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Ear, Nose & Throat Associates |
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June 2007 News Archives
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June 1: Technology lessens sinus surgery risk, Fresno Bee
By Erik Lacayo / The Bee
Thanks to new technology, some Hanford patients can breathe easier with surgery once considered too risky.
A new $199,000 computerized image guidance system, recently purchased by Hanford Community Medical Center, enables surgeons to repair sinuses that contain polyps when they lie near a patient’s brain or eyes. A surgeon uses a 3–D image of the sinuses generated from a CT scan taken of the patient’s head. A camera also shows the surgeon where the instruments are within 1 to 2 millimeters as he operates.
"That allows us to accurately see where our instruments are," said sinus surgeon Dr. Daniel Schlund. "It’s much more precise."
The computer–guided system, which was purchased in March, is used in Hanford by Schlund and Dr. Ronald Wong. Schlund said they have been waiting two years for this technology. Without the guidance system, Schlund said, surgeons couldn’t clear polyps and other obstructions too close to the eyes and brain.
The guidance system in Hanford is the first one in Kings County and one of only a few in the Central Valley, said Schlund, who also uses a similar system at Children’s Hospital Central California in Madera County.
Schlund said there is a lot of demand for the surgery this time of year and estimates he will use the system in 40% of his surgeries. The technology allows him to enter through the nose in most cases, which reduces the need for facial incisions and potential scars.
Richard Larson, a dean of instruction at Reedley College, was the first patient under the new system in April and said he had surgery on a Thursday and was back at work the following Monday.
"It’s certainly a tremendous benefit to have that kind of technology and equipment," Larson said.
Larson suffered from frequent sinus infections and had difficulty sleeping and being able to taste and smell. He said he had sinus surgeries in the past, but the latest surgery has given him the most relief because it cleared polyps deep in his frontal sinuses.
"I can taste food again," he said.
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June 5: For Those With Hearing Loss, the Noise Can Be Awful, The Washington Post
By Kathi Mestayer
Special to The Washington Post
The hardest thing I’ve had to come to terms with in the 17 years since my hearing started to fail is not silence but intrusive noises: They ring in my ears, obscure the sounds I want to listen to and startle me when they amplify themselves without warning. There I am, working quietly at my desk, when the knock at my door becomes – Crash! – a tympanic interruption, and I leap to attention.
There are times when I want to stand up and yell, "Keep it down!"
Mine is what’s called sensorineural hearing loss, which can be caused by loud noises and is often associated with aging (I was 35 when it began) but in my case is probably genetic. Most of my immediate family members have lost their hearing as they’ve aged, and they walk around, like me, with hunks of beige–ish plastic in and around their ears.
Fifteen percent of American adults have some kind of hearing loss, according to the National Institute on Deafness and Other Communication Disorders. Those of us in that group have learned to adapt to a world that ever larger numbers of people are likely to share because more of us are getting, well, older.
You have to wonder whether kids these days are ruining their hearing with all that loud music piped from iPods directly into their ear canals. There’s no doubt that noise causes hearing loss, but there is no hard evidence yet that noise–induced hearing loss is on the rise. In any event, I’m hardly in a position to give that lecture, having danced through my share of rock concerts, right in front of amps that were bigger than I was.
Now I live with my own noisy reminders of my hearing loss. The ringing in my ears is known as tinnitus. The American Tinnitus Association says that of the estimated 50 million people in the United States who have it, 12 million are affected severely enough to seek help. In one of his letters, Ludwig Van Beethoven wrote, "My ears whistle and buzz constantly day and night. I can say I am living a wretched life."
It’s a condition in which the inner ear produces noise. (My tinnitus played mariachi music to me for several days, as my brain tried to make sense of the input from my inner ear.) Researchers have discovered that it is typically heard in the particular frequency range in which there is a hearing loss.
Treatment often consists of retraining the brain with low–level "white" noise (delivered through a device that looks like a hearing aid) that can, over time, minimize the tinnitus.
