1. Tinnitus can be a symptom of a wide range of different underlying pathologies and accompanied... more 1. Tinnitus can be a symptom of a wide range of different underlying pathologies and accompanied by many different comorbidities, indicating the need for comprehensive multidisciplinary diagnostic assessment. 2. Basic diagnostics should include a detailed case history, assessment of tinnitus severity, clinical ear examination, and audiological measurement of hearing function. For a considerable number of patients, these first diagnostic steps
Classical studies have demonstrated genetic heterogeneity for nonsyndromic autosomal recessive co... more Classical studies have demonstrated genetic heterogeneity for nonsyndromic autosomal recessive congenital neurosensory deafness, with at least six loci postulated. Linkage analysis in two consanguineous Tunisian kindreds has demonstrated that one such deafness locus, DFNB1, maps near chromosome 13 markers D13S175, D13S143, and D13S115. We tested these markers for cosegregation with deafness in 18 New Zealand and 1 Australian nonconsanguineous kindreds, each of which included at least two siblings with nonsyndromic presumed congenital sensorineural deafness and that had a pedigree structure consistent with autosomal recessive inheritance. When all families were combined, a peak two-point lod score of 2.547 (theta = .1) was obtained for D13S175, 0.780 (theta = .2) for D13S143, and 0.664 (theta = .3) for D13S115. While there was no statistically significant evidence for heterogeneity at any of the three loci tested, nine families showed cosegregation of marker haplotypes with deafness....
... 1 Personality describes a set of behavioural traits which display continuity through the life... more ... 1 Personality describes a set of behavioural traits which display continuity through the life course ... The criterion placement in relation to tinnitus would be the reason why two people with the same history of injury and the ... Tinnitus severity, loudness, and depression.[see comment]. ...
Clinical and scientific research has opened up a wide range of options for treating patients with... more Clinical and scientific research has opened up a wide range of options for treating patients with tinnitus. Many of these options are sophisticated and are delivered through specialist tinnitus clinics. However tinnitus is a very common complaint. Most patients with tinnitus need to be satisfactorily cared for by front line clinicians. This chapter describes how one clinician who has looked after some thousands of patients with tinnitus looks after them now. It describes the model I use to explain tinnitus to the patient and develop a management plan. It describes how I assess patients with tinnitus. It lists the treatment options available. It describes the management provided at the first (and usually only) encounter. It stresses the value of a written report. It describes further management and onward referral. It describes my use of drugs in those patients for whom the tinnitus remains overwhelming.
Many drugs and some foods can cause or aggravate tinnitus in some patients. These substances shou... more Many drugs and some foods can cause or aggravate tinnitus in some patients. These substances should be identified and withdrawn. Tinnitus may be improved by the treatment of associated conditions, infections, or hearing loss with appropriate drugs--hypotensives, antibiotics, vasodilators, fluoride or thyroxine. Intravenous lignocaine can temporarily reduce or abolish tinnitus in many patients but can aggravate existing tinnitus in some and may have no effect on others. Analogy with pain of central origin suggests that the beneficial effects of lignocaine (lidocaine) may be due to its anticonvulsant action. Lignocaine is used as a test to distinguish between different mechanisms of tinnitus and to predict responses to oral anticonvulsants. Dramatic responses with lignocaine are usually associated with cochlear hearing loss and often with comparable though less marked responses to oral anticonvulsants. Patients who do not benefit from lignocaine do not respond to oral anticonvulsants....
Impedence audiometry was used to assess the response to treatment with antibiotics of children wi... more Impedence audiometry was used to assess the response to treatment with antibiotics of children with secretory otitis media. Only ears with pressure at maximum compliance of less than --150mm water were included. There was a significant improvement with Bactrim, ampicillin and Vibramycin. There was no change without treatment and deterioration with penicillin.
The effect of intravenous lignocaine upon the symptom of tinnitus has been assessed in seventy-ei... more The effect of intravenous lignocaine upon the symptom of tinnitus has been assessed in seventy-eight patients and the results correlated with associated hearing loss. Lignocaine appears to be highly effective in suppressing tinnitus in patients with presumed damage or degeneration of the Organ of Corti and is less effective in other groups. It is postulated that tinnitus in patients with Organ of Corti damage is the result of abnormal hyperactivity in the auditory pathway following deafferentation.
Australian Journal of Experimental Biology and Medical Science, 1962
The water content of rat-liver slices increased from 70·0 p.c. to 75·6 p.c. when they were incuba... more The water content of rat-liver slices increased from 70·0 p.c. to 75·6 p.c. when they were incubated in oxygen and to 79·3 p.c. when they were incubated in nitrogen. When slices which had become swollen during incubation in nitrogen were re-incubated in small volumes of oxygenated media the slices lost water until they contained as much as slices incubated from
1. When medical treatment is blamed, tinnitus may be harder to treat. 2. Adverse consequences are... more 1. When medical treatment is blamed, tinnitus may be harder to treat. 2. Adverse consequences are better accepted and more easily managed if the patient had been well informed before treatment started and had acknowledged and accepted the risk. 3. Ear ...
