Summary: In the hunt for effective treatments for tinnitus, a debilitating condition affecting approximately 750 million people worldwide, researchers found that low-level laser therapy outshines other therapies.
The study demonstrated superior outcomes from laser acupuncture alone and transmeatal low-power laser stimulation. The laser therapies are believed to improve peripheral irrigation, stimulate inner ear cell proliferation, and foster collagen production.
The study’s findings are instrumental in developing new treatment protocols for tinnitus across various medical disciplines.
Tinnitus, often described as a ringing or hissing in the ears, affects roughly 750 million people globally and currently has no FDA-approved standard treatments.
Low-level laser therapy, including laser acupuncture and transmeatal low-power laser stimulation, demonstrated superior outcomes in treating tinnitus.
The study suggests that laser therapy improves peripheral irrigation and stimulates inner ear cell proliferation and collagen production, which may contribute to its effectiveness against tinnitus.
Low-level laser therapy and associated photobiomodulation is the most effective of the known treatments for tinnitus, according to a study comparing the main therapies in current use, conducted by Brazilian scientists affiliated with the Optics and Photonics Research Center (CEPOF).
The study is reported in an article published in the Journal of Personalized Medicine.
Some 750 million people suffer from tinnitus worldwide, according to a European study that analyzed five decades of patient data. Often described as ringing or hissing in the ears, it is considered a symptom rather than a disease, but is unpleasant and in some cases incapacitating.
Its known causes can range from a buildup of earwax and insufficient peripheral irrigation in the inner ear to brain damage and bruxism. There are no standard treatments or drugs approved by the United States Food and Drug Administration (FDA).
“Tinnitus is a very widespread symptom throughout the general population. It’s treated with a vast number of methods, from ear lavage to local anesthetics, anti-depressants, antihistamines, anti-psychotics and sedatives, with different results,” said Vitor Hugo Panhóca, a researcher at CEPOF.
“After finding articles in the scientific literature that presented consistent laser therapy outcomes, we decided to compare the main treatments and pursue more responses to the problem.”
During a four-week period, Panhóca and his team tested alternative and complementary treatments for idiopathic (with no apparent cause) and refractory tinnitus on more than 100 men and women aged 18-65, divided randomly into ten groups.
The treatments tested were laser acupuncture, flunarizine dihydrochloride, Ginkgo biloba (a medicinal plant), and low-level laser stimulation of the internal auditory canal or meatus (transmeatal stimulation), on its own and combined with vacuum therapy, ultrasound, G. biloba or flunarizine dihydrochloride.
The patients were submitted to eight twice-per-week treatment sessions. They were clinically assessed before treatment began, after the eighth session and two weeks later, using a “tinnitus handicap inventory questionnaire” with a total of 25 questions. A functional subscale comprised 11 questions on mental, social, occupational and physical limitations due to tinnitus.
The best outcomes were observed in patients treated with laser acupuncture alone and transmeatal low-power laser stimulation alone. In the latter case, they improved even more when irradiation time was increased from 6 minutes to 15 minutes.
Combinations of laser therapy with vacuum therapy or G. biloba, laser acupuncture alone, and flunarizine dihydrochloride alone also had lasting therapeutic effects.
“The positive effects include anti-inflammatory action and relaxation. We believe laser therapy can increase peripheral irrigation, which may be the main cause of the problem in many cases, as well as stimulating inner ear cell proliferation and collagen production,” Panhóca said.
While the CEPOF study is not the only one to show that laser therapy can improve the condition of tinnitus patients, it paves the way to creation of a protocol for use by dentists, ear, nose and throat specialists, speech therapists and other medical practitioners who have such patients, as the number of sessions and intensity of the treatment vary greatly in the literature.
“Understanding how successful therapies work will help us focus on the most productive approaches in forthcoming studies. This is part of the learning curve when you innovate in health treatments like this,” Panhóca said, adding that it is also necessary to investigate the long-term effects of laser therapy.
The study was conducted in collaboration with researchers at Irmandade Santa Casa de Misericórdia Hospital in São Carlos, University of Central São Paulo (UNICEP), and Integrated Therapy Center in Londrina (Paraná state), Brazil, as well as Tyndall National Institute at University College Cork (UCC) in Ireland.
About this tinnitus research news
Author: Julia Moióli Source; FAPESP Contact: Julia Moióli – FAPESP Image: The image is credited to Neuroscience News
Effects of Red and Infrared Laser Therapy in Patients with Tinnitus: A Double-Blind, Clinical, Randomized Controlled Study Combining Light with Ultrasound, Drugs and Vacuum Therapy
Background: Tinnitus is a symptom with no specific cause known to date, and there are no associated pharmacogenomics of hearing disorders and no FDA-approved drugs for tinnitus treatment. The effectiveness of drug treatments is not reproducible on idiopathic patients and inexistent in refractory patients. Personalized treatments for these patients are a great clinical need. Our study investigated the outcome of potential alternative and complementary treatment modalities for idiopathic and refractory tinnitus patients.
Methods: We were the first to evaluate the tinnitus handicap inventory (THI) score changes over the course of treatment up to 15 days after complete cessation of treatment for novel transmeatal low-level laser therapy (LLLT) modalities using light alone, as well as LLLT combined with vacuum therapy (VT), ultrasound (US), Ginkgo biloba (GB) and flunarizine dihydrochloride (FD), while also comparing all treatment outcomes with laser puncture (LP), FD alone and GB alone.
Results: A positive treatment outcome (superior to a placebo effect) was achieved by using either LP or transmeatal LLLT, whereas short-term antagonistic effects of VT, US, GB and FD when combined with LLLT. For transmeatal LLLT, an improvement in the treatment outcome was observed by increasing the irradiation time from 6 min to 15 min (with 100-mW of applied laser power at 660 nm). Finally, a lasting therapeutic effect higher than the placebo was observed at 15 days after treatment upon combining LLLT with VT, GB or by using FD alone, by using the transmeatal LLLT alone or by using LP.
Conclusions: LP and Transmeatal LLLT can be promising alternative treatments for idiopathic and refractory tinnitus patients. Future studies should investigate the long-term effects of LLLT in tinnitus patients, as well as the dosimetry and wavelength of transmeatal LLLT.