Then there’s hyperacusis, an increased sensitivity to sound that often occurs soon after the onset of hearing loss. It can be stressful and exhausting. One treatment consists of gradual desensitization to sound using noise at a volume just below the discomfort threshold. My stepmother, for example, wears a special noise–generating device in her ear. Hyperacusis makes people cringe at sounds that don’t cause discomfort to others.
Another manifestation of increased sensitivity is known as recruitment, which is a sudden, abnormal increase in perceived loudness. Richmond audiologist Deborah Ogilvie describes it as "sounds getting too loud too fast." It’s as if there’s no middle ground, like that knock on my office door. One possible explanation is that the damaged hair cells – or cilia – in the inner ear "recruit" nearby healthy cells, turning the volume up very high, very suddenly.
Background noise is also a huge problem for those of us with hearing loss. Tolerance of noise and the ability to understand speech in a noisy environment are distinct, and they vary markedly between individuals, according to a study published in the Journal of the American Academy of Audiology in 2006. In a noisy gathering, I’m left perplexed and exhausted as I try to distinguish the conversations I want to listen to from the surrounding racket.
According to Ogilvie, most digital hearing aids can be programmed to take some of the edge off recruitment, and many have features for reducing background noise. But even the most advanced aids and cochlear implants, with their increasingly miraculous bells and whistles, cannot bring one’s hearing back to normal.
The truth is that, for many people, they can’t even make the bells and whistles go away. For me, having a hearing loss is like living in a quieter place, except when it’s noisier.
Kathi Mestayer, a consultant, writes the blog Hearingaidsrcool.blogspot.com.
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June 6: Arkansas Girl Gets Voice Back After Surgery, Oakland Tribune
By JILL ZEMAN
Associated Press Writer
LITTLE ROCK, Ark. (AP) – Emily Adams was doing nothing unusual, nothing reckless when she lost her ability to speak. The teenager from Pocahontas was helping her father last month with yardwork – he on the riding lawnmower, she about 30 or 40 feet away with a push–mower. Without realizing it, Tom Adams struck a rock with the lawnmower. The rock – about the size of a softball – soared across the yard and struck Emily in the throat and chin.
"I looked over and saw her holding her neck, motioning for me to come to her," Tom Adams recalled Wednesday as Emily was being prepared for surgery at Arkansas Children’s Hospital. "And I went to her, didn’t know what had happened, didn’t even remember hitting no rock or nothing."
"I jumped off the lawnmower and went over and she more or less just collapsed in my arms."
The teen clutched her throat as blood dribbled from a cut on her chin. Her father scooped her up, carried her inside and eventually got her into an ambulance that took her to the Randolph County Medical Center.
"At the time, she wasn’t breathing, she had really stopped breathing," Tom Adams said. "I thought she was just hyperventilating and I told her to just breathe."
What the family didn’t know then was that the impact of the rock fractured Emily’s larynx, making it nearly impossible for the teen to speak or breathe.
Initially, hospital workers thought Emily’s throat was just swollen. But after a worker called Arkansas Children’s Hospital to discuss Emily’s case, medical staff decided to life–flight the teen to Little Rock.
There, she underwent a six–hour surgery and received a tracheotomy, where a tube is inserted in the throat to help with breathing.
Also part of that procedure, said her surgeon, Dr. Chuck Bower, was repair of some of the damage that had been done – reattachment of a section of cartilage that had been separated, and repair of a rupture to her trachea – along with installation of a stent to hold things in place while they healed.
More than three weeks later, Emily was back in Little Rock on Wednesday – her 14th birthday – for another surgery. This time, doctors planned a microlaryngoscopy – surgery on the vocal cords.
"It went great," said Bower, chief of pediatric otolaryngology at Children’s hospital. "She has her voice back, and she’s talking and she’s happy."
Her voice is likely not to sound the same, even after a third operation, Bower said.
"Hopefully, it will be a modest alteration," the surgeon said, "but sometimes we see challenges with the voice that may need work down the road."
