Treatment: Muscle Needling & Muscle Injections

Introduction: It is well established that treatment of head and neck myofascial dysfunction can alleviate both tinnitus and chronic migraine. Muscle Injections with a neurotoxic protein (BTX) has become a standard treatment for chronic migraine.  

In a recent study of BTX for migraine, subjects were asked if they had tinnitus and whether or not it was affected by their BTX Injections.

Methods:  Fifty-seven patients with chronic migraine received BTX injections into craniocervical muscles using the “follow-the-pain” protocol for headache.  

Results:  Five of the 57 patients said they had tinnitus.  Muscle Injections abolished the tinnitus in two, including one whose tinnitus of ten years’ duration resolved permanently with one Muscle Injections treatment. The tinnitus loudness of the other four was attenuated between 70 to 100 percent for about three months, which paralleled their headaches response.

Discussion/Conclusion:  Tinnitus associated with chronic migraine is abolished/quieted by intramuscular craniocervical BTX injections. 

This serendipitous result warrants further study of Muscle Injections for tinnitus.

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More evidence that neurotoxic protein Muscle Injections (BTX) can abolish tinnitus: intermittent unilateral pulsatile tinnitus: what can it do for other types of tinnitus?

 Robert Aaron Levine, Danièle Ranoux

Department of Otolaryngology, Tel Aviv Medical Center, Tel Aviv, Israel

Pain center, Fondation Ophtalmologique, Paris, France

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Background: In a previous study all 5 patients with chronic non-pulsatile tinnitus and chronic migraine (CM) had a major response to Muscle Injections (BTX): abolished in two, (including one permanently) and for the other three attenuated between 70 to 90 percent for about three months, which paralleled their headaches response.

We now report eleven other CM patients with intermittent unilateral pulsatile tinnitus (PT). All received BTX injected into their ipsilateral suboccipital splenius capitis muscle only and their tinnitus was abolished for 4 to 9 months, which paralleled their headache response.  For four of the eleven their PT occurred only when recumbent.

Discussion: As reported previously intermittent PT is pathognomonic for the somatosensory pulsatile tinnitus syndrome (SSPT).  Likewise recumbent PT is highly suggestive of SSPT.  Furthermore in the experience of the authors unilateral somatic tinnitus is most commonly associated with myofascial findings (tender, with increased bulk and tension) in the ipsilateral suboccipital splenius capitis muscle.

Our findings that BTX abolishes intermittent unilateral PT expands now the indications for BTX to another subtype of tinnitus and emphasizes the need for a more comprehensive study of BTX for tinnitus.