Round and Oval Window Reinforcement for the Treatment of Hyperacusis

http://www.ncbi.nlm.nih.gov/pubmed/25456168

Abstract

PURPOSE:
To present the outcomes of two patients (three ears) with hyperacusis treated with round and oval window reinforcement.

MATERIALS AND METHODS:
Transcanal placement of temporalis fascia on the round window membrane and stapes footplate was performed. Loudness discomfort level testing was performed. Results of pre and post-operative hyperacusis questionnaires and audiometric testing were reviewed.

RESULTS:
Two patients (three ears) underwent surgery. Results from the hyperacusis questionnaire improved by 21 and 13 points, respectively. Except for a mild loss in the high frequencies, no change in hearing was noted post-operatively. Both patients reported no negative effects from surgery, marked improvement in ability to tolerate noise, and would recommend the procedure to others. There were no complications.

CONCLUSIONS:
Round and oval window reinforcement is a minimally invasive option for treating hyperacusis when usual medical therapies fail. Further studies are needed to evaluate the effectiveness of the procedure in reducing noise intolerance.

Sounds awfully like a mini earplug

 

More info from Dr. Silverstein:
http://www.earsinus.com/inventions-and-procedures-developed-by-herbert-silverstein-m-d/

And then there is his first (?) patient Carol's testimony:
http://www.chat-hyperacusis.net/post/hyperacusis-surgery-7084386

 

So is this doctor saying that H is caused only by Superior Semicircular Canal Dehiscence?

 

No, I don't see it that way.

 

I can appreciate how this might work, at sound ow amplitudes the eardrum would behave as normal , for higher amplitudes it would be stiffer, trick would be to get the frequency response function matched to requirements, at a range of amplitudes. As a stop gap measure it might be useful but will do nothing for tinnitus and is not a root cause solution for H. However its a step forward I guess

 

Viking said his h was cured with keppra...Think I'd rather try keppra than this...But hopefully keppra does work, more people need to try it for h.

 

This seems a crude, inelegant heath robinson type treatment

 

Maybe, but in the absence of anything much else....

 

true, its a start, it may lead to something, maybe something unexpected.

 

Some more info:
http://hyperacusisfocus.org/research/treatment/surgery/

 

Which is pretty much all of medecine right now. Something wrong with your body? Dig it out.

Appendicitis? Take it out. Gallstones? Take out that damn gallbladder. Colon cancer? Cut out the affected part. and reattach the remaining parts.

 

If this causes a decrease in high-frequency hearing, might that not lead to increased high-frequency tinnitus over time?

 

http://www.earsinus.com/inventions-and-procedures-developed-by-herbert-silverstein-m-d/

I know that the dehiscence of the superior canal causes hyperacusis. But is this surgery also for the tinnitus/hyperacusis suffers?

http://www.ncbi.nlm.nih.gov/pubmed/25456168

 

I know he's doing a lot to try and develop the procedure, but he needs more candidates who understand that it carries certain risks (though less than the other surgical option) and will give it a go, and he needs longer term data on efficacy. He's actually doing something potentially useful in the surgical field though. This is new, and beats years of hunting around for magic pills with magical intellectual property rights that exist only in a far away imagination.

 

This is a pretty novel procedure. I doubt your average local ENT would agree to perform it.

 

Here in Portugal they do it if you have dehiscence of the superior canal, but the symptoms are different, you have what's called tulio's phenomenon where noise gives you vertigo.
I didn't knew it could potentially work to hyperacusis from acoustic trauma. At least some patients... if it's true reported better tolerance to loud levels.

 

You can also read more about this here: http://hyperacusisfocus.org/research/surgery/

Last year I was in contact with Dr. Silverstein and he claimed this was a very easy and quick outpatient procedure that every ENT should be able to do. Don't forget that ENT's are first and foremost surgeons, not just GP's.

 

I guess the question then moves from "could they do it?" to "would they do it?".

 

Some new info and a video:
http://www.earsinus.com/inventions-and-procedures-developed-by-herbert-silverstein-m-d/

 

I don't know about anyone else, but with my level of "non life" with sever T, SRT (sound reactive T) and H....THIS LOOKS BLOODY DARN GOOD!!!
The H and reactivity to sounds is what is keeping me out of "life" (well interactions with humans basically). Yes my T is incredibly loud, but it is that same tone/frequency as it always has been for 59 years...just louder at each successive "damage/volume increase point" *[See my Profile/Information tab if interested].
This procedure looks minimally invasive, quick and even reversible...and probably a helluva lot more effective than Keppra which was a total nightmare for me (and on close observation, has no more or less potential efficacy for H than any other of the dozens of AEDs one could use).

I have already phoned the Silverstein Institute (standing 20 feet from my speaker-phone on low volume) and left a message that I am highly interested in possibly having this procedure done.

