[Nov. 24, 2023: JJ Shavit, The Brighter Side of News]
Low-level laser therapy and associated photobiomodulation is the most effective of the known treatments for tinnitus. (CREDIT: Journal of Personalized Medicine)
Tinnitus, often characterized by the persistent ringing or hissing in the ears, has plagued the lives of approximately 750 million individuals worldwide. While it is not a disease in itself, this debilitating condition has long eluded a definitive cure or standard treatment, leaving countless sufferers in search of relief.
However, a recent study conducted by Brazilian scientists affiliated with the Optics and Photonics Research Center (CEPOF) may offer newfound hope to tinnitus patients. Their research, which rigorously compared various existing treatments, suggests that low-level laser therapy, coupled with photobiomodulation, is emerging as the most effective solution to date. This groundbreaking study, reported in the Journal of Personalized Medicine, provides promising insights into the future management of tinnitus.
Tinnitus: A Global Challenge
Tinnitus is a prevalent symptom experienced by millions worldwide, impacting their quality of life. A European study analyzing patient data spanning five decades revealed the staggering scope of this issue. From a buildup of earwax and inadequate inner ear circulation to more severe factors such as brain damage and bruxism, the causes of tinnitus are diverse. Yet, despite its prevalence and impact, there are no standard treatments or FDA-approved drugs available to address this ailment.
Brazilian researchers compared the therapies used most frequently for tinnitus, which affects some 750 million worldwide (CREDIT: Panhóca, V.H. et al./J. Pers. Med.)
Dr. Vitor Hugo Panhóca, a researcher at CEPOF, emphasized the need for effective tinnitus treatments, stating, "Tinnitus is a very widespread symptom throughout the general population. It’s treated with a vast number of methods, from ear lavage to local anesthetics, anti-depressants, anti-histamines, anti-psychotics, and sedatives, with different results." This lack of consensus underscores the urgency of finding viable treatment options.
The Quest for Effective Treatments
In response to the challenges posed by tinnitus, Dr. Panhóca and his team embarked on a rigorous research endeavor. Over the course of four weeks, they investigated alternative and complementary therapies for idiopathic and refractory tinnitus in more than 100 individuals, aged 18 to 65, randomly divided into ten groups. These therapies included laser acupuncture, flunarizine dihydrochloride, Ginkgo biloba, and low-level laser stimulation of the internal auditory canal (transmeatal stimulation), both alone and in combination with various adjunct therapies.
Each patient underwent eight bi-weekly treatment sessions and was assessed using a "tinnitus handicap inventory questionnaire" featuring 25 questions. This questionnaire included a functional subscale with 11 questions addressing mental, social, occupational, and physical limitations due to tinnitus.
Upon analyzing the data, the researchers made several noteworthy discoveries. The most promising results were observed in patients treated with laser acupuncture alone and transmeatal low-power laser stimulation alone. Notably, the latter group exhibited even greater improvement when the duration of laser irradiation was extended from 6 to 15 minutes. Additionally, combinations of laser therapy with vacuum therapy or Ginkgo biloba, as well as laser acupuncture alone and flunarizine dihydrochloride alone, also demonstrated lasting therapeutic effects.
Dr. Panhóca explained, "The positive effects include anti-inflammatory action and relaxation. We believe laser therapy can increase peripheral irrigation, which may be the main cause of the problem in many cases, as well as stimulating inner ear cell proliferation and collagen production." These findings suggest that low-level laser therapy may address underlying factors contributing to tinnitus.
Barplot comparing the non-normalized TH1 scores at T0, T1 and T2 between tinnitus treatment modalities explored in this study (from G1 to G10). (CREDIT: Journal of Personalized Medicine)
Standardizing Treatment Protocols
While the efficacy of laser therapy in alleviating tinnitus is not entirely novel, the CEPOF study makes significant strides towards standardizing treatment protocols. This development holds great promise for healthcare professionals, including dentists, ear, nose, and throat specialists, and speech therapists, who treat tinnitus patients. Currently, the literature lacks consensus on the optimal number of sessions and treatment intensity, making it challenging to provide consistent care.
Dr. Panhóca emphasized the importance of understanding successful therapies to streamline future treatments, saying, "Understanding how successful therapies work will help us focus on the most productive approaches in forthcoming studies. This is part of the learning curve when you innovate in health treatments like this." Additionally, long-term effects of laser therapy must be thoroughly investigated to ensure its safety and efficacy.
Comparison between study groups showing the evolution of different interventions to treat tinnitus. (CREDIT: Journal of Personalized Medicine)
This pioneering study received support from FAPESP, which awarded a postdoctoral scholarship to Dr. Fernanda Rossi Paolillo, a key contributor to the research. The study was conducted in collaboration with researchers at Irmandade Santa Casa de Misericórdia Hospital in São Carlos, University of Central São Paulo (UNICEP), and the Integrated Therapy Center in Londrina, Brazil. Furthermore, international collaboration with the Tyndall National Institute at University College Cork (UCC) in Ireland enriched the study's scope.
While further research is necessary to confirm the long-term efficacy and safety of laser therapy, these findings represent a significant step forward in the quest to alleviate the burden of tinnitus on those affected by it.
The study was conducted in collaboration with researchers at Irmandade Santa Casa de Misericórdia Hospital in São Carlos, University of Central São Paulo (UNICEP), and Integrated Therapy Center in Londrina (Paraná state), Brazil, as well as Tyndall National Institute at University College Cork (UCC) in Ireland.
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