Application of the vagus nerve stimulation method in the complex therapy of tinnitus

Tinnitus is a significant clinical problem that has a significant impact on the quality of life of patients. Despite the development of conservative and invasive treatment methods, chronic tinnitus often persists, especially in neurogenic and idiopathic etiologies. In recent years, the attention of researchers has been drawn to the involvement of the autonomic nervous system in the pathogenesis of tinnitus, in particular, the potential for modulating central auditory activity through the vagus nerve. The aim of our study was to evaluate the effectiveness of transcutaneous stimulation of the left cervical branch of the vagus nerve in the complex therapy of tinnitus as a method of neuromodulation in order to reduce the severity of tinnitus and correct autonomic imbalance. The method was evaluated using the example of treating a patient with chronic tinnitus, who, after an acoustic injury, underwent a course of combination therapy: daily 20-minute transcutaneous stimulation of the vagus nerve using the Neurostim device in combination with individually selected sound therapy. Efficacy was assessed using THI, VAS and analysis of autonomic regulation indices (LF/HF). After a 20-day course of therapy, the noise intensity on the THI scale decreased from 58 to 34 points (from severe to mild), the LF/HF index decreased from 4.45 to 3.42, indicating a decrease in sympathicotonia. The patient noted improved sleep and general well-being, a decrease in subjective noise intensity to 3 points on the VAS scale. Transcutaneous vagus nerve stimulation in combination with sound therapy can be considered a promising direction in neuroregulatory therapy for tinnitus. The method is well tolerated and has the potential for wide clinical application, but requires further research to standardize stimulation parameters and select patients.

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