Tinnitus

2. Doutorando da FCAV-UNESP/Jaboticabal 3. Doutoranda da FCAV-UNESP/Jaboticabal 4. Docente do Departamento de Clínica e Cirurgia Veterinária FCAV-UNESP/Jaboticabal. A síndrome vestibular periférica é uma condição clínica comum em cães. Várias doenças podem causar essa síndrome. Entretanto, sua patofisiologia ainda é pouco conhecida. As alterações clínicas geralmente são autolimitantes, a recuperação pode ser longa e, em casos crônicos, os déficits neurológicos podem ser irreversíveis. Em medicina veterinária, há poucas opções terapêuticas. Na Medicina, o dicloridrato de betaístina é amplamente utilizado. Essa medicação foi empregada em seis cães com síndrome vestibular periférica. Os resultados mostraram melhora clínica com sete a dez dias de tratamento e recuperação quase completa entre vinte e trinta dias. Este trabalho descreve a utilização da betaistina em cães com síndrome vestibular periférica, a rápida melhora clínica e ausência de efeitos adversos. Os resultados obtidos parecem justificar o uso de dicloridrato de betaistina na terapia de distúrbios vestibulares periféricos em animais de companhia.

BackgroundMeniere's syndrome or disease (MS/D) is typically characterised by episodic vertigo, aural fullness, tinnitus and fluctuating hearing loss. There are multiple options available for treatment with variation in consensus on the best intervention.ObjectiveTo evaluate the evidence on the efficacy of intratympanic therapies [steroids, gentamicin, antivirals and other therapies] on the frequency and severity of vertigo and other symptoms of MS/D.Search strategyA literature search was performed on AMED, EMBASE, HMIC, MEDLINE, PsycINFO, BNI, CINAHL, HEALTH BUSINESS ELITE, CENTRAL and Cochrane Ear, Nose and Throat disorders group trials register using various MeSH. The search was restricted to English and human subjects, and the last date of search was December 2014.Selection criteriaRandomised controlled trials of intratympanic therapies [steroids, gentamicin antivirals and latanoprost] versus a placebo or another treatment.ResultsWe analysed 8 RCT's comparing intratympani...

Background Hearing loss affects access to spoken language, which can affect cognition and development, and can negatively affect social wellbeing. We present updated estimates from the Global Burden of Disease (GBD) study on the prevalence of hearing loss in 2019, as well as the condition's associated disability. We did systematic reviews of population-representative surveys on hearing loss prevalence from 1990 to 2019. We fitted nested meta-regression models for severity-specific prevalence, accounting for hearing aid coverage, cause, and the presence of tinnitus. We also forecasted the prevalence of hearing loss until 2050. An estimated 1•57 billion (95% uncertainty interval 1•51-1•64) people globally had hearing loss in 2019, accounting for one in five people (20•3% [19•5-21•1]). Of these, 403•3 million (357•3-449•5) people had hearing loss that was moderate or higher in severity after adjusting for hearing aid use, and 430•4 million (381•7-479•6) without adjustment. The largest number of people with moderate-to-complete hearing loss resided in the Western Pacific region (127•1 million people [112•3-142•6]). Of all people with a hearing impairment, 62•1% (60•2-63•9) were older than 50 years. The Healthcare Access and Quality (HAQ) Index explained 65•8% of the variation in national agestandardised rates of years lived with disability, because countries with a low HAQ Index had higher rates of years lived with disability. By 2050, a projected 2•45 billion (2•35-2•56) people will have hearing loss, a 56•1% (47•3-65•2) increase from 2019, despite stable age-standardised prevalence. Interpretation As populations age, the number of people with hearing loss will increase. Interventions such as childhood screening, hearing aids, effective management of otitis media and meningitis, and cochlear implants have the potential to ameliorate this burden. Because the burden of moderate-to-complete hearing loss is concentrated in countries with low health-care quality and access, stronger health-care provision mechanisms are needed to reduce the burden of unaddressed hearing loss in these settings. Funding Bill & Melinda Gates Foundation and WHO.

