We treat tinnitus - Kinetic Centrum Nowoczesnej Audiologii

We treat tinnitus
Advanced center of tinnitus reduction and hearing loss treatment
What makes us special?
Four technologies of tinnitus
reduction
Advanced technologies of hearing
loss treatment with multisensory
and musical training
Advanced technology of
diagnosing tinnitus type and
nervous system activity
About us
Our facility is leading the world in terms of connecting medical consultations, diagnostics
and treatment with the world of audiology and neurobiology. Hearing constitutes 80% of the
nervous system; therefore, all kinds of issues regarding tinnitus, disorders of cognitive processes,
reorganization and deprivation of hearing concern the nervous system itself. While everyone is
trying to find an answer in audiology, we have already found it in neurobiology. It’s the main reason
for us being successful in an effective treatment of tinnitus, hearing loss, disorders of cognitive
processes, depression and schizophrenia. In 2014 in Warsaw, we opened our very first clinic and in
2015 in Bydgoszcz, we opened our second clinic. Future clinics will be located in China, Germany,
France and the USA. We want to share our passion and what we have discovered with everyone.
Diagnostics in our clinics
In our clinics, we provide individual approach to each tinnitus patient. We realize that the nervous
system of a patient who has been suffering from tinnitus for 2 years is different from a patient with
6-year experience. It’s connected with plasticity of the nervous system. That’s why we use specialized
program of choosing technology to a plasticity model which causes tinnitus in the nervous system.
Each patient has a number of medical tests performed starting from high frequency audiometry in
the range between 125 Hz to 20 kHz towards diagnostics of sudden hearing loss, testing for activity
of the nervous system, examination of the horizontal fibers of the auditory cortex and hyperactivity
of the corpus callosum fibers. Those tests examine deep structures of the nervous system. We are
trying to foresee consequences caused by sudden hearing loss which encouraged hyperactivity
of the nervous system (tinnitus). The next step is choosing technology to a diagnosed model and
changes that occurred.
An exemplary path of diagnostics in our clinic
1. Hearing tests
High frequency tonal audiometry test
in the range of 125 Hz to 20kHz
2. Neurodiagnostics
ABR/ ASRR test in search of hidden
hearing loss
3. Test for plasticity type that occurred
in the nervous system
Why we are able to reduce tinnitus and other clinics can’t?
Thanks to advanced technology we are able to diagnose one of four plasticity models which occurred
in a tinnitus patient. After having our tinnitus patient diagnosed with one of four models, we choose
the most effective treatment. Thanks to this approach we know which technologies we should use
and which ones will bring no results at all.
Tinnitus up to 4 years
Tinnitus up to 2 years
Tinnitus above 4 years
Enhanced synchronization of
neurons
Spontaneous activity of
synapses
Hyperactive horizontal fibers of
the auditory cortex
Enhaced
synchronization
Spontaneous
activity
Hiperactive
corpus callosum
Hyperactive corpus callosum fibers – tinnitus caused by acoustic trauma
Hiperactive horizontal
fibers structure
Our technologies – brief description of what we discovered
Transcranial stimulation rTMS is now used in many countries in depression and schizophrenia
treatment. This technology was tested also in terms of tinnitus treatment. As it turned out, it is
highly effective in tinnitus reduction up to 90% when used with enhanced synchronization of
the auditory cortex neurons. This technology is used in our clinics for tinnitus patients who’s been
suffering for over 2 years. Their cells from the range of hearing loss are not stimulated properly and
they lose connections with the auditory cortex neurons. Neurons are trying to find different source
of stimulation. Then, a huge population of neurons which lacks stimulation from the cells of the
hearing loss range connects with neurons and fibers which have access to the stimulation with
healthy cells. In this way, a region of neurons which analyze audible signal is too big; it also emerges
as hypersensitivity to too loud sounds.
rTMS stimulation and its effectiveness matching the cause of tinnitus: enhanced synchronization
Simplified model
Neurons
Auditory cell
Hyperactive synapses in patient
with tinnitus lasting 2 years
Simplified model
Neurons
Hyperactive synapses in patient
with tinnitus above 2 years
Auditory cell
The picture presents two models of generating tinnitus. Within first two years, synapses remain
hyperactive; however, due to lack of stimulation they connect with other cells which work properly.
