Tinnitus

Looking at tinnitus from TCM point of view

Anna van der Vlies

Tinnitus, Western Medicine

• Tinnitus is noise in the ear.• Subjective tinnitus is perception of sound in the

absence of an acoustic stimulus and is heard only by the patient. Most tinnitus is subjective.

• Objective tinnitus is uncommon and results from noise generated by structures near the ear. Sometimes the tinnitus is loud enough to be heard by the examiner.

• Tinnitus may be described as buzzing, ringing, roaring, whistling, or hissing and is sometimes variable and complex. Objective tinnitus typically is pulsatile (synchronous with the heartbeat) or intermittent. Tinnitus is most noticeable in quiet environments and in the absence of distracting stimuli and, thus, frequently seems worse at bedtime.

• Tinnitus may be intermittent or continuous. Continuous tinnitus is at best annoying and is often quite distressing. Some patients adapt to its presence better than others; depression occasionally results. Stress generally exacerbates tinnitus.

• The sound is a manifestation of neural activities, which generates the tinnitus in the central auditive system.

Causes Tinnitus

. Acoustic trauma • Aging• Reaction to medicine• Meniere disease• Infections and tumor and a stroke that affect

auditory pathways also may be responsible• Sudden deafness• As a symptom of other diseases, e.g. anemia• A blocked vertebra

• Infections in teeth or Lyme.• Problems with the jaw• Hypertension

Western solutions

• Hearing aid• Filtered music therapy• Anti depressant• Psychotherapy• Niacin : Vit B3: vasodilation• Prevention / protect ears

Small intestine,

Galbladder

San Jiao

Luo vessel Large intestine

TCM, ClassicsThe Jing qi from the kidneys communicates with 2 ears. If the kidneys are balanced, one can hear 5 tones. (condition of kidneys)Heart, being the emperor, is in charge of the extrasensory openings.

The ear is te place where many meridians meet. Deficiency of stomach qi causes emptiness from vessels and meridians who meet in the ear. Prick GB 3.And: Everywhere, where an EPF can go, there is emptiness. There is not enough nourishment in the upper jiao to feed the brain.And: When Jing is empty, one is deafAnd: If the sea of marrow is empty, one is dizzy and you will have tinnitus

First step

• Deficiency: Slow start, low tone, all the time, less when you press the ear, volume may be lower

• Excess: Sudden onset, loud, intervals, worse with pressure, caused by loud noise.

Key questions to ask

• Is the tone high or low?• Do you hear the sound all the time?• Can you give an indication to how loud the tone

is?• Did the tinnitus start at once or slowly?• Other signs, like: bitter taste (liver), headache or

dizziness or skin problems (possibly internal wind), neck problems (examine), trauma (yu) or signs of phlegm

• Because of the deficiency, qi and blood cannot rise to clear and nourish the marrow and the openings. This can lead to tinnitus.

Damp heat or phlegm can obstruct the openings of the head, which can lead to tinnitus. Phlegm can also combine easily with fire and so can Gan fire rise to the brain.

Combination: Kidney def. Liver yang rising: Loud with high tone and slow beginning.

• Due to Kidney Yang def: Du 4, Kid 3, Kid 7, Ren 4 (moxa), Ren 6 (moxa) , BL 23.

• Kidney Yin Xu: Kid 3, Sp 6.• Kidney Jing: Du 4, Ren 4

• Blood deficiency: Sp 6, Sp 10, Ren 4, St 36, Ht 5, PC 6

• Deficiency upper jiao: Ren 17, Lu 9, Ub: 13 , Ren 6 , Du 20, SJ 16, Si 19.

Excess type

• Liver yang rising: Liv.2 (Liv. 3)• To calm liver yang rising, sooth ear : SJ 5, SJ3• GB 20: calm liver yang rising and internal wind• GB 43 : to clear liver fire and to influence the

ears• GB 8, SJ3/SJ5 : To ease the ear• Li 4: regulates clear rising yang and

descending cloudy yin

Phlegm and Fire rising

• St 40• Du 12, Du 9• Sp 9• GB 20• SJ 3, SJ 5: To clear the area• (if possible or necessary , include dietary

advise)

Tinnitus points

• GB 2• Du 20, Du 19• Sj 2, SJ 17, SJ 21• Si 16, Si 17, Si 18, SI 19• Tai Yang, Sishencong, Yintang

Tinnitus, moxa and ginger

• To unblock the channels and improve circulation.

• SJ 17, GB 2, SJ 21, SI 19, Lu7, GB 43, Sj3, Liv 3,Gb40 (combi of needles and electro acu)

• Large pieces of ginger with a smal needle hole with pagoda shaped ginger on top, on the auricle, move the pieces of ginger

• Once a day, for 10 days

Treatment

• Often• Combine distal and local points• Life style advice if necessary • Treat what you diagnose

Sources

• A manual of acupuncture, Deadman• Foundations of Chines Medicine, Maciocia• Chinese acupuncture and moxibustion• Verloren stilte , M.C. Duijvestijn• Syllabus Shenzhou