Background: Rickettsial infections are re-emerging. A study of the geographical distribution of rickettsial infections, their clinical manifestations, and their complications would facilitate early diagnosis. Methods: Thirty-one selected patients from the Western Province of Sri Lanka were studied for rickettsial species, clinical manifestations, and complications. Results: Of 31 patients with possible rickettsioses, 29 (94%) fell into the categories of confirmed, presumptive, or exposed cases of acute rickettsial infections (scrub typhus was diagnosed in 19 (66%), spotted fever group in eight (28%)). Early acute infection or past exposure was suggested in two (7%) cases; cross-reactivity of antigens or past exposure to one or more species was suggested in nine (31%). Seventeen out of 19 (89%) patients with scrub typhus had eschars. Nine out of 29 (32%) patients had a discrete erythematous papular rash: seven caused by spotted fever group, two by scrub typhus. Severe complications were pneumonitis in eight (28%), myocarditis in five (17%), deafness in four (14%), and tinnitus in two (7%). The mean duration of illness before onset of complications was 12.0 (SD 1.4) days. All patients except one made a good clinical recovery with doxycycline or a combination of doxycycline and chloramphenicol. Conclusions: In a region representing the low country wet zone of Sri Lanka, the main rickettsial agent seems to be Orientia tsutsugamushi. Delay in diagnosis may result in complications. All species responded well to current treatment.

Introduction. idiopathic subjective non-pulsating tinnitus (iSNPT) is a frustrating diagnosis to physicians owing to the limited effectiveness of traditional pharmacological approaches. This study aimed to investigate the effect of acupuncture on quality of life in elderly people with iSNPT. Methods. overall, 40 patients of both sexes with iSNPT lasting for > 3 consecutive months and aged 65 years participated in this study. They were assigned into the study and the control groups, 20 patients each. The study group received the prescribed medications in addition to manual acupuncture on the following acupoints:

Tinnitus is a symptom in which the patient can hear ringing, buzzing and similar sounds in the ear for 3 months longer. In our study, we aimed to analyse the cerebellum volume and cerebellum connections in patients with chronic tinnitus using VolBrain program. A total number of 10 patients and 10 otherwise healthy peoples records were then enrolled. Volumetric analysis was performed with automated segmentation of the cerebellum and its lobules, using magnetic resonance imaging (MRI). The mean volumes of 10 cerebellar volume were compared between the tinnitus and control groups. Quadrangular lobular portion of the cerebellum, the flocculonodular part and the volume of the central cerebellar lobule were decreased in the tinnitus group. White and grey matter decreased and the amygdala size was increased. We found statistically important volumetric changes in our study. VolBrain can be used in the future for analysing, diagnosis and treatment tinnitus patients. We recommend to use this practical, free of charge and easy programme to analyse for tinnitus patients. This may provide us with practical and useful information about the disease. In patients with tinnitus, the volume loss was 17.48% in the quadrangular lobe, 21% in the central lobule, and 9.33% in the total cerebellum volume.

Tension pneumocephalus, though rare, poses a significant risk following neurosurgical procedures, involving the buildup of pressurized air within the cranial cavity. Here, we present the case of a 13-year-old male who experienced a right nasal septal deviation after trauma, subsequently developing symptoms indicative of increased intracranial pressure due to tension pneumocephalus. Swift identification and urgent surgical intervention resulted in successful decompression and symptom resolution. This case highlights the critical importance of promptly recognizing early signs of tension pneumocephalus in post-neurosurgical patients and the necessity for immediate management to avert adverse outcomes.

Previous studies in patients with Parkinson's disease have reported that a single session of repetitive transcranial magnetic stimulation (rTMS) can improve some or all of the motor symptoms for 30 to 60 minutes. A recent study suggested that repeated sessions of rTMS lead to effects that can last for at least 1 month. Here we report data that both confirm and extend this work. Fifty-five unmedicated PD patients were classified into four groups: two groups (early and late PD) received 25 Hz rTMS bilaterally on the motor arm and leg areas; other groups acted as control for frequency (10 Hz) and for site of stimulation (occipital stimulation). All patients received six consecutive daily sessions (3,000 pulses for each session). The first two groups then received a further three booster sessions (3 consecutive days of rTMS) after 1, 2, and 3 months, while the third group had only one additional session after the first month. Unified Parkinson's Disease Rating Scale (UP-DRS), walking time, key-tapping speed, and self-assessment scale were measured for each patient before and after each rTMS session and before and after the monthly sessions. Compared to occipital stimulation, 25 Hz rTMS over motor areas improved all measures in both early and late groups; the group that received 10 Hz rTMS improved more than the occipital group but less than the 25 Hz groups. The effect built up gradually during the sessions and was maintained for 1 month after, with a slight reduction in efficacy. Interestingly, the effect was restored and maintained for the next month by the booster sessions. We conclude that 25 Hz rTMS can lead to cumulative and long-lasting effects on motor performance.

BACKGROUND: Gamma Knife radiosurgery (GKRS) is commonly used in treating small vestibular schwannomas; however, its use for larger vestibular schwannomas is still controversial. OBJECTIVE: To assess the long-term safety and efficacy of treating eligible Koos grade 4 vestibular schwannomas with GKRS. METHODS: We conducted a single-center, retrospective evaluation of patient undergoing GKRS for Koos grade 4 vestibular schