Case Study: Pulsed Radiofrequency of the Vagal Nerve for Tinnitus

Exploring New Frontiers in Tinnitus Treatment: Vagal Nerve Stimulation

The quest for effective tinnitus treatments has led to the exploration of innovative therapeutic avenues, with vagal nerve stimulation (VNS) emerging as a promising strategy for relief. A mix of recent updates in research and cutting-edge technology, VNS typically involves low-level electrical stimulation of the vagal nerve, which has shown potential in not just managing but significantly reducing the symptoms of tinnitus. This breakthrough is illuminated in a case study, where pulsed radio frequency—a minimally invasive neuromodulator technique—was employed to stimulate the auricular branch of the vagal nerve.

In this case study, the clinician incorporated a 22-gauge, 60 mm-long needle with a 5 mm active tip that was inserted percutaneously at the inner side of the tragus, targeting the auricular branch of the vagal nerve. The specified settings—42 V, 2 Hz, and 10 milliseconds—were administered for a 10-minute session, culminating in remarkable outcomes. The patient experienced a drastic reduction in tinnitus intensity, down to 5% of its original level on the left side and 20% on the right. Furthermore, a notable improvement in hearing was documented, with enhancements of 20 to 30 dB across a range of frequencies in both ears.

These findings create hope for persons grappling with severe tinnitus and hearing loss and underscore the efficacy of pulsed radio frequency of the vagal nerve as a safe, repeatable, and non-invasive therapy.

Stimpod NMS460 and the Auricular Branch of Vagus

Stimpod NMS460 gives clinicians the ability to deliver pulsed radio-frequency (tPRF) in a non-invasive fashion.  What was typically an invasive procedure requiring imaging equipment and percutaneous needles can now be performed transcutaneously.

To stimulate the auricular branch of the vagus nerve, one can place the treatment probe as seen in the photo below.

Stimulation site for vagal nerve stimulation using a Stimpod

Reference:

Koning HM, van Hemert FJ. Pulsed Radiofrequency of the Vagal Nerve for Tinnitus -A Case-Study. Int Tinnitus J. 2022 Mar 3;25(2):172-175. doi: 10.5935/0946-5448.20210031. PMID: 35239302.

https://pubmed.ncbi.nlm.nih.gov/35239302/

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