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Nitric oxide Bhramari Pranayam and deafness

Article  in  Indian Journal of Otology · January 2016

DOI: 10.4103/0971-7749.176507

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Nitric oxide Bhramari Pranayam and
deafness
Nitric oxide is a gas molecule which has become an
exceptionally important molecule in biophysics. It is a key
biological messenger playing an important role in various
biological processes at the cellular level. Nitric oxide is known
as endothelium‑derived relaxing factor and is biosynthesized
endogenously from semi‑essential amino acid, L‑argenine,
molecular oxygen, and various nitric oxide synthase enzymes.
Nitric oxide contributes to nonspecific host defense against
bacterial, viral, fungal, parasitic infections, hence takes care
of infection in the body. Nitric oxide improves ventilation–
perfusion ratio in the lung along with relaxation of bronchial
tree smooth muscles, hence oxygen uptake is increased and
provides relief in bronchial asthma.
Nitric oxide is known to modulate nor epinephrine,
serotonin, dopamine, glutamate, and the other major
neurotransmitters involved in the neurological process.
Nitric oxide plays a significant role in the inner ear to regulate
the physiological reactions in cochlea. It also contributes
to the basal discharge and response of afferent fibers. It is
also established that a neurotransmitter or neuromodulator
adenosine triphosphate  (ATP) plays an important role in
neurotransmission. Elevation of ATP concentration in the
endolymph or perilymph by active noise trauma or hypoxia
plays an important role in preventing cochlear damage.[1]
Nitric oxide plays an important role at this level in functioning
of inner ear physiology by regulating cochlear blood flow.[2]
Nitric oxide is produced endogenously from the blood vessels
and mucosa of nose and paranasal sinuses. Nitric oxide is
naturally produced in youth and goes down with aging,
mainly hampering the blood circulation to ear, brain, heart,
and sex organs.
Release of nitric oxide production is reduced in sinusitis.
Chronic infection hampers the production and minimizes
the action of nitric oxide.
Humming increases the production of nitric oxide from
sinuses and nasal mucosa. Eby explained humming as a
sonic cleanser, cures the infection of sinuses by decreasing
the swelling of sinus ostea resulting into better drainage
and oxygenation.[3] Humming exercise also increases the
vital capacity. It is estimated that humming increases the
endogenous generation of nitric oxide level by 15‑fold as
compared with the quite exhalation.[4] Due to its vasodilator
effect, nitric oxide can control the filling of nasal capacitance
© 2016 Indian Journal of Otology | Published by Wolters Kluwer - Medknow |
EDITORIAL
vessels, thus nasal air flow, nasal mucosal temperature,
and humidification, hence providing air conditioning to
sinuses and respiratory passage. This in turn affects the
ciliary flow and clinsing of nose, paranasal sinuses including
nasopharyngeal tubes. Better air flow and ciliary clearances
of nasopharyngeal tubes influence the ventilation and
impedance of the middle ear resulting in improvement in
the quality of hearing. The nitric oxide generated during
humming, by increasing the Eustachian tube function and
ventilation of cochlea through the round window affects the
cochlear physiology, neurotransmission and regulation of
cochlear blood flow.[5] It has been observed that adding tiny
amount of nitric oxide to the oxygen to the premature infants
prevents blindness, cerebral palsy, and deafness.[6]
Sinuses are air‑filled cavities and also act as a resonator; high
volume, low pitch 130  Hz humming 60–120  times 4  times
a day can clear the symptoms of chronic rhino sinusitis in
4 days’ time.
Measuring nitric oxide is a simple procedure, easier then
diabetes, strips are available, put a drop of saliva and instant
results are available. Morning empty stomach sample is
required; mouth wash and oral antibiotic are to be refrained
in past 24 h which affect the accuracy of results.
Electromagnetic field  (EMF) generated by Wi‑Fi, cell
phones, remote control devices, television, microwave
ovens, and other radio devices can affect the individuals.
