Trans-electrical nerve stimulation (TENS) for somatic tinnitus.
The somatic tinnitus syndrome includes those forms of tinnitus that are associated with a somatic disorder involving the head and upper neck. It has been suggested that physiological mechanisms where interactions occur between the somatosensory and auditory systems are the etiology for that kind of tinnitus. Trans-electrical nerve stimulation (TENS) of areas of skin close to the ear increases the activation of the dorsal cochlear nucleus through the somatosensory pathway and may augment the inhibitory role of this nucleus on the CNS and thereby ameliorate tinnitus. In a prospective descriptive study of 26 patients with the probable diagnosis of somatic tinnitus we found that TENS could improve the tinnitus in 46% of the participants (23% did not hear it anymore, and in 23% its intensity was reduced). VAS scores improved from 6.5 to 6.0 after 2 weeks of treatment (p<0.01). Patients used TENS at home for 2h, once per day during 2 weeks (alternating ramped burst, 150 pps, with pulse duration of 100 micro s, amplitude 0-60 mA; average TENS intensity was 27 mA). Intermittent "typewriter" type of tinnitus was the most responsive. Somatic tinnitus without otologic disease had better response than tinnitus associated to otological causes (p=0.047).