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Some forms of tinnitus are caused by damage to the microscopic hairs in the inner ear, that, once damaged, can send electrical signals that cause the ringing sound. So wouldn't that mean that just eliminating the hairs entirely would cure the tinnitus? Deafness would be caused but some people would likely find living with no sound at all more preferable to constant ringing.

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    Many might think that but I doubt they would think so months later.
    – Carey Gregory
    Mar 5, 2018 at 4:57
  • This is speculation and off topic. Mar 11, 2018 at 7:42
  • @GrahamChiu It certainly is not speculation and has been used clinically. See my answer.
    – Bryan Krause
    Mar 12, 2018 at 20:07
  • The question is about the receptors, and not the nerve. Does your answer address the actual question with other than theory? Mar 12, 2018 at 20:35
  • Theory is not a bad thing. Almost everything in biology is solved by theory. The theory that perception is a phenomenon in the brain and that the auditory nerve carries sensory information from hair cells to the brain is not controversial. The OP seems to assume that the simplest way to cause deafness is to lesion the hair cells; in clinical practice, lesions of the auditory nerve have been used instead, with mixed results. The answer is the same.
    – Bryan Krause
    Mar 12, 2018 at 22:27

1 Answer 1

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Short answer

Sometimes (and yes, deafening has been used as a treatment for some patients).

Tinnitus has multiple causes

Although the mechanisms of tinnitus are not completely understood, many forms of sustained tinnitus are not caused by activity in hair cells. Rather, the causes involve auditory brain regions beyond the inner ear, likely due to those circuits no longer receiving the input they used to receive after damage to the cochlea.

Hearing damage in certain frequencies both kills the hair cells (causing deafness) and also induces tinnitus. Therefore, deafness as a cure for tinnitus seems not only undesirable but quite counterproductive in those cases.

In contrast, cochlear implants have in some cases reduced tinnitus, and this is effectively the opposite solution: restoring some version of lost hearing, rather than removing what remains.

Deafening can be a cure for peripheral (originating in the ear) tinnitus

Some forms of tinnitus seem to have a peripheral origin. For example, tinnitus may occur when there is a selective loss of outer but not inner hair cells in a region of the cochlea. In this context, lesioning those inner hair cells could possibly solve the problem, while also deafening the patient at those frequencies. I am unaware, however, of a surgical procedure that can successfully produce such a selective lesion (please comment if anyone knows differently).

Curing tinnitus by lesioning the auditory nerve (thereby deafening the patient) can cure tinnitus in some patients. However, deafening a patient is a rather severe course of action.

Summary

In summary, tinnitus refers to a spectrum of conditions, and depending on the causes in a particular patient, completely different courses of action may be appropriate. Deafening can cure tinnitus in some intractable cases, but is completely inappropriate in others.


References

Arts, R. A., George, E. L., Stokroos, R. J., & Vermeire, K. (2012). cochlear implants as a treatment of tinnitus in single-sided deafness. Current opinion in otolaryngology & head and neck surgery, 20(5), 398-403.

Baguley, D. M. (2002). Mechanisms of tinnitus. British medical bulletin, 63(1), 195-212.

Baguley, D. M., & Atlas, M. D. (2007). Cochlear implants and tinnitus. Progress in brain research, 166, 347-355.

Hesse, G. (2016). Evidence and Lack of Evidence in the Treatment of Tinnitus. Laryngo-rhino-otologie, 95, S155-91.

Jackson, P. (1985). A comparison of the effects of eighth nerve section with lidocaine on tinnitus. The Journal of Laryngology & Otology, 99(7), 663-666.

Pulec, J. L. (1995). Cochlear nerve section for intractable tinnitus. Ear, nose, & throat journal, 74(7), 468-470.

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    @AliceD Modified your edit a bit; on further thought I don't like upstream or downstream.
    – Bryan Krause
    Jun 7, 2018 at 22:01
  • Upstream = from end organ to brain, seems OK to me, whatever milks your Jersey ;-)
    – AliceD
    Jun 7, 2018 at 22:06
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    But downstream is used to mean "after" in a sequence. Neither is entirely appropriate as your edit highlights lol
    – Bryan Krause
    Jun 7, 2018 at 22:52

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