A third operation is planned in a few weeks, Bower said.
It will be "a minor tweak, hopefully," he said.
"We’ll look at it with scopes, make sure everything is healed adequately, and she’ll be able to get her tube out shortly thereafter," the surgeon said.
Wearing pink slippers before Wednesday’s surgery, Emily communicated with her parents and visitors by mouthing words. When asked whether she was ready to start drinking liquids again – everything now must be honey–thickened – she nodded vigorously.
One of eight children, Emily is now the center of attention, her father said with a laugh.
"We got her a bell at the house to ring when she needs us, needs somebody to listen to her," he said.
Emily’s injury was far worse than her family initially thought – her mother, Wendy Adams, said doctors first thought the teen could be treated and released at the Pocahontas hospital. But the randomness of the injury is still hard for the family to grasp.
Bower said operations for vocal–cord reconstruction are fairly common, usually after a patient has been on a ventilator.
"Trauma to this extent, however, is fairly unusual," he said, and the cause – a rock thrown by a lawnmower – was even more unusual.
And for his riding lawnmower, Tom Adams said: "I cannot imagine that thing throwing a rock that far and doing that much damage, but it did."
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June 7: Music to deaf ears: Auditory nerve implant can deliver wide range of sounds, early tests show, WebWire
ANN ARBOR, Mich. – More than three decades ago, scientists pursued the then–radical idea of implanting tiny electronic hearing devices in the inner ear to help profoundly deaf people. An even bolder alternative that promised superior results — implanting a device directly in the auditory nerve — was set aside as too difficult, given the technology of the day.
Now, however, scientists have shown in animals that it’s possible to implant a tiny, ultra-thin electrode array in the auditory nerve that can successfully transmit a wide range of sounds to the brain. The studies took place at the University of Michigan Kresge Hearing Research Institute.
If the idea pans out in further animal and human studies, profoundly and severely deaf people would have another option that could allow them to hear low-pitched sounds common in speech, converse in a noisy room, identify high and low voices, and appreciate music — areas where cochlea implants, though a boon, have significant limitations.
“In nearly every measure, these work better than cochlear implants,” says U-M researcher John C. Middlebrooks. He led a study requested by the National Institutes of Health to re-evaluate the potential of auditory nerve implants. Middlebrooks is a U-M Medical School professor of otolaryngology and biomedical engineering. He collaborated with Russell L. Snyder of the University of California, San Francisco and Utah State University. The two co-authored an article on the results in the June issue of Journal of the Association for Research in Otolaryngology.
The possible auditory nerve implants likely would be suitable for the same people who are candidates today for cochlear implants: the profoundly deaf, who can’t hear at all, and the severely deaf, whose hearing ability is greatly reduced. Also, the animal studies suggest that implantation of the devices has little impact on normal hearing, offering the possibility of restoring sensitivity to high frequencies while preserving remaining low-frequency hearing.
Middlebrooks says it’s possible that the low power requirements of the auditory nerve implants might lead to development of totally implantable devices. That would be an improvement over the external speech processor and battery pack cochlear implant users need to wear and often have to recharge daily.
If the initial success in animals is borne out in further tests, a human auditory nerve implant is probably five to 10 years away, he says.
The researchers used cats bred for laboratory use in their experiments. They measured brain processing of auditory signals in normal conditions, then compared deaf animals’ brain responses to sounds using cochlear implants and then the direct auditory nerve implants. These measurements employed neuron -monitoring technology developed earlier at U-M. The scientists found their sensitive 16-electrode microarray resulted in several advantages over cochlear implants.
Approved by the Food and Drug Administration in 1984, cochlear implants have greatly benefited profoundly and severely deaf people. More than 100,000 implants have been performed worldwide in the last two decades, including more than 1,000 at U-M.
Like the new device, cochlear implants are small electrode arrays that receive signals from an external sound processor... They are designed to stimulate the auditory nerve and other cells to produce a sensation of hearing. But their location, separated from auditory nerve fibers by fluid and a bony wall, is a limitation.
