Low-Level Laser Therapy (LLLT) for Tinnitus — Efficacy Debate

Discussion in 'Alternative Treatments and Research' started by Sen, Feb 24, 2013.

tinnitus forum
    1. Sen
      Caffeine

      Sen Member

      Tinnitus Since:
      October, 2012.
      as far as i am aware, there is no evidence that low level laser therapy is effective.
       
    2. Molan
      No Mood

      Molan Member

      Tinnitus Since:
      2005
    3. carlover
      English

      carlover Member Benefactor

      Location:
      London
      Tinnitus Since:
      1986
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    4. erik
      Breezy

      erik Manager Staff Benefactor

      Location:
      Washington State, USA
      Tinnitus Since:
      04/15/2012
      Cause of Tinnitus:
      Most likely hearing loss
      Yes interesting. Would even be more interesting to see how he is doing now a year or so later.
       
    5. dan
      Chatty

      dan Member

      Tinnitus Since:
      06/2011
      It's a scam.
       
    6. carlover
      English

      carlover Member Benefactor

      Location:
      London
      Tinnitus Since:
      1986
    7. Leo1994
      Suicidal

      Leo1994 Member

      Location:
      Sweden
      Tinnitus Since:
      2005
    8. erik
      Breezy

      erik Manager Staff Benefactor

      Location:
      Washington State, USA
      Tinnitus Since:
      04/15/2012
      Cause of Tinnitus:
      Most likely hearing loss
    9. Owch

      Owch Member

      Tinnitus Since:
      03/2013
      This is a good point: if the therapy were widespread then costs would be very low - I guess mass-produced medical lasers would be very cheap to buy and the therapy simply involves pointing a laser at somebody's ear and so isn't even as complicated as taking a blood sample!

      But I think the problem is that the Medical establishment doesn't work in the way we might hope. As an example from another area... recently I had bad bronchitis and my pharmacist recommended I take a product called 'Umckaloabo' and said it had an interesting history. I bought it but was intrigued and a quick google later and I found the following:
      http://www.docstoc.com/docs/30401407/The-strange-story-of-umckaloabo

      Personally I found Umckaloabo to be very effective in treating my bronchitis but the point is that the medical profession did their best to close the guy down when he offered it and only many years after his death (and I assume the ending of any patents he might have held) did 'Big Pharma' pick-up on the treatment and are now seemingly making a fortune out of it!

      I could speculate on the reasons that LLLT is ignored and even attacked from various quarters but the fact is that some people have experienced measurable improvements in their hearing after taking clinically-applied LLLT: the person I spoke with before taking the treatment; a bunch of people at Dr Wilden's clinic who's audiograms I saw; and also the chap on this forum taking stem cell treatment in Bangkok posted some audiograms showing a clear improvement in his hearing after he had 2 months of treatment at Dr Wilden's clinic and via home laser.

      I don't know what the effects will be on me, but I'm hoping I'll be able post some audiograms showing similar improvements in some months :)
       
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    10. erik
      Breezy

      erik Manager Staff Benefactor

      Location:
      Washington State, USA
      Tinnitus Since:
      04/15/2012
      Cause of Tinnitus:
      Most likely hearing loss
      Low Level Laser Therapy does not appear to be effective healing damaged hearing cells or improving hearing functions.

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3658388/

      Abstract
      One purported use of low-level laser therapy (LLLT) is to promote healing in damaged cells. The effects of LLLT on hearing loss and tinnitus have received some study, but results have been equivocal. The purpose of this study was to determine if LLLT improved hearing, speech understanding, and/or cochlear function in adults with hearing loss. Using a randomized, double-blind, placebo-controlled design, subjects were assigned to a treatment, placebo, or control group. The treatment group was given LLLT, which consisted of shining low-level lasers onto the outer ear, head, and neck. Each laser treatment lasted approximately five minutes. Three treatments were applied within the course of one week. A battery of auditory tests was administered immediately before the first treatment and immediately after the third treatment. The battery consisted of pure-tone audiometry, the Connected Speech Test, and transient-evoked otoacoustic emissions. Data were analyzed by comparing pre- and posttest results. No statistically significant differences were found between groups for any of the auditory tests. Additionally, no clinically significant differences were found in any individual subjects. This trial is registered with ClinicalTrials.gov (NCT01820416).
       
