Tinnitus

Of Tinnitus: “This impediment does come from Ventosity or Wind the which is in the head and in the ears and cannot get out”. (The Breviary of Helthe, 1547)

Tinnitus is the perception of ringing, buzzing, hissing, or other sounds in one or both ears or in the head when no external sound source is present. It maybe described as hissing, rushing, humming or roaring, or cicada-like, amongst others.

It may be associated with hearing loss, ear fullness, hypertension or dizziness

Common causes:

• Hearing loss: degeneration usually due to old-age, but also excess exposure to loud noise
• Obstruction: build-up of wax or fluid in the middle ear, or congestion due to middle ear infection
• Medical conditions: Temporo-mandibular joint (TMJ) syndrome, Ménière’s disease, Hypertension, or eustachian tube dysfunction
• Medication: NSAIDs, certain antibiotics and chemotherapy

Treatment in Modern Medicine

In modern medicine, treating underlying problems such as wax build-up or middle ear infection. The use of hearing aids if related to hearing loss, sound therapy and counselling.

Treatment in Traditional Medicine

In Traditional Medicine, Tinnitus is generally classed as a Wind disorder (irregular or erratic Qi), and is therefore often treated with formulas used for other Wind disorders such as Dizziness and Epilepsy.

It can be classed into the following Subtypes:

Internal Wind–more high-pitched, changeable, bounding pulse
Wind-Heat–often louder Tinnitus
Wind-Phlegm/Damp–dull, humming or more low-pitched
Deficient Wind–may be severe, intractable; usually with symptoms of Yin deficiency, sore lower back, dry mouth

Unnai practitioners also say the Brain can be congested from “morbid humors” such as Melancholy or stagnant Phlegm, and these require purging from the Brain.

Topical Treatments:

For Tinnitus, oils used topically are very beneficial. Warm oil such as Almond or Sesame oil are very useful, with Bitter Almond oil being especially preferred for topically use in the ears in the Western tradition. Various compound oils are prepared for topical use. The use of steam from boiling herbs is another useful tactic, herbs like Wormwood being especially useful.

Ayurveda uses oils topically in the ear (Karna Purana), up the nose (Nasya), and oil applied to the scalp or dripped onto the forehead (Shirodhara & Shiro Abhyanga). These therapies are very good to calm the nerves and settle Wind.

Tibetan Medicine will use powders of herbs like Nutmeg and Caraway seed, applied to cloth covered with warm oil and applied to specific wind points of the head such as the vertex, the forehead or ears to settle Wind.

Unani in particular will often used medicated steam directly to the ears, and will also use Hijama (Cupping with Bloodletting applied to the Head). Medicated foot-baths are also useful.

In TCM, Acupuncture is especially indicated, and moxa and cupping are also used as adjuncts.

Diet:

Avoid cold, raw, dry foods, and excess use of beans that generate Wind is very important. Warm, oily foods are generally better. Avoiding caffeine and excess alcohol is important too.

Special Formula

Research

GENERAL/REVIEW:
–Herbal medicines in the treatment of tinnitus: An updated review.
–Medical Therapy of Hearing Impairment and Tinnitus with Chinese Medicine: An Overview.
–Antioxidants, minerals, vitamins, and herbal remedies in tinnitus therapy
–Alternative Treatments of Tinnitus: Alternative Medicine.
HERBS:
GINKGO:
–Tinnitus outcomes after ginkgo biloba extract in sudden sensorineural hearing loss: a dose-comparative and prognostic study.
–Ginkgo biloba in the treatment of tinnitus: An updated literature review.
–Herbal medicines in the treatment of tinnitus: An updated review.
FORMULAS / COMBINATIONS:
–Network pharmacology and bioinformatics approach to unravel the mechanism of Xiao-chai-hu-tang herbal formula in tinnitus treatment.
–[Clinical observation on idiopathic tinnitus treated with acupuncture, buzhong yiqi tang and cizhu wan].
–Efficacy of adjuvant Chinese herbal formula treatment for chronic tinnitus: a retrospective observational study.
–Behavioral and Immunohistochemical Evidence for Suppressive Effects of Goshajinkigan on Salicylate-Induced Tinnitus in Rats.
–A Chinese Medicine Formula (Bushen Huoxue Tongluo) for the Treatment of Chronic Subjective Tinnitus: A Study Protocol for a Pilot, Assessor-Blinded, Randomized Clinical Trial.
–Therapeutic effects of Rosa canina, Urtica dioica and Tanacetum vulgare herbalcombination in treatment of tinnitus symptoms: A double-blind randomised clinical trial.
OTHER:
–[Professor YANG Jun’s experience in treatment of neuropathic tinnitus with acupuncture and moxibustion based on disease elements].