“Access to specific nerve fibers is blunted,” Middlebrooks says. “The effect is rather like talking to someone through a closed door.”
With the new intraneural stimulation procedure, that effect is eliminated, and there are other technical advantages, too. “The intimate contact of the array with the nerve fibers achieves more precise activation of fibers signaling specific frequencies, reduced electrical current requirements and dramatically reduced interference among electrodes when they are stimulated simultaneously,” Middlebrooks says.
Middlebrooks has talked with U-M surgeons in otolaryngology about surgical approaches in humans, and is working with U-M biomedical engineers on an intraneural device that can remain in place and be tested further in animals over the next two years. The devices need to be studied over time to see if they are safely tolerated by the auditory nerve.
“If our work continues to go very well, we might begin human trials in no less than five years,” Middleton says.
Such a device might be used first in people whose cochleas are filled with bone and therefore aren’t eligible for a cochlear implant, or people whose cochlear implants are no longer effective.
The University of Michigan has submitted a patent application for the procedure. Through its Office of Technology Transfer, it is seeking a commercialization partner to assist in bringing the technology to market.
Funding for the study came from the National Institute on Deafness and Other Communication Disorders, National Institutes of Health.
Journal citation: “Auditory Prosthesis with a Penetrating Nerve Array,” Journal of the Association for Research in Otolaryngology, Volume 8, Number 2 / June, 2007; 10.1007/s10162-007-0070-2 (DOI)
Written by: Anne Rueter
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June 12: Be brave; tell friend about bad breath, Clarion Ledger
R & B singer James Ingram said it best – "there’s no easy way to break somebody’s heart." If you think that’s bad, try telling someone their breath is on the foul side.
When a person has bad breath, you’d think they’d know it. Having to point it out surely will always result in embarrassment and hurt feelings.
Whether that person is a friend, relative, colleague or just someone you happen to sit next to, it’s not easy passing along the stinky news. Politely offering a mint has worked at times, but when the person turns down your offer – the agony!
NEED A MINT?
Besides, a mint may minimize the unpleasant odor resulting from burger and fries, but it is no match for other forms of halitosis that may be an indication of a more serious health problem.
Bad breath can be a precursor to periodontal disease caused by plaque on teeth. It also may be a sign of a medical disorder, such as a local infection in the respiratory tract (nose, throat, windpipe, lungs), chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, or a liver or kidney ailment, according to the American Dental Association. Simply having a dry mouth, when the amount of saliva is too low, can cause bad breath.
An increase of anaerobic, sulfur–producing bacteria that exists in everyone’s mouths also can cause bad breath. In a dry mouth, these bacteria can thrive.
WARNING SIGN
Having bad breath could be your body’s way of telling you to seek medical attention. Dentists and other medical experts don’t take bad breath lightly because they realize, in many cases, bad breath is just the tip of the iceberg.
Lifelong sufferers typically spend years and lots of money trying to live a normal life. When persistent bad breath isn’t cured with mouth rinses, brushing or flossing, some people have even sought relief through surgery, which isn’t always a guarantee of fresh breath.
Telling someone about their bad breath is beneficial in many ways. It saves them from further embarrassment and could prompt them to seek much–needed medical treatment. One Web site, freshbreath.com, even offers to anonymously send a message to someone for you.
It’s a dirty job, but someone has to do it.
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June 12: Implanted device may help treat sleep apnea, The Indianapolis Star
Dr. Tod Huntley, an ear, nose and throat physician with Head & Neck Surgery Associates in Carmel, discusses a new treatment for sleep apnea.
Question: Sleep apnea, in which people stop breathing repeatedly as they sleep, can lead to accidents if people who go untreated suffer sleep deprivation. What can a person do for this condition?