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    11. Owch

      Owch Member

      Tinnitus Since:
      03/2013
      Many thanks for the link

      I've read the document.

      The problem with that trial compared to the treatment I received was:

      Quote: "The treatment group was given LLLT, which consisted of shining low-level lasers onto the outer ear, head, and neck. Each laser treatment lasted approximately five minutes. Three treatments were applied within the course of one week.
      <snip>
      The probe contained two laser diodes. One diode produced light in the green part of the visible light spectrum (532 x2009.gif nm wavelength), and the other diode produced light in the red part of the visible light spectrum (635 x2009.gif nm wavelength). Both diodes produced energy levels of 7.5 x2009.gif mW (class IIIb).
      <snip>
      Subjects in the treatment group had the low-level laser applied for approximately 4 minutes to the area around both pinnae, the back of the neck, and the top of the head"


      7.5 mW is not very much... current home devices output 30 to 90mW (clinical LLLT lasers are much more powerful) and the subjects received a very short dose of treatment: 3 sessions of 5 minutes means 15 minutes total spread over a whole week! Not only that, but the laser was seemingly not directed in the ear for the whole 5 minutes of the session, but for only 2 minutes out of the 5 (looking at the image of the areas applied with timings), with the rest being around the neck and TMJ joint and the top of the head. I believe a normal home treatment in one day would be at least 30mW in each ear for 15 to 30 minutes - ie. a lot more in a single day home treatment than they received over the whole trial (though I haven't a laser of my own and have not tried this so only speak of what I have read from others).

      My treatment in the clinic involved being zapped by a clinical laser of over 200mW (I forget the exact power) on two different frequencies. I also can't remember the exact frequencies but one was red (but I don't think it was 532nm) and one was in the IR spectrum (I can mail Dr Widlen to find the exact specs of his lasers if it is interesting to anybody). I received ten treatments of 30 minutes each in both ears (ie. one hour total per treatment as the laser was applied to one ear and then the other) so my exposure was much, much, (much!) higher than that received by the participants in this trial. I guess the people whose Audiograms show improvments similarly had longer exposure to higher enegetic levels of radiation. Sadly I don't think that the protocol in the listed trial has much relevance to the therapy I received.

      I don't know if the laser treatment will help me - this remains to be seen - but I am personally convinced that it has improved the hearing of some other people who have taken it. Did you see the audiograms posted by 'attheedgeofscience' after the two months of this therapy, what was your feeling about them?
       
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    12. Owch

      Owch Member

      Tinnitus Since:
      03/2013
      I just looked again at the test protocol used in that trial...

      You can find the explanatory image from the report here:
      ISRN.OTOLARYNGOLOGY2013-916370.001.jpg
      Actually each individual ear received only 1 minute of direct exposure to a low powered laser in each of the 3 treatment sessions (the rest of the time it appears to have been dragged around the head and the neck)... so each ear had a grand total of 3 minutes direct exposure spread over one week!

      I wonder why they bothered?
       
      • Like Like x 4
    13. Molan
      No Mood

      Molan Member

      Tinnitus Since:
      2005
      @Owch, thank you for looking into this. It appears to me that this was yet another study that was deliberately designed to fail.

      It's strange how they cannot just duplicate what Wilden does and then we would have a clearer idea of whether his protocol is effective when tested independently. It's abit of a joke to be honest.
       
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    14. Molan
      No Mood

      Molan Member

      Tinnitus Since:
      2005
      For anyone interested a study was done last year on rats which was first study that has demonstrated the beneficial effect of LLLT on the recovery of cochlear hair cells.

