How does TMJ affect tinnitus. What are the common symptoms of TMJ disorder. Can treating TMJ alleviate tinnitus. What are the available treatment options for TMJ-related tinnitus. How does jaw misalignment contribute to ear ringing. Is there a link between bite problems and tinnitus. What role do ear muscles play in TMJ-related tinnitus.

The Link Between TMJ Disorders and Tinnitus

Temporomandibular joint (TMJ) disorders and tinnitus are often interconnected, with jaw problems potentially causing or exacerbating ear ringing. While tinnitus is commonly associated with age-related or noise-induced hearing loss, evidence suggests that TMJ issues can be a root cause in some cases. Understanding this relationship is crucial for proper diagnosis and treatment.

TMJ disorders occur when there’s a misalignment or dysfunction in the jaw joint, which can lead to a cascade of symptoms affecting not only the jaw but also surrounding areas, including the ears. This connection is due to the intricate network of nerves, muscles, and tissues in the head and neck region.

How TMJ Affects Tinnitus

The impact of TMJ on tinnitus can be explained through several mechanisms:

• Muscle tension: TMJ disorders can cause tension in the muscles surrounding the ear, potentially affecting hearing and contributing to tinnitus.
• Nerve irritation: The trigeminal nerve, which is connected to both jaw muscles and ear muscles, can become irritated due to TMJ issues, leading to tinnitus.
• Eustachian tube dysfunction: TMJ problems may affect the function of the Eustachian tube, which regulates ear pressure, potentially causing tinnitus.
• Blood flow changes: Altered blood flow in the head and neck region due to TMJ disorders may contribute to tinnitus symptoms.

Common Symptoms of TMJ Disorder

Recognizing the symptoms of TMJ disorder is essential for early diagnosis and treatment. While tinnitus can be a symptom, there are several other indicators to watch for:

• Jaw pain or tenderness
• Clicking or popping sounds when opening or closing the mouth
• Difficulty or discomfort while chewing
• Facial pain or aching
• Headaches, particularly in the temple area
• Earaches or ear pain
• Neck and shoulder pain
• Limited jaw movement or locking

If you experience a combination of these symptoms along with tinnitus, it’s advisable to consult a TMJ specialist or dentist for a proper evaluation.

The Role of Bite Misalignment in TMJ-Related Tinnitus

A misaligned bite, also known as malocclusion, can be a significant contributor to TMJ disorders and, consequently, tinnitus. When teeth don’t align properly, it can lead to an imbalance in the entire craniofacial system.

How Bite Problems Affect the Jaw and Ears

Bite misalignment can cause:

1. Muscle strain: Uneven bite forces can strain jaw muscles, leading to tension that may affect the ears.
2. Joint stress: Improper alignment can put excessive stress on the TMJ, potentially causing inflammation and pain that radiates to the ears.
3. Nerve compression: Misalignment may compress or irritate nerves in the jaw area, potentially affecting ear function.
4. Postural changes: To compensate for bite issues, people may alter their head and neck posture, which can indirectly affect the ears and contribute to tinnitus.

Ear Muscle Involvement in TMJ-Related Tinnitus

The ear muscles play a crucial role in the connection between TMJ disorders and tinnitus. Two specific muscles are of particular interest:

• Tensor tympani: This muscle is attached to the eardrum and helps dampen loud sounds.
• Tensor veli palatini: This muscle is involved in opening the Eustachian tube, which equalizes pressure in the middle ear.

Both of these muscles are innervated by the trigeminal nerve, which also supplies the jaw muscles. When TMJ issues cause tension or dysfunction in the jaw muscles, it can indirectly affect these ear muscles, potentially leading to tinnitus symptoms.

The Trigeminal Nerve Connection

The trigeminal nerve’s involvement in both jaw and ear function creates a pathway for TMJ problems to manifest as tinnitus. When jaw muscles are tense or inflamed due to TMJ disorders, it can cause referred pain or dysfunction along the trigeminal nerve pathway, potentially affecting the ear muscles and contributing to tinnitus.

Diagnosis of TMJ-Related Tinnitus

Diagnosing TMJ-related tinnitus requires a comprehensive approach, often involving collaboration between dentists, ENT specialists, and audiologists. The diagnostic process typically includes:

• Medical history review
• Physical examination of the jaw, head, and neck
• Dental evaluation to assess bite alignment
• Imaging studies (X-rays, CT scans, or MRI) to visualize the TMJ
• Hearing tests to rule out other causes of tinnitus
• TMJ-specific tests, such as jaw movement analysis

Accurate diagnosis is crucial for developing an effective treatment plan tailored to the individual’s specific condition.