Answer: Sleep apnea is as common as asthma in the adult population. There are about 17 million people in the United States with sleep apnea, and many of these are not diagnosed. The current treatment is a nasal CPAP (continuous positive airway pressure machine). When used as recommended, it’s a very effective treatment. The problem is that up to half the patients or more don’t use this as recommended. They complain of discomfort or an inability to sleep with it. So patients often abandon this therapy in two to three weeks.
Q: How about surgery?
A: Surgical therapy is insufficient or problematic because the most common procedures that are done only treat the soft palate and are extremely painful. There are surgical options, but at this point we don’t have an optimal procedure. They’re not as effective as we’d like. They can be painful, and patients may need several surgeries.
Q: Now you’re involved with a trial of a new device to treat sleep apnea. Tell me about this experimental procedure.
A: It’s a minimally invasive procedure, where a device is surgically implanted in the tongue and the mandible, or lower jaw. Its purpose is to prevent obstruction of the upper airway. The two unique attributes are the minimally invasive nature of the implantation and that it’s adjustable. It’s designed for moderate to severe apnea. It’s not just a snoring treatment.
Q: How many patients will the trial enroll?
A: About 40 patients throughout the country. I’m probably going to have about half. We’re one of four sites doing this. We recently did this on the first patient in the United States. We keep patients overnight for observation, but I could envision this potentially being an outpatient procedure.
For more information, visit aspiremedical.com. There is no cost. We’re limiting it to patients ages 18 to 65 who are not morbidly obese. This particular procedure, if it pans out, could be a revolutionary treatment for sleep apnea. It could make surgery much less invasive and a very effective part of treatment. I envision in the future this could be offered to almost any sleep apnea patient.
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June 12: Genes In Human Inner Ear Cells Restored, ScienceDaily
Researchers at the University of Virginia Health System have discovered a way to transfer genes, which they hope will restore hearing, into diseased tissue of the human inner ear. This important step brings scientists closer to curing genetic or acquired hearing loss.
Dr. Jeffrey Holt, associate professor of neuroscience and otolaryngology at UVa, and his research team, including Dr. Bradley Kesser, an assistant professor of otolaryngology, targeted a gene known as KCNQ4, which causes genetic hearing loss in humans when mutated. They engineered a correct form of the gene and created a gene therapy delivery system that successfully transferred the KCNQ4 gene into human hair cells harvested from the inner ears of patients with hearing loss.
"Our results show that gene therapy reagents are effective in human inner ear tissue. Taken together with the results from another group of scientists who showed that similar gene therapy compounds can produce new hair cells and restore hearing function in guinea pigs suggest that the future of gene therapy in the human inner ear is sound," Holt said.
Hair cells have hair–like projections that line the cochlea. In people with normal hearing, hair cells convert sound into electrical signals, which are ultimately transmitted to the brain. People with hearing loss suffer from too few, damaged or missing hair cells. Holt’s past research uncovered the speed at which hair cells develop in mouse embryos, a finding necessary to help researchers learn how to regenerate hair cells. With this current development, Holt and his team could one day restore the hearing process in damaged hair cells.
"This is a critically important step forward. We hope this breakthrough will propel the field of hearing and deafness research toward our collective goal of curing genetic and acquired deafness," Holt said.
This discovery will appear Thursday, June 14, in the online issue of Gene Therapy.
Note: This story has been adapted from a news release issued by University of Virginia Health System.
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June 12: Hearing loss gene discovered, ScienceDaily
ANTWERP, Belgium, June 19 (UPI) – Belgian scientists have identified a gene responsible for the most common cause of hearing loss among white adults – otosclerosis.
A University of Antwerp team, led by Melissa Thys, said the finding might lead to new treatments for the malady that affects approximately 1 in 250 people.
Otosclerosis causes progressive hearing loss as the growing bone in the middle ear interrupts sound waves passing to the inner ear. While the causative factors remain unknown, one of the genetic components has been identified.
"The gene (TGBF1) in which the variant is located points to a pathway that contributes to the disease," said Thys. "This may be a lead for better forms of treatment in the future; currently the best option is an operation."