      Abstract
      Cochlear hair cells are the sensory receptors of the auditory system. It is well established that antibiotic drugs such as gentamicin can damage hair cells and cause hearing loss. Rescuing hair cells after ototoxic injury is an important issue in hearing recovery. Although many studies have indicated a positive effect of low-level laser therapy (LLLT) on neural cell survival, there has been no study on the effects of LLLT on cochlear hair cells. Therefore, the aim of this study was to elucidate the effects of LLLT on hair cell survival following gentamicin exposure in organotypic cultures of the cochlea of rats. The cochlea cultures were then divided into a control group (n = 8), a laser-only group (n = 8), a gentamicin-only group (n = 8) and a gentamicin plus laser group (n = 7). The control cultures were allowed to grow continuously for 11 days. The laser-only cultures were irradiated with a laser with a wavelength of 810 nm at 8 mW/cm(2) for 60 min per day (0.48 J/cm(2)) for 6 days. The gentamicin groups were exposed to 1 mM gentamicin for 48 h and allowed to recover (gentamicin-only group) or allowed to recover with daily irradiation (gentamicin plus laser group). The hair cells in all groups were stained with FM1-43 and counted every 3 days. The number of hair cells was significantly larger in the gentamicin plus laser group than in the gentamicin-only group. The number of hair cells was larger in the laser-only group than in the control group, but the difference did not reach statistical significance. These results suggest that LLLT may promote hair cell survival following gentamicin damage in the cochlea. This is the first study in the literature that has demonstrated the beneficial effect of LLLT on the recovery of cochlear hair cells.


      http://www.ncbi.nlm.nih.gov/pubmed/22138884
       
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    15. Owch

      Owch Member

      Tinnitus Since:
      03/2013
      Yes, that was my own thought as well when reading the study: lots of testing at the end (audiometric, speech understanding and some kind of transient response testing that I don't understand) to show it didn't work, but no (or almost no) actual therapy applied!

      Probably not valuable to get too much into the 'whys and wherefores' of this however as it would be easy to get dragged off-topic.

      Or how about as a start somebody simply following-up on the patients Dr Wilden claims to have cured to see if they have medical records proving hearing issues before the treatment and if they really do have better hearing now?

      Thank you so much for that link! It gives me some hope that my own experience with this therapy may prove positive. I don't know if cochlear hair cell recovery means no more tinnitus, but I guess it would be a good starting point for other tinnitus treatments, and surely (please!) it must mean an end to this awful recruitment/hyperacusis :(
       
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    16. Molan
      No Mood

      Molan Member

      Tinnitus Since:
      2005
      I agree 100% that would seem to be a rather obvious thing they could do.

      Here is another study from the same people in the previous abstract I posted. It shows promise in my opinion.


      Abstract

      We investigated the effect of low-level laser radiation on rescuing hair cells of the cochlea after acute acoustic trauma and hearing loss. Nine rats were exposed to noise. Starting the following day, the left ears (NL ears) of the rats were irradiated at an energy output of 100 to 165 mW/cm(2) for 60 min for 12 days in a row. The right ears (N ears) were considered as the control group. Frequency-specific hearing levels were measured before the noise exposure and also after the 1st, 3rd to 5th, 8th to 10th and 12th irradiations. After the 12th treatment, hair cells were observed using a scanning electron microscope. Compared to initial hearing levels at all frequencies, thresholds increased markedly after noise exposure. After the 12th irradiation, hearing threshold was significantly lower for the NL ears compared to the N ears. When observed using an electron microscope, the number of hair cells in the middle turn of the NL ears was significantly larger than that of the N ears. Our findings suggest that low-level laser irradiation promotes recovery of hearing thresholds after acute acoustic trauma.
      PMID:
      22734788
      [PubMed - in process]
      LinkOut - more resources


      http://www.ncbi.nlm.nih.gov/pubmed/22734788
       
      • Like Like x 3
    17. jes
      Familiar

      jes Member Benefactor

      Location:
      copenhagen denmark
      Tinnitus Since:
      10/2012
      Wilden talk about haircel regeneration.But the problem what I can see is that the haircels do not have that gen that
      tels them to regenerate when they get dammage.Thats why you can use laser akupunkture ozon massage you name it
      and nothing happens.I was by wilden a year ago.He can smell a solid credit cart.I am sure he would like it to regenerate,but in that case we would all have been there long time ago.He Sticks to his teory,that seems wery logic
      but the realityes.Laser can be used in a after a hairfal to help those who dont know if they wil live or die.to erlend I would buy the small tinnitool and use it everyday.His big lasers just made my t louder.His big lasers looks fancy,but they do not start any regeneration,and I am sure he knows.Perhabs they can find that gen and we can use it as eardrops. I see some hope in these new items that should tell the brain not to listento t. The Price 1k for 5 hours laser,when I told him that mine got louder,he said it was a good sighn on regeneration.
       