The microwave pulse is absorbed by the soft tissue, launches
thermoplastic waves of acoustic pressure reaching the
inner ear via bone conduction, and stimulates the cochlear
receptors. The response may vary in individuals, but EMF
may lead/aggravate the tinnitus, hearing impairment, vertigo,
Meniere’s disease, acoustic neuroma apart from leading to
irritability, epilepsy, and autism. EMF may also lead to DNA
mutation and birth defects in a fetus if a pregnant woman is
exposed. The WHO has also classified it as a possible cause
of acoustic neuroma. Children are affected more with cell
phone radiation.[7,8]
With the increasing life span, we expect the prevalence of
deafness as high as 40% above the age of 75  years.[9] The
worst part of this deafness is it affects speech frequencies,
hence only 20% can be benefited even with the best possible
hearing aids.[10] This huge population of senior citizen will be
a big liability and great national loss. Hence, we have to make
all the efforts to prevent this aging hearing loss and if curable
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Taneja: Nitric oxide Bhramari deafness
to cure it. Remember even 5 dB of improvement is a great
improvement in terms of speech discrimination as 5 dB is not
simple 5%, decibel is an octave meaning 5 times.[10]
The workers of printing press, fuelling station (petrol pump),
basic metal industries, chemical industries, pesticides, and lead
industry are at 2‑fold higher risk due to noise pollution and
chemical toxicity, hence these workers should be made aware
and prevented from this preventable hearing loss.
Noise, diabetes, cervical spondyliosis, hypertension,
hypothyroidism, obesity, sinusitis, and eustachian tube
dysfunction ototoxicity of drugs and chemicals are
the few which aggravate the age‑related sensorineural
deafness (presbyacusis). Noise‑induced hearing loss is 100%
preventable, but once the patient had it, is for life time.[11]
Bhramari Pranayama (Bee Breath)[12]
It is a breathing exercise; a humming sound is produced during
exhalation with an effort to generate the echo in the ears.
In modern medicine, higher frequency sounds (ultrasound
therapy) is a known modality in the treatment of tinnitus and
sensorineural deafness. Apart from restoration of hearing by
stimulating the hair cells and generating action potential, it
is also quite effective in de‑stressing. Bhramari releases nitric
oxide in the body.
The exercise can be performed sitting comfortably in calm
places, eyes closed, relaxed mood with a smile on face, place
your index finger gently in the ear canal or on tragal cartilage to
gently block the ear canal. Take a deep breath and as you exhale
slowly, make a loud humming sound and generate echo, and
focus your attention toward the inner ears [Figure 1]. A high
pitch sound gives better results. It also helps in regaining better
speech recognition.
Shanmukhi Mudra is a modification of Bhramari Pranayama
for better and earlier improvement. The procedure is place
Figure 1: Bhramari Pranayama
2
your both thumbs at tragal cartilage or at the inlet of external
auditory canal, both hands’ index fingers on the forehead
just above the eyebrows, middle fingers on the eyes, ring
fingers on the nostril, and little finger on upper lip. Take a
deep breath and tuck your chin into the chest, close your
mouth, with ballooning of cheek high pitch humming sound
is produced [Figure 2] (https://youtu.be/9rOnhM_WO6s.).
Diet influences your body, mind, and soul, hence you are what
you eat, drink, and do (yoga). Your life style, diet, and yoga
help you fight with disease. In diet, beet root, spinach, lettuce,
Chinese cabbage, radish, mustard leaf, carrots, and green beans
are the sources for providing semi‑essential amino acids which
are precursor for the production of nitric oxide in the body.
The production of nitric oxide is influenced and enhanced by
exercise and humming sound.
Nitrite is converted into nitric oxide by the macrophages and
endothelium of respiratory mucosa including mucosa of nose
and paranasal sinuses, which in turn dilates the vessel. The
endothelium releases more nitric oxide on physical activity
and in low cholesterol level. Stress reduces the release of nitric
oxide. Horror movies reduce nitric oxide level whereas comedy
movies increase nitric oxide level.
