Transcutaneous electrical nerve stimulation (TENS) of upper cervical nerve (C2) for the treatment of somatic tinnitus

Somatic tinnitus has been defined as tinnitus temporally associated to a somatic disorder involving the head and neck. Several studies have demonstrated the interactions between the somatosensory and auditory system at the dorsal cochlear nucleus (DCN), inferior colliculus, and parietal association areas. The objective is to verify the effect of transcutaneous electrical nerve stimulation of the upper cervical nerve (C2) in the treatment of somatic tinnitus. As electrical stimulation of C2 increases activation of the DCN through the somatosensory pathway and enlarges the inhibitory role of the DCN on the central nervous system, C2 TENS can be considered for tinnitus modulation. A total of 240 patients in whom tinnitus is modulated by somatosensory events (e.g., tinnitus change with rotation, retro- and antiflexion of neck) or modulated by pressure on head or face were included in this study. Both a real and a sham TENS treatment were applied for 30 min (10 min of 6 Hz, followed by 10 min of 40 Hz and 10 min of sham). Significant tinnitus suppression was found (P < 0.001). Only 17.9% (N = 43) of the patients with tinnitus responded to C2 TENS. They had an improvement of 42.92%, and six patients had a reduction of 100%.