immerse my head and ears in hot bath-tub. When I get out I put my little finger into the wet ear and then fast pull it out which creates some suction in the ear which sucks the water out and I think also some vax.


That's risking rupturing your ear drum.


Thank you very much for commenting this because I do the same thing and probably wouldn't have found out.


Well I think I do it gently enough. Have there been any reported cases of pulling your finger out of your ear breaking the eardrum?


I can't find it now but I read a story, in I think in https://old.reddit.com/r/tifu, about a man and woman having sexy fun times. The woman's thighs were wrapped around the guy's head, she orgasmed, her legs spamsed, and because of the sweat her thighs formed a vacuum seal on both his ears and ruptured one or both of them.

There are plenty of other stories about ruptured ear drums though: https://old.reddit.com/r/tifu/search?q=eardrum&restrict_sr=o....


Amazing and terrible story


Yikes. As someone who's had two tympanoplasties, I would NOT do this.


I'm also following FX-322 and keeping my fingers crossed that the trials result in a real significant effective treatment for my SSHL in my right ear. It would really be amazing!


Thanks for the resources. I'm usually following https://www.tinnitustreatmentreport.com/ for all things tinnitus and that's where I saw the FX-322


Tinnitus Treatment Report creator here. Glad you find the site useful and thank you for sharing the link. Appreciated.


Hearing Loss Treatment Report creator here. Thank you for referencing the site, I appreciate it.


I've been following frequency therapeutics as well. I don't think the Neuromod treatment would provide much help to me. My tinnitus does not bother me in any meaningful way. The bothersome thing for me is hearing loss. Noisy environments interfere with my ability to hear conversation. Some frequencies I simply cannot hear. Some noises, cheap/bad audio in the higher frequencies for instance, actually hurt my ears. When the hair clippers get close to my ear, it is nearly painful. A lot of people think that is odd because hearing loss should mean I don't hear it. As a musician and audio lover, I would pay a relatively large amount of money to have normal hearing.


I was in a T-bone accident where another car hit me centered right in between the driver and passenger doors. My left ear now has tinnitus, and I too have a hard time hearing conversation in large groups of people. However, after the wreck, I visited hearing specialist several times. I always passed their tests of the faint frequencies. They cannot explain where the ringing originates.?!?! It's one of those things it is hard to get a doctor to believe you since they can't actually see anything wrong. No broken bones, no lacerations, not bruising, nothing. Just ringing that they cannot hear.


TMJ can cause tinnitus; specifically there is a nerve connecting your jaw to the areas near your ear. Damage to this nerve, e.g., caused by years of unmitigated clenching/grinding at night or by an injury, can cause this. A neurologist may help suggest some tests. In the case of TMJ, there's a specific CT scan that will identify damaged cartilage below the ear that is typically linked to tinnitus.


TMJ was the cause of about 7% of my migraine. Watched a few YouTube videos, self massages for a few days. Found a spot that was super painful. Once it released, Migraines mostly gone.


can you link the videos that worked for you?


Might be the bob and brad physio videos. Not op, but was looking at this recently and they have some of the most prominent ones.


Yea those are really good ones.

For most topics I recommend dr Jo as a starting point Bob and Brad if they want to step up the game.


thanks!


When you say “unmitigated” do you mean via a mouth guard or something else?

I clench, have a mouth guard, but still clench. Don’t know of other treatments but would love to find one. I have tinnitus either as a result or from a bike accident which hurt my jaw and started the clenching.


I have mild tinnitus. When I move my jaw forward the sound intensives strongly, and then fades when my jaw relaxes. So there is definitely a connection for me.


This is not too unusual. For me if I jut my jaw forward, it temporarily increases the noise also.


Wow, it actually makes mine slightly quieter, or possibly of a deeper timbre.


I have heard that it can be likened to phantom limb syndrome: the brain is over-compensating for missing stimulation by creating it


On the off chance that this helps: I get tinnitus when my neck and/or jaw are clenched. This is a known phenomenon, you can google it. In fact, the onset of tinnitus is sometimes the only thing that makes me aware of how tense my neck is. If you were in a collision, it's possible your nervous system as adopted a pattern of muscle tension to compensate, or in anticipation of trauma, or something. Anyway, perhaps try relaxing your neck/head/jaw when this happens?


