HEAR THAT?: Draper Laboratory in Cambridge, Mass., is fleshing out a concept for a small delivery device that can provide relief to tinnitus sufferers. The device would be inserted near the membrane-covered window separating the middle ear from the inner ear and release medication into the cochlea.
Image: Courtesy of Draper Laboratory
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Loud, concussive explosions on the battlefield may last only a few seconds, but many soldiers returning from combat in the Middle East are experiencing lingering symptoms that cause them to perceive sounds even when it is quiet. Doctors can do little to treat the problem—typically described as a ringing in the ears—because they lack an effective way of delivering medication to the inner ear. That could change in a few years, in the form of an implantable polymer-based microscale drug-release system that delivers medicine to the inner ear.
Called tinnitus, the condition afflicts at least one in every 10 American adults and is the most common disability among Afghanistan and Iraq war veterans, according to the U.S. Department of Veterans Affairs (VA). Up to 40 percent of all veterans may be suffering from tinnitus, and the VA spends about $1 billion annually on disability payments for tinnitus, according to a study published last year in Nature. (Scientific American is part of Nature Publishing Group.)
To address the problem, the U.S. Department of Defense has commissioned Draper Laboratory in Cambridge, Mass., to spend the next year fleshing out a concept for a small delivery device inserted near the membrane-covered window—no more than three millimeters in diameter—separating the middle ear from the inner ear. Once at the membrane the device (essentially a polymer capsule, although Draper is not developing any of medicines that might be placed inside) would release a drug into the cochlea, the tubular organ residing in the inner ear that enables us to hear. The plan is to embed wireless communications into the capsule so that a patient or doctor can control the dosage. After the capsule finishes delivering its supply of drugs, it would dissolve.
Although Draper's project is still in the very early stages and years away from any clinical testing, it holds more promise than many of today's most common approaches to tinnitus treatment, which include deep breathing, using background noise to drown out the ringing or simply learning to ignore the bothersome sound. Steroids injected into the eardrum have shown some promise in helping patients with certain hearing and balance disorders, but the ear begins eliminating these drugs through the eustachian tube (a passageway in the middle ear that acts as a pressure equalizer) as soon as the patient talks, swallows or even sits up. As a result, the patient must endure several injections into their ear and remain immobilized for a time after each injection to get any relief from the malady.
"By and large there aren't that many good ways to treat tinnitus," says Lloyd Minor, provost and senior vice president for academic affairs at Johns Hopkins University. Draper's work "is potentially a novel way of delivering drugs to treat tinnitus. In general, we don't have the types of drug-delivery systems that we would like to get medication into the inner ear."
NeuroSystec Corp. is developing a neuro-active agent designed to calm the hyperactive nerves responsible for cochlear tinnitus. The Valencia, Calif., biotech start-up has licensed an osmotic pump from Durect Corp. in Cupertino, Calif., a company working on a number of drug delivery mechanisms for various parts of the body, including the inner ear.
Other advanced approaches of addressing tinnitus have been in the works for years, but most are still not ready for the market. Otonomy, Inc., in San Diego is testing a sustained release dexamethasone (a type of steroid) gel that would be injected into the middle ear, where it would stay in place, dissolving slowly and delivering treatments for hearing and balance disorders. MicroTransponder, a medical device company spun out from the University of Texas at Dallas in 2007, is looking to broaden the use of its implanted wired neuro-stimulation system for treating epilepsy to likewise help tinnitus patients.
The neuro-stimulation approach shows greater promise than those based on delivering medication to the inner ear at this time, says Michael McKenna, an otologist and neurologist at Massachusetts Eye and Ear in Boston. Targeted drug therapy is of questionable benefit because tinnitus comes from a variety of causes—including age-related hearing loss, traumatic ear injuries or circulatory system disorders—and has varying degrees of severity, he adds.
Perhaps some combination of all these efforts will end up delivering the relief that tinnitus sufferers seek. "Nothing really has been a panacea, so there is the need for further technological development," Minor says. If Draper's technology "works in the way they're hoping it will work, it will potentially be a big advance for the field."
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30 Comments
Add CommentDisability??? I've had Tinnitis for 40 years and no one's compensated me. It's nothing; a minor, persistent, insistent, perpetual, always-present nothing. Deal with it.
