Hi everyone,

I’m Minbo Shim, M.D., Otolaryngologist.

I’ve trained two doctors for ShimSPOT treatment in the USA.

1. Dr. John Lieurance : his clinic is located in Sarasota, FL- Southeast part of America
2. Dr. Patrick Love : his clinic is located in Spokane, WA – West part of America

Now American people have more options to get this ShimSPOT treatment.

I’m expanding the clinics where you can get this ShimSPOT treatment.

You can come to my office located in Seoul, South Korea, or you can visit one of those clinics.

I’ll be in the USA from Sep. 10 to 14 to run a booth, in Philadelphia, PA.

After that, I’ll fly to the west side of America, and will be there until Sep. 22th.

If anyone living in the USA wants to get this ShimSPOT treatment while I’m in the western part of America in the clinic I’ve mentioned, send me an email at heliocityclinic@gmail.com.

Only Sep. 19th will be available for now.

You can absolutely come to my clinic located in South Korea at any time.

• You can see scientific evidence of PRP treatment using ShimSPOT for improving cochlear function here.

Question:  You claim PRP can improve cochlear function. What is the evidence for this?

Answer:    

1. Evidence 1: Several growth factors such as BDNF, FGF, and IGF-1 have neuroprotective effects, promote neuronal precursor differentiation, and contribute to the recovery of PTA levels in patients with SSHL  

*for BDNF & FGF

1. Previous studies demonstrated a neuroprotective effect of different growth factors such as brain-derived neurotrophic factor (BDNF) (Schabitz et al., 2000 https://www.ahajournals.org/doi/10.1161/01.STR.31.9.2212 , Fibroblast growth factors (FGF) (Fisher et al., 1995 https://journals.sagepub.com/doi/10.1038/jcbfm.1995.121 ; Li & Stephenson, 2002 https://www.sciencedirect.com/science/article/abs/pii/S001448860297994X?via%3Dihub).

*for IGF-1

1. Homozygous IGF-1(-/-) mice present an all-frequency involved bilateral sensorineural hearing loss. https://pubmed.ncbi.nlm.nih.gov/16420467/
2. Topical IGF-1 application via gelatin hydrogels contributes to the recovery of PTA levels in patients with SSHL https://pubmed.ncbi.nlm.nih.gov/22772021/

*for IGF-1 & BDNF

1.  IGF-1 and BDNF act together or sequentially to promote neuronal precursor differentiation. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6792940/

Evidence 2: Platelet contains growth factors including BDNF, FGF, IGF-1

1.  Platelet α granules contain a variety of both pro- and anti-angiogenic proteins. Growth factors stored in α-granules include vascular endothelium growth factor (VEGF), platelet-derived growth factor (PDGF), fibroblast growth factor (FGF), epidermal growth factor (EGF), hepatocyte growth factor (HGF), and insulin-like growth factor (IGF). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2720568/
2. BDNF levels in platelets can reach 100- to 1,000-fold those of neurons, making platelets the most important peripheral reservoir of BDNF. Similarly to neurons, platelets store BDNF mainly in α-granules and release it into the bloodstream during platelet activation. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7723927/#:~:text=BDNF%20levels%20in%20platelets%20can,during%20platelet%20activation%20(16).

* Summary for evidence:  

1. BDNF, IGF-1, and FGF work for neuroprotection, promotion of neuronal precursor differentiation, and recovery of PTA levels.
2. Platelet α granules contain these BDNF, IGF-1, and FGF.
3. Platelet α granules release these growth factors into the bloodstream during platelet activation. 

When I put together this evidence, I could set up a hypothesis.

1. Activated platelet will release BDNF, IGF-1, and FGF.
2. Released growth factors will improve cochlear function by neuroprotection and promotion of neuronal precursor differentiation. 
3. Because activated PRP will become sticky, it will not only emit growth factors but also temporarily block the eustachian tube orifice on the middle ear wall while the growth factors are diffusing through the round window membrane. 

Question: Are you concerned that a blind transtympanic injection could be misdirected away from the safer inferior portion of the tympanum and into the posterior superior quadrant and thus potentially dislodge the incus of stapes or cut the chorda tympani nerve?