I appreciate the suggestion. I do have a bit of aftershock (I avoid calling it PTSD) where if I'm sitting waiting for a left turn where will I suddenly get a weird flinch feeling without actually flinching.

For me, the ringing is only noticeable when it is quiet, so bed time is annoying. I run a small fan for the white noise to compensate. Other times of the day, music is playing while I'm working (not headphones).


Just because it's not been mentioned in the other comments thus far: Car crashes are loud. And it's worse if you don't see it coming (so that you could "prepare" your ears).

See also https://bgr.com/2017/02/08/mercedes-pre-safe-sound-pink-nois....


Yeah, totally blind sided by it, so I never saw it coming. Someone tried to pass me on the left while I was turning left with my turn signal on (it was still flashing after the fact according to the police report). It was a 2 lane FM road in a double solid line. I also had a side impact airbag that deployed, so no telling how loud that was as well. Thankful for it, as it prevented all of the shattered glass from flying into the car and my face.


I spent a weekend with my east texas relatives shooting pumpkins with big guns and my hearing has not recovered since that was like 15 years ago...


For me it was using a nail gun once after forgetting to put on the ear protectors. That was 10 years ago. The ringing in the ear closest to the nail gun is constant and sometimes annoying, but mostly which I can subconsciously filter out.


Took me a while to understand based on my own hearing loss that it's not about decreased sensitivity to sound. Hearing is about sound volumes that occur between two limits: The threshold of sensitivity (above which you discern that the sound exists), and the threshold of pain (above which the sound is painful). Between those limits lies hearing.

In age-related "hearing loss," the threshold of sensitivity rises while the threshold of pain stays the same or even decreases slightly. So the range of volumes you can comfortably discern becomes narrower. This explains why simply increasing the volume often does more harm than good. What's really needed to treat hearing loss is frequency-specific volume compression.


Of course prolonged exposure to loud sounds which are not explicitly painful can still cause hearing damage.


I've often wondered why sometimes it's worse than others. It's always there. I always hear the ringing, but most times I can ignore it, but there are other times it just seems so much louder.

I would like to know what all those triggers are so I can try to avoid them. Some are obvious - real loud noises, heavy exercise, etc, but others not so much.


I've been dealing with it for nearly 20 years now.

I'm apparently fairly adept at putting it to the background these days, because I mostly don't notice it except for when it's particularly quiet, or something specifically triggers my awareness of it. Certain sounds in certain frequency ranges trigger it off too. My youngest kid had a playful shriek thing she did that would palpably hurt me and cause it to kick off.

Seeing this post on HN itself is triggering and I'm now very conscious of the high pitched ringing sound.

I would be willing to pay good money to be cured of this.


It's the same for me too, but stress triggers mine as well or at least doesn't let me ignore it. I'm considering flying to Ireland to try this as soon as we're allowed. I'd be on a flight right now if I could. I just want to experience silence again, at least for an hour or two.


I think I'm the same. Like 95% of the time I don't notice at all. But without fail during a quiet moment somewhere in the day I become aware of it somehow.


I have really strong tinnitus either when:

- I did not sleep enough

- I wake up in the middle of my sleep

- I drink a lot of alcohol

- There is a lot of noise arround me

- In few cases it's just random and get stronger for no apparent reasons


I notice it when I've stayed awake too long, and am exhausted. So I agree.


Meh. I notice it most when the insomnia is acting up and I lay in bed waiting for sleep which doesn't want to come.


I can relate, it's just awful.


That's how it started for me, now it is constant. I'd look into high frequency hearing loss if it becomes more persistent.


I remember once in college I was sitting at a table with some friends studying. One said, "how can you guys study with that light humming like that?"

And sure enough, one of the overhead fluorescent lights had an electrical humming coming from it.

And it became hard to study from that moment forward.


Never hang out with an audio mixer. They point out some many noises in day-to-day life that I have just tuned out or never even noticed. Once they point it out though, I can't not hear it. To be fair, I'm that way about video and compression pointing out to people how shitting cable quality is. I'm a TV sales rep's worst nightmare.