Treatment Options for TMJ-Related Tinnitus

Managing TMJ-related tinnitus often involves a multifaceted approach aimed at addressing the underlying jaw issues while providing relief from tinnitus symptoms. Treatment options may include:

Conservative Treatments

• Jaw exercises and physical therapy
• Stress management techniques
• Application of heat or cold packs
• Lifestyle modifications (e.g., avoiding hard foods, limiting jaw movements)
• Over-the-counter pain relievers and anti-inflammatory medications

Dental Interventions

• Custom-fitted orthotic devices or splints
• Orthodontic treatment to correct bite alignment
• Dental restorations to improve bite

Advanced Therapies

• TENS (Transcutaneous Electrical Nerve Stimulation) therapy
• Botox injections to relax jaw muscles
• Trigger point injections
• Cognitive Behavioral Therapy (CBT) for managing tinnitus-related distress

Surgical Options

In severe cases where conservative treatments are ineffective, surgical interventions may be considered. These can include:

• Arthrocentesis (joint fluid removal)
• Arthroplasty (joint repair)
• Total joint replacement (in extreme cases)

It’s important to note that surgical options are typically considered a last resort and are only recommended when other treatments have failed to provide relief.

The Importance of Early Intervention

Addressing TMJ-related tinnitus early is crucial for preventing the progression of symptoms and minimizing long-term impact. Early intervention can:

• Reduce the risk of chronic pain development
• Prevent further damage to the jaw joint
• Improve overall quality of life
• Potentially reverse or significantly reduce tinnitus symptoms

Patients experiencing persistent tinnitus, especially in conjunction with jaw pain or other TMJ symptoms, should seek professional evaluation promptly. A timely diagnosis and treatment plan can make a significant difference in managing both TMJ disorders and related tinnitus.

Holistic Approaches to Managing TMJ and Tinnitus

In addition to conventional treatments, many patients find relief through holistic and complementary approaches. These methods aim to address not only the physical symptoms but also the overall well-being of the individual:

Mindfulness and Meditation

Practicing mindfulness and meditation can help reduce stress and tension, which are often contributing factors to TMJ disorders and tinnitus. These techniques can also improve one’s ability to cope with persistent symptoms.

Acupuncture

Some studies suggest that acupuncture may help alleviate TMJ pain and potentially reduce tinnitus symptoms. While more research is needed, many patients report positive outcomes from this traditional Chinese medicine practice.

Nutritional Approaches

A balanced diet rich in anti-inflammatory foods may help reduce inflammation associated with TMJ disorders. Additionally, certain supplements like magnesium and B vitamins have been suggested to potentially help with tinnitus, though scientific evidence is limited.

Posture Correction

Improving overall posture, especially in the head and neck region, can help alleviate strain on the TMJ and potentially reduce associated symptoms, including tinnitus.

Biofeedback

This technique helps patients become more aware of their physiological processes, allowing them to gain some control over muscle tension and pain. It can be particularly helpful in managing TMJ-related symptoms.

While these holistic approaches can be beneficial, they should be used in conjunction with, not as a replacement for, professional medical advice and treatment. Always consult with a healthcare provider before starting any new treatment regimen.

Prevention Strategies for TMJ-Related Tinnitus

While not all cases of TMJ disorders and related tinnitus can be prevented, there are several strategies that can help reduce the risk or severity of these conditions:

Maintain Good Posture

Proper posture, especially when sitting for long periods, can help reduce strain on the jaw and neck muscles. Be mindful of your head and neck position throughout the day.

Practice Stress Management

Stress can lead to jaw clenching and teeth grinding, which are major contributors to TMJ disorders. Incorporate stress-reduction techniques such as deep breathing, regular exercise, or yoga into your daily routine.

Avoid Excessive Jaw Movements

Limit activities that require prolonged or extreme jaw movements, such as chewing gum, biting nails, or eating hard foods. Be cautious when yawning widely or singing for extended periods.

Use Proper Dental Hygiene

Regular dental check-ups and maintaining good oral hygiene can help identify and address bite issues early, potentially preventing TMJ problems from developing.

