Newswise — According to a study conducted by Brazilian scientists affiliated with the Optics and Photonics Research Center (CEPOF), low-level laser therapy and its associated photobiomodulation have been found to be the most effective among the known treatments for tinnitus. The study, which compared the main therapies currently in use, is detailed in an article published in the Journal of Personalized Medicine.

CEPOF, the Optics and Photonics Research Center, is a Research, Innovation, and Dissemination Center (RIDC) located at the University of São Paulo's São Carlos Institute of Physics (IFSC-USP) in Brazil. It is funded by FAPESP (São Paulo Research Foundation) and serves as a hub for research, innovation, and knowledge dissemination in the field of optics and photonics. The recent study on tinnitus treatments, mentioned earlier, was conducted by Brazilian scientists affiliated with CEPOF. The findings of the study were published in the Journal of Personalized Medicine.

According to a comprehensive European study that examined five decades of patient data, approximately 750 million individuals worldwide suffer from tinnitus. This condition, often characterized by a perception of ringing or hissing in the ears, is regarded as a symptom rather than a disease. Nevertheless, it can be distressing and, in severe cases, debilitating. Tinnitus can have various causes, including factors such as excessive earwax accumulation, inadequate blood flow to the inner ear, brain injuries, and bruxism (teeth grinding). Currently, there are no universally accepted standard treatments or medications for tinnitus that have been approved by the United States Food and Drug Administration (FDA).

Vitor Hugo Panhóca, a researcher at CEPOF, emphasized the prevalence of tinnitus as a common symptom experienced by a significant portion of the population. He highlighted the wide range of methods employed to treat this condition, including ear lavage, local anesthetics, anti-depressants, anti-histamines, anti-psychotics, and sedatives, each yielding varying results. In light of discovering scientific literature that consistently demonstrated positive outcomes with laser therapy, the researchers at CEPOF made the decision to compare the effectiveness of different treatments and gather further insights into addressing this problem.

During a four-week study conducted by Panhóca and his team, they investigated alternative and complementary treatments for idiopathic (without an apparent cause) and refractory tinnitus. The study involved over 100 men and women between the ages of 18 and 65, who were randomly assigned to ten different groups. Various treatments were tested, including laser acupuncture, flunarizine dihydrochloride, Ginkgo biloba (a medicinal plant), and low-level laser stimulation of the internal auditory canal or meatus (transmeatal stimulation). Additionally, these treatments were examined both individually and in combination with vacuum therapy, ultrasound, G. biloba, or flunarizine dihydrochloride. The study aimed to assess the effectiveness of these interventions in managing tinnitus symptoms.

The patients underwent eight biweekly treatment sessions. They were evaluated before treatment, after the eighth session, and two weeks later using a "tinnitus handicap inventory questionnaire" containing 25 questions. A subset of 11 questions assessed mental, social, occupational, and physical limitations caused by tinnitus.

The most favorable results were observed in patients who received laser acupuncture as a standalone treatment and those who underwent transmeatal low-power laser stimulation alone. Notably, the latter group demonstrated further improvement when the duration of laser irradiation increased from 6 minutes to 15 minutes. Significant and lasting therapeutic effects were also seen in patients who received combinations of laser therapy with vacuum therapy or G. biloba, as well as in those treated solely with laser acupuncture or flunarizine dihydrochloride. These findings highlight the effectiveness of these treatment approaches in managing tinnitus symptoms.

According to Panhóca, the positive effects of laser therapy for tinnitus treatment include its anti-inflammatory action and ability to induce relaxation. The researchers hypothesize that laser therapy can enhance peripheral irrigation, which could be a primary factor contributing to the problem in numerous cases. Additionally, they believe that laser therapy can stimulate the proliferation of inner ear cells and promote collagen production. These mechanisms potentially contribute to the therapeutic benefits observed in patients undergoing laser therapy for tinnitus.

New protocols

Although the CEPOF study isn't the sole evidence indicating the effectiveness of laser therapy in enhancing tinnitus patients' condition, it establishes the groundwork for formulating a guideline applicable to dentists, ENT specialists, speech therapists, and other healthcare professionals treating such patients. The literature exhibits considerable diversity in the number of sessions and the treatment's intensity, warranting the development of a standardized protocol."Comprehending the mechanisms behind effective therapies will enable us to prioritize the most fruitful strategies in future investigations. This constitutes an integral aspect of the learning process when pioneering health treatments of this nature," stated Panhóca. He further emphasized the importance of exploring the enduring implications of laser therapy.

FAPESP also supported the study via a postdoctoral scholarship awarded to Fernanda Rossi Paolillo.

The study was conducted in collaboration with researchers at Irmandade Santa Casa de Misericórdia Hospital in São Carlos, University of Central São Paulo (UNICEP), and Integrated Therapy Center in Londrina (Paraná state), Brazil, as well as Tyndall National Institute at University College Cork (UCC) in Ireland.

Journal Link: Journal of Personalized Medicine