There was one movie I was watching and I noticed the sound of a (propeller) plane flying overhead. I wouldn't normally have noticed this, except I was wearing headphones. I couldn't help but wonder if they noticed. and if so - did someone said - "screw this, we're not reshooting the scene."


Mayo Clinic has a long list of causes and triggers:

https://www.mayoclinic.org/diseases-conditions/tinnitus/symp...


I was a heavy cell phone user for several years, I developed tinnitus in my right ear (same ear I would hold the phone to) it thankfully resolved itself when I stopped using mobile phones. Hope this information can help someone.


Not sure why this is dead.

> This study showed that there is significant loss in the

> dominant ear compared to the non-dominant ear (P < 0.05).

> Chronic usage mobile phone revealed high frequency

> hearing loss in the dominant ear (mobile phone used)

> compared to the non dominant ear.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918279/

Anecdotally, a hearing test performed after many years of having my earpiece in my right ear found that in the vocal frequency ranges my right ear has some hearing loss. (It was not like that before.) Which may or may not be coincidental.

It's not a stretch to think that holding a speaker–which is often far louder than it should be–right up to one's ear for extended periods every day could cause tinnitus in that ear.


Same here, my awareness of it comes and goes, but I swear the effect itself varies from time to time. I seem more likely to notice the ringing if there's white noise in the background, like from a fan or AC, but it's just a theory.


For me its worse when my introversion is acting up. Its like having a song stuck in your head. It really only goes away if you engage with the rest of the world.


Edit: I stand corrected, there is a specialized CE certification that reviews limited fitness for purpose, although it does not seem very comparable to something like FDA requirements for double blind testing etc., so I'm still highly skeptical. Original comment:

There may be something here, but their presentation leaves a "snake oil" impression. Mostly because of their repeated emphasis on "CE" certification, as though that had any bearing on the effectiveness of this treatment. They even say it has "CE-mark certification for the treatment of tinnitus", which is really misleading, as CE simply means it complies with certain regulations regarding the construction of electronic devices, nothing at all about fitness for a given medical purpose.


No, there is CE marking for medical devices in the EU which means it has achieved conformity for the Medical Devices directive. Generally equivalent to FDA regulation.


Just beware there is an EU CE and Chinese export C E. They are different. I probably can't post a link but the search you need is this: CE eu markings CE china export. CE is a mark of quality assurance and compliance. C E is not the same. [edit for spelling]


Link for those curious https://en.m.wikipedia.org/wiki/CE_marking#China_Export

Though I believe neuromod is advertising CE compliance not ‘China Export’


If the space is meant to represent the gap between the C and E, then you have this backwards: the European mark has one letter-width space between the C and E, and the forged mark from China has the C and E right next to each other.


Thanks, I wasn't aware there was a more targeted review for medical devices, and updated my comment with a note to that effect.

However it does not seem comparable to a fairly rigorous FDA double-blind experimental process requirements, it only requires the manufacturer to provide a clinical evaluation that appears to be just a little more than a literature review [0][1]

[0]https://www.emergobyul.com/services/europe/ce-certification

[1]https://www.emergobyul.com/sites/default/files/eu-meddev-2_7...


I thought it was nice, given the extreme anti-science / anti-regulation attitudes we see in the USA.


This is going to sound silly to most people, but I've been suffering from Tinnitus for a long time. This technique won't cure it but it certainly brings relief for me, to the point where I can ignore it.

When my Tinnitus is particularly piercing, I imagine it as a radiant bright white line in my head. I then mentally begin to reduce the radiance of the light until it is gone. This dulls the sound immensely, I'm still aware of it but it no longer hinders me.

For bonus points, I use a similar technique for getting rid of ear worms. In that case, I mentally put the song into a wooden box, close the lid and let it fall into the sea. Works every time.


There are several of these kinds of mindful/imagination techniques.

https://rewiringtinnitus.com/ also provides some in book and audio form, where you visualize your tinnitus as a knob you can turn or a person making the noise.