"However, there is often an additional component of hearing loss that can’t be restored by surgery," she added. "As the gene involved is a growth factor and the disease manifests itself by the abnormal growth of bone in the middle ear, it may have a large potential for therapy."
The research was reported during this week’s annual meeting of the European Society of Human Genetics in Nice, France.
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June 25: Easing the torment of tinnitus, The Seattle Times
By Nick Thomas
While the human scars from bombs and bullets are often visible reminders of the horrors of war, invisible injuries can be just as devastating. For U.S. Navy veteran David Young, an unseen terror has been haunting him for years.
Young spent 20 years stationed on aircraft carriers working as a boatswain’s mate. Surrounded by aircraft as he went about his daily duties, there was no escaping noise from the thunderous engines. In his sleeping compartment below the flight deck, Young also spent many restless nights as outgoing fighter jets roared just a few feet above him around the clock.
"We were issued hearing protection," said Young, 53, who lives in Bremerton. "But it was still a noisy environment, and we often had to remove the ear plugs to communicate."
Toward the end of his service in 1993, Young began to experience a high–pitched ringing in his ears, a hum like a whole room full of fluorescent lights.
"The military doctors told me I had developed tinnitus," said Young. "They said it couldn’t be treated and that I should just get used to it and stop complaining."
Young’s tinnitus was not severe, but it was annoying, and he resigned himself to living with the condition as a civilian after retiring from the military 14 years ago.
But that all changed last January.
"I just woke up one morning, and the sound had tripled in volume," said Young. "It was incredibly loud, and I could no longer ignore it. It was with me 24 hours a day, seven days a week."
What is tinnitus? A ringing, hissing, roaring, whistling, chirping, or clicking sound in the ears with no external source.
What causes it? Multiple causes. Most common cause is noise exposure. Other causes could be wax build–up, certain medications, cardiovascular disease, sinus infection, or disorders such as hypo– or hyperthyroidism. When it’s a symptom of an infection or other disorder, tinnitus often disappears when the primary problem is treated.
Is there a cure? Not yet, but a variety of treatments, including sound therapy described in this article, have helped some people live with the condition. Eighty–five percent of tinnitus sufferers do get better.
How to prevent noise trauma: If you’re in an environment where you have to shout to be heard, it’s too loud. At that noise level, eight hours of exposure could cause ear damage. (In fact, more than an hour with a powered lawnmower can cause ear damage.) Repeated exposure to loud noise can have a cumulative effect. Properly used earplugs or earmuffs can reduce noise levels by 15 decibels.
Unrelenting noise
The statistics of tinnitus are as horrifying as the affliction itself. According to the Portland–based American Tinnitus Association (ATA), some 50 million Americans experience intermittent or permanent tinnitus. Between 10 million and 12 million have severe and chronic tinnitus and some 2 million are completely disabled by the condition. In most cases, such as Young’s, the cause can be traced to loud noise that damages the fragile sound–detecting cells in the inner ear.
Disease, tumors, medications, or physical trauma to the head or neck can also be a trigger. But Young had experienced none of these in the weeks and months leading up to the sudden increase in his tinnitus.
"Every doctor I went to couldn’t explain it, and could do nothing to help me," said Young. The unrelenting noise in his head disrupted his concentration and kept him awake, sometimes for days.
With no relief in sight, Young began researching his options. Internet searches kept pointing to one promising treatment: sound therapy.
"I found information about actor William Shatner, who had success using tinnitus retraining therapy [TRT]," said Young. "The science looked good, and it had been around for a while."
Shatner’s situation
If there is a celebrity "poster boy" for tinnitus, it would have to be Shatner, whose career – and life – were threatened by the condition. The 76–year–old "Boston Legal" star says his problems began about 15 years ago, probably the result of advancing age compounded by exposure to many on–screen special–effects explosions throughout his 50–year movie and television career.
