Lidocaine and Dexamethasone Perfusion

[Inge]

As stated above, I had this procedure performed on one of my ears at Shea Clinic. The procedure itself is uneventful. After the drop of phenol on the ear drum you feel nothing. When the drop hits the ear drum it stings for 5-10 seconds or so and the Dr waits a few moments and then suctions off the excess phenol and wax/debris from on top of the ear drum. After about one minute the Dr takes a small instrument (laser) and makes a very small hole in the ear drum while watching on a large flat panel (30") display monitor that is being fed by a Leica stereo scope with video CCD attachment. The laser perforation of the tympanic membrane takes 1 second and then the nurse hands the Dr a 20 gage syringe with the mixture of dexamethosone and lidocaine. The Dr then tells you that a sensation of cold in the inner ear will happen upon injection of the mixture. As he begins the injection your vestibular system reacts to the cold temperature of the mixture and you get vertigo fairly quickly and it slowly subsides. The Dr asks if your ok....and if your hearing is ok. You are then taken to recovery and the dex/lido IV is started for 2 hours. As the IV is in place you feel a sensation of slight numbness throughout your body and the ringing in your ear diminishes measurably. This procedure is repeated (3) times over a 3 day period. On day 3 my tinnitus was almost 100% gone. I had go in the bathroom in complete silence to hear it. I stayed at the Residence Inn (owned by the Shea family trust) and each day I used the breezeway that connects to the clinic to make my trek to the 3rd floor out patient surgical center.

Does the procedure work? The answer is......"it depends". For me it turned my T into a shhhhhhhh sound from a EEEEEEEEE sound. And cut the volume in half. Since my insurance paid for the entire procedure 100% and I obtained a measure of improvement I am pleased and I would say it worked for me. It did NOT cure my T but it is the only procedure that has worked to reduce it at all and it easily cut the volume by 50%.

I have read comments on this site stating that if the Shea procedure was so great that many people would be getting the procedure.....well, after a visit to the Shea clinic it doesn't take long to see that the magnitude of the Shea operation is quite large in scale and many people (each day) have this procedure (perfusion). Some people have the procedure every 3-4 years and respond quite well to it.

During my 4 days at the Shea Clinic I had the occasion to speak with at least 10 separate perfusion patients during the free "social hour" at the Residence Inn dining room each evening where patients were comparing notes and talking about their ear problems. About half the people going through the perfusion treatment have tinnitus and balance issues (Menaries or hydrops).....and the others have just tinnitus. In each group there are positive and negative responders to the treatment protocol.

Perfusion effectiveness for tinnitus is probably a 50/50 situation for any given person. Tinnitus, while everyone wants to cloak it as some mysterious malady, is really quite simple to explain.....the hearing nerve becomes damaged (90%+ caused by aggregate exposure to to high sPL) and as the higher frequencies of the hearing range are lost tinnitus becomes noticeable as the range drops below 8000. To achieve deep silence in the auditory system the hearing nerve uses certain portions of the high frequency range to inhibit and maintain a "deep silence". Once this inhibitory function is lost tinnitus is perceived.

The perfusion process works by flooding the cochlea with a powerful corticosteroid through the round window membrane that (if it can reach the lesion) may be able to repair or lessen the damage. The lidocaine shuts down abbherent neuron function and allows for an opportunity to reset the auditory communication path ways should the dexamethosone have a positive effect on the targeted lesion.

In cases where dexamethosone reaches the lesion in the early stages of tinnitus it is very effective at ameliorating the malady. As time passes the lesion becomes more permanent and less receptive to repair/reversal.

There are also cases where the perfusate chemical concentration levels at the lesion site can be not be achieved for various reasons and mixed perfusion treatment results are achieved.

My particular perfusion treatment protocol reduced the volume of my tinnitus by an estimated 50% and changed the sound type to a more tolerated sound.

There is really no other known treatment protocol that offers any probable impact on tinnitus. None!

All other treatment modalities only play off an individuals ability to habituate to the tinnitus over time. Example; some people go out and get Soundcure or Neuromonics and report great results while others report it does nothing?