1. Tinnitus can be a symptom of a wide range of different underlying pathologies and accompanied... more 1. Tinnitus can be a symptom of a wide range of different underlying pathologies and accompanied by many different comorbidities, indicating the need for comprehensive multidisciplinary diagnostic assessment. 2. Basic diagnostics should include a detailed case history, assessment of tinnitus severity, clinical ear examination, and audiological measurement of hearing function. For a considerable number of patients, these first diagnostic steps
Classical studies have demonstrated genetic heterogeneity for nonsyndromic autosomal recessive co... more Classical studies have demonstrated genetic heterogeneity for nonsyndromic autosomal recessive congenital neurosensory deafness, with at least six loci postulated. Linkage analysis in two consanguineous Tunisian kindreds has demonstrated that one such deafness locus, DFNB1, maps near chromosome 13 markers D13S175, D13S143, and D13S115. We tested these markers for cosegregation with deafness in 18 New Zealand and 1 Australian nonconsanguineous kindreds, each of which included at least two siblings with nonsyndromic presumed congenital sensorineural deafness and that had a pedigree structure consistent with autosomal recessive inheritance. When all families were combined, a peak two-point lod score of 2.547 (theta = .1) was obtained for D13S175, 0.780 (theta = .2) for D13S143, and 0.664 (theta = .3) for D13S115. While there was no statistically significant evidence for heterogeneity at any of the three loci tested, nine families showed cosegregation of marker haplotypes with deafness....
... 1 Personality describes a set of behavioural traits which display continuity through the life... more ... 1 Personality describes a set of behavioural traits which display continuity through the life course ... The criterion placement in relation to tinnitus would be the reason why two people with the same history of injury and the ... Tinnitus severity, loudness, and depression.[see comment]. ...
Clinical and scientific research has opened up a wide range of options for treating patients with... more Clinical and scientific research has opened up a wide range of options for treating patients with tinnitus. Many of these options are sophisticated and are delivered through specialist tinnitus clinics. However tinnitus is a very common complaint. Most patients with tinnitus need to be satisfactorily cared for by front line clinicians. This chapter describes how one clinician who has looked after some thousands of patients with tinnitus looks after them now. It describes the model I use to explain tinnitus to the patient and develop a management plan. It describes how I assess patients with tinnitus. It lists the treatment options available. It describes the management provided at the first (and usually only) encounter. It stresses the value of a written report. It describes further management and onward referral. It describes my use of drugs in those patients for whom the tinnitus remains overwhelming.
Many drugs and some foods can cause or aggravate tinnitus in some patients. These substances shou... more Many drugs and some foods can cause or aggravate tinnitus in some patients. These substances should be identified and withdrawn. Tinnitus may be improved by the treatment of associated conditions, infections, or hearing loss with appropriate drugs--hypotensives, antibiotics, vasodilators, fluoride or thyroxine. Intravenous lignocaine can temporarily reduce or abolish tinnitus in many patients but can aggravate existing tinnitus in some and may have no effect on others. Analogy with pain of central origin suggests that the beneficial effects of lignocaine (lidocaine) may be due to its anticonvulsant action. Lignocaine is used as a test to distinguish between different mechanisms of tinnitus and to predict responses to oral anticonvulsants. Dramatic responses with lignocaine are usually associated with cochlear hearing loss and often with comparable though less marked responses to oral anticonvulsants. Patients who do not benefit from lignocaine do not respond to oral anticonvulsants....
Impedence audiometry was used to assess the response to treatment with antibiotics of children wi... more Impedence audiometry was used to assess the response to treatment with antibiotics of children with secretory otitis media. Only ears with pressure at maximum compliance of less than --150mm water were included. There was a significant improvement with Bactrim, ampicillin and Vibramycin. There was no change without treatment and deterioration with penicillin.
The effect of intravenous lignocaine upon the symptom of tinnitus has been assessed in seventy-ei... more The effect of intravenous lignocaine upon the symptom of tinnitus has been assessed in seventy-eight patients and the results correlated with associated hearing loss. Lignocaine appears to be highly effective in suppressing tinnitus in patients with presumed damage or degeneration of the Organ of Corti and is less effective in other groups. It is postulated that tinnitus in patients with Organ of Corti damage is the result of abnormal hyperactivity in the auditory pathway following deafferentation.
Australian Journal of Experimental Biology and Medical Science, 1962
The water content of rat-liver slices increased from 70·0 p.c. to 75·6 p.c. when they were incuba... more The water content of rat-liver slices increased from 70·0 p.c. to 75·6 p.c. when they were incubated in oxygen and to 79·3 p.c. when they were incubated in nitrogen. When slices which had become swollen during incubation in nitrogen were re-incubated in small volumes of oxygenated media the slices lost water until they contained as much as slices incubated from
1. When medical treatment is blamed, tinnitus may be harder to treat. 2. Adverse consequences are... more 1. When medical treatment is blamed, tinnitus may be harder to treat. 2. Adverse consequences are better accepted and more easily managed if the patient had been well informed before treatment started and had acknowledged and accepted the risk. 3. Ear ...
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