Doesn't really work for me though, though sometimes it does seem like I can "tune" my tinnitus a bit.


Interesting, thank you.


OK. That is interesting. Every so often something incredible comes out, like this. I assume that this only relieves certain types of sources of Tinnitus, as I know there are several causes.

So, the question is, what percentage of people can be relieved with this?


I got mine from war, having survived mortar round blasts as a child on several occasions from as near as 3 meters (for example, one shell exploded right above our living room window while I was playing cards with my cousin, another exploded killing a woman and injuring several others while I was lying down behind an apple tree, having heard the sound made when a mortar shell is launched). I highly doubt that this would work on me, but I wouldn't mind trying it out.


Yeah, the moment I read your comment I knew this could only be one place and time.

I was transported back to my 8 year old self learning about speed of sound by looking at smoke appearing in the distance and counting seconds until I hear the explosion and multiplying by 300 to get the distance.

Also learning the different sounds explosions make depending on where they land (soft ground, hard target, different calibre or type of munitions)..


your inner ear hairs are likely badly damaged. But this is a nerve treatment, so it might be able to train your brain to ignore the false signals from the broken ear hairs.


Wow. May I ask which battle zone this was?


Bosnia and Herzegovina. I was 10 when the war begun. I spent 4 years in city of Gorazde, under siege, without electricity, communications and running water. I started to write a book (in english) about these 4 years but it got too difficult to re-live so I put it on hold for a while. Not sure anyone would ever want to read this.


>Not sure anyone would ever want to read this.

I would read such a book. Sharing your experiences can help others begin to understand what survivors like you have gone through.

My emails in my profile if you'd like to chat with me.


My dad was in the Canvey Island Floods (1950s, killed 2,500 people in Europe, 58 people on Canvey Island, an island on the Thames in the UK). he lost two baby brothers.

He's never, ever, talked to me or my sister about it.

But has been on TV more than once about it.

I can't even begin to imagine what you went through, but the brain has strange defence mechanisms when it comes to dealing with stuff like that.

I'm sure people would read it, but that doesn't mean you have to write it if you don't want to.


Thank you. Just the news from that time was so shocking. I can't imagine being caught in the middle of it.


More interestingly, is there an easy way to figure out if it is for you. Do you pay if it doesn't work?


This worked for me. You don't hear about it much because they're nothing to sell.

https://www.youtube.com/watch?v=wNjDBOJfMfY


Or because of the... tinnitus ;)


There are multiple threads on TinnitusTalk about this. This one, in particular, focuses on actual experiences with the device:

https://www.tinnitustalk.com/threads/lenire-—-user-experienc...


How was this discovered?

Did someone lick the terminals of a 9V battery and realize their tinnitus changed for the better?



Thanks! For those who are busy:

>Hubert Lim, a biomedical engineer at the University of Minnesota, Twin Cities, hit on the role of the tongue in tinnitus by accident. A few years ago, he experimented with using a technique called deep brain stimulation to restore his patients’ hearing. When he inserted a pencil-size rod covered in electrodes directly into the brains of five patients, some of those electrodes landed slightly outside the target zone—a common problem with deep brain stimulation, Lim says. Later, when he started up the device to map out its effects on the brain, a patient who had been bothered by ringing ears for many years, said, “Oh, my tinnitus! I can’t hear my tinnitus,” Lim recalls.


Has anyone tried this kinds of treatments? The internet seems full of snake oil cures. To my knowledge the only medically accepted treatment for tinnitus is antidepressants, so you don't feel so bad about having tinnitus.


HN covered a study that was looking for a motion sickness cure but found that holding a vibrator to the skull behind the ear stopped tinnitus for a lot of people.


This thread on a tinnitus forum discusses a subsequent trial of that vibrator in a controlled setting. Doesn't sound at all promising.

https://www.tinnitustalk.com/threads/head-mounted-device-for...


I've had chronic tinnitus in my left ear since doing a hand-stand pushup over a year ago. I'd really enjoy not having this ringing. I wonder when/if it will make it to the United States.


I wonder if I could lick a 9 volt battery and play back some high frequency tones through my headphones to get a similar effect?