If a person perceives some relief while on sound therapy it is more probable that they reached some level of habituation during the sound therapy treatment than the sound therapy actually having an impact on the tinnitus.

The same for TRT and various drug protocols.

The perfusion treatment is not well aligned with a habituation curve in that it either works or does not and you have a direct correlation to its effectiveness, or lack thereof....very quickly.

The price of the procedure is $8400 for the three day protocol. If your insurance deductible is met the cost can be zero. Your insurance has no say if the procedure is covered or not. It's a standard CPT billing code of 69801 and simply means "delivery of medications and/or steroids to the inner ear". This CPT code does not require a pre authorization. Shea accepts the insurance pay rate for 69801 as payment in full.

Feel free to ask me any questions you wish regarding this procedure.

With all due respect you sound more like a doctor promoting his practice rather than a patient. What lay person knows anything about billing codes? I find your posting suspicious to say the least.

 

[1MW]

today i got 16mg methylprednisolone and after 3 hours i have 70% reduction

 

[Carlos1]

today i got 16mg methylprednisolone and after 3 hours i have 70% reduction

@1MW Hey 1MW can you describe the procedure you had

 

[markoana]

today i got 16mg methylprednisolone and after 3 hours i have 70% reduction

Isn't scientifically too late for coticosteroids like prenisolone and methylprednisolone few years after onset..?

 

[Nucleo]

Isn't scientifically too late for coticosteroids like prenisolone and methylprednisolone few years after onset..?

Too late to repair the damage done by trauma. Still works for inflammation.

 

[markoana]

Yes, but 1MW didn't wrote that he has any inflammation. That's why I asked.

 

[1MW]

My T cause is unknown ...
10 hours after 16mg methylprednisolone and my T is 0/10 and i have no H and no reactive T.
To me corticosteroids work 100% but the result is temporary.

 

[jdjd09]

Would this treatment help me? I have some high frequency hearing loss from 6-8khz. 30db and 40db in that range in one ear with the loud tinnitus.

This all occurred mid December. It's now March. It's within 90 day window. Will this cure me? I'm near Tennessee.

 

[JasonP]

Could the new over the counter Lidocare patch work for tinnitus?

 

[Poyraz]

My T cause is unknown ...
10 hours after 16mg methylprednisolone and my T is 0/10 and i have no H and no reactive T.
To me corticosteroids work 100% but the result is temporary.

This is so exciting!
I'm also not sure of my cause(but I do highly suspect of benzos) maybe I can give it a try. I really wonder you still use it.

 

[2563Hz]

I'm sorry to say I'd heard enough at "Shea Clinic." I know they've built a massive business that draws people from all over the world, but after two tympanoplasties that I've come to believe were totally unnecessary, I'm done with the Doctors Shea.

 

[Emmi]

Hi everyone,

I was wondering if an intratympanic dexamethasone injection with lidocaine, for example done at the Shea Clinic, could still help after 11 months?

Probably it will only help in an acute phase and I did an infusion therapy with cortisone already and that did not have any effect, so I am not sure if this will have any benefit.. but i just want to do something against it :/

Is it complete nonsense??

 

[mrfixit38671]

had this procedure (lidocain and dexamethosone) at Shea clinic about 10 years ago...lasted me about 2 days and back again...hope you have better luck than me...keep us posted

 

[Christian78]

for me it made tinnits worse after some time

 

[Emmi]

@mrfixit38671

How long did you have your T already when you did that treatment?

@Christian78

Do you know the cause of your T? And how long did you have it already when you did the treatment? And are you feeling a bit better?

 

[undecided]

Some people get total temporary relief with steroids, other people just get worst tinnitus.
It's a dice roll.
For me, it's a 5-15% reduction so I don't bother at all (not the intratympanic procedure, intramuscular or pill).

 

[Emmi]

@undecided

So best case scenario would be temporary relief? Or do you know people where the effects are long term as well? Uhh I don't know if I shall do it.. tried Cortisone already via infusion.. and that didn't help unfortunately, but didn't make it worse either. Probably I am too late for it anyway

 

[J. D.]