Oh...as a footnote. Just watch the video. The guy looks 100% genuine and legit. I have seen LOTS of every shade of docs, medicos & quacks in the last 20 years. I can sniff out the bullshit ones. This guy looks like the real thing.

Zimichael

 

If you want a video and reminder of so many things that 'we' avoid...Restaurants, movies, concerts, crowds, markets, music events, etc., etc...plus a look at Silverstein, here it is *(Note the date = current):

http://www.earsinus.com/inventions-and-procedures-developed-by-herbert-silverstein-m-d/

Zimichael

 

True, he's actually done it, and written up his results. There was a notable and positive post at Hyperacusis Network message board some time back from one of those patients named Carol.

 

Yes it's the real deal..a woman in a fb group I belong to, had the procedure done and it was a success

 

@Zimichael

I live 15 minutes from the Silverstein Institute and had an intratympanic injection of cortiosteroids done, about a year and a half ago, for T and hearing loss. I know the proceedure here is for H, but be careful of their claims. I was confidentially told, I had a 50-70% chance of reversing my hearing loss and diminishment of my T, if I had the proceedure done. After the proceedure, my hearing was re-tested and there was zero change. In fact, I think it became worse. I had to sign a few legal forms, which were given to me, after I was prepped and ready to go. One stating, that the proceedure could possibly lead to increased loss of hearing. I almost walked out, but I was desperate and had it done.

Point being, ask to see the paperwork required for you to sign, prior to the setting up the proceedure and try to contact anyone, who had it done and get the real scoop.

 

We need to find Carol...or whatever her name was..I think Carol as well..@Zimichael I actually just went through my fb msgs to see if I could find her cause I was almost positive I sent her a PM..but sadly did not find it. I wanted to connect with her and see how she is doing and relay the info to you or maybe have her come here and post.

 

I already posted it but here is Carol's story about the procedure again. She also gives away her e-mail in that thread if anyone wanna contact her so @Blackbird26 you might wanna try that.

http://www.chat-hyperacusis.net/post/hyperacusis-surgery-7084386

 

Hey all re above post since mine...Yes, yes, yes.

Please any info form anyone would be great as clearly there are "questions" galore if you have actually had this done @Sailboardman and it did bugger all, and maybe made your hearing worse!

Now the key take-away I get from all this is that H is a different animal than T. Indeed Silverstein clearly states that unfortunately the procedure does NOT affect or improve T. So I can understand that if you did not have H @Sailboardman then maybe it would be a 'wash'.
The whole thing looks like a kind of "damper" application to a a resonating surface so to speak..and I can sense that that may affect the 'amplification resonance' of sound that is more easily converted to 'volume' = H, than affecting T which is clearly "deeper" brain shit as well...or primarily.

Just guessing of course. Though indeed my interest is in the H part as that it the main life killer and isolation causer in my life. The T is a huge headache yes, but if I could chill the bloody reactivity and sound sensitivity somewhat, I may be able to do a few things again other than just read books.

Just a late added edit P.S. - In the video, Silverstein struck me as a really genuine, caring, open, patient oriented doc. He did not look fake or self serving. His answers were human centered and no ego shit really at all. Thus my conclusions about this whole procedure took on about 50% more credibility than say if I had just read about it. I know what "ego/bullshit docs" look like and do. He did not fit the bill at all. I hope I am correct in that initial impression. But "reality" trumps all.

Best, Zimichael

 

@Zimichael,

Their operation there is top notch and supposed to be one of the best, on the east coast. Caring people and informative staff. I attended a few Tinnitus support meetings there, but not many people showed up after awhile, so I opted out.

 

Seems like, theoretically, it could make T worse, because of reduced stimulation to the nerve. At the same time, it could make T better over time, or at least stabilize it, because of added dampening of already damaged nerves, especially in the case of reactive T.

Another question would be, might the brain later turn up the gain again, to compensate for the dampened system?

It's a little puzzling, too, as to why this procedure causes "hearing loss" only in high frequencies. I thought the idea would be to lower or dampen the volume of everything--unless these patients have pain-based hyperacusis rather than volume-based.

Would sure like to talk to the patients--and preferably more than three.

 

I've read carols story a few months ago on the hyperacusis chat forum. I remembered that the surgery wasn't very invasive and only abot 30-45 minutes and was reversable. Nice to hear pain(only an aspirin nedeed occasionally) and side effects seem to be good too... typical for minor invasive surgery.

It's nice to see the persons behind the story, touching! I'm really happy for them.

The theory behind it made sense to me too.
I have not heard one technical medical question... does that added tissue needs to be replaced every few years (or more). Maybe they'll still need to find this out... and even then, if it works, its well worth it.

I really hope you can get in touch with these people very soon @Zimichael
Thank you for posting this very hopefull video. Succes story's of others are always inspiring too!