This kind of plasticity occurs in tinnitus patients with an experience from 2 to 6 years. In order to
reduce tinnitus in such a case, we have to use rTMS technology to depolarize neurons. Acoustic
stimulation could bring effects, but the stimulation process will surely last longer.
Synaptic Adaptation Arc Therapy - this particular therapy was created by us on the basis of our
experience and individual approach to each patient. This therapy focuses on sound stimulation
of the inner ear region where auditory cells died suddenly. When sudden hearing loss emerges,
the nervous system consisting of neurons is unable to adapt to change of stimulation so fast and
it remains unchanged (how it was before hearing loss occurred). It results in natural increase of
activity in the inner ear region where hair cells died suddenly; thus, our hearing gets worse. When
the nervous system notices lack of stimulation from the cells afflicted by sudden hearing loss, it
boosts its activity. Hearable shriek or different, characteristic sound (tinnitus) is a result of synaptic
hyperactivity. It’s the first model which appears in patients with tinnitus lasting up to 2 years. There
is no such technology in the world which could reduce tinnitus to this particular model. For this
reason, we have created our own technology - Synaptic Adaptation Arc Therapy, and we patented it.
This technology uses the process of adaptation of the nervous system to receiving gradually weaker
stimulation with production of cytoskeletal protein Arc/ Arg 3.1 (it is naturally produced within
escalating hearing loss). That is why patients with gradually developing hearing loss does not suffer
from tinnitus. Their nervous system produces Arc/ Arg 3.1 protein, and adjusts its size and activity
to the stimulation level. When sudden hearing loss emerges, the nervous system cannot adjust
its structure to sudden deterioration of hearing. That is why patients with sudden hearing loss
experience tinnitus (hyperactivity of the nervous system). Our technology was created to deal with
this problem by using Synaptic Adaptation Arc Therapy. This technology uses acoustic stimulation
which declines within time and it causes exactly the same reaction which appears in sudden hearing
loss. Also, this technology encourages the production of Arc/ Arg 3.1 protein which then adjusts the
size and activity of synapses and neurons to the stimulation decreasing within time. We tend to use
this technology to the spontaneous synaptic activity model which always emerges within first years
after tinnitus had occurred.
Synaptic Adaptation Arc Therapy and its effectiveness, matching the cause of tinnitus:
spontaneous activity of synapses
Simplified model
Neurons
Simplified model
Hyperactive synapses in patient
with tinnitus lasting 2 years
Neuron
Hyperactive synapses in patient with
tinnitus lasting 2 years
Normal hearing
Auditory cell
Sudden death of auditory cells
The picture presents properly working auditory system where fibers and neurons are connected with
every cell. During sudden death of outer auditory cells, activity of synapses is increased. Synapses no
longer receive stimulation from inner auditory cells. In this way, each tinnitus patient has a model of
spontaneous synaptic activity developed at the very first stage of the illness. In order to reduce this
tinnitus model, Synaptic Adaptation Arc Therapy has to be used.
Acoustic Neuromodulation CR therapy
This therapy has already been in use in Germany, England and Poland. Its aim is to reduce hyperactive
fibers between neurons of the auditory cortex. Along with sudden hearing loss occurs lack of balance
in terms of activity between stimulating and hampering neurons. Large neural population of the
auditory cortex which lacks sudden hearing loss increases its activity by horizontal connections with
hyperactive synaptic structure of neurons with sudden hearing loss. For this plasticity model and
tinnitus type we select acoustic neuromodulation therapy. The therapy is also acoustic stimulation
with scientific algorithm elaborated by German scientists.
Acoustic Neuromodulation CR therapy and its effectiveness, matching the cause of tinnitus:
hyperactive horizontal fibers of the auditory cortex
Simplified model
Hyperactive horizontal fibers
Hyperactive horizontal fibers
Neuron
Sudden death of auditory cells
Musical training
Brain Volts is a laboratory in Northwestern university. A great amount of research published there
covers the area of influence music has on the nervous system, neurons’ reaction and plasticity. When
sudden hearing loss caused by acoustic trauma occurs we often observe that only one ear suffers
from sudden hearing loss (as audiogram shows) whereas the other has no visible cell damage.