I had the procedure done in March 2016. The difference in my procedure and one described earlier was that I was put to sleep and woke up in recovery and had about an hour left to lie there on my side. I only had one ear done, my right.

They say that our ailment is not hereditary but, I have to differ from that belief. I have it, my mom has it and my great grandmother had it. My younger sister is developing ringing in her ears. My mom has suffered for over forty years (hearing loss, ringing, vertigo, nausea) and when an episode hits she is incapacitated. My dad has to carry her to the bed because she cannot walk on her own and it can last for days. She is 75 and quit driving about five or six years ago because she never knew when an attack would occur. Other than this she is in good health.

The last ten months have been her best over the last 40 years. When I went to the Shea Clinic I was in one room having the procedure and she was in the next room having it done. We both have been vertigo free since the procedure but suffer from balance problems occasionally. I have found that even though the vertigo is not experienced I still suffer symptoms. When I would have an episode I would have trouble focusing and very tired and worn out.

I still have the ringing and significant hearing loss in my right ear.

 

[Rafroki]

Does this work for patients with noise induced trauma such as loud music?

 

[just1morething]

@Smark

Not sure if they if they still do ear perfusions? I don't think so.

 

[Sonic17]

As stated above, I had this procedure performed on one of my ears at Shea Clinic. The procedure itself is uneventful. After the drop of phenol on the ear drum you feel nothing. When the drop hits the ear drum it stings for 5-10 seconds or so and the Dr waits a few moments and then suctions off the excess phenol and wax/debris from on top of the ear drum. After about one minute the Dr takes a small instrument (laser) and makes a very small hole in the ear drum while watching on a large flat panel (30") display monitor that is being fed by a Leica stereo scope with video CCD attachment. The laser perforation of the tympanic membrane takes 1 second and then the nurse hands the Dr a 20 gage syringe with the mixture of dexamethosone and lidocaine. The Dr then tells you that a sensation of cold in the inner ear will happen upon injection of the mixture. As he begins the injection your vestibular system reacts to the cold temperature of the mixture and you get vertigo fairly quickly and it slowly subsides. The Dr asks if your ok....and if your hearing is ok. You are then taken to recovery and the dex/lido IV is started for 2 hours. As the IV is in place you feel a sensation of slight numbness throughout your body and the ringing in your ear diminishes measurably. This procedure is repeated (3) times over a 3 day period. On day 3 my tinnitus was almost 100% gone. I had go in the bathroom in complete silence to hear it. I stayed at the Residence Inn (owned by the Shea family trust) and each day I used the breezeway that connects to the clinic to make my trek to the 3rd floor out patient surgical center.

Does the procedure work? The answer is......"it depends". For me it turned my T into a shhhhhhhh sound from a EEEEEEEEE sound. And cut the volume in half. Since my insurance paid for the entire procedure 100% and I obtained a measure of improvement I am pleased and I would say it worked for me. It did NOT cure my T but it is the only procedure that has worked to reduce it at all and it easily cut the volume by 50%.

I have read comments on this site stating that if the Shea procedure was so great that many people would be getting the procedure.....well, after a visit to the Shea clinic it doesn't take long to see that the magnitude of the Shea operation is quite large in scale and many people (each day) have this procedure (perfusion). Some people have the procedure every 3-4 years and respond quite well to it.

During my 4 days at the Shea Clinic I had the occasion to speak with at least 10 separate perfusion patients during the free "social hour" at the Residence Inn dining room each evening where patients were comparing notes and talking about their ear problems. About half the people going through the perfusion treatment have tinnitus and balance issues (Menaries or hydrops).....and the others have just tinnitus. In each group there are positive and negative responders to the treatment protocol.

Perfusion effectiveness for tinnitus is probably a 50/50 situation for any given person. Tinnitus, while everyone wants to cloak it as some mysterious malady, is really quite simple to explain.....the hearing nerve becomes damaged (90%+ caused by aggregate exposure to to high sPL) and as the higher frequencies of the hearing range are lost tinnitus becomes noticeable as the range drops below 8000. To achieve deep silence in the auditory system the hearing nerve uses certain portions of the high frequency range to inhibit and maintain a "deep silence". Once this inhibitory function is lost tinnitus is perceived.