Reply | Report Abuse | Link to thisI'll believe a cure when I can't hear it anymore.
I've had a significant ringing at 3 kHz, probably since my 1970 tour of duty in Viet Nam. While I realize that the severity or amplitude may vary widely, I never imagined that I might qualify for disability payments! I wonder if I can get payed going back to 1970? I'm sure I would have accumulated a vast fortune over the years if it had not been for this darned tinnitis holding me back...
Reply | Report Abuse | Link to thisEvery time I have mentioned the ringing in my ears to the VA Dr.'s they have more or less ignored me. I did get a hearing test once even though I told them that I can pass a hearing test (CDL testing proved this) the problem was not the ability to hear different sounds in a sound proof room with headphones on. I have given up on the VA as far as this problem I have had since 1971. I do not want money from them but it would be nice to not be ignored. I have heard that people with tinnitus which delivers a different decibel or htz level in each ear have it far worse than those with an equilibrium of pitch and volume in each ear. I am of the latter group and I am thankful for that in the least.
Reply | Report Abuse | Link to thisPeople, you do realize that not everyone experiences the same symptoms or has the same lifestyle as you, don't you?
Reply | Report Abuse | Link to thisIt's like saying "I had a cancerous lesion on my little finger once and it never bothered me so those people with lung cancer are real crybabies".
I'm over 50 and I developed tinnitus a couple of years ago, some variant of Meniere's got me from out of the blue and put me on a year and a half long journey recovering from all sorts of balance disorders.
I am a software architect/engineer and concentration for long periods of time is vital to me/my job. I nearly lost my job due to my inability to concentrate with the constant, very loud screeching in both my ears. I may lose that job yet as I'm still only able to achieve about 50% of what I could before the ringing started.
If ringing doesn't bother you while you're driving a truck or directing traffic or whatever it is you do, good for you. I'm glad your life isn't significantly affected by it, but please don't pretend that your symptoms or your lifestyle is mine.
This comment is proof that ignorance and self-centeredness are also disabilities.
Reply | Report Abuse | Link to thisThere is a phenomena called RF hearing which has been known about since around 1950 (please see wikipedia/tinnitus page reference number 14 by Motorola Research Lab Florida), possibly the reason why doctors are not interested is there is no medicine to remove the RF (due to TV, satellite, cell phones, bluetooth, Wifi) that is present in our environment and it is only the drug companies that put money into solving medical problems. I am an electronic engineer who has tinnitus since using a certain 'berry' cell phone.. On the article mentioned above, Motorola Research Lab in Florida state that tinnitus is not considered to be an adverse affect so are not concerned by it. Until the RF is removed from the environment it is not possible to know what underlying medical reasons could be causing (if any)...
Reply | Report Abuse | Link to thisThere's an over-the-counter ear drops for it that i use occasionally. I had my adenoids lasered off which cured mine for about 15 years, just came back a bit last year or so. There's also 'venous hum', a different condition of hearing your own blood flow.
Reply | Report Abuse | Link to thisHave you tried wearing a tinfoil hat to shield against the RF?
Reply | Report Abuse | Link to thisI have "suffered" from tinnitus for the last 30 or 40 years and have not been in the least worried by it.
Reply | Report Abuse | Link to thisLaying in bed at night I percieve the sound of a small mountain sream to emulate a hovering helicopter in the near distance...ie, loud enough but easy to ignore
I'm 47 and I can not remember not having tinnitus. I clearly remember the presence of ringing as a child, long before I was exposed to loud noise and decades before I knew it was an affliction, i.e., not normal, and had a name. While I am accustomed to it as I don't know any different, I can't enjoy true silence, let alone a merely quiet environment without a continuous noise similar to, if not identical to the "eeeee" emitted by an old CRT TV set.
Reply | Report Abuse | Link to thisI've never enjoyed it, I do "suffer" from it, in that life would be better without it. Luckily, I had the foresight to protect my hearing with quality passive attenuating and active noise cancelling/reducing earphones as a pilot over the past 20+ years, so I've managed to keep the condition from deteriorating for the most part. I would love to experience silence someday; I remain hopeful that some sort of safe cure may be found. It seems to me that those who have tinnitus and dismiss others who complain of this condition are insensitive and not particularly concerned nor appreciative of the benefits of silence and very low ambient noise levels. In other words, they're insensitive; lucky them, I suppose.
