Repeated Modified Nerve Blocks and Auditory and Non-Auditory Nerve Stimulation

Prevalence and Associated Factors of Tinnitus: Data From the Korean National Health and Nutrition Examination Survey 2009–2011

Prevalent as anywhere else in the world...

 

I think the question is more about why isn't this treatment a hotter topic inside Korea if they have been doing it successfully for twenty years.

 

I did some armchair assessment on the results.

1) What Sedley points out in above worries me a quite a bit. In general in science, it is very uncommon for things to appear like this... out of the blue.

2) I checked the authors. I could not find their profiles or almost any previous papers on https://scholar.google.com/. This could just mean that they are skilled practitioners that have through trial and error stumbled on to something. Still it is a worry-some sign.

3) The case that supports the results is that the study is very well reported, e.g. each patient is listed as a separate individual with details. This reduces the chance that the results would be totally fabricated.



My worldview is probabilistic so I say there is

• 15% chance that the results hold in replication
• 25% change that they do provide some but lesser benefit
• 60% change that they do nothing or almost nothing.

 

Because of points (1) and (2)?

 

Yeah, seems likely. Such a shame though, for a few days some of us had hope. Hope that has been crushed yet again

 

AirBnb (nice) for 2 weeks in Seoul = $1,000
Round trip flight from LAX = $1,000
6 Treatments @ $300 = $1,800
Food (which is amazing - I've been) = $500
Total = $4,300

For a trip to Seoul + chance at a reduction/cure this seems damn reasonable to me.

 

I might go if we can get more information about this and it looks promising.

 

I think that's the absolute cheapest scenario. I highly doubt 6 sessions would do much (if we assume the treatment is not snake oil), more likely 10 and upwards. Also, I believe there is 7-day or something quarantine time upon arrival, so yeah... Possibly around $10,000.

 

20 years of selling a scam.

 

Well it's a sad fact but if there is some ailment that conventional medicine can't cure, the alternative therapies kind of mushroom upward. Some/many of the doctors actually believe in the efficacy of the treatment. And then there are the spontaneous remissions... and occasionally (not often), the good doctors are spot on. It works. the theory was right. And sometimes it works and no one understands why it works. That's life.

 

A bargain!

 

Yeah well, if we knew for sure that it definitely works, I'd pay that! But the more we learn about it, the worse it's starting to look. Also, I don't know if I'd risk getting spikes etc from such a long flight...

 

Let us stay positive. It is the best paper I've read from a results perspective. There is nothing to be gained from publishing a well structured and referenced paper other than trying to publicise a treatment that works. Why in God's name bother publishing this internationally if it didn't work? What would they have to gain? Only ridicule and doubt like what is happening here on the board.

From my perspective it looks like the family members have seen the potential for this to go international and make financial gain from a treatment that has worked for many years. We really need a guinea pig or ten to travel for the treatment.

We could be pleasantly surprised.

 

They are prepared to teach westerners via video or in person. Reach out to your local facilities (e.g., pain management clinics) and see if they'd be prepared to look into this.

 

Yes and also because tinnitus is very prevalent. If their treatments worked, word would spread from mouth to mouth.

Has anyone checked Korean social media posts? If this works as reported, I would expect to see testimonials on social media.

 

I tried to call at just after 5 pm South Korean time. Answerphone. No response to my chaser email either. Very disappointing.

 

They are probably insanely busy right now and I wouldn't read into it. An article about their treatment made its way all around the internet. Everyone and their mother is probably emailing them asking questions.

 

That is exactly what I was afraid of.

I said I was part of an organisation and would coordinate with them if need be. I do not know how many others have attempted to get in touch with them.

 

Please could you clear up what you mean exactly by duration/age?

If what you are saying is that the therapy works well with little regard to the age of the patient — that's good.

If what you are saying is that it works well with little regard to the duration of onset of the tinnitus — that's biiii...iiiig. In other words, it can alleviate chronic tinnitus. Almost too good to be true.

 

Why is somatosensory tinnitus an exclusion for participation in the paper?

 

It's not a concern.

 

Taking a recap of it all.

If this therapy is a variation of acupuncture or a combination of acupuncture and Lidocaine, well as far as I know, acupuncture has not yielded significant/lasting results in chronic cases. Lidocaine yes, but only of a temporary short-term nature.

It might be useful to categorise the research efforts according to the theory.

For example, Frequency Therapeutics' theory is that it can or will regenerate hair cells and synapses in the cochlea which will improve hearing and thus alleviate the tinnitus which acts like a "phanthom pain" manifested as ringing, hissing etc.

Otonomy, I understand, will regrow the synapses and the theory is that this is the root cause of tinnitus.

Other theories are that tinnitus is caused by damage to some filter mechanism presumably located closer to the brain.

Another theory is that tinnitus is caused by inflammation.

OK, those are the ones that justify their hopes for success on theory.

Then there are the other ones such as yeah, Curcumin, Magnesium, vitamin B complex that seem to alleviate some people's tinnitus, no one knows exactly why or the theory is so obscure that it defies scrutiny.

I believe the theory method would be more likely to yield results, after all, they've been trying to cure tinnitus and hearing loss since the time of the Ancient Pharaohs and Sumerians (and still haven't come up with something that works).

 

The article has over 349,000 views and it is in the top 1% of most viewed 'Frontiers In Neuroscience' articles after just 10 days.

 

A little update from the team regarding hyperacusis.

