Pulsed Radiofrequency of the Vagal Nerve for Tinnitus -A Case-Study.

TINNITUS BACKGROUND: Vagal nerve stimulation is a promising therapy for tinnitus. Pulsed radiofrequency is a minimally invasive neuromodulator technique that could be applied repeatedly without damage to neural tissue. In this case-study we document the use of pulsed radiofrequency of the vagal nerve as a successful therapy without harm for patients with tinnitus. METHODS: A 22-gauge, 60 mm-long needle with a 5 mm active tip was placed percutaneously at the inner side of the tragus. The auricular branch of the vagal nerve was subjected to pulsed radiofrequency at 42 V, 2 Hz, and 10 milliseconds for 10 minutes. RESULTS: Pulsed radiofrequency of the vagal nerve can reduce tinnitus and improve hearing in a patient with severe tinnitus and hearing loss. The intensity of the tinnitus was reduced to 5% of the original intensity at the left side and to 20% at the right side. An improved hearing of 20 to 30 dB from 250 Hz to 8 kHz in the left ear and from 250 Hz to 2 kHz in the right ear was objectivated in the audiogram. CONCLUSIONS: This case-study document that PRF of the vagal nerve can reduce tinnitus and improve hearing in a patient with severe tinnitus and hearing loss. However, further research of PRF of the vagal nerve in tinnitus patients is needed.

Percutaneous Radiofrequency Lesion of the Superior Cervical Sympathetic Ganglion in Patients with Tinnitus.

OBJECTIVE: The aim of this study was to determine the efficacy of radiofrequency lesioning of the superior cervical sympathetic ganglion for patients with tinnitus. STUDY DESIGN: This is a retrospective long-term clinical review of patients with tinnitus treated with a blockade of the superior cervical sympathetic ganglion. SETTING: The human subjects were 366 consecutive patients who came to the DC Klinieken in Almere and Amsterdam from January 2010 to January 2014 for consultations on their tinnitus that persisted for 1 month or longer. SUBJECTS AND METHODS: Data were recorded from patients whose charts were reviewed retrospectively to identify the patients who were treated with a blockade of the superior cervical sympathetic ganglion for tinnitus. An independent observer conducted a long-term follow-up assessment of the therapy by telephone interview. RESULTS: Relief of tinnitus at 7-week follow-up was achieved in 64% of the patients treated with a radiofrequency lesion of the superior cervical sympathetic ganglion after a positive test blockade of this structure. Two years after the treatment, the maintenance of a tinnitus relief occurred in almost 40% of the patients with a follow-up period of two years or longer. CONCLUSIONS: A radiofrequency lesion of the superior cervical sympathetic ganglion may be a useful alternative for patients with tinnitus not responding to conventional therapy.