May have similar results as overwriting your bootloader binary with the same number of bytes from /dev/random.


Just make sure your batteries are at least 80% charged or you are plugged in. Power loss during a firmware update like that can be catastrophic.


Probably not. It's become apparant that the timing component is critical. The electric pulses have to have certain timing characteristics.


Related, another a sound therapy that's been around for 50+ years called Berard AIT - Auditory Integration Training - that uses modulation/oscillation that helps treat many things including tinnitus; a book called "Hearing Equals Behaviour: Updated and Expanded" is on Amazon.

I definitely want to dive deeper into Lenire to see how or if it differs.


I have very noticeable ringing in my ears ever since I can remember. 2 things

1 Hearing tests have always indicated I have excellent hearing. 2. The ringing doesn't bother me, even in extremely quiet environments. Speaking of, the most peaceful quiet I've encountered was in a bamboo forest somewhere in middle China. I'll never forget the utter silence.


Same for me, the tinnitus is actually comforting. Like the noise when showering vs taking a bath. As long as my hearing is fine, I’m fine. The only solution for tinnitus is habituation. Fighting it puts it into focus and makes it worse without fail.


I worked at a place that had a cube farm with white noise generators to suppress background noise. These things triggered the small amount of tinnitus I have, also some co-workers complained. The frequencies they put out definitely matters- ones with no high pitch output are definitely better.

(pretty sure my Tinnitus was from a certain Metallica concert..)


It’s the same with ANC. It’s still noise pumped into your ear. So even though you may perceive it as silence because it cancels out the sound waves entering your ears, it’s still sound entering, and thus facilitating tinnitus when exposed to it too long. Even though you feel it’s been 8 hours of silence.


The way you wrote that, doesn't make sense. The idea behind ANC is that you have some signal, sin(wt+p) from ambient noise, and to it you add -sin(wt+p). The sum of these is zero. You perceive it as silence because it is: you have added the exact opposite of some signal to cancel it out, and the result is zero, no signal whatsoever.

It would be easy to test and demonstrate that the ANC system is properly band-limited and doesn't cause any short term (perhaps imperceptible) noise spikes. I would think any engineer designing this kind of gear would be wary of causing hearing damage by making a design that works the way you suggest.


I think my tinnitus is caused by my microbiome. When I eat poorly (sweets, sugar, junk food, refined carbs, etc), I suspect that some bad bacteria multiply too much in my gut and they create some toxins that cause me tinnitus. When I eat more salads (vegetables, green leaves), lots of fiber, my tinnitus dissapears completely.


It simply could be from the inflammation that sugars/carbs cause in the body, as well is if your body is reacting to certain foods you're eating - it will impact your nervous system; inflammation has a depressant effect.


Hopefully something will work out eventually. Each of my ears has tinnitus of various pitches and while you get used to it, its disconcerting to hear a sudden new pitch every couple of months and know that you've permanently lost some kind of hearing (and gained a new persistent aural 'tone').


I really wish I had access to this, I have chemotherapy induced tinnitus and it has been mostly unchanged since finishing chemo 5 years ago.

My Oncologist said it would get better over time, and it has, but its still far off from where I was when I started.


If this can be reverse engineered and made into an rpi zero or something... I would be all over that.

Also, I really hate reading about tinnitus because it just reminds my brain to stop ignoring that ringing sound...


Interesting treatment thread on Reddit using the tongue to deliver sound. https://www.reddit.com/r/science/comments/jc5m6y/new_researc...


I’m a neuroscientist and just read their “phase 2b protocol” paper. As far as I can tell, there are no actual control groups. Registering a trial with clinicaltrials.gov is a nice step, but they don’t compare at all to patient improvements in people that don’t receive treatment let alone a sham. Thus, the study does not appear designed to prove efficacy even though they will surely claim it.


The trial was divided into three groups. Group 1 got simultaneous tongue stimulation and audio tone and each tone was correlated to a separate electric lead on the device. Groups 2 and 3 had no association between the tones and which leads were activated (I think they were just random, or they used them all? Can't tell) Group 2 had a small delay between tone and stimulation, group 3 had a longer one (0.5s+) and also used a much narrower subset of tones. All 3 groups showed improvement and any differences were well within the error bands.