Nitric oxide helps memory and behavior by transmitting
information between neurogenic cells in the brain, apart from
calming the brain by improving the quality of sleep. Nitric
oxide may increase the recognition of sense that is speech
discrimination improves the quality of hearing which goes
down with the age.
I conclude the correction of Vitamin D deficiency,[13,14]
avoiding exposure to ototoxic chemicals, minimum use of
ototoxic drugs, and electromagnetic radiation prevent or
delay aging hearing loss. Bhramari Pranayam, releases nitric
oxide and when combined with Kumbhak, Greeva Chalan
along with modification of diet and life style can prevent or
delay the aging hearing loss. It potentiates immunity and
Figure 2: Shanmukhi Mudra
Indian Journal of Otology | January 2016 | Vol 22 | Issue 1 |
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Taneja: Nitric oxide Bhramari deafness
senile degeneration  (dementia Alzheimer’s) including old
age deafness.
Declaration of participant consent
The authors certify that they have obtained all appropriate
participant consent forms. In the form the participant(s) has/
have given his/her/their consent for his/her/their images and
other clinical information to be reported in the journal. The
participants understand that their names and initials will not
be published and due efforts will be made to conceal their
identity, but anonymity cannot be guaranteed.
M. K. Taneja
Senior ENT and Head Neck Surgeon, Indian Institute of
Ear Diseases, New Delhi, India
E‑mail: ijo_editor@rediffmail.com
References
1. Muñoz DJ, Thorne PR, Housley GD, Billett TE. Adenosine
5’‑triphosphate (ATP) concentrations in the endolymph and
perilymph of the Guinea‑pig cochlea. Hear Res 1995;90:119‑25.
2. Brechtelsbauer PB, Nuttall AL, Miller JM. Basal nitric oxide
production in regulation of cochlear blood flow. Hear Res
1994;77:38‑42.
3. Eby GA. Strong humming for one hour daily to terminate chronic
rhinosinusitis in four days: A case report and hypothesis for action
by stimulation of endogenous nasal nitric oxide production. Med
Hypotheses 2006;66:851‑4.
4. Maniscalo M. Humming, nitric oxide and paranasal sinuses
ventilation. Eur Respir J 2003;22:323‑9.
5. Fessenden JD, Schacht J. Localization of soluble guanylate
cyclase activity in the guinea pig cochlea suggests involvement
in regulation of blood flow and supporting cell physiology.
J Histochem Cytochem 1997;45:1401‑8.
6. Eastor J. Inhaled Nitric Oxide Protects the Brains of High
Indian Journal of Otology | January 2016 | Vol 22 | Issue 1 |
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Risk Premature Infants, Press Release, University of Chicago;
2006. Available from: http://www.uchohospitals.edu/
news/20050707‑oxide.html.
7. Taneja MK, Varshney H, Taneja V, Varshney J. Ototoxicity,
drugs, chemicals, mobile phones and deafness. Indian J Otol
2015;21:161‑4.
8. IARC Classifies Radiofrequency Electromagnetic Fields as Possibly
Carcinogenic to Humans Press Release No. 208. Available from:
http://www.iarc.fr/en/media‑centre/pr/2011/pdfs/pr208_E.
pdf. [Last accessed on 2011 May 31].
9. Taneja MK. Deafness, a social stigma: Physician perspective.
Indian J Otolaryngol Head Neck Surg 2014;66:353‑8.
10. Taneja MK, Quereshi S. Holistic approach to deafness. Indian J
Otol 2015;21:1‑3.
11. Taneja MK. Noise‑induced hearing loss. Indian J Otol 2014;20:151‑4.
12. https://youtu.be/9rOnhM_WO6s.
13. Taneja  MK, Taneja  V. Vitamin D deficiency in E.N.T. patients.
Indian J Otolaryngol Head Neck Surg 2013;65:57‑60.
14. Taneja MK. Role of Vitamin D in prevention of deafness. Indian
J Otol 2012;18:55‑7.
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How to cite this article: Taneja MK. Nitric oxide Bhramari Pranayam
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