The perfusion process works by flooding the cochlea with a powerful corticosteroid through the round window membrane that (if it can reach the lesion) may be able to repair or lessen the damage. The lidocaine shuts down abbherent neuron function and allows for an opportunity to reset the auditory communication path ways should the dexamethosone have a positive effect on the targeted lesion.

In cases where dexamethosone reaches the lesion in the early stages of tinnitus it is very effective at ameliorating the malady. As time passes the lesion becomes more permanent and less receptive to repair/reversal.

There are also cases where the perfusate chemical concentration levels at the lesion site can be not be achieved for various reasons and mixed perfusion treatment results are achieved.

My particular perfusion treatment protocol reduced the volume of my tinnitus by an estimated 50% and changed the sound type to a more tolerated sound.

There is really no other known treatment protocol that offers any probable impact on tinnitus. None!

All other treatment modalities only play off an individuals ability to habituate to the tinnitus over time. Example; some people go out and get Soundcure or Neuromonics and report great results while others report it does nothing?

If a person perceives some relief while on sound therapy it is more probable that they reached some level of habituation during the sound therapy treatment than the sound therapy actually having an impact on the tinnitus.

The same for TRT and various drug protocols.

The perfusion treatment is not well aligned with a habituation curve in that it either works or does not and you have a direct correlation to its effectiveness, or lack thereof....very quickly.

The price of the procedure is $8400 for the three day protocol. If your insurance deductible is met the cost can be zero. Your insurance has no say if the procedure is covered or not. It's a standard CPT billing code of 69801 and simply means "delivery of medications and/or steroids to the inner ear". This CPT code does not require a pre authorization. Shea accepts the insurance pay rate for 69801 as payment in full.

Feel free to ask me any questions you wish regarding this procedure.

Will they accept people from other countries (Canada)?

 

[just1morething]

Will they accept people from other countries (Canada)?

I was there in 2011. My insurance I had covered it out of network back then. I doubt my current insurance would cover anything. I'm sure they would accept anyone with green money. Not sure if the procedure they did to me helped any. If it did it didn't last.

 

[FlatDarkEarth]

I see there hasn't been any activity on this thread in nearly two years.

I had an ENT suggest a Decadron (Dexamethasone) perfusion for my tinnitus (I do not have vertigo issues) which sounds similar to what the Shea Clinic does. Has anyone had experience with this? There really isn't a lot I can find online...

 

[Uklawyer]

@FlatDarkEarth, did you go ahead with the perfusion?

 

[FlatDarkEarth]

@FlatDarkEarth, did you go ahead with the perfusion?

@Uklawyer, no I didn't but I am revisiting the idea. As I posted in my thread in Support today, I am having a really bad flare up. If antidepressants don't improve the situation, I am considering microdosing Psilocybin, TMS, or a Dexamethasone infusion.

I've been too scared to get something injected into my ear for fear it could make it worse.

 

[Rockman]

@Stacken77

 

[RadioKid722]

Does anyone know where in the US I can have a Dexamethasone and Lidocaine profusion? Does Shea Clinic still do them?

 

[RadioKid722]

I called Shea Clinic and they still do this procedure. Has anyone had this done recently? Who has had any results from this procedure?

 

[David S]

I called Shea Clinic and they still do this procedure. Has anyone had this done recently? Who has had any results from this procedure?

@RadioKid722, did they say anything about success rate? What type of tinnitus do they have success with?

 

[RadioKid722]

@RadioKid722, did they say anything about success rate? What type of tinnitus do they have success with?

I didn't ask. But since they still do it I'd imagine they have some success with lessening the severity of the tinnitus. I read online average score before and after as 75 and 48, so a significant reduction in volume.

I think I am going to fly out there in a few weeks and have the procedure done. It's 3 days + 1 day for consultation. They said they'd schedule me starting on a Monday for consultation since I'm from out of town, so I can have the procedure done Tuesday, Wednesday and Thursday. There is a hotel just up the street I can stay at.