Answer: 

First, we have to insert the outer part of ShimSPOT into the patient’s ear canal.

It is used to open the ear canal to observe the eardrum. 

After we find out the right spot, we have to hold the outer part of the ShimSPOT trying to not move the left hand., then insert the inner part. The inner part has a very narrow hole, 1 mm in diameter, from the middle of it, which has a 10 cm length. It guides the needle to the right spot of the eardrum. 

Then we inject the PRP or any other drug.

In this situation, we even don’t have to see the eardrum while injecting PRP or any drugs.

Once we’ve found the right spot by using the outer part and fixed the target with the inner part, 

there is no risk of sticking to other spots like the posterior superior portion of the eardrum. 

If there is no inner part, turbid PRP fluid oozing from the hole made by the first injection would preclude the operator to find out the safe anterior inferior part when he wants to inject PRP or other drugs in a row. 

The mechanism using this device enables the operator to inject repeatedly without seeing the eardrum through the same hole on the eardrum.

Usually, 2~3 times of injection is required for one session of treatment. 

I’ve verified my hypothesis since 2014.

You can see the clinical data for hearing improvement by ShimSPOT PRP treatment here.

1. PHARMACEUTICAL COMPOSITION FOR PREVENTING OR TREATING

SENSORNEURAL, HEARING LOSS OR TNNTUS INCLUDING PLATELET RICH PLASMA AND METHOD USING THE SAME: https://patentimages.storage.googleapis.com/e9/94/d8/853dee7266d85f/US20170056447A1.pdf

I tried PRP for patients who had chronic sensorineural hearing loss in 2015.

I’ve annalized the result and got the patent for it.

For most of the frequencies, the pure-tone threshold was decreased after injecting the PRP(P<0.05),

which means their hearing improved after PRP injection.

2. Until 2019, there were no other studies reported worldwide.

In 2019, at last, a paper was published.

: Platelet Rich Plasma (PRP): A Revolutionary Treatment of Sensorineural Hearing Loss: https://actascientific.com/ASOL/pdf/ASOL-01-0022.pdf

It showed that out of 200 patients with injection PRP intratympanic, 172 patients were having improvement in hearing after 5 times of repeated injections and 28 patients didn’t show any improvement in hearing. Out of 28 patients, 19 patients were above 70years and with diabetes, and 9 were above 70 years old.

They didn’t show any further detailed data in this paper, though.

3. In 2022, a paper that showed more detailed data was published.

: Clinicoaudiological evaluation of hearing improvement in patients with sensorineural hearing loss using intratympanic platelet-rich plasma versus steroid injection https://www.ijorl.com/index.php/ijorl/article/view/3447

The improvement from baseline to the follow-up period was higher in the PRP group 10.21±10.45 compared to the DEXA group 1.24±1.34. It is statistically significant (p=0.001).

In this study, they found that a single dose of intratympanic PRP injection is having better results than dexamethasone in terms of hearing improvement. They concluded that injecting platelet-rich plasma through the tympanic membrane is a better modality of treatment of SNHL than injecting dexamethasone through the tympanic membrane.

These findings are in line with that of the study of BBPS Tyagi and Rani. ( https://actascientific.com/ASOL/pdf/ASOL-01-0022.pdf ) and consistent with the result of my study as well.

Based on my experience, the result of multiple times of injections of PRP during one session of treatment was better than a single injection.

the device ShimSPOT was invented to make multiple injections easier and safer.

• You might be wondering what Talala is.
• Talala is a virtual medical communication platform, which enables video connection between doctors and patients

• Every doctor and person around the world can join the Talala for free. : HTTP://talala.us

Every doctor & patient who is interested in ShimSPOT treatment must join the Talala first to get any information and keep in communication during the treatment.

Minbo Shim, M.D.

Cheong Min Clinic

Contact :

Any doctors who want to participate in the network of ShimSPOT,

email : contact@talala.net

For reservation of ShimSPOT treatment: heliocityclinic@gmail.com