My tinnitus started a little over a year ago due to an infection in my inner ear. Most of the latest research points towards tinnitus being a problem of the auditory circuits within the brain and not necessarily within the inner ear itself. When my tinnitus began I would have rated its intensity as a 3, but over the last couple of days the intensity has increased to a 4 or a 5. I've put together a plan for myself to deal with the contingency of worsening tinnitus. It is as follows;
If my tinnitus reaches an intensity of 6-7 on a 1-10 scale my first line treatments will be to attempt the TMS that is already approved as a treatment for depression and for which trials are underway for tinnitus. There is at least one study out there which suggests that TMS can affect the regulation of genes. This may be its mechanism of action. I haven't researched it thoroughly as I just read about it yesterday. From the studies I have read about thus far, TMS seems to be effective in upwards of 60% of participants. I also like that it is noninvasive and without any obvious side effects.
There is also another trial in the works that involves delivering stimulation to the vagus nerve while playing tones that match an individual's tinnitus frequencies. This in sense,is training the neural areas of the brain not to be in an excited state at these frequencies. This is in trials and has been also met with good success with upwards of 60% effectiveness. This involves implantation of electrodes and wearing a small device for the course of therapy; it is obviously slightly more invasive than TMS.
My last option would be a rather extreme measure and involves partial destruction of some of the auditory areas of the brain. I would undertake this only if I felt that I was suicidal and would be OK without a sense of any hearing at all and also other possible neurological deficits. Research has shown that destruction of the inner ear is not enough in many cases to make any difference to tinnitus at all; this is because once the pathological neurological activity has set itself up, it persists in the circuits of the brain and not in the inner ear. Therefore if areas of the brain that are responsible for this abnormal activity are lesioned or destroyed, all sense of hearing and tinnitus should cease. Primary auditory processing happens in the primary auditory cortex on both sides of the brain. In this area certain portions are responsible for hearing certain frequencies, from low to high.
There is a targeted radiation therapy known as either gammaknife or cyberknife stereotactic radiation surgery. What it does is to send beams of either gamma rays or x-rays through the head from different sources which converge to the areas to be irradiated. To get to the point, I would consult with a neurologist and radio surgery center to have those primary auditory cortices partially destroyed. This would be a last resort option and one would lose their sense of hearing but along with that, the tinnitus as well. The maximal treatment areas with stereotactic radiation treatment is usually limited to a 3.5cm diameter area in the brain. The primary auditory cortices occupy a slightly larger area than this, but if the areas targeted were the areas responsible for high frequency sound and the goal was not to completely destroy the tissue but to damage it and render it non-functional, I believe radiation doses would be within relatively safe limits. It also should be noted that although one wouldn't be able to consciously hear sounds they likely would be aware of direction of sounds as more primitive processing happens in other areas of the brain as well.
This is a last resort type of option only for those that are on the verge of suicide. I think that with the right surgeon and a careful understanding and explanation of the tradeoffs, one could have a chance of getting some of their sanity back with this type of procedure. I know that if I ever reach that point this will be my last option and just wanted to share this with those out there who are on their last legs with this horrible affliction.