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Stem Cell Therapy for Tinnitus

10 February 2020

Introduction
Current Approaches to Manage Tinnitus
Mindfulness Techniques
Medications and Dietary Supplements
Sound Amplification
Stem Cell Therapy as a Promising Approach to Tinnitus Treatment
What Are the Expected Results?
Patient Outcomes and Testimonials of Tinnitus Treatment with Stem Cells
Stem Cell Therapy Procedure for Tinnitus
Potential Side Effects and Contraindications of Stem Cell Treatment
When Can a Patient Expect to See Improvement?
List of References

Introduction

About 360 million people globally suffer from hearing loss, which is the most common sensory disorder in humans [1]. This condition is caused primarily by damage to the hair cells and neurons of the inner ear. In some patients, hearing loss results in tinnitus. Approximately 90% of cases of chronic tinnitus are associated with some degree of sensorineural hearing loss. Such patients hear sounds like ringing, clicking, buzzing, hissing, humming or roaring in the absence of any corresponding external sound. 

Tinnitus is experienced as annoying sounds like ringing, clicking, buzzing, hissing, humming or roaring in the absence of any corresponding external sounds.

Figure 1. Tinnitus is experienced as annoying sounds like ringing, clicking, buzzing, hissing, humming or roaring in the absence of any corresponding external sounds.

The following causes are associated with the development of tinnitus:

Common Reasons: Other Physical Conditions and Diseases: Medications:
  • Loud noise
  • Age-related hearing loss
  • Earwax blockage
  • Ear bone changes
  • Head or neck injuries or tumors
  • Eustachian tube dysfunction
  • Muscle spasms in the inner ear
  • Meniere's disease
  • Problems with the temporomandibular joint
  • Acoustic neuroma
  • Vascular pathologies (atherosclerosis, post-stroke condition, etc.)
  • High or low blood pressure
  • Osteochondrosis
  • Arteriovenous malformation (AVM)
  • Antibiotics (polymyxin B, erythromycin, vancomycin neomycin)
  • Chemotherapy agents (methotrexate, cisplatin, carboplatin)
  • Diuretics (bumetanide, ethacrynic acid, furosemide)
  • Quinine
  • Aspirin (at high doses like 8 to 12 tablets a day)
  • Antidepressants (fluoxetine, sertraline, paroxetine, citalopram hydrobromide, fluvoxamine)

 

This video demonstrates the mechanism of tinnitus caused by a very intense noise. Due to the failed connection between the hair cells and the auditory nerve, the nerve fiber does not receive normal stimulation and starts self-stimulation, sending signals to the brain which are perceived as a whistling noise [2].

Current Approaches to Manage Tinnitus

Currently, there is no approved way to fully cure the perception of tinnitus in most cases. It is only possible to lessen the severity of the disease and its annoyance. Measures that improve sleep and reduce stress, and decrease caffeine and alcohol consumption help to reduce problems associated with tinnitus, such as insomnia, anxiety, and depression [3]. 

The following treatment strategies may help people manage their condition:

Mindfulness Techniques

Cognitive Behavioral Therapy (CBT) has been shown to be one of the most effective treatments in reducing the distress caused by tinnitus and increasing the patient’s quality of life [4]. Relaxation techniques and exercises as a part of CBT may also be helpful in relieving stress and decreasing anxiety, which can exacerbate the perceived intensity of tinnitus.

Mindfulness practices, such as relaxation and meditation, help to decrease tinnitus intensity.

Figure 2. Mindfulness practices, such as relaxation and meditation, help to decrease tinnitus intensity.

Medications and Dietary Supplements

Medications such as melatonin and antidepressants, in combination with conservative management, can be beneficial to ameliorate tinnitus symptoms by improving sleep and helping to minimize the emotional response (annoyance/aggravation) [3, 5, 6, 7].

There are some indications that Vitamin B12, Zinc and Magnesium may provide some tinnitus relief.

Sound Amplification

Some patients find relief by using hearing aids, specialized tinnitus maskers and white-noise generators. They can mask the phantom sound by amplifying ambient noise or generating background noise [3].

