29/12/2021
Ross Hauser, MD discusses the neurology behind why many people with cervical instability complain of tinnitus:
About half of the patients that I see have tinnitus or ringing in the ears. There are many differnt types and designations of tinnitus. Some tinnitus is the high pitch type, some are the low pitch type, some are pulsatile, they have a beat. Then there is the humming type. I am going to explain in this video and the notes below, the neurology of tinnitus.
There are many different ways that cervical instability causes tinnitus. The most common way that cervical neck instability causes tinnitus or ringing in the ears is because it disrupts eustachian tube function or if it causes compression of the carotid sheath or carotid artery. Then you get a pulsatile tinnitus, a rhythmic beating that corresponds to the heart beat.
What are we seeing in this image? The most common ways cervical instability causes tinnitus There are many types of tinnitus. There is:
1. Head pressure tinnitus
2. Venous hum tinnitus
3. Pulsatile tinnitus
4. Ear fullness tinnitus
5. Sensory tinnitus
These different types of tinnitus can be caused by:
- Increased intracranial pressure
- Internal jugular vein compression
- Carotid artery compression
- Vestibular neuritis
- Blocked cerebrospinal fluid
- Eustachian tube dysfunction
- Vestibular nerve swelling
- Vestibulocochlear nerve injury
- Meniere’s disease
“Treating cervical spine disorders can result in a reduction of tinnitus.”
The idea that treating cervical spine instability as a method of treating tinnitus, is an idea that we, as well as many researchers and clinicians, have had for a long time. Yet recent research still has to present this idea as “novel” or new. Henk M Koning, MD, Ph.D., whose research is presented in this article published a paper in The International Tinnitus Journal (1) in November 2020 where he stated at the very onset “Treating cervical spine disorders can result in a reduction of tinnitus.”
Here are the summary learning points:
- The object of the study was to determine the benefit of (painkiller injection) therapy of the third and fourth cervical nerves in reducing tinnitus
- There were 37 tinnitus patients who were treated with injection into the third and fourth cervical nerves
- In a group of tinnitus patients, 19% of the patients reported less tinnitus after therapy of the third and fourth cervical nerves. Most of the patients had a moderate reduction of 25% to 50%.
- At 3.8 months, 50% of the successfully treated patients still had a positive effect. No adverse events of the procedure were observed.
Conclusions: “Treating cervical spine disorders can reduce tinnitus.”