Definitely a sloppy design, changing so many variables between the groups. No active control (maybe vibration on the tongue or something). To me the conclusion is that the general method probably works, but almost everything the actual device is overkill, from the 32 different leads to the "proprietary algorithm" and you could do the same thing with just one lead and probably some random tone played over airpods.


Maybe it does something, but tinnitus tends to simple improve over time, too: [1]. Again not a great study as unclear what treatment options people sought, but they have zero evidence of efficacy as I understand it. It’s inaccurate to call these “double-blind” because there is no control group.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC128822/#!po=32....


Bingo.


Susan Shore and her team at the University of Michigan are working on a similar device. They have an animal model that they are able to test under. They have reportedly had success in humans as well:

https://stm.sciencemag.org/content/10/422/eaal3175.full


There was a post [1] here a few months ago that mentioned a medical device built for motion sickness iirc, but patients reported that it also reduced or eliminated their tinnitus.

My tinnitus is fairly minimal but I'd love to try both of these devices.

[1] https://news.ycombinator.com/item?id=21572827


A question to the people among you who have tinnitus:

When you put a finger in each ear and create overpressure or underpressure, does the pitch change?

Does it change when you clench your teeth?

Is it louder on one side then on the other?

Maybe there are different types of tinnitus that we could describe better if we had some dimensions/categories like the above in which we could categorize our specific type of tinnitus?


I think there are many different forms (probably with different causes). My tinnitus is exclusively on the left and varies in loudness.

Clenching my teeth has always given me a tinnitus-like experience but it never bothered/interested me until I got "real" tinnitus. I understand this form of tinnitus is related to the temporomandibular joint

For me, alternating frequencies give some relieve but fortunately. I use the "tonal tinnitus therapy" app for this. I'm not sure if this is part of the mentioned new therapy (which includes electrical stimulation of the tongue?)

Judging from other peoples experiences, my tinnitus is relatively mild anyway (but still bothers me)

Als, my ENT doctor, when looking into my tinnitus complaints, asked if there's a difference when heartrate increases (and possibly bloodpressure?). This does seem to be an indication of some specific cause. For me it doesn't.


There's definitely different types.

Mine is a constant high-pitch whine in one ear, a very constant frequency, unaffected by mouth movements or poking at my ear. Others get very different or varying frequencies, or pulsatile tinnitus - https://www.tinnitus.org.uk/pulsatile-tinnitus

It can seem loud when I'm somewhere quiet, but with a bit of background noise and while focused on something else, my brain seems to manage to tune it out.

(The absolute worst thing for it seems to be reading about and thinking about tinnitus... so it's probably time to go and read something else...)


Yes Yes No


I'm tired of all of these "masking" type treatments that supposedly help your body to stop noticing Tinnitus. I want to see something that actually stops the problem at the source. Tinnitus usually gets worse over time so at some point, it becomes difficult to ignore. I've been dealing with it for over 20 years and I'm fed up.


I'm about 15 years of constant tinnitus. The trouble with curing it is that it seems to be a problem with your brain not receiving the signal it expects form from the auditory nerve.

This famous reddit trick[0.] for at least temporarily curing tinnitus seems to lend credence to this idea. It essentially involves making noise near the skull, which presumably does temporarily stimulate the auditory nerve even if the ear drum itself is not able to correct create a signal.

My tinnitus has nothing to do with my ear drum, and interestingly enough this trick does not work for me.

I suspect curing tinnitus would require understanding a lot more about how nerves work and how to simulate sending an auditory signal without actually sending one.

0. https://np.reddit.com/r/WTF/comments/3l3uri/these_guys_light...


I debugged my own Tinnitus, most doctors don't know anything and don't care about it. It turned out to be related to my neck, so I wonder on what subset of Tinnitus sufferers this treatment is even relevant.

A short story about my debugging after frustration with the conventional medicine.