Protect Your Hearing

While not directly related to TMJ, protecting your hearing can help prevent other forms of tinnitus. Use ear protection in noisy environments and avoid prolonged exposure to loud sounds.

Be Mindful of Sleep Position

Sleeping on your back or side with proper head and neck support can help reduce nighttime teeth grinding and jaw clenching.

By incorporating these preventive measures into daily life, individuals can potentially reduce their risk of developing TMJ disorders and associated tinnitus. However, if symptoms persist or worsen, it’s crucial to seek professional medical advice for proper diagnosis and treatment.

The Future of TMJ and Tinnitus Research

As our understanding of the relationship between TMJ disorders and tinnitus continues to evolve, ongoing research is exploring new avenues for diagnosis, treatment, and prevention. Some promising areas of study include:

Advanced Imaging Techniques

Researchers are developing more sophisticated imaging methods to better visualize the intricate structures of the jaw and ear. These advancements may lead to earlier and more accurate diagnoses of TMJ-related tinnitus.

Genetic Factors

Studies are investigating potential genetic predispositions to TMJ disorders and tinnitus. This research could pave the way for personalized treatment approaches based on an individual’s genetic profile.

Neurostimulation Therapies

Emerging neurostimulation techniques, such as transcranial magnetic stimulation (TMS), are being explored as potential treatments for both TMJ pain and tinnitus. These non-invasive methods aim to modulate neural activity in specific brain regions.

Biomarkers for TMJ Disorders

Scientists are working to identify specific biomarkers that could indicate the presence or severity of TMJ disorders. This could lead to more objective diagnostic tools and tailored treatment plans.

Regenerative Medicine

Research into regenerative therapies, such as stem cell treatments and platelet-rich plasma (PRP) injections, shows promise for repairing damaged TMJ tissues and potentially alleviating associated symptoms like tinnitus.

Interdisciplinary Approaches

There is a growing emphasis on interdisciplinary collaboration between dentists, audiologists, neurologists, and other specialists to provide comprehensive care for patients with TMJ-related tinnitus. This holistic approach may lead to more effective treatment strategies.

As research progresses, it’s likely that new and more effective treatments for TMJ-related tinnitus will emerge. Patients and healthcare providers should stay informed about these developments to ensure access to the most current and effective care options.

In conclusion, the connection between TMJ disorders and tinnitus is a complex but important area of study in both dentistry and audiology. By understanding this relationship, healthcare providers can offer more targeted and effective treatments, potentially improving the quality of life for millions of people affected by these conditions. As research continues to advance, we can look forward to even more sophisticated diagnostic tools and innovative therapies to address TMJ-related tinnitus.

Is Your “Bad Bite” the Cause of Your Ear Ringing and Pain?

Your tinnitus is possibly a symptom of a larger problem – namely, TMJ Disorder. But the reality is that even this disorder is a symptom.

The cause of TMJ issues is misalignment of the teeth. Misalignment puts the bones, muscles, joints, and tendons of the head and neck out of alignment as well.

This causes a lot of strain on the muscles, including those of the ear. The ear muscles – the tensor tympani and tensor levi palatine – react to facial muscle tension. The reason for this is because they are both connected to the trigeminal nerve.

The result: ear pain and ringing.

Jaw pain can contribute to problems throughout the body

If you thought TMJ disorder only affects the head and neck – think again.

It affects the entire body.

If you think about it, the way our body is connected from our head to our toes is a beautiful thing. It allows for harmony and fluidity of movement. But the slightest imbalance in your jaws can result in tinnitus, headaches, dizziness, nausea, and jaw pain.

We Believe… Every Patient Deserves to Find Relief – What a TMJ Dentist Can Do For You

If you experience TMJ tinnitus, jaw pain, migraines, or clicking and popping of your jaw joint, you need to come to my office.

woman with ear ringingWithout jaw joint and tinnitus treatment, your symptoms are likely to get worse down the road. As your symptoms progress, the ringing and ear pain can get more intense. What is now an occasional ear ringing and headache can easily turn into being in constant pain down the road.

It is vital to get the treatment you need to get relief from your symptoms of today, as well as the issues that could arise tomorrow.

One of the common causes of TMJ disorder and tinnitus is a misaligned bite. I have multiple ways of helping you find relief.