"I was in a terrible state," said Shatner from his home in California. "The more you worry about it, the worse it gets. I couldn’t sleep or think, and I even thought about suicide."
In 1996, Shatner traveled to the University of Maryland and met with Dr. Pawel Jastreboff, who introduced him to TRT. Jastreboff, who now works at Emory University’s School of Medicine, began clinical use of TRT six years earlier.
Shatner’s treatment involved wearing a small electronic device that generated a low–level, broadband sound – a white noise – that helped his brain put the tinnitus in the background.
"When used in conjunction with counseling, 80 percent of the more than 1,000 patients I have personally treated have responded very well," said Jastreboff from his office in Atlanta. Jastreboff also credits Shatner’s high profile and willingness to talk about his tinnitus for giving people like Young hope.
"I wore the device for 24 hours a day for several months," said Shatner. "Now, I don’t hear the tinnitus 95 percent of the time. So it’s important to let people know that in many cases, tinnitus can be managed. I’m living proof you can conquer it."
Other forms of treatment
In addition to sound therapy, counseling and medications have also been used to treat tinnitus. Because tinnitus can be emotionally distressing, counseling and psychotherapy can help some patients, while drugs may reduce anxiety and depression, which both exacerbate the condition.
Encouraged by Shatner’s experience, Young approached Portland audiologist Marsha Johnson about TRT as a treatment option. Because of the severity of Young’s tinnitus, she suggested trying a new sound therapy program called Neuromonics (from neurology plus harmonics), which had only been available in the U.S. since late last year and takes half the time of TRT – about six months – to complete.
Neuromonics uses white noise, a pleasant "shower–type" sound, embedded in relaxing music to reprogram the brain to filter out the tinnitus in much the same way as the brain learns to ignore the pressure of a wristwatch touching the skin. The patient uses the Neuromonics device for just a couple of hours each day.
"I’m using it with 11 patients at the moment, and they are telling me their tinnitus is less noticeable and that they are sleeping better," said Johnson, who runs the Oregon Tinnitus & Hyperacusis Treatment Clinic and is the only provider of Neuromonics in the Pacific Northwest.
Prior to its availability in the United States, its effectiveness was studied in Australia in four clinical trials over a 10–year period. Researchers found that 86 percent of the trial participants reported a significant increase in relief from their tinnitus after six months on Neuromonics treatment, which was developed by Paul Davis at Australia’s Curtin University.
The results were considerably better than those who received broadband noise treatment combined with counseling (47 percent) or counseling only (21 percent).
Like TRT, Neuromonics is expensive – around $5,500 for a processor about the size of a cellphone – and is not covered by most medical insurances.
A sufferer’s advice
Despite the cost, Young was pleased with the results at first. "After 2-1/2 months, I noticed an improvement. It doesn’t make the tinnitus go away, but you do notice it less," he said.
But a mild heart attack in April brought a resurgence of his tinnitus.
"I’m back to the point where I can no longer sleep again," said Young who, like Shatner and many other tinnitus sufferers, has actually wrestled with thoughts of suicide.
"But I’m not ready to go, accidentally or on purpose," said Young. "I don’t want my family to be without a husband and father. I’m just going to have to stick with the treatments and hope to get the tinnitus under control again."
Encouraged by his own early results with sound therapy, Young advises people who have been told there is no treatment for their tinnitus to seek help from an expert.
"Without treatment, tinnitus really envelops your whole life," Young conceded. "You can’t hide from it."
Hope for a cure
David Fagerlie, chief executive of the American Tinnitus Association, is optimistic that research will eventually provide a cure for tinnitus.
"Every credited researcher I have spoken to believes there is a real cure on the horizon," he said. "Unfortunately, the federal government spends less than $2 million for tinnitus research each year. Much more is needed."
A brain "error"
Harvard researcher Jennifer Melcher is also hopeful of a cure. She uses imaging technology, such as functional magnetic resonance imaging (f–MRI), to study the area of the brain that interprets neural input from the ears.