 

If we just could get any of the tinnitus clinics in Europe to consider trying this. The study now has almost 350,000 views. Quite an interest.

 

I have heard back. I appreciate the effort to answer my questions.

———

Hello.

Thank you for your interest about our study.

1. I understand that treatment is 3 times per week. Is this correct? Can you do more treatments in one week?

We performed the procedure 2–3 times a week for the first 2–3 weeks. After confirming a marked continuous decrease or disappearance of tinnitus, we tapered the treatment to 1 or 2 times per week and then once every 1 or 2 weeks. Treatment was terminated when patients felt comfortable for over 2 weeks during the treatment period, or when patients wanted to stop the treatment.

Also, we can do more treatment in a week. But, 3 times per week is enough for treatment.

2. Can you say, on average, how many treatments a person would need? How long would a person have to stay in South Korea for treatment?

The number of treatments is about fifteen if averaged, ignoring the patient's age, underlying disease, and duration of illness.

This treatment process takes on average 2 to 3 months.

Therefore, if you are coming for treatment from abroad, we recommend that you come with sufficient time.

3. The study ended in December 2018. Do you know how many patients you have treated in total with this method? Have you improved the treatment since December 2018? Do you have a lot of patients now using this treatment?

In fact, we've been treating patients with this therapy over 20 years. The overall success rate is similar to that of the study, and repeated treatment resulted in better outcomes even if the response were slow.

I’ve not calculated exactly how many people have tried this treatment. But I think there are over 700 people in our single institution alone. If I include my disciple’s clinic, it is over 1000 people.

4. You have stated that "In more than 87.5% of patients (14/15 subacute, 35/40 chronic), tinnitus disappeared or had significantly reduced by the end of the treatment."

Can you tell me if this figure is still true today if you now take into account all patients that you have treated using this method (or all patients for whom you have evidence of success or failure of treatment)?

Results are similar for patients who have completed treatment. T-VAS score was usually reduced significantly from 7.13 to 0.6 in the subacute group and from 7.73 to 1.53 in the chronic group (not zero).

For example 10 person try this procedure 2 out of 10 cured (tinnitus all gone). 5~6 persons out of 10 improved enough that it is not bothered. 1~2 persons out of 10 not changed.

And severe hearing loss (who need hearing aids), heavy alcohol consumption, chronic heart and kidney diseases, diabetes and long tinnitus duration are poor prognostic factors.

5. Have you followed up further with the patients in the trial to see if their tinnitus has changed after 1 year?

As we mentioned in our paper. The follow-up period is relatively short. So, we did not checked all of them. However, some patients continued to visit our clinics for other problems, and they are consistently maintain their tinnitus improvement without change.

6. Are there any adverse side effects of the treatment? Can the needling be dangerous if wrongly placed? Can there be any nerve damage?

Rarely negligible nerve and vessel injuries, rarely transient dizziness, needle insertion pain, postintervention pain for 1~2 days, rarely transient facial palsy (5~15 minutes) which is a good sign for tinnitus treatment because it confirmed that the needle was close to the facial nerve.

I have had no serious side effects with my patients.

7. The cost is US$200-$300 per treatment. Is this correct?

Costs for treatment are approximately between 200~300 US dollars per each treatment with medical insurance. (If patient doesn't have insurance it costs about 250-350 US dollars per each treatment).

8. Your study was done with So Woon Sirh, Department of Anesthesiology and Pain Medicine, Wiltse Memorial Hospital, Suwon-si, South Korea and Hah Yong mun Department of Neurosurgery, Yangju Armed Forces Hospital, Yangju-si, South Korea Do you know if this treatment has been used outside of your pain clinic? Have you worked with any other hospitals or clinics using this method?

Have you treated any person outside of South Korea?

Yes. over 15 institutions in Korea. A study on Korean patients only.

Thank you.

English might be a little bit broken. It is my second foreign language, so please understand.

Best regards
Heon Man Sirh.

———

They also replied to my chaser asking me to be patient since they are replying to each enquiry in order of receipt. Must have received a fair few.

@Jerad - I did not ask about Lidocaine alternatives in the original email. I have not forgotten though. I will ask if I contact them again.

 

Great information @Uklawyer, thank you! I think we gathered enough details for a week period of time. Now we just need some people to go ahead and test this. It sounds really promising they have treated over 1000 patients so far.

 

I just got an email from Dr. De Ridder. He said that he is considering to offer this treatment at his clinic, but has some reservations about the design of the study (possible bias).

 

Hi @Christiaan, did you ask Dr. De Ridder for this treatment specifically?

If they were to offer it here in EU, I would be highly interested in it.

 

I am certainly considering traveling to South Korea to try this treatment. I have several well-connected friends there that could host me and help with travel details. I’m on indefinite leave from work as my tinnitus has gotten so bad after taking Amitriptyline for 10 days. It went from a mild ring to the sound of a freight train slamming on its brakes. I require masking at all times and I also have visual snow syndrome.

I am also considering the Brai3n clinic in Belgium. Is that clinic worth the time/money? It seems they are just doing a combo of the various tinnitus treatments that only seem to help a small fraction.

I certainly don’t want to try something that will make the tinnitus worse or compound my problems. I already have a myriad of other symptoms besides tinnitus from my visual snow, the worst being persistent dizziness. That being said, this new tinnitus has completely sucked the joy out of life.

I would love to hear your thoughts.