There are also some experimental therapies, such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), that use electric signals to mitigate the activity of brain cells, which generate the phantom noise [8, 9].

Stem Cell Therapy as a Promising Approach to Tinnitus Treatment

Recent developments in stem cell technology have offered new opportunities to treat deafness.  In scientific experiments, researchers have used human stem cells to restore damaged hair cells and to repair damage to the auditory nerve in deaf animals, restoring their hearing [10].

Based on this and other similar studies, a methodology was developed for implementation in clinical practice.

The current method of stem cell application for tinnitus is intravenous delivery and postotic injection (local introduction in the area behind the ear) of adult mesenchymal stem cells (MSCs) derived from different sources – bone marrow, adipose tissue, placenta, and umbilical cord. They are widely used and studied for the treatment of orthopedic, autoimmune, neurological, cardiac diseases and others due to their healing and regenerative potential [11, 12, 13].

In the therapy, mesenchymal stem cells can be administered intravenously or locally, or both ways.

Figure 3. In the therapy, mesenchymal stem cells can be administered intravenously or locally, or both ways.

It was shown that systemically injected MSCs preferentially migrated to the site of injury and improved recovery [14, 15, 16]. They act by producing the vast array of bioactive factors (cytokines, chemokines, growth factors) that are involved in the key biologic processes, such as tissue regeneration, wound healing, angiogenesis, modulation of the immune system and others [17, 18].

What Are the Expected Results?

The neuroprotective, immunomodulating and overall health-promoting properties of stem cell-based therapy can help improve the quality of life for patients with tinnitus by:

It is important to note that despite the above-listed treatment properties, stem cells are not a guaranteed cure. The treatment efficacy may vary due to such factors as the patient’s age, the cause of tinnitus, the severity of the disease, the absence of comorbidities, lifestyle, including nutrition, the availability of support of additional therapies, etc. Integrated treatment (diet, supplements, concomitant procedures) is recommended for optimal results.

Patient Outcomes and Testimonials of Tinnitus Treatment with Stem Cells

Patient from Serbia, 36 years old.

Diagnosis: Tinnitus of the left ear caused by audio trauma.

Duration: 6 months.

Treatment: Donated stem cells, neurogenesis-induced therapy, additional nutrient support.

Treatment results:

“I was diagnosed 6 months ago with tinnitus, which was caused by audio trauma or loud noise on the lateral of my left ear and yeah, after research, I decided to come and to try stem cells in order to alleviate or to solve this problem. Swiss Medica is really focusing on trying to get you better, not just to sell you stem cells, which is a great advantage when you compare it with other stem cell clinics. Staff was great, very professional, with a lot of experience and I felt that every day they were actually trying to solve my problem, not just to give me stem cells and send me home. Yeah, I would definitely recommend stem cells. So, it’s not just stem cells, you’re getting some other nutrients, amino acids, some special medications for inducing neurogenesis and fixing the neurological problem, which tinnitus is.”

Get a free online consultation from a Medical Advisor to learn about expected results for your case >>>

Stem Cell Therapy Procedure for Tinnitus

Both autologous (patient’s own) MSCs or donor cells (derived from placenta and/or umbilical cord) may be used for treating tinnitus. Stem cells are infused intravenously through an IV Drip. The patient’s cells are collected under local anesthesia and then are processed to obtain specific cell products – SVF (stromal vascular fraction) – with optimal treatment properties. SVF is injected locally for a targeted impact on the problem area. Thus, the patient receives two separate injections of cell products.

To ensure the best treatment results, patients may be offered additional therapies, such as:

and some others (optionally). 

The treatment program is customized considering the needs and health conditions of each patient. We also include consultations with specialists in neurology, neurorehabilitation, psychology, and nutrition, if required.

Potential Side Effects and Contraindications of Stem Cell Treatment

Stem cell-based therapy is usually well-tolerated by most patients, with rare local side-effects from the cell harvesting or injection procedure. Short-term fever was reported in less than 5% of patients; they recovered spontaneously.