    18. Jodi
      Confused

      Jodi Member

      Location:
      Europe
      Tinnitus Since:
      03/1999
      What do you think of this?

      "Comprehensive laser rehabilitation therapy of tinnitus has proven successfull and beneficial for treatment of this widespread civilization disease. Its long-term results are convincing, bringing significant relief to 36 per cent of patients and even leaving remarkable 26 per cent of patients with out any symptoms (see Miroslav Prochazka, Ales Hahn: Comprehensive Laser Rehabilitation Therapy of Tinnitus: Long-Term Double Blind Study on a Group of 200 Patients in 3 Years, Laser Partner No. 51/2002). With the results mentioned above we can really speak about a breakthrough. This study brings an additional overview of the role of LLLT (Low Level Laser Therapy) in the treatment. Our results enable us to pinpoint laser as the leading element in the overall therapy of tinnitus."

      http://ammhealth.co.za/pdf/info/latest/The Role of LLLT in Treatment of Tinnitus.pdf
       
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    19. Jodi
      Confused

      Jodi Member

      Location:
      Europe
      Tinnitus Since:
      03/1999
      Another study. Comments?

      "We investigated the effect of low-level laser radiation on rescuing hair cells of the cochlea after acute acoustic trauma and hearing loss. Nine rats were exposed to noise. Starting the following day, the left ears (NL ears) of the rats were irradiated at an energy output of 100 to 165 mW/cm(2) for 60 min for 12 days in a row. The right ears (N ears) were considered as the control group. Frequency-specific hearing levels were measured before the noise exposure and also after the 1st, 3rd to 5th, 8th to 10th and 12th irradiations. After the 12th treatment, hair cells were observed using a scanning electron microscope. Compared to initial hearing levels at all frequencies, thresholds increased markedly after noise exposure. After the 12th irradiation, hearing threshold was significantly lower for the NL ears compared to the N ears. When observed using an electron microscope, the number of hair cells in the middle turn of the NL ears was significantly larger than that of the N ears. Our findings suggest that low-level laser irradiation promotes recovery of hearing thresholds after acute acoustic trauma."

      Effect of low-level laser treatment on cochlea ... [J Biomed Opt. 2012] - PubMed - NCBI
       
      • Informative Informative x 1
    20. So my collaborator specializes in lasers for the ear. I have not heard anything about this but I will ask him.
       
      • Optimistic Optimistic x 1
    21. Jodi
      Confused

      Jodi Member

      Location:
      Europe
      Tinnitus Since:
      03/1999
      Ok. Please keep us updated!
       
    22. Jodi
      Confused

      Jodi Member

      Location:
      Europe
      Tinnitus Since:
      03/1999
      I think I´ll give LLLC a go as well. But for home use, which devices are out there? I´ll start a list:

      MLS (Medical Laser System) €3073 By Dr. Wilden. LINK

      emLas-520A $450
      emLas-520B $530
      emLas-520C $450
      LINK

      Luci Basic, €2900 LINK (Is this one also "made" by, or from Dr. Wilden?)
       
      • Like Like x 1
    23. The research doesn't look great on this. Don't waste your money!
      Prospective, randomized double-blind studies area good way to rule out placebo effect. These are the top four. Only one shows an effect, but its not a well-designed study.
      The effect of low-level laser therapy on he... [ISRN Otolaryngol. 2013] - PubMed - NCBI
      Transmeatal low-level laser therapy for chr... [Audiol Neurootol. 2009] - PubMed - NCBI
      Effectiveness of transmeatal low power laser... [J Laryngol Otol. 2008] - PubMed - NCBI
      Transmeatal low-power laser irradiation for ti... [Otol Neurotol. 2002] - PubMed - NCBI
       
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    24. Erlend
      Question it

      Erlend Member Benefactor

      Location:
      Scandinavia
      Tinnitus Since:
      05/2013
      What we've seen on this forum is that the studies are "designed to fail". They use nowhere near the amounts or intensity Dr Wilden reccomends.
       
