Tinnitus 3: The Neck Cancer Removals

Presentation

  • 60 y-o auto dealer having had four neck surgeries to remove cancerous tumors and cysts
  • Presents with left-sided tinnitus, the side where most of the surgical scars are
  • Lymph nodes had been removed during surgery
  • Left-sided ‘hissing’ rated at 10/10, and is accompanied by neck pain
  • Symptoms ease with heat at night, ice in the morning, and sleeping on the left side

Evaluation, clinical reasoning & treatment strategizing

  • Very asymmetrical face and neck surface anatomy
  • The neck was very puffy
  • Limited AROMs and PROMs, especially head rotation to the left, indicating a possible shortening of the left SCM in combination with the right obliquus capitis inferior. Lateral flexion was restricted bilaterally ++, indicating the scaleni and other lateral flexors
  • Confesses that he drinks up to eight diet cokes per day at his stressful job

Treatment

  • Trapezius and SCM were of initial interest, followed by semispinalis capitis, the splenii, deep head of masseter, digastric and MFR of the left ear
  • All neck muscles were treated L > R
  • Later treatments included extra-oral muscles, palatini muscles, and later the full intra-oral protocol, of which he is not fond
  • Later, the gentler CRAFTA cranial manipulation protocol was employed
  • An MLD therapist was recommended to reroute lymph drainage of the neck

Results
 and follow-up

  • Within three treatments his weekday tinnitus had dropped to 5/10, then to 3/10, then at the 6 week mark 1-2/10.
  • Interestingly, his tinnitus improved on weekends when he stayed at his lake house
  • During the five treatment years he has seen me 52 times. Often he reports no symptoms
  • He has been thoroughly evaluated by Dr. Hopkins a Personal Health MD, and co-treated with an acupuncturist knowledgeable in tinnitus