There are certain contraindications to stem cell therapy, which include:

Women who are pregnant or breastfeeding, as well as people with mental disorders and addictions, are not allowed to receive stem cell therapy.

When Can a Patient Expect to See Improvement?

About 1.5-3 months is needed for the full effect to manifest after stem cell therapy. Initial signs of improvement may be observed even 1 week after treatment. Usually six months after treatment, one can make a conclusion about the results of the therapy. 

Ask our Medical Advisor if cell-based therapy will benefit you >>>

— Published on February 10, 2020

by Swiss Medica team

List of References

  1. Mahmoudian-Sani MR et al. Comparison of Three Types of Mesenchymal Stem Cells (Bone Marrow, Adipose Tissue, and Umbilical Cord-Derived) as Potential Sources for Inner Ear Regeneration. Int Tinnitus J. 2017 Dec 1;21(2):122-127.
  2. Specialized educational website “Journey into the World of Hearing”. 
  3. Folmer RL, Martin WH, Shi Y. Tinnitus: questions to reveal the cause, answers to provide relief. J Fam Pract. 2004;53(7):532–40. 
  4. Martinez-Devesa P et al. Cognitive behavioural therapy for tinnitus. Cochrane Database Syst Rev. 2010 Sep 8;(9):CD005233.
  5. Megwalu UC, Finnell JE, Piccirillo JF. The effects of melatonin on tinnitus and sleep. Otolaryngol Head Neck Surg. 2006;134(2):210–3.
  6. Robinson S. Antidepressants for treatment of tinnitus. Prog Brain Res. 2007;166:263–71.
  7. Fornaro M, Martino M. Tinnitus psychopharmacology: a comprehensive review of its pathomechanisms and management. Neuropsychiatr Dis Treat. 2010;6:209–18.
  8. Yuan T et al. Transcranial direct current stimulation for the treatment of tinnitus: a review of clinical trials and mechanisms of action. BMC Neurosci. 2018; 19: 66.
  9. Schoisswohl S et al. RTMS parameters in tinnitus trials: a systematic review. Sci Rep. 2019; 9: 12190.
  10. Improving delivery of stem cells to the inner ear, National charity for people with hearing loss, UK.
  11. Nancarrow-Lei R et al. A Systemic Review of Adult Mesenchymal Stem Cell Sources and their Multilineage Differentiation Potential Relevant to Musculoskeletal Tissue Repair and Regeneration.Curr Stem Cell Res Ther. 2017;12(8):601-610.
  12. Vu Q, Xie K, Eckert M, Zhao W, Cramer SC. Meta-analysis of preclinical studies of mesenchymal stromal cells for ischemic stroke. Neurology. 2014; 82:1277–1286.
  13. Laroni A et al. Mesenchymal stem cells for the treatment of neurological diseases: Immunoregulation beyond neuroprotection. Immunol Lett. 2015 Dec;168(2):183-90.
  14. van Velthoven CT, Kavelaars A, Heijnen CJ. Mesenchymal stem cells as a treatment for neonatal ischemic brain damage. Pediatr Res 2012; 71:474–81.
  15. Chen J, Li Y, Wang L et al. Therapeutic benefit of intravenous administration of bone marrow stromal cells after cerebral ischemia in rats. Stroke 2001; 32: 1005–11.
  16. Payne NL et al. Distinct immunomodulatory and migratory mechanisms underpin the therapeutic potential of human mesenchymal stem cells in autoimmune demyelination. Cell Transplant. 2013;22(8):1409-25. 
  17. Chen L et al. Paracrine Factors of Mesenchymal Stem Cells Recruit Macrophages and Endothelial Lineage Cells and Enhance Wound Healing. PLoS One. 2008; 3(4): e1886.
  18. Kyurkchiev D et al. Secretion of immunoregulatory cytokines by mesenchymal stem cells. World J Stem Cells. 2014 Nov 26;6(5): 552–570.

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