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We analyzed relationships among tinnitus relief, dizziness, and results of vertical autocorrelation studies of head movement to investigate the effect of greater occipital nerve block on the sensory and motor system in 2 patients with abnormal head movement. Tinnitus improved in 14 (52%) of 28 tinnitus patients after occipital nerve block. The percentage of patients reporting tinnitus improvement (54%, or 7 patients) among 13 patients without a history of trauma was not significantly higher than among 12 patients with trauma (33% or 4 patients). However, tinnitus improvement in patients with dizziness but without trauma was more frequent than that reported by nontraumatic tinnitus patients without dizziness (p<.05). Vertical autocorrelation results while stepping in place were better in patients with tinnitus relief than in those not reporting tinnitus relief (p =.001). Dizziness improved in 8 of 13 patients (62%) with trauma, similar to improvement in 8 of 14 patients without trauma (57%). Improved word perception test results in the presence of noise suggested that improvement in tinnitus and dizziness after occipital nerve block was related to improved attention.

We investigated the effects of tinnitus on postural responses using posturography. Thirty-three tinnitus patients (19 female and 14 male) ranging in age from 33 to 67 years (mean age, 53) were selected randomly at our outpatient clinic. Nobody complained of dizziness. Posturographic examination was given before and after 30-minute electrical stimulation. Items tested were envelope area, area (root mean square), total length, total length-area, mean amplitude of lateral body sway (mx), and anteroposterior sway (my). Those parameters did not improve in patients without tinnitus relief. Two postural measures (envelope area and mx) showed significant improvement in patients with tinnitus relief. These effects appeared only on positions involving restricted visual feedback. In a comparison of postural measures in patients with and without tinnitus relief, all parameters except total length and mx improved significantly in patients with eyes open. Our study showed that aside from the auditory system, tinnitus can affect balance, implying that tinnitus may be a factor in increasing unsteadiness in patients with tinnitus.

The present study aimed to explain how tinnitus relief following electrical promontory stimulation affects detection of changes in pitch frequency. To determine the effects of tinnitus relief on the auditory system. Japanese words with the same sound but different intonation were used to verify the effects of tinnitus relief on pitch detection in tinnitus patients Eight out of 11 patients experienced relief of tinnitus following treatment. The averaged number of the ratio in 8 patients with relief of tinnitus, 0.58, was significantly higher (p < 0.02) than that in 3 patients without relief, 0.15. In comparison with averaged hearing level, there was no significant difference in averaged hearing level between 8 patients with relief of tinnitus (52.4 dBSL; SD: 11.4) and 3 without relief of tinnitus (58.0 dBSL; SD: 14.7) (p > 0.68). No significant difference in age between patients with and without relief of tinnitus was observed.

The present study showed that there were close relationships between tinnitus relief and improved word perception by means of a grammatically correct but non-sense Japanese word perception test. Fourteen out of 20 patients reported tinnitus relief and improvement in hearing. Nine out of the 14 patients were thought to be significantly improved in word perception. Improved word perception was observed in 7 out of 10 patients whose ears tested were opposite to ears treated while in 2 out of 10 patients whose ears tested were the same as ears treated. Improved word perception was observed in 5 patients at one segment, 2 patients at two segments and 2 patients at three segments. Improved word perception was observed in one patient at the first segment, 5 patients at the second segment, 5 patients at the third segment and 5 patients at the fourth segment. There were no significant differences in hearing level nor age in patients with and without relief of tinnitus.

An electrical tinnitus suppressor based on the use of an extracochlear stimulator has been developed at Hokkaido University, Sapporo, Japan, and was implanted in 2 male and 2 female patients. Tinnitus improved in all patients because the auditory nerve was able to be stimulated at home whenever patients wanted treatment. Additional benefits reported after electrical stimulation of the cochlea included sound sleep, relaxation in all cases, and improved hearing acuity in Cases 1, 2, and 4. Minimal temporary complications, including habituation and ear drum perforation, were observed.

The purpose of this study was to introduce the electroconduction system for an implantable tinnitus suppressor. This system is a modification of the extracochlear implant system, which was developed at Hokkaido University. This system consists of a stimulator and two coils. One of the coils is implanted inside the temporal bone and its size, including the current limiter, is 9 mm long, 6.4 mm wide and 6 mm thick. Another is contained in the plastic case which is used for hearing aids. The efficacy of conduction depends on the wave frequency. The most effective frequency was about 30 kHz. The maximum current required to relieve tinnitus is 100 microA when using this system. The heat emitted from the coil inside the case is so minimal at an intensity of 100 microA as to be negligible systemically. The electromagnetic coupling system works well for more than 4 months in saline.

An electrical tinnitus suppressor, which was developed at Hokkaido University, was implanted in a female tinnitus patient. She had suffered from bilateral chronic otitis media and her bilateral hearing was seriously impaired. The electrical tinnitus suppressor consists of a stimulator, a coil inside the plastic hearing aid case and an implanted coil in the mastoid. The auditory nerve is stimulated at home twice. Using the system, her hearing ability and emotion improved in addition to tinnitus suppression. Her hearing level and tinnitus also improved in the ear contralateral to the stimulated side.

Electrical promontory stimulation relieved tinnitus in 74 (57.4%) of 129 ears (112 patients). There was no significant difference in etiology of tinnitus, age, average audiogram, or tinnitus frequency between patients who responded to electrical stimulation and those who did not. Most patients who did not respond to the initial stimulation trial did not respond to the subsequent trials, suggesting that the initial response to treatment predicts the subsequent response. Patients who did not respond to repetitive treatment were supposed to be under severe stress.