Wet Cupping Therapy as an Integrative Medicine Treatment for Subjective Tinnitus

Wet Cupping therapy (WCT): One of the complementary and integrative medicine healingpractices, which uses cups with superficial scarifications of the selected points on theskin.Tinnitus was defined as the perception of a sound without an associated known stimulusconsciously.In spite of several work and research studies, the pathophysiology of Tinnitus is stillunclear. Tinnitus is one of the major audiological symptoms. Despite its huge personaland presumed economic impact, there are only limited therapeutic options available. Thereason for this deficiency lies in the very nature of the disease as it is deeplyconnected to elementary plasticity of auditory processing in the central nervous system.Furthermore, tinnitus with unknown causes was classified as subjective tinnitus, and iftinnitus duration was more than six months, it was classified as chronic tinnitus. One ofthe major challenges in tinnitus is to explore the pathophysiological causes to find anappropriate effective treatment.Cupping therapy is an integrative and complementary medicine practice. Cupping therapytypes were numerous, and there was a published classification of cupping therapy types.Wet cupping therapy is one of the technical types of cupping therapy. Wet cupping waspracticed by applying cups on selected body points. Superficial scarifications should beperformed by using a sterile surgical blade after removing the cups. The cups should bere‐applied again. Cupping therapy showed promising and significant effects in themanagement of various diseases such as: headache, migraine, neck pain, low back pain, andknee osteoarthritis. A previous case report and a pilot study were conducted to evaluatethe safety and efficacy of cupping therapy in the management of tinnitus and dizziness.The promising effects and the wide safety profile of wet cupping therapy were reported inthis study. Furthermore, wet cupping therapy reduced the discomfort of tinnitus anddizziness. Evidently, cupping therapy was reported to have a wide safety profile as shownin previous published systematic reviews.Tinnitus Handicap Inventory (THI) uses validated tinnitus questionnaires, is aself‐administered test that is used to help determine the degree of distress suffered bythe tinnitus patient. It is widely used in medical offices and in clinical trials todetermine the effectiveness of a given therapy. The purpose of this questionnaire is toidentify difficulties that may be experienced because of tinnitus, focused instead on theimpact of tinnitus on a person's activities of daily living. The THI is the most recent,most reliable, and most widely used of several questionnaires developed over the last 20years.Hearing Level shows the audible threshold for standardized frequencies as measured by anaudiometer. It will measure the intensity in decibels at certain frequencies measured inhertz.The hypothesis of this condition is that wet cupping therapy has a significant effect asa complementary therapy for the management of subjective and continuous tinnitus.Cupping reported effects that can be of benefit for tinnitus patients include increasingmicrocirculation in the area treated, reducing pro‐inflammatory cytokines (IL‐6, TNF‐α),increasing anti‐inflammatory lipids, and a neuromodulation effect.This clinical trial is a large clinical trial design which will be based on a previouslyconducted pilot trial at Hamad Medical Corporation (HMC). The previously published pilottrial was the first world pilot clinical trial in this field which was conducted IN HMC,and to continue our work, this trial is a leading clinical trial which will improve theknowledge regarding the use of integrative medicine in the field of ear pathologies. Itwill provide the first evidence about the effectiveness and safety of using cuppingtherapy as an integrative therapy for the management of chronic subjective tinnitus. Itis the first step of a long way to collect and provide evidence regarding the use ofcupping therapy for the management of tinnitus.Study objectives 1. To examine the effect of wet cupping therapy as an integrative therapy on perceivedtinnitus handicap severity among adults with subjective tinnitus. 2. To evaluate the safety of wet cupping therapy as an integrative therapy treatmentfor subjective tinnitus.