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Can acupuncture help bilateral vestibulopathy

Q:  I have recently recovered from endocarditis, and having been treated with gentamicin have been left with bilateral vestibulopathy. I am wondering whether acupuncture would be effective in this case.

A:  From a western medical perspective we would have to say that the damage caused by the effects of gentamicin can lead to permanent problems, although the website of one of the major American organisations for hearing loss offers a rather more encouraging picture than most:

This is a condition that realistically often causes some permanent disability. In patients with gentamicin-induced ototoxicity, the symptoms generally peak at three months
from the last dose of gentamicin. In the long run however, (five years), most patients become substantially better. There are multiple reasons why people get
better. First, there is evidence that the damaged vestibular hair cells in the inner ear can regenerate, although the extent to which this occurs and the degree to which they are functional is not presently clear (Staecker et al., 2011; Forge et al, 1993)). Some recovery presumably occurs because marginal hair cells recover, because the brain rewires itself to adapt to the new situation (plasticity), and because people change the way they do things to adjust to their situation.

The majority of websites, however, are not usually as optimistic, and there is more often than not a touch of 'when it's gone, it's gone' about their prognostications.

From a Chinese medicine perspective we have to be careful not to engender a sense of false optimism. If there has been proven physical damage to the nerve structures of the inner ear there is not a great deal that acupuncture can achieve. The evidence for the regeneration of nerves with the help of acupuncture is not good except for a few trials with experimental animals (what our colleagues call 'ratpuncture'), and we have to be realistic. However, there are a number of ways in which balance can be affected in Chinese medicine terms, and if there has been a pathological change in the flow of energy in the area, whether brought about by a change in the area or by a
functional change in the whole system which has generated this particular symptom, then there may be some cause for cautious optimism that acupuncture
treatment might have a small impact on the problem. If there is a feasibility that some of the vestibular apparatus can regenerate, then anything which encourages the system as a whole to work better may help in this process.

On that basis there would be no reason not to visit a BAcC member local to you for a slightly more considered view than we can offer from a distance, and they may well be able to identify areas or patterns of weakness, the correction of which may help you to recover to a degree. What we would say, though, is that we would be surprised if the recovery was complete, and our own understanding is that positive change might take a considerable amount of time. This always makes it difficult because it is very difficult to set down good outcome measures which can take into account 5% change. One of our esteemed Japanese colleagues once memorably said that if a patient tells
you they are 10% better they are just saying 'you're a nice person, keep trying.' Her view was that anything less than 25% was difficult to judge. We would recommend, therefore, that if you did see a BAcC member who thought that treatment might help, it would be really important to set regular review periods and to try very hard to find a clearly defined outcome marker to get a sense of what progress, if any, was being made. Can acupunctu

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