For this particular model we use musical training. Neurons from the auditory cortex often
simultaneously analyze sound and somatosensory stimulation. It has been proved that playing a
musical instrument increases the number of hampering neurons (they change electric potential
from high to low). That’s why rebuilding neurons by playing an instrument is so effective. When
auditory cortex and visual cortex are stimulated with sound in terms of their memory activity, it will
cause crossed stimulation of pyramidal neurons from the auditory cortex. It means the neurons will
be rebuilt. Along with musical training, the patient is obliged to follow diet requirements which
increase glycerin level, neurotransmitter GABA and BDNF neurotrophic proteins. The last of those
three is responsible for speeding up the process of rebuilding neurons and making communications
between neurons easier.
Musical training and effectiveness matching the tinnitus cause: hyperactive corpus callosum fibers
from the auditory cortex
Hyperactive corpus
callosum synapses
Neurons of the right
auditory cortex
Damaged neurons
Neurons of the left
auditory cortex
Neurons of the healthy
auditory cortex which
receive spontaneous
electric potential from
synapses without
Corpus callosum fibers
Standards we establish today will become standards of every clinic
responsible for tinnitus reduction and hearing loss treatment all over the
Most common mistakes in tinnitus diagnostics and consultations made by other clinics
Insufficient consultation
Basic hearing diagnostics
without performing the
most important test – high
frequency tonal audiometry
and without conducting tests
for the nervous system
Selecting one technology
to each medical case
without diagnostics
and knowing various
plasticity types;
therefore, not knowing
generated tinnitus
Neglecting diet and
physical activity which
might be helpful in
influencing effective
treatment with therapy
stimulation by using the
most important proteins
of the nervous system –
BDNF – NT 3 Serotonin
Our golden rule and unusual approach which makes us irreplaceable
Our approach
Initial consultation
At first, we determine
model of generated
tinnitus taking into
consideration physical
activity, alcohol,
environment, diet
and time of the day
and how it influence
tinnitus intensity
Diagnostics
Extended hearing
tests, examination
of the nervous
system to diagnose
tinnitus model. In
order to confirm
tinnitus model we
perform at least two
neurodiagnostic tests.
Repeated medical
consultation
Discussing test
results, graphic and
visual explanation
of tinnitus model
and its cause,
qualifying a patient
for a therapy, diet
consultation.
Following diet and
physical activity
requirements
A patient has to follow
diet and physical
activity requirements,
because it will
create appropriate
conditions to start a
therapy (selected on
the basis of previous
diagnostics).
Begining a therapy
If a patient noticed
he/ she has become
more resistant to
stress, tiredness and
tinnitus has been
muted, it means all
proteins necessary to
begin a therapy have
been regulated.
Introduction of our clinics
Warsaw
In our medical center in Warsaw we have Audiologist’s Room where
tinnitus patients are substituted with prostheses and where their
cochlear implant processors are regulated. We are one of a few clinics
in Poland and Europe which uses tests for auditory sensory memory and
short-time memory. Also, we perform tests for audio-visual dynamics to
choose an appropriate hearing aid model for our patient. In our clinics
we provide SeboTek hearing aids (the only ones on the market with the
wide amplification range up to 16 kHz).
Except advanced tinnitus and hearing loss diagnostics we perform
hearing tests using ABR and ASSR attention test P300. Those tests are
also used to select hearing aids for the youngest patients. Soundproof
booth is equipped with the latest technology 3D Tympanometry, ABR,
Otoacoustic emission, high-frequency audiometry, test platform of
cognitive processes and tinnitus diagnostic platform (platform used to
diagnose tinnitus model). Thanks to our specialized equipment we are
able to diagnose even the most difficult cases.
In our clinics, we also have Dietician’s Room. Dietician helps us maintain
the highest level of therapy effectiveness and stimulation influence on
auditory cortex regeneration after hearing loss. What we eat and what
kind of diet we keep greatly influences how fast a therapy will bring
noticeable results and how fast the structure of the nervous system will
be reorganized during post-cochlear implant rehabilitation or after
using a hearing aid.
One of the most amazing places in our clinic is a room for musical
training, where we help out patients who suffer from sudden
hearing loss or acoustic trauma to rebuild damaged structure
of the neurons. The aim of the musical training is to use it in the
process of reconstructing neurons, and not to make a patient
an enthusiast of playing an instrument. Performing musical
training for 6 months shortens regeneration time of the auditory
cortex neurons from 10 000 hours to 5 000 hours. Some patients
decide to continue playing an instrument after the therapy is
completed. We develop our hidden talents at different age.