One day after I came back from work it started in one ear, lasted for half an hour and went away for few minutes and came back to stay. I had no other symptoms, no pain, nothing. Visited a few ENT, a neurologist, had MRIs - all clean, no tumours no other problems. No hearing loss, no other problems with the ears.

The only thing that seemed to help was a nice hot shower. According to the articles I read on reputable sources, it must have been the running water sound that's masking it but I was better for a period of time after the shower and I couldn't reproduce the effect with recorded water sound.

So I conducted an experiment: I would use cold water to see if it helps. It did not. It wasn't the sound it was the heat that was helping, the relaxation of the cold shower.

But I did not had any neck problems? Yes, lately my posture wasnt great and I was having longer than usual time in front of the computer but I had no pain or anything like that. Anyway, I looked for massages and so on and discovered this technique on Youtube about tapping behind your head with your fingers. The method did not work for me but as I was trying it out I discovered that if I do a massage to a specific parts of my neck the tinnitus will get much less louder and even change tonne.

So one day I had a stiff neck, It lasted for days so I went to a doctor and she gave me muscle relaxants and painkillers. Wow, it turns out the muscle relaxants not only make my neck mobile again but the tinnitus got much better!

Now I was sure, it must be about my neck! Previously noticed that the tinnitus got better on vacation but I speculated that it was about the stress. Now I start thinking that it was about my sitting position.

Got myself an external keyboard, a nice monitor and laptop stand so I began using my computer the way that those leaflets about proper sitting position recommend. I did the neck exercises too and the tinnitus that no one was able to do anything about almost disappeared if few months. Every now and then it will come back but I know exactly where to rub to make it go away. It's not completely gone and at some sleeping positions it would come back louder but before finding a way to manage it I was thinking that my life is over because I coldn't think anything without thinking about the sound in my ears.

Pay attention to your sitting position people! It's no joke. The pain is nothing, you can be tough and not care, you can take painkillers and manage it but Tinnitus is something different. It is in your head, you can't cut it off and you can't take a pill to make it go away for a while. It's one of the most horrible things, it consumes you, makes you worse person because you couldn't sleep well since years, you cannot engage in deep thinking where one ide takes you to another idea. It's like working in an open office space next to the server room.

Get yourself a nice stand if you are using a laptop, use external keyboard a mouse/trackpad so that you can sit straight.


If it’s related to your neck then it’s tension related, that’s one form of tinnitus, one that can be remedied. When you have actual ear damage, it’s quite another story :)


I was also hoping for a tumor because at least can be removed surgically.


Tinnitus appeared to me at the beginning of this godforsaken year of 2020 and I think I have two separate types of tinnitus, with one most likely being due to neck tension (which is more intense on my left ear). I know this because when I stretch my chin to my chest (like exampled in https://www.healthline.com/health/neck-tension#treatments) I start to hear a more pronounced wooshing sound on my ears and gives a burning sensation to my neck and shoulders. I would really appreciate if you could share the neck exercises that you're using.

For the record, I take great care on computer ergonomics so I've, at least, have that covered. And yes, Tinnitus is a curse.


I also have multiple, the scary one is the constant frequency one and it’s the one that comes back if I lay sideways with strain on the neck(Thankfully doesn’t stay anymore). The more tolerable one is the one that sounds like old tv with no signal, this one responds well to massage. There’s also one that sounds like water running in the pipes, I actually like that one - in even helps me sleep :)

Anyway, The orthopedist gave me this leaflet with the exercises illustrated. Pretty basic stuff and in Turkish but the illustrations are good enough:

https://ibb.co/XWnTZVB https://ibb.co/r6PBbTK

You apply pressure for 10 seconds each, repeat 3 times before moving to the next one.

These are intended to strengthen up the neck muscles.


"The more tolerable one is the one that sounds like old tv with no signal" That's actually the other type of tinnitus that I have, but this is actually the one that I find most tolerable (in the sense that at least it's the more silent one, which I can mask with other noises).

This tinnitus crap showed up to me randomly while working in an open office at the beginning of this year (I wasn't wearing headphones or anything) and a bit after COVID started acting up all over the world and I've been WFH since. As a consequence of this, I think I might not be able to ever return to a regular open office. Really funny timing if one thinks about it.


