Because tinnitus is the No. 1 cause of disability among veterans, accounting for nearly 11 percent of all VA disability claims, Congress has intervened to ensure that the military takes the condition seriously. “Congress has mandated better reporting of tinnitus, so we’re now trying to reach out to troops to help them self-identify and report problems,” said Lt. Col. Mark Packer, MD. “We’re also working on improving access to care and making it quicker. There’s a lot of ongoing research in terms of diagnosing tinnitus too. There are likely different brands of tinnitus that may stem from different areas along the auditory pathway.”
Explore This IssueJanuary 2013
The Department of Defense has also begun implementing a VA-initiated program called Progressive Audiologic Tinnitus Management. The program involves “self-screening, education, referred care if there is a hearing loss, hearing rehabilitation, behavioral health stress management strategies and tinnitus retraining therapy,” Dr. Packer said.
Military physicians are also carefully tracking civilian research studies and advances. At a recent session at the 2012 American Academy of Otolaryngology-Head and Neck Surgery meeting, Michael Seidman, MD, FACS, director of the division of otologic/neurotologic surgery and medical director of wellness at Henry Ford Health System in Detroit, discussed research findings that may help auditorily injured troops, including electrical stimulation of the brain to treat tinnitus. Dr. Seidman has successfully used magnetoencephalography to tonotopically map the location in the brain where the tinnitus may be generated and then surgically implanted electrodes to stimulate that portion of the brain to essentially “electrically jam” the tinnitus (Laryngoscope. 2008;118:491-500). “The first person we did, we pretty much cured his ringing,” Dr. Seidman said. “The second person, we improved her tinnitus by about 30 percent. Two others noted another 50 to 80 percent improvement in their symptoms. Two other patients, sadly, we didn’t help at all.”
Jinsheng Zhang, PhD, associate research director of the Laboratory of Tinnitus and Auditory Neuroscience Research at Wayne State University in Detroit, is working with the Office of Naval Research to investigate the possible use of noninvasive electrical stimulation techniques to treat tinnitus. “Nobody wants us to open up their skull and put in electrodes, especially if their tinnitus is not severe or debilitating,” Dr. Zhang said. “So right now, we’re thinking about how to make it noninvasive or even minimally invasive.”