Botox Might Help Your Tinnitus — It Helped Me

Hi, all. I've had tinnitus since 1990. This past July I had a flare up of tinnitus and hyperacusis that was so severe I couldn't walk through the streets because passing cars, buses and motorcycles were impossibly loud. People all around me were going about their business, completely undisturbed by the noise, so I knew it was just me. I burst into tears in public. I was thinking: if it stayed like this, I'd never be able to concentrate again; if I couldn't concentrate, I'd lose my job. If I lost my job... well, you get the idea. That was literally the worst day of my life.

I started doing hours and hours of research. I went to an ENT specialist, by the way, and he asked me: "What can I tell you that you don't already know?" Gee, thanks, doc! Tinnitus forums offered me a LOT of help, so I'd like to thank everyone who put up information over the years. But all the info was scattered here and there, and I had to piece them together bit by bit, over the course of months. Around October, I saw somewhere that there is a 50% correlation between tinnitus and temporomandibular disorder. I have that too, but so mild it's never bothered me. I read that TMD can be helped with Botox. All of you know that a drowning man grasps at straws, so I grasped at this. I found a dentist who specializes in treating TMD with Botox, and told him my thoughts on the tinnitus connection. He agreed to treat me. I'm not sure this is important, but he told me he uses only the most expensive variety. So I have no idea whether other varieties are appropriate for this.

The dentist gave me 5 injections in my lower left jaw, 5 in the lower right, then 4 various places around my left ear, and 4 around my right. All these parts of your face are interconnected with muscles and nerves. I had my treatment at 10am, and by 6pm my tinnitus had decreased so much that if it had stayed at that level for the rest of my life, I would have happily accepted that. It has now been one week, and my tinnitus has stayed very low. It used to be very high in the mornings; now it's the same all day, and I can ignore it pretty easily. The dentist said that it takes at least a week to fully take effect, so I might still see further improvement. Botox usually lasts 3 months. It will be interesting to see what my tinnitus is like three months from now. Be warned that it's very expensive. I have insurance, but this dentist was out of network, so my initial consultation was $500 and the treatment itself was $1200. Insurance will only pay for some of it. On the other hand, it has worked all week, and I'm beginning to feel confident that it will work longer, so it was worth every penny. Remember, I had this for 28 years, and this is the first time I've had this much quiet for this prolonged a period. I'd forgotten what quiet was like.

PLEASE NOTE THIS MIGHT NOT WORK FOR EVERYONE. I'll give you some details about my tinnitus characteristics and if they match up with yours, Botox might help you too.

1) I have temporomandibular disorder (clicking of the jaw). It's worse on my left side, and so was my tinnitus, which is a clue they could be related.

2) Sometimes when my jaw clicks, the sound of my tinnitus changes.

3) Several years ago, when I had to have a filling and the dentist numbed the tooth with lidocaine, my tinnitus went away for two days.

4) When I had to have exploratory surgery, I was given propofol, and that also suppressed my tinnitus for two days.

5) If I press my fingers to the side of my head, my tinnitus changes.

6) Acupuncture has worked for me, though very short term. It has never lasted more than 48 hours. But if acupuncture can suppress your tinnitus for even one hour, that proves that your tinnitus can be suppressed. Not every acupuncturist can do this! I've been to some useless acupuncturists. If you're near a Chinatown, look for recommendations on Yelp.

7) Sometimes, just for 2-3 seconds, my tinnitus would go away, and when it did, it felt like a muscle in my ear was contracting. I don't know if I have muscles in my ears. Just saying what it felt like. If your tinnitus has any of these characteristics, it might be worth it to look into Botox.

Again, I want to thank everyone who gave me so many useful clues to look into. All of you taught me so much more than any doctor ever did. There's so much about tinnitus that sucks, including that most people don't believe you have it and have no idea how deeply it impacts every aspect of your life.

 

Very interesting. My hyperacusis does not allow me to walk the streets except with earmuff and plugs, and not busy streets even then. I have an appointment on Monday with a neurologist, and their clinic does Botox injections so I am planning to bring this up. I also have TMD. And fentanyl (propofol) gave me silence for a while a year ago.

My question is, did your hyperacusis decrease from the Botox injection as well?

 

I'm not sure. Weeks of acupuncture treatments (2 or 3 times a week for more than 3 months) brought my hyperacusis down significantly before I had the Botox. This morning I walked past a construction site which, only a couple of months ago, I went out of my way to avoid. Today it was still unpleasant, but it was entirely bearable. Note I still wear earplugs when I walk through the streets, as I never know what's going to sneak up on me - a sudden siren, a very loud truck horn, etc. Today earplugs were sufficient to protect me. On the day I described in my initial post, I was wearing both headphones and earplugs, and still found myself in tears.

 

Update on my condition - January 16, 2019

Hi, all.

Follow up on the December 28, 2018 Botox-for-TMD treatment that significantly helped my tinnitus.