      • Agree Agree x 2
    25. Lulubug69
      Artistic

      Lulubug69 Member

      Tinnitus Since:
      9/2013
      I'm not sure what I believe, but I do know that keeping discussions going about Tinnitus is a good thing. Proving and disproving is how we get to a cure. Question everything.
       
    26. yonkapin

      yonkapin Member Benefactor

      Location:
      Melbourne, Australia
      Tinnitus Since:
      March 2012
      Not taking sides, but we have someone who has tried LLLT and didn't have a positive experience:

      On the other hand, I remember attheageofscience posting positive results with his audiograms after receiving treatment from Dr Wilden but this was within a couple months of whatever acoustic trauma he experienced so it might have been spontaneous recovery.
       
    27. Hopeful
      Wishful

      Hopeful Member Benefactor

      Tinnitus Since:
      06/13
      All right. What a heated debate. I don't like the vibe! Here are my two cents:

      Yes, Dr. Wilden's 'scientific' explanations are a bit lame. Is he a quack? Well, some people seem to have had positive effect of his treatments. Does this mean that his treatment would pass a double-blind placebo controlled study? No one knows, but probably not.

      I know a guy who's tinnitus dissolved after having head massage. It was bad and he had had it for 6 months. Does this mean that head massage cures tinnitus? No, of course not.

      I know a guy who gets acupuncture once a month for his tinnitus. It helps him a lot. Lowers the volume. Does this mean that acupuncture helps with tinnitus?

      You can find so many stories around the internet with people having relieve from their tinnitus. Someone even posted here about hot chokolade from Starbucks taking away the noise. Does hot chokolade cure tinnitus?

      The etiology of tinnitus is diverse. So can the treatments be. rTMS helps only a percentage. Even the praised AM101 doesn't work for everyone.

      As long as I know people are not straight out scammers, I am willing to try stuff for my T. I don't care if it's not scientifically proved. I don't care if it's placebo.
       
      • Like Like x 4
    28. attheedgeofscience
      Uninvolved

      attheedgeofscience Member Hall of Fame

      Location:
      Denmark
      Tinnitus Since:
      Childhood
      Cause of Tinnitus:
      Head Injury
      There is too much bullshit in this thread (and I haven't even read half of it). I generally don't respond to bullshit (because it is not worthy of my time). But since I have time today and nothing better to do and others might benefit as well, I will weigh in with my input. The problem here is that too many people with no first hand experience start commenting on something they know absolutely nothing about (but would like to appear as if they do). This is the very root cause of bullshit...

      So for those interested in some "non-bullshit" about LLLT or cold-laser therapy, read on.

      I will start by saying that I am neither for or against LLLT, but I happen to be a former patient of dr. Wilden, so I know what I am talking about. Dr. Wilden is the most well known of all the clinics providing LLLT - there are other clinics in Norway, Sweden, Denmark, Australia, and USA - and perhaps a couple I don't know of. I underwent therapy for a two month period this summer. During this time, I had 7 audiograms done to monitor my progress (the first and last audiograms are attached here as one file). During this two month period I met with 4 different audiologists at the clinic in Regensburg and also had 4 consultations with dr. Wilden. I also met and communicated with several patients and former patients.

      Some facts about LLLT at Dr. Wilden's practice in Regensburg:
      • He uses the initial audiogram as a benchmark for the treatment. He divides the audiogram into 3 quadrants - those with (relatively) good hearing, those with hearing loss, and those with severe hearing loss. Based on this, he will recommend a treatment plan - and that is why he always requests an audiogram. In my case, my hearing fell within the first category (ie. good hearing). He therefore recommended I do 5 sessions of LLLT (each session costs EUR 200,- and last one hour; both ears are lasered even if tinnitus is unilateral). So for those saying he is after your money, I will have to disagree. Why? Because he could easily have stated that I should do the standard 10 hours of therapy (which is the norm), but because my hearing is pretty good and the onset of tinnitus recent, he said "start with 5 hours...".
      • The lasers use two different wavelengths (infrared and red) with an output of >200 mW (red wavelengths target the high frequency hair cells, infra-red targets the low ones). During my time at the clinic it became apparent that dr. Wilden is fighting a battle against the hearing aid companies who are trying to discredit his work. They do so by ordering seemingly independent studies of LLLT's (lack of) effectiveness, but which in reality are studies designed to fail (by using laser output of only 5-15 mw for 10 minutes or so). The reason for this is - of course - simple: market share protection and money...!
      • I came to know one of the audiologists quite well, and I asked him about the success rate in relation to tinnitus. He said about 30% have a decrease or total elimination of their tinnitus.
      • It is possible to recover almost any amount of hearing loss, but it may take as long as 3 years to do so (if the hearing loss is severe). The only people who will not respond are those who have gone completely deaf.

