Acupuncture for some Ear disorders
Acupuncture for Ringing in the Ears (Tinnitus)
Ringing in the ears, or tinnitus, is broadly grouped into two categories: subjective and objective. Far more common, subjective tinnitus is most likely caused by abnormal neuronal activity, which may result from changes in the inner ear environment similar to those causing sensorineural deafness. The commonest cause of tinnitus is similar to hearing loss, which is due to damage or degeneration of cochlear hair cells. Besides being generated from the cochlea itself, tinnitus can also arise from the central nervous system. In this regard, the dorsal column nucleus (DCN) is thought to play an important role in generating tinnitus. Tinnitus is further complicated by the influence of the brain's emotional and reactive systems involving negative feedback loops. With an estimated prevalence of 10–15%, tinnitus is a common symptom with about 20% of adult sufferers requiring clinical intervention. Usual care tinnitus treatments often include vasodilator drugs to increase cochlear blood supply and inner ear tissue metabolism. Long-term consumption may have adverse effects such as lethargy and anxiety. Drugs for chronic tinnitus, such as lidocaine, demonstrate limited efficacy. The use of glucocorticoids has also been investigated, but results have not been substantiated. This has prompted researchers to explore the therapeutic effect of Traditional Chinese Medicine (TCM) on tinnitus, specifically, the TCM modalities of acupuncture. In animal studies, the modulation of firing rate and synchrony in DCN neurons by somatosensory input was shown to be physiologically correlated with somatic tinnitus, which is consistent with clinical studies that many of the patients with somatically induced tinnitus who are responders to acupuncture well indicate that acupuncture might be a modality of somatosensory-based treatment [Levine et al. 2007]. Besides, the study also showed that acupuncture might have an effect on the activity of the outer hair cells through its efferent nervous system. Several RCT studies indicate that acupuncture is an effective modality for the alleviation of tinnitus, and this technique is safe and brings no side effects to patients.
Acupuncture for Sensorineural Hearing Loss:
Deafness, or hearing loss, can typically be categorized into four types:
1 Conductive Hearing Loss: caused by something that stops sounds from getting through the outer or middle ear. This type of hearing loss can often be treated with medicine or surgery.
2 Sensorineural Hearing Loss: occurs when there is a problem in the way the inner ear or hearing nerve works.
3 Mixed Hearing Loss: includes both conductive and sensorineural hearing loss.
4 Auditory Neuropathy Spectrum Disorder: occurs when sound enters the ear normally, but because of damage to the inner ear or the hearing nerve, sound isn't organized in a way that the brain can understand.
Here, we address sensorineural Hearing loss (SNHL), which results from any interface along the sound wave transduction and perception from stapes to the auditory cortex. Sound is delivered from the stapes and the oval window and transmitted to the organ of Corti in the cochlea, where the cochlea undergoes first amplification by the outer hair cells (OHCs) and then electrochemical transduction by the inner hair cells (IHCs). The cochlea receives an acoustic signal, and a traveling wave is generated, which traverses the basilar membrane of the cochlea, stimulating OHCs which act as a biological amplifier/compressor and modify the signal. The basilar membrane of the cochlea is highly frequency-specific and tonotopically organized. The base of the basilar membrane responds to higher-frequency sounds, while the apex responds to lower frequencies. The IHCs in the cochlea transduce the energy of the traveling wave to an electric action potential and synapse at the spiral ganglion to form the auditory nerve on which signals are delivered to the auditory cortex via brain stem nucleus (superior olive, cochlear nuclei, inferior colliculus, thalamus).
Within TCM, deafness is potentially related to one or more of the following diagnostic patterns: Blood stagnation, kidney yin deficiency, and/or liver deficiency. While in clinical situations, there are any numbers of other possibilities. Many times there could be a layered combination of patterns in an interwoven blend with their symptoms; they may be a reciprocal causation issue-result relationship. Therefore, acupuncture treatment will be based on syndromes and patterns differentiation and focus on points over associated meridians to rebalance the energy and blood of correlated Zang and Fu by manipulation of needles to coordinate (enhance or reduce) the target key points of different meridians on which the improvement of blood circulation in cochlear and the better transmission of auditory signals will be achieved.