• Orthodontics – This is the ultimate TMJ Disorder treatment. If your bite is to blame, we need to fix it. And that is what braces will help us to do.
• TENS Machine – Tight muscles can be a major source of jaw pain. This is a gentle electronic stimulation of the jaw muscles that assists them in releasing and relaxing more fully.
• Custom-Fit Orthotic – This device aligns the jaw so that it’s in a position that’s natural and comfortable. We use a K7 mapping tool to analyze your jaw, which helps us to properly design the orthotic.
• Another solution for more severe TMJ pain is a full mouth reconstruction – where we rebuild and reshape the teeth to allow for a better bite, relieving the muscles and joints in the area.

I’ve worked with multiple patients who experience painful symptoms and continue to educate myself to help them. My goal is to always stay current with treatment techniques and technology. Doing so provides me with some amazing tools that help me provide symptom relief to my patients.

I’ve worked with multiple patients who experience painful symptoms and continue to educate myself to help them. My goal is to always stay current with treatment techniques and technology. Doing so provides me with some amazing tools that help me provide symptom relief to my patients.

Don’t Put Tinnitus Treatment Off Any Longer

You may think that ear ringing or occasional ear pain is just a simple annoyance. But that’s really not true – not if you look at your symptoms as part of a bigger concern that’s happening to your body…

TMJ patients with ringing in their ears often experience pain of one sort or another. They may have earaches, migraines, or shoulder tension. And none of that falls under the category of “simply annoying.”

These symptoms of TMJ disorder can affect your daily life. Even if you don’t have any painful symptoms now, that doesn’t mean you won’t get them in the future.

Save yourself a lot of pain and frustration by getting treatment from my Mount Prospect dentist office. We’ll create a TMJ treatment plan that will provide you with relief and prevent further damage down the road.

Do you think you might have TMJ Disorder? Here at the Meyer Dental Group we believe that TMJ sufferers should get a proper diagnosis from their a dentist. Book a TMJ consultation or fill out my free TMJ Pain Questionnaire. You’ll get a response with my recommendations for treatment and relief.

Dr. Tom Meyer DDS – TMJ Chicago dentist, dentist Mount Prospect

TMJ Disorders and Tinnitus: Relationship and Treatment

Tinnitus (ringing in the ears) is largely associated with age- or noise-related hearing loss. Mounting evidence has found that, in a smaller number of cases, temporomandibular joint (TMJ) disorders may be a root cause of tinnitus instead of hearing loss.

People with subjective tinnitus hear disquieting sounds, such as ringing, buzzing, and humming, that are imperceptible to others. This condition becomes more common as people age and begin to lose their hearing.

In contrast, tinnitus associated with TMJ disorders typically affects a younger demographic. It’s also more common in people who were assigned female at birth than those who were assigned male at birth.

In this article, we explore the connection between tinnitus and TMJ disorders. We also discuss potential treatments that may provide relief for both conditions.

TMJs connect your lower jaw (mandible) to your skull on both sides of your face. These joints are located directly in front of your ears. Your TMJs support the jaw muscles needed for eating, yawning, and speaking.

Causes of TMJ disorders

TMJ disorders are caused by inflammation or irritation of the ligaments and muscles surrounding the joints.

Potential causes include:

• grinding teeth during sleep (bruxism)
• arthritis in the jaw
• trauma to the head or neck
• malocclusion (having an overbite or underbite)
• dislocation of the TMJ disk

Symptoms of TMJ disorders

Symptoms of TMJ disorders include:

• clicking or popping sound in jaw
• pain in the jaw and ear
• headache
• difficulty opening your mouth
• jaws that lock in an open or closed position

A 2018 systematic review and meta-analysis of multiple studies found that the prevalence of tinnitus was higher in people with TMJ disorders than in people without TMJ disorders. This may be due to the proximity of the inner ear to the TMJ.

A part in the inner ear called the cochlea transforms sound waves into electrical impulses that the brain translates into recognizable sounds. Damage to the hair cells in the cochlea is a catalyst for tinnitus.

Because the cochlea is located next to the temporomandibular joint, irritation and inflammation in the joint may damage the cochlea and other parts of the inner ear. This may cause subjective tinnitus.

Subjective vs objective tinnitus

Subjective tinnitus is the most common form of tinnitus. Noises are heard only by a person with tinnitus and are not generated by an exterior sound source.