What ever you do it won't work? I have ringing in both of my ears for years &dizzingness & l never been to any wars dosen't matter which one. One cousin of mine just started getting it in one ,driving him nuts said if he get it in both ears to shoot him.get used to it I did. Althought am hard of hearing my cousin is not. So what is it really?
Reply | Report Abuse | Link to thisWhat ever you do it won't work? I have ringing in both of my ears for years &dizzingness & l never been to any wars dosen't matter which one. One cousin of mine just started getting it in one ,driving him nuts said if he get it in both ears to shoot him.get used to it I did. Althought am hard of hearing my cousin is not. So what is it really?
Reply | Report Abuse | Link to thisMeniere's disease wherein there is both auditory and balance effects are of a different origin than tinnitus caused by ear damage from loud sounds of a percussive or rock and roll origins. Many forms of inner ear imbalance, extremes of vertigo and so forth can be treated if they are not caused by arterial disorders in the inner ear by of all things, a series of head maneuvers that move erratics of loose calcium particles that normally remain attached to nerve endings in that part of the balance centres. This has become a common and standard treatment for what is called Benign Paroxysmal Positional Vertigo. Sometimes people have both this and tinnitus and it can be diagnosed as Meniere's and might NOT be thus as the Meniere's is hard to treat at all and the BPPV is easily treated. The tinnitus is in essence not always associated with this and when it is not, my suggestion is that one ought to try physical treatment of the BPPV and ignore the tinnitus or treat them as differing and unrelated syndromes. One can find treatments for BPPV on line and a modern physician who is up on such treatments can refer a patient to a physiotherapist who is trained to make the correctly patterned moves to eliminate the errant calcium granules that cause extremes of vertigo. Tinnitus..well...that is a different situation and some seems to be caused by neurological issues that are in the brain and NOT in the ear at all. For example, there are cases in which listening to sound in the left ear changes the perceived loudness of the tinnitus in the opposite ear and it literally appears to modulate! indeed..this does say something about where the apparent sound might come from...the Central Nervous System in other words in part at least. The main thing is that it is a matter of trial and error for most sufferers of both the tinnitus and the possibly related or possibly UNRELATED BPPV. There are many articles on these subjects easily found online. I am not a medical person but I not only know about it from reading but have both and can attest that I do know exactly what MIGHT be going on for some sufferers but surely that is between the sufferer and the medical people that one might choose. It is not in other words..simple but do not take no for an answer for symptoms as I lived for 60 years with bouts of BPPV until I encountered a neurologist who said, simply, oh, we can fix you right up...and it was done ( by a physiotherapist!) For some there is a cure that lasts for years and can be done over with lasting affects.
Reply | Report Abuse | Link to thisThat does not seem to be a remark that is helpful, or open to learning about something you do not undrstand.
Reply | Report Abuse | Link to thisI can fully empathise with you DFC64, I realised a few years ago that I had this noise since my youth. It is mostly a mind-over matter problem. I wonder if the continous backgrd noise interferes with speech comprehension? Certainly when the breeze stops I wish I could here the silence of the countryside.
Reply | Report Abuse | Link to thisThe idea of 'RF hearing' has occurred to me however, a test might be to travel non radio-infected areas and you should discern a change in background sound?
Do vets really want one more "treatment" offered by the government?
Reply | Report Abuse | Link to thisRadio frequency is well above the audible range so on the surface the idea that it may cause tinnitus seems silly. Once you learn about natural signal step down and harmonic vibration the idea that the RF may be degraded to a lower frequency that does interact with the very sensitive parts of the middle or inner ear becomes more plausible. As a child I used to have a terrible time with cathode ray tube TVs. The high pitched squealing was painful but no one else seemed to hear it. Turning off the TV made it go away. When I studied electronics I learned that improper positioning and soldering could cause happy little RF broadcast antennas.
Reply | Report Abuse | Link to thisFor the long term, a boom box right next to my ear made the problem go away by reducing my ability to hear higher ranges of sounds.