In our clinic you will also find a room equipped with a training
program which aims to develop cognitive processes in patients
with acoustic trauma, hearing loss and during the process of
inserting implants. Thanks to those specialized tests you are
able to practise aspects of better speech recognition in noise,
sound localization and regeneration of auditory cortex neurons
through the stimulation of the parietal lobe and frontal lobe.
There is a specialized chair with electric regulation in our
room used for rTMS transcranial stimulations, rTMS Magstim
Stimulator and Syneika neuronavigation, for controlling and
monitoring the whole process with modern optic visualization.
Bydgoszcz
In our clinic in Bydgoszcz we also perform all available tests
connected with hearing diagnostics, cognitive processes,
hidden hearing loss, tests for activity of the nervous
system and neurodiagnostics. Also, our patients might be
a part of EEG brain testing program before a therapy for
tinnitus reduction starts. We have the best specialists and
measuring equipment of the latest technology.
Except a room for tinnitus reduction equipped with rTMS
stimulator and neuronavigation, there is also a room
for training and neurobiological rehabilitation with
specialized devices. It is then possible to increase the level
of BDNF proteins, adaptive protein Arc/ Arg 3.1, to regulate
the atrial natriuretic peptide (ANP). It eliminates the risk
of creating other factors of ischemia, lack of oxygen in
the inner ear and the maze which may lead to recurrent
attacks of dizziness and tinnitus.
Each of our clinics provides patients with four
technologies of tinnitus reduction. Synaptic
Adaptation Arc Therapy is automatically programmed for the whole therapy and that can be
done by an audiologist during any appointment.
Thus, it’s not necessary for our patient to visit us
in the clinic to change settings. The device does
that automatically and according to initial settings.
Our future?
We are planning to develop our clinics in other countries and to provides services in different ways.
It’s been almost 2 years since our journey started and we have to improve the website because
our standards, rules and science develops very rapidly. We are constantly trying to improve our
technologies in terms of diagnostics, consultations or treatment itself. We are finding new ways to
select therapies and treatment methods more effectively.
Our website, 2014
Our website, 2016
Our website has been modified and it is more clear and easier to use now. Also, we are the only clinic
in Poland which provides audiology and laryngology services with two consultation options and
clinical diagnostics. We have created our own diagnostics platform and online consultation center.
Thanks to this platform our patients are able to decide whether they want to visit us in one of the
clinics or consult with the specialist online via videoconference (available after registration). If a
doctor suggests medical tests or diet, a patient can go to the ‘Diagnostics’ bookmark at our website
and go through the online medical protocol (identical to the one we have in our clinics). The results
will show if it’s necessary for a patient to visit us in our clinic.
Thus, we are able to provide services for Polish and foreign patients and it has become easily accessible
worldwide. This is a revolutionary program, so it requires time before it becomes a standard way of
patient-doctor communication.
Media about us
At our website you will find ‘Media’ bookmark, where we provide information about TV interviews
we gave and newspaper articles we appeared in. We surely are innovative and one in a kind, so we
attract media attention in the country and abroad.
Adam Pabiś tells us about tinnitus treatment in the
morning show ‘Pytanie na Śniadanie’
Adam Pabiś described a method used in tinnitus
treatment created by Bioacoustic and used in Kinetic
Centrum Nowoczesnej Audiologii. Then, he answered
viewers’ questions.
Tinnitus – Kurier Warszawski
Lastly, we hosted journalists from Kurier Warszawski,
TVP Info in our clinic – Kinetic Centrum Nowoczesnej
Audiologii. We told them about modern methods of
tinnitus treatment.
Innovations for you – Tinnitus in TVP
Our medical center had an opportunity to take part in the
recording ‘Innovations for you’ in TVP, hosted by Roman
Młodkowski. President of the Board of two companies:
Bioacoustic and Kinetic Centrum Nowoczesnej Audiologii,
Adam Pabiś, told about modern method of tinnitus
treatment and development plans. We hope you enjoy
watching.