Objective tinnitus is a rarer form of tinnitus. The sounds are typically caused by internal circulatory functions (blood flow) or defects in the structures of the ear. The sounds may be loud enough to be heard by another person.

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A 2019 research study found that TMJ and tinnitus often occur together in people who were assigned female at birth and who are younger than the average tinnitus patient.

Tinnitus in this group tends to be severe and accompanied by pain, pressure, and high levels of stress.

Accompanying symptoms include:

• dizziness
• headache
• vertigo
• neck pain
• poor quality of life

Tinnitus related to TMJ disorders is sometimes referred to as a type of somatic tinnitus. Somatic tinnitus is defined as tinnitus that’s caused by a musculoskeletal problem.

Researchers involved in a 2019 study noted that people with tinnitus and TMJ disorders might make up a specific tinnitus subtype. Their reasoning was based on this group’s responsiveness to specific treatments.

A 2012 study noted that people with tinnitus and TMJ disorders were able to reduce tinnitus symptoms through movements of the head and jaw. Music and sound stimulation also had a beneficial effect.

Research data from as far back as 1997 found that treating TMJ disorders helps alleviate tinnitus in people with both conditions. However, recent studies suggest more research is needed to confirm this connection.

Even so, the American Tinnitus Association is in favor of treating TMJ disorders to alleviate tinnitus that’s caused by problems with the joint.

Possible treatments for TMJ disorders

There are several types of treatments for TMJ disorders that may help alleviate both tinnitus and jaw pain. These include:

• medications, such as muscle relaxants and antidepressants
• a soft food diet
• dental treatments, including bite realignment
• mouth guards to prevent tooth grinding
• oral splints to realign the eardrum
• physical therapy to stretch and strengthen jaw muscles
• corticosteroid injections into the joint
• minimally invasive surgical procedures, such as arthrocentesis
• open joint surgery (arthrotomy)

TMJ disorders and tinnitus are challenging conditions that can negatively affect your quality of life. Whether you have TMJ disorders or symptoms of tinnitus in one or both ears, talk with a doctor. This is especially important if you’re having difficulty keeping up with daily activities, or if you feel anxious or depressed.

Treatments exist for both tinnitus and TMJ disorders.

TMJ disorders are often treated by a dental professional. Talk with your current healthcare professional about the type of specialist who’s best suited to treat your symptoms.

Research suggests TMJ disorders are a cause of tinnitus in some instances. People who have both conditions tend to be younger than the average tinnitus patient.

People assigned female at birth also seem to be more affected by TMJ disorders and accompanying tinnitus than people assigned male at birth.

When tinnitus is caused by TMJ disorders, treatments specific to this cause may help alleviate symptoms.

Talk with your doctor or dentist about potential treatments and which may be best suited for you.

Temporomandibular Joint and Tinnitus – Tinnitus Neuro-Tinnitus Treatment

17
Apr
2019

17 Apr 2019 News, Causes of subjective tinnitus ah, in evidence not needs. The same goes for neck problems. Tinnitus is often caused by injuries to the jaw and neck, which we successfully ignore in our youth. But then, when talking, chewing, turning and tilting the head begin to cause tinnitus, many seek medical help. And they do exactly the right thing. Modern medicine has many opportunities to save such patients from annoying and annoying tinnitus.

Contents of the article:

• 1 Features of the TMJ
• 2 How does the pathology of the TMJ manifest itself?
  • 2.1 Diagnosis: where and by whom?
• 3 How to treat?
• 4 Neck problems and tinnitus

TMJ features

The temporomandibular joint is a complex articulation that allows the jaw to move not only up and down, but also sideways. In addition, it is controlled by the most powerful muscles of the human body – chewing.

Problems with it can be different:

1. dislocation of the fibrous disc inside the articular cavity;
2. injury of articular surfaces;
3. excessive muscular effort applied to the jaw;
4. arthritis, as a manifestation of systemic pathology and arthrosis, as a result of wear and tear of the joint;
5. infectious processes spreading to the TMJ from the ENT organs, the mastoid process.

How does TMJ pathology manifest itself?

Typical symptoms for the problems listed above are pain when opening the mouth and tinnitus. The reason for the first is clear: swelling of the capsule, friction of the articular heads. As for tinnitus, things are a bit more complicated here.