I had a small setback on the 7th day. I did a back stretch that day that involved making my head the lowest part of my body, instead of my feet. After about 5 minutes, when I came up from the stretch, my near-silence was gone, and my tinnitus had returned. It wasn't HORRIBLE, but it was back. On January 13, 2019 I visited the acupuncturist again - first time in almost a month, which is the longest I've gone without acupuncture since my June flare-up. I told her how well the Botox treatment had worked for me, and asked her if she could insert the needles as deeply as the dentist had to see if needles alone, without Botox, could have the same effect. She politely refused, saying that was not the way she had been trained. I was disappointed, but I get it. She did the responsible thing - she had no way of knowing what the outcome would be, so she treated me in the manner she knew would be safe.

She also mentioned, based on what I told her, that my tinnitus might be "positional", and might relate to "crystals" in my ears. I have since done a little research on that, and while I believe I might very well have crystals in my ears, it's hard to believe my tinnitus is primarily positional. It's also hard to believe that the good work of the Botox (or the depth of the needles), could be undone as easily as that. Also, crystals seem to relate to dizziness/vertigo, and I don't suffer from that.

My tinnitus was audible when I lay down for that day's acupuncture treatment, and hadn't changed when I got up (it can take more than a day to take effect.) Yesterday - two days later - my tinnitus got mercifully quiet again. I could still hear it, but it had moved from foreground noise to background noise. I can't be sure whether that means the botox is still working, but simply can't be expected to work in a linear manner (i.e., with no setbacks at all), or whether the acu. treatment functioned like a booster for the botox.

A friend of mine suggested I look into "dry needling", which is, in effect, injections without serum. Turns out there is dry needling for TMD, and the dentist who treated me with botox can also treat me with dry needling. Physical therapists also do dry needling, so if you're interested, it would be worth finding out if they are less expensive, or covered by insurance. I haven't looked into that yet. And since botox is dreadfully expensive, it would be great if dry needling worked just as well as injections with serum.

This morning I woke with noise (I almost always do), but 10 minutes under running shower water brought it down ("residual inhibition"?), and it's still down, several hours later, as I write this. I can't help but think that either the Botox or the deep needles are stimulating damaged nerves to do their job better. Before the Botox treatment, residual inhibition would probably not have lasted this long.

I will at some point do the dry needling - hopefully in the same injection sites. Right now, I'm wondering when it's best to do that - before the Botox has run its (usually) 3 month course, to act as a booster? Not till after the three months are over? As soon as my tinnitus gets loud again? I'm mulling all of this over, because there is no predetermined protocol.

 

I would not recommend Botox to anyone. It is a neurotoxin, it is literally poison for your nerves. Look up Botox and hearing loss. Lots of people have experienced hearing loss and tinnitus from using it.

 

I received Botox at a cosmetic clinic in the masseter (jaw muscles), 30-35 units each side for TMJ pain due to clenching at night from tinnitus stress. I woke up with shockingly reduced tinnitus the next day! I was astounded with some silent moments in the day. Before this, my tinnitus was resistant to treatment as I had not found any changes or relief in SEVERE multi-tone ringing and distortions. Botox takes full effect after 10 days, so it can only get better from here.

The paper linked above has impressive results! 14 out of 17 patients with disabling tinnitus saw improvement, with disappearance in 11! That's 82% improvement and 65% cured! The sites of injection were the temporals and masseter. Botox costs $9-$13 a unit at cosmetic offices.

Tinnitus sedation after botulinum toxin injection into the manducator muscles

Introduction
The treatment of bruxism by injection of the manducator muscles aims to reduce the tone of the temporals and masseters, requiring non-negligible amounts of botulinum toxin, accompanied by inevitable diffusion of the product. In a retrospective study carried out on a cohort of patients treated for bruxism, we observed remarkable efficacy of botulinum toxin in some of them with tinnitus, whatever the origin.

Material and methods
This is a retrospective study of 288 patients treated for bruxism in the same institution. All the patients were injected into the masseter and temporal muscles with botulinum toxin (Botox *: Allergan Pharmaceuticals, Westport, Ireland), the injected doses varying according to the intensity of the contractions observed between 30 and 100 U at the level of the masseter and between 10 and 50 U in the temporal muscle. The files were reviewed over a period of 2 years, between 2015 and 2016.

Results
Out of 288 files reviewed, 17 patients suffered from disabling tinnitus, resistant to any form of drug therapy. Fourteen saw their symptoms decrease (in 3 cases) or disappear completely (11 cases), with an effectiveness persisting at least until the following session (3 months).

Discussion
By their common innervation by the trigeminal nerve, neuromuscular dysfunction of the masticatory muscles could induce reflex hypertonicity of the muscles of the middle ear, as well as myoclonus of the palate resulting in tinnitus. Some of them could have a toxic origin, by excessive release of glutamate in the ear. N-methyl-D-aspartate (NMDA-Rs) receptors are located at each synapse of the auditory pathways, and are characterized by a slow response, with a long refractory period, after excitation by glutamate, allowing protection of the system in the event of a sound attack. An over-excitation beyond the possibilities of repair would be involved in the occurrence of hearing loss related to noise, presbycusis and the occurrence of tinnitus.

Conclusion
Our series is the first to demonstrate a possible effect, probably by inhibiting the release of glutamate, at the receptors of the inner ear. An open and prospective study, ideally multicenter, will be necessary to confirm the validity and the reproductive character of our results.

 

This is all so reassuring to hear, thank you!

Could anyone please share details of doctors who do Botox? I'd like to give it a try. I'm prepared to travel anywhere.

Thank you!