Traditional Chinese acupuncture was used in four cases of intractable tinnitus associated with presbyacusis, showing greater losses at higher frequencies while lower frequencies were only slightly below the normal threshold on a pure tone audiogram. Further audiologic evaluation by means of a speech discrimination test and short-increment sensitivity index (SISI) showed that cases 1 and 2 were the labyrinthine impairment type, case 3 was the mixed type, and case 4 was the retrolabyrinthine type. However, the etiology and pathogenesis of all patients were diagnosed as constitutional deficiency of kidney essence failing to nourish both the ear and brain, the so-called “sea of marrow” based on TCM differentiation. Following the principle of invigorating kidney essence and nourishing “Kidney Qi, ” acupuncture treatment was given around the ear as well as at distal points on the extremities once a week, with 10 sessions constituting one therapeutic course.
In cases 1, 2 and 3, a temporary minor reduction effect of tinnitus lasting half a day to a few days could usually be achieved by each acupuncture session, and long-term effects, with significant improvement of subjective intensity and loudness of tinnitus (which always dropped to 1/2-1/3 of the pretreatment levels) was possibly obtained after 3-4 treatment sessions. Acupuncture was less effective in case 4, in which some fluctuation of tinnitus loudness values was reported within the period of treatment, but there was no remarkable stable improvement, either in terms of loudness or disturbance of the tinnitus after 10 treatment sessions.
The results indicate that traditional Chinese acupuncture is a recommendable therapy in treating age-related tinnitus, especially the labyrinthine type or mixed type rather than the retrolabyrinthine type.