First, the masticatory muscles are located next to the muscle fibers that control the structures of the middle ear. Therefore, the excessive tone of the masticatory muscles affects hearing, contributes to the appearance of tinnitus.

Secondly, in the pathology of the TMJ, small ligaments that go from the joint to the auditory ossicles of the middle ear may be involved in the process. Comments are superfluous.

Thirdly, the nerve centers that control the work of the temporomandibular joint are closely connected with the parts of the brain responsible for hearing and interpreting sounds. If one system suffers, then the function of the second is also impaired.

In addition, when a joint is dysfunctional, it starts making sounds on its own.

And quite characteristic: clicking with each opening and closing of the mouth, creaking, even grinding. Very annoying and stressful condition.

Diagnostics: where and who?

For most patients, it is enough to see a dentist. But it is also worth preparing for instrumental additional examination: X-ray, CT, and sometimes MRI.

In modern conditions, it is even possible to do arthroscopy: to examine the state of the temporomandibular joint with the help of a micro-camera inserted into its cavity.

How to treat?

In many cases, TMJ problems are helped by simple recommendations:

• switch to a soft food diet;
• relaxation exercises for chewing muscles;
• use of non-steroidal anti-inflammatory drugs;
• people with bruxism (teeth grinding at night) should have a special mouth guard fitted.

But sometimes, in order for the noise to finally subside, one has to resort to surgery and even prosthetics of individual structures of the joint.

Neck problems and tinnitus

The cervical spine is very vulnerable, especially in case of an accident. It is also prone to inflammation and osteochondrosis.
Regarding common diseases of the cervical region, we have a separate article on our website (opens in a new tab).

Read about the pathology of the cervical spine

Tinnitus associated with neck pathology is often accompanied by psycho-emotional disorders (depression), cognitive (poor memory, difficulty concentrating) and somatic (dizziness) disorders.

Naturally, in order to help such patients get rid of tinnitus, it is necessary to establish the source of the problem as accurately as possible, for which the entire arsenal of techniques (X-ray, CT, MRI) is used. And only after a complete examination, it is possible to draw up an algorithm for the treatment of a particular patient.

The Tinnitus Neuro clinic has everything you need for professional assistance to people with cervicogenic tinnitus: call us 8-495-374-92-03 or contact us through the website.

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Indications for intra-articular (temporomandibular joint) steroids for tinnitus

Indications for intra-articular (temporomandibular joint) steroids for tinnitus

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Indications for intra-articular (in the temporomandibular joint) administration of steroids for tinnitus

Journal:

Bulletin of otorhinolaryngology.

2019;84(6): 138‑138

How to quote:

Indications for intra-articular (in the temporomandibular joint) administration of steroids for tinnitus. Bulletin of otorhinolaryngology.
2019;84(6):138-138.
Temporomandibular steroids in patients with tinnitus: only on indication. Vestnik Oto-Rino-Laringologii. 2019;84(6):138-138. (In Russ.)

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K. Henk, K. Mark

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Patients with tinnitus of undetermined cause may have temporomandibular joint (TMJ) dysfunction, one treatment for which is intra-articular steroids. The aim of this study was to determine the efficacy of temporomandibular joint steroid administration for the treatment of patients with tinnitus and to more specifically determine the indications for this therapy. We analyzed 70 case histories of patients who came to the clinic from October 2016 to October 2018 for consultations about tinnitus lasting more than 1 month. They were treated with steroid injections into the temporomandibular joint. The data of complaints and anamnesis of patients, radiographs of the cervical spine and audiograms were evaluated. Dynamic monitoring of the effectiveness of therapy was carried out by an independent observer using a telephone survey. Reduction in tinnitus during the 7-week follow-up was achieved in 20% of patients receiving intra-articular injections. After 18 months, this positive effect was observed in 50% of patients. Of the side effects from intra-articular injections after 7 weeks of observation, an increase in the intensity of tinnitus was noted in 11% of patients and general side effects from the use of steroids in 3% of patients. In patients with ANS disorders, unilateral tinnitus was identified in combination with pain in the neck. In 53% of patients with unilateral tinnitus in combination with neck pain, after 7 weeks of treatment with intra-articular injections, a decrease in the intensity of tinnitus was noted, and in 40% of them, the intensity of the noise decreased by more than half. An increase in the intensity of tinnitus as a side effect was observed in 7% of patients in this group.