Międzynarodowe gazety:
http://scienceinpoland.pap.pl/en/news/news,406757,silence-the-noise-with-sounds.html
Polish press:
http://pulsinnowacji.pb.pl/4250204,24824,bioacoustic-uciszy-szum-w-uszach http://wyborcza.biz/
biznes/1,100896,18966732,cisza-w-uchu-szum-na-rynku-pomysl-29-latka-z-polski-wart-2.html
Mamy w Polsce wielu utalentowanych naukowców i wynalazców. Dwa lata temu wprowadziliśmy w naszym plebiscycie trzy kategorie,
w których nominujemy ludzi zaangażowanych w ciekawe projekty badawcze. Ostateczną decyzję dotyczącą wyboru nagrodzonych zostawiamy
Wam! Na nominowanych możecie głosować od XXXX do YYYYY 2016 r. za pośrednictwem strony internetowej www.soczewki.focus.pl
INNOWACJE MEDYCZNE
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IMPLANT DO LECZENIA
PRZEPUKLINY
INNOWACJE TECHNICZNE
Uczeni z Pomorskiego Uniwersytetu
Medycznego i Zachodniopomorskiego Uniwersytetu Technologicznego
stworzyli implant ułatwiający
operowanie przepuklin. Płynny
polimer po wstrzyknięciu do
organizmu zamienia się w gąbczastą
substancję, wzmacniającą osłabione
miejsce. Zabieg ma trwać tylko pół
godziny.
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BUTELKA IZOTERMICZNA
INNOWACJE INFORMATYCZNE
Zespół z Politechniki Gdańskiej
postanowił ulepszyć termos.
W efekcie powstał pojemnik, który
pozwala na utrzymanie niskiej
temperatury napoju nawet przez
kilkanaście godzin. Może mieć
dowolny kształt i być wykonany
zarówno ze szkła, jak i z plastiku.
Jest przy tym tani w produkcji
i bezpieczny dla zdrowia.
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LOGOWANIE SIĘ
ZA POMOCĄ GŁOSU
Większość z nas cały czas wpisuje
hasła w komputerze czy PIN
w telefonie. Krakowska firma
proponuje alternatywę – rozpoznawanie użytkownika po głosie. System
może być stosowany w telefonicznych
centrach obsługi klienta np. banków
czy firm ubezpieczeniowych. Więcej:
www.voicepin.com
Zagłosuj na www.soczewki.foc
Na głosujących, którzy odpow
konkursowe, czekają atrakcyj
Nasza autorska terapia adaptacji synaptycznej dostała nawet nominację znanego w Polsce
czasopisma naukowego Focus
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PŁYN DO PRZECHOWYWANIA
NARZĄDÓW
ŚWIETLNY POMIAR
POZIOMU GLUKOZY
TERAPIA
SZUMÓW USZNYCH
TERMOGRAFICZNE
WYKRYWANIE RAKA PIERSI
Focus — Luty 2015
Naukowcy związani ze Śląskim
Uniwersytetem Medycznym
opracowali nowy płyn do przechowywania narządów pobranych do
przeszczepu: serca, wątroby, trzustki
lub nerek. Biolasol jest o połowę
tańszy niż jego zagraniczne
odpowiedniki. Na rynek wprowadziła
go firma Biochefa. Więcej: www.
biochefa.pl
Aby zmierzyć poziom glukozy
u chorego na cukrzycę trzeba dziś
pobrać krew. Grupa studentów
Wojskowej Akademii Technicznej
w Warszawie pracuje nad technologią iSULIN, dzięki której badanie
jest nieinwazyjne. Wystarczy
przystawić palec do czujnika
diodowego, a potem odczytać wynik
np. na ekranie smartfona.
Słuchawki połączone
z tzw. neuroprocesorem pomagają
pacjentom cierpiącym na dokuczliwe
szumy uszne. Poprawę widać już po
kilku miesiącach stałej terapii.
Nowatorską technologię Terapii
Adaptacji Synaptycznej Arc
opracowali specjaliści z warszawskiego Centrum Nowoczesnej Audiologii
– Kinetic. Więcej: www.kinetic-cna.pl
Firma Braster z Ożarowa Mazowieckiego skonstruowała tester do
diagnostyki raka piersi. Dzięki
technologii termografii kontaktowej
można wykryć ogniska komórek
nowotworowych, które mają wyższą
temperaturę niż zdrowe tkanki.
Braster Tester ma być stosowany
samodzielnie przez kobiety w domu.