Poppa Beer: Your tinnitus must be severe to distract you when you are "laying in bed." Presumably you meant "lying in bed."
Reply | Report Abuse | Link to thisPick up a tambourine in each hand, hold them next to your ears and shake them vigorously. That's what I hear. Though, I must admit, on a good day it would be more accurate to hold them about 18" away from your head.
Reply | Report Abuse | Link to thisA 65 y.o. two-tour I-Corps corpsman.
That purple heart was worth a free pair of hearing aides!
They help.
Not everyone experiences the same level of tinnitus. Some people hear low gurgling sounds, some people hear high pitch. I can imagine that a very high pitch, which is also too loud to drowned out, could be maddening. It's unkind to assume that what you are able to tolerate is what others cannot and I hope that you don't have to experience the worse end of the spectrum to understand. Think before you speak and consider how insensitive it sounds to people who are suffering.
Reply | Report Abuse | Link to thisMost people I speak to who have tinnitus don't have it bad. Others do. I have it in both ears. My left is severe while my right is not. When you can hear your tinnitus in a busy gym or an airline cabin while in flight, you have bad tinnitus, bottom line.
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Reply | Report Abuse | Link to thisFYI:
My tinnitus has now totally disappeared, I can even hear the whispers of small children whispering their secrets. I’m now hearing things I’ve never heard before.
QUOTE SOURCE: http://www.lowellmason.com/health.html
(Product used via: www.StemTech.com)
My boyfriend was able to get rid of his tinnitus (probably from working as a DJ in clubs) by a holistic approach. You really need to cure the whole body-mind-energy system. Here's what he did:
Reply | Report Abuse | Link to this- took painkillers (only the first 2 months luckily)
- totally reduced noise in his surrounding (we moved to different apartment outside city center!)
- wore tinnitus masker to cover up the intense sound at the beginning
- started yoga classes and learned easy daily mental and physical relaxation techniqes
- signed up for a dosha-balance treatment in ayurvedic center
- modified his diet according to ayurveda principles
- went throught body purification process (colon and liver purification accoring to hathayoga)
- took health supplements (vitamins, zinc and gingko biloba)
It's been two years and he's been happier than ever.
He's found a lot of inspiration at http://www.ringinginleftear.org
Has anybody considered botox to dampen nerve function?
Reply | Report Abuse | Link to thisAgree, most people have minor ringing, easily ignored, others have extremely loud and it can be debilitating.
Reply | Report Abuse | Link to thisAfter I turned 53 I was lucky enough to experience a cycle of all possible conditions. Mine can be silent for days, or roar like an insistent steam jet, or putter along like a little stream.
On average, over 2 years, it has gotten quieter. I have been getting better at habituating it. Of course, it's no problem on the days (as many as 5 in a row) when it is quiet and now very little or no problem when silent. The loud days are more challenging (such as today) but somehow I'm even able to ignore it then more and more. I don't know, even if it was always loud, maybe I would be able to ignore it by now, but it can be anything for me on any day. That's harder to get used to ... but mostly I'm good now. Maybe it's only an issue 2 days a month now ... down from 4 days a week.
Curing Tinnitus can never be achieved by tackling one of the many factors responsible for Tinnitus. If you've ever tried to cure your <a href="http://tinnituss.net"_blank">tinnitus</a> using a one-dimensional treatment like drugs, herbal supplements or even detox diets and failed - it's probably because you have tackled only one aspect of the disease.
Reply | Report Abuse | Link to thishttp://tinnituss.net
Reply | Report Abuse | Link to thisThank you for this comment! I've read some people take their lives over this and that's kind of scary.
Reply | Report Abuse | Link to thisI have had tinnitus for about 32 years after a very bad motorcycle accident. lost all hearing, facial injuries, both temporal bones fractured. Loss of sight one eye. The T started about 6 months after accident. has driven me crazy all these years. Used to drink a lot to ease the crazy noises. My doc today suggested steroids. Has anyone gotten relief from the horrible noises (buzzing, hissing, roaring, etc) by taking steroids? if so how long did relief last?
Reply | Report Abuse | Link to thisForgot to add i have had a cochlear implant for about 23 years.
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