She says we now know that tinnitus is really a brain problem, rather than a hearing problem, because damage to the inner ear can cause the brain to register an "error," which it interprets as the sounds heard by tinnitus patients.
"Influencing that area of the brain with drugs or electrical stimulation," Melcher says, "may one day stop the noise."
Nick Thomas is a college teacher and freelance writer. He can be reached at nthomas@mail.aum.edu.
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June 25: Study heats up old cold herb, Baltimore Sun
Echinacea might reduce chances of becoming ill, researcher says
By Sindya N. Bhanoo
America’s on–again, off–again romance with echinacea could be on again.
The popular herbal supplement, made from the purple coneflower, might reduce the chances of catching a cold by 58 percent, according to the latest in a long line of confusing and contradictory studies.
Better yet, echinacea might reduce the length of a cold by an average of 1.4 days – a substantial savings, because colds cause 40 percent of the nation’s lost work time, the authors of a recent study say.
The study, conducted by scientists from the University of Connecticut, is published online today in The Lancet Infectious Diseases, a British medical journal. Echinacea is a herb with a long-standing medicinal reputation among Americans, who spend an estimated $2 billion a year on nonprescription cough and cold remedies.
Over the years, studies of echinacea have shown "a trend of improving colds," but none involved enough patients to be statistically significant, said the author of today’s article, Dr. Craig Coleman of the University of Connecticut’s School of Pharmacy.
Other studies have shown just the opposite. In 2000, German scientists reported that echinacea could help treat colds but not necessarily prevent them. In 2005, a study of more than 400 patients published in the New England Journal of Medicine indicated that echinacea had no effect on colds at all.
Coleman’s team performed a meta–analysis, combining the results of 14 independent studies involving more than 1,600 patients.
Some experts say that’s still not good enough. They argue that Coleman’s meta–analysis combines too many studies with different combinations of drugs.
"Some of the patients were also taking Vitamin C, rosemary, thyme ... you really don’t know what’s going on," said Dr. Adriane Fugh–Berman, associate professor of complementary and alternative medicine at Georgetown University.
To compensate for this problem, Coleman said, his team did a "sensitivity analysis" to determine whether echinacea worked on its own.
"There was still reduction in cold duration," Coleman said, but not enough to be statistically significant.
Archaeologists say American Indians used echinacea more than 400 years ago to toughen their immune systems and treat wounds. Herbalists prescribe it today for urinary and yeast infections, ear infections and hay fever.
Although echinacea is generally regarded as safe, the American Herbal Products Association cautions those with pollen allergies to avoid it. The same goes for asthmatic patients, particularly children, according to Fugh–Berman, who said it often makes their condition worse.
"I’ve had [asthma] cases where the child will get better as soon as you stop giving them echinacea," she said.
Doctors also advise patients with autoimmune diseases, diabetes, multiple sclerosis and HIV infections to avoid the herb, according to the Web site of the Baltimore Washington Medical Center.
Coleman has conducted safety research, to be published later this summer. In that study, researchers gave echinacea to healthy patients while they monitored their blood pressure and electrocardiogram readings. Both were normal.
"In a short–term basis, this drug is relatively safe," Coleman concluded.
Although he said his analysis was thorough and proved the herb’s effectiveness on colds, Coleman conceded that there’s still a lot to learn.
"There are nine species of echinacea, and there are three that are known to have medicinal qualities," Coleman said. "Each of those species have different dosage forms in different portions."
Coleman’s work might result in more federal funding for echinacea studies, according to Dr. Brian Berman, director of the Center for Integrative Medicine at the University of Maryland.
What’s harder to get, Berman said, is drug company funding, which is critical to conducting clinical trials that would test echinacea more conclusively.
"A pharmaceutical company wouldn’t be able to exclusively market the medication because it is not patentable," Berman said.
Still, he said the latest analysis might trigger a wave of public interest in the drug, as studies in the early 1990s did for St.–John’s–wort as a treatment for depression.
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