      Did you know...
      • The Formula One mclaren team has one of its engineers undergoing therapy there every year?
      • The US airforce in Germany has several of its staff undergoing therapy at the clinic?
      • There are people flying across continents - and for regular follow-ups each year - to attend therapy at dr. Wildens clinic?
      • That LLLT is not just useful for hearing loss and tinnitus, but also for fullness in the ears, Menieres disease and hyperacusis?
      • LLLT is not just used for inner ear conditions, but is also used in dermatology (ezcema), physiotherapy (tendinitis), neurology (nerve healing ie. Bell's palsy) and for many other conditions?
      Now back to me and my first hand experience with LLLT. Did it work? Well, to my surprise my hearing has improved significantly. This can be seen from my audiograms, but I can also feel this when using headphones (I have had to adjust my volume levels down 3 times since undergoing therapy). I was somewhat sceptical about the treatment since all ENTs claim that once your hearing is lost, it is lost forever (one more reason for the incompetence of ENTs; my audiograms show a solid improvement). As for my tinnitus - which was the main reason for doing the therapy - the LLLT has not really done anything, I would say. And I was even told that I was an ideal candidate since my hearing loss was in the first quadrant of the audiogram (meaning I would have a quick response to the therapy). But as I say, I have met others who did respond well to the treatment. It would seem that those benefitting the most from the treatment are those with Menieres disease.

      So as a conclusion, I am neither for or against the treatment (i.e. it did work for hearing loss, but not for tinnitus).

      For those interested, here is a youtube clip on LLLT:

      LaserHear by HearingMed
       

      Attached Files:

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    29. Jake
      Irritated

      Jake Member

      Location:
      Lawrence, KS
      Tinnitus Since:
      07/2013
      I agree with @ResonanceCEO. If Dr. Wilden believes that his treatments can be scientifically backed, then why not take the time to accurately document his work through scientific publication? @attheedgeofscience, that is AWESOME that your audiograms improved so dramatically. In fact, I'm very jealous and intrigued. I am no expert by any means, but as a journalist, I will always take hard evidence over speculation (for lack of a better word) any day of the week. But who knows? There really might be something to Dr. Wilden's treatment. Until I see some hard, consistent data, I'll keep my money in my wallet.
       
      • Like Like x 1
    30. erik
      Breezy

      erik Manager Staff Benefactor

      Location:
      Washington State, USA
      Tinnitus Since:
      04/15/2012
      Cause of Tinnitus:
      Most likely hearing loss
      I agree. Dr Wilden has been doing this for many many years. If this treatment actually works, why is it not the standard in treating tinnitus worldwide. Why would you not want to back it and do everything you could to get the backing so that everyone who is suffering from tinnitus could get treatment? I would think that if this treatment is as successful as Dr Wilden and other, there would be similar clinics worldwide licensing and offering this as a viable treatment for T and the studies to fully back it.

      The use of lasers for vision correction (Lasik/PRK) was discovered in 1980, Patented in 1989 and FDA backed clinicals from 1989-1998. Then in 1998, It was approved for general use and licensed. Eighteen years after its invention it is the standard in refractive surgery, thousands of clinics offer it worldwide and 11 million people a year have this treatment.

      Dr Wilden has been using LLT to treat Tinnitus and inner ear diseases for almost 17 years and still where are we in regards to having this as a treatment for tinnitus on a mass level?

      I am not here to criticize anyone's point of view or even state that Dr Wilden's treatments do or do not work because I do not know for a fact either way. Maybe it only works for a small percentage of tinnitus or certain types. But it would seem since most T is based in hearing loss and his lasers treat this area of the inner ear, then it would work for most types of T.

      I just want to ask questions that anyone with tinnitus might ask about a treatment that has been around this long, supposedly works but few people have access to it.
       
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