Więcej: www.braster.eu
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MONITOROWANIE
PSZCZÓŁ W ULU
PŁYNNY PANCERZ
KULOODPORNY
PORTFEL Z WŁÓKNA
WĘGLOWEGO
ROBOT KOLEJOWY
Pszczelarze mają dużo pracy przy
doglądaniu pasieki. Pomóc im w tym
ma system elektronicznego
monitorowania ula, opracowany
przez studenta Akademii Górniczo-Hutniczej. Dzięki czujnikom
i powiadomieniom SMS pszczelarz
będzie wiedział np., kiedy pszczoły
zaczynają chorować. Więcej: www.
fb.com/ProjektMaja
Kamizelki chroniące przed kulami są
najczęściej ciężkie i grube. Polscy
naukowcy współpracujący z łódzką
firmą Moratex chcą to zmienić,
zastępując sztywny materiał cieczą
reologiczną, która twardnieje pod
wpływem uderzenia. Dzięki temu
kamizelki będą wygodniejsze i
lżejsze.
Jak ochronić zbliżeniową kartę
płatniczą przed zdalnym odczytaniem
z niej danych? Można zawijać ją
w folę aluminiową, ale bardziej
stylowym rozwiązaniem jest portfel,
który nie przepuszcza fal radiowych.
Firma Carbon Workshop wykorzystała
w tym celu bardzo wytrzymały
materiał, jakim jest włókno węglowe.
Więcej: www.carbonworkshop.pl
Obsługa lokomotyw towarowych
i ich wagonów to zadanie trudne
i niebezpieczne. Aby zmniejszyć
ryzyko wypadku inżynierowie Grupy
Zarmen z Chorzowa pracują nad
robotem kolejowym, który sam
będzie wykonywał manewry,
podłączał i odłączał wagony oraz
przewoził ładunek na miejsce.
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SERWIS
DLA MIŁOŚNIKÓW ZWIERZĄT
SPOŁECZNOŚCIOWE
KONKURSY FOTOGRAFICZNE
WYKRYWANIE
AUTYZMU U DZIECI
ZAKUPY PATRIOTYCZNE
DingDog pozwala właścicielom psów
na poznawanie się i umawianie na
wspólne spacery. Możemy sprawdzić
na mapie, kto spaceruje z psem
w pobliżu lub ogłosić, że sami
wybieramy się na przechadzkę. Część
zysków z aplikacji ma być przeznaczona na pomoc dla zwierząt (np.
w schroniskach). Więcej: www.
dingdog.pl
Serwis Shuttout pozwala miłośnikom
fotografii na zarabianie na swoich
zdjęciach. Wystarczy je zgłosić do
konkursu lub zorganizować własny.
Nagrody są finansowane z niewielkich opłat za wpisowe, wnoszonych
przez każdego uczestnika rywalizacji.
Więcej: www.shuttout.com
Krakowska firma Harimata stworzyła
aplikację ułatwiającą rozpoznanie
autyzmu u dzieci. Kilkulatek bawi się
zestawem prostych gier na tablecie,
a program analizuje jego zachowanie.
Aplikacja Play.Care przeznaczona jest
dla rodziców (wersja dla profesjonalistów ma pojawić się wkrótce). Jej
skuteczność sięga 90 proc. Więcej:
www.playcareapp.com
Aplikacja o nazwie Pola potrafi
sprawdzić, czy kupowany przez nas
produkt pochodzi z polskiej firmy. Po
zeskanowaniu kodu kreskowego
smartfonem dowiemy się, czy
producent opiera się na polskim
kapitale, ma zakłady w Polsce
i tworzy wykwalifikowane miejsca
pracy. Więcej: www.pola-app.pl
Regulamin konkursu na www
Conferences we prepared
This year, we organized Research and Development Conference for doctors from across the country
to share knowledge and experience we have in advanced hearing loss and tinnitus treatment and
testing. Conferences took place in three cities: Warsaw, Bydgoszcz and Katowice.
Neurobiology
in audiologii
audiology
Neurobiologia w
Konferencje i szkolenia poświęcone tematyce neurobiologii w współczesnej audiologii
Conference
and training devoted to neuroscience in modern audiology
This year we also organized ‘Neurobiology in audiology’ conference – the first
conference in Poland where we presented our product for doctors in the whole
country, and we trained first clients.
We treat tinnitus