Acúfenos: Sección tratamiento: TENS

Trans-electrical nerve stimulation (TENS) for somatic tinnitus

References and further reading may be available for this article. To view references and further reading you must purchase this article.

C. Herraiz^{1, 2, ,} , A. Toledano¹ and I. Diges¹

¹ Unidad de Otorrinolaringología, Fundación Hospital Alcorcón, C/Budapest, 1. Alcorcón 28922, Madrid, Spain
² Unidad de Acúfenos, Instituto ORL Antolí-Candela, Madrid, Spain

Available online 22 October 2007.

Abstract

The somatic tinnitus syndrome includes those forms of tinnitus that are associated with a somatic disorder involving the head and upper neck.

It has been suggested that physiological mechanisms where interactions occur between the somatosensory and auditory systems are the etiology for that kind of tinnitus.

Trans-electrical nerve stimulation (TENS) of areas of skin close to the ear increases the activation of the dorsal cochlear nucleus through the somatosensory pathway and may augment the inhibitory role of this nucleus on the CNS and thereby ameliorate tinnitus.

In a prospective descriptive study of 26 patients with the probable diagnosis of somatic tinnitus we found that TENS could improve the tinnitus in 46% of the participants (23% did not hear it anymore, and in 23% its intensity was reduced).

VAS scores improved from 6.5 to 6.0 after 2 weeks of treatment (p<0.01).

Patients used TENS at home for 2 h, once per day during 2 weeks (alternating ramped burst, 150 pps, with pulse duration of 100 μs, amplitude 0–60 mA; average TENS intensity was 27 mA).

Intermittent “typewriter” type of tinnitus was the most responsive.

Somatic tinnitus without otologic disease had better response than tinnitus associated to otological causes (p=0.047).

Keywords: tinnitus; somatic tinnitus; transcutaneous electric stimulation; myoclonus; temporomandibular joint

Fig. 1. Representation of the pathways involved in somatic tinnitus modulation. We show the possible place where the transelectrical nerve stimulation could act and reduce tinnitus intensity. The effect of TENS in the somatic tinnitus could restore the dorsal cochlear nucleus (DCN) inhibition through the electrical stimulation of the somatic pathway. (See Color Plate 37.1 in Color Plate Section.)

View Within Article

---

Plate 37.1. Representation of the pathways involved in somatic tinnitus modulation. We show the possible place where the transelectrical nerve stimulation could act and reduce tinnitus intensity. The effect of TENS in the somatic tinnitus could restore the dorsal cochlear nucleus (DCN) inhibition through the electrical stimulation of the somatic pathway. (For B/W version, see page 390 in the volume.)

View Within Article

---

Fig. 2. Response to TENS treatment after 2 weeks. Tinnitus improvement was referred by 46% of the patients (disappearance+better). (See Color Plate 37.2 in Color Plate Section.)

View Within Article

---

Plate 37.2. Response to TENS treatment after 2 weeks. Tinnitus improvement was referred by 46% of the patients (disappearance+better). (For B/W version, see page 392 in the volume.)

View Within Article

---

Table 1. Tinnitus pitch
Note: PT, pure tone; NBN, narrow band noise.

View Within Article

---

Fuente: Progress in Brain Research
Volume 166, 2007, Pages 389-394, 552-553
Tinnitus: Pathophysiology and Treatment