That's interesting.

I remember reading that one way of treating it would be lace your fingers behind your neck and do a flicking motion onto your neck with your fingers. Could be imaginary but it seemed to help. YMMV


That was the relief technique I tried but did not work for me but discovered the one that works: Rubbing in single motion by starting from back my shoulder up to the back of my ear.


Don't leave us hanging, what was the issue? (and was it fixable!)

EDIT: @mrtksn, thank you for editing and elaborating your post.


He died of a sore neck.


Sorry, I posted prematurely. Now I completed the story!



That's really cool. I read about notched sound therapy years ago, but it required expensive tests in an audio lab and proprietary white noise device. AudioNotch is a mobile app that lets you tune your notch parameters on your phone and then apply your filter to your own music.

I usually listen to broadband white or brown noise while a work. My favorite is this simulation of spaceship engine hum https://youtu.be/TvUHt54Ucrg but I'm going to check out AudioNotch since it can be tuned to my particular tinnitus frequency.


I tried something like this once. For me, it just made the tinnitus pitch change. That was pretty frustrating. It can be quite persistent.


I have tinnitus since I've been on beta blocker treatment. I switched to some other molecule for a while, and it disappeared (however it induced other problems, like constant tachycardia, so I got my previous treatment back).

It's not clearly indicated as a side effect, but it's very clearly the cause.


Interesting. I recently had mine evaluated and they suggested fractal tones (zen tones from widex). Mines stress related and I’m sure plays into my misophonia so I’m excited to learn about this treatment



AirPods Pro caused both tinnitus and vertigo for me. Went away after a few days as soon as I switched to the older AirPods.


What you experienced may be a baseline change when using noise cancellation. It happens with all noise cancelling headphones after long use (for me). I am NOT an authoritative source on it but what I heard was that the brain makes a baseline for the background / silence and when that noise is removed (active noise cancelled) then the brain recalibrates which may cause the same symptom as tinnitus as the brain tries to cancel it out but supposedly without the permanent damage. I consider it "possible" but I haven't seen hard science on it.


Well maybe we should treat the source of the problem, which is electromagnetic pollution


It would be interesting if this technique could be adapted towards treating visual snow.


This and all the comments sound like garbage to me.

This is a neurological disease, no amount of nerve stimulation will ever help. I am a sufferer.

The older comments here are quite suspicious.


Skepticism is likely warranted, but it reads as if you are suggesting nerves are not related to neurological disease. That’s extra confusing since a neurological disorder affects the nervous system of which nerves are a part.


You're... very incorrect.

Tinnitus can be caused by a neurological disease

Tinnitus can also be caused by incredibly tight/weak neck muscles such as the scalenes/SCM

Tinnitus can also be caused by high blood pressure - literally from hearing the blood.

Tinnitus can also be caused by compression of blood vessels - such as the subclavian artery (subclavian bruit) - often due to induced turbulent flow through the area.

Tinnitus can also be caused by something such as a cerebrospinal fluid leak.

Educate yourself.

Many people cured of CSF leaks or something like Thoracic Outlet Syndrome in which a scalene muscle is cut report decades of tinnitus being somewhat or completely relieved after surgery.

Tinnitus is caused by many, many things - some of which are cured from random things that people don't realize is going to have effect.

However, if you do have one of few neurological disease causes/damaged hairs, that shit definitely sucks and I don't think there's much hope yet aside from earbuds playing a matched frequency. I've actually heard of a good amount of success for some with supposed damaged hairs in that line of treatment - have you ever attempted to try it?

Not my intent to sound like a dick. I've had pretty severe tinnitus for now half of my life and I'm quite young. Shit sucks.


Tinnitus is a symptom and has several different causes. Mostly it's nerve damage and currently there's no way to fix that, but for other people it's something else, and there can be fixes.

And even when it's a symptom of nerve damage there are things that can help. My tinnitus got a lot better when I started using a hearing aid.


Read the book "Hearing Equals Behaviour: Updated and Expand" found on Amazon - maybe it'll give you something to look into, a treatment that may help you dramatically.


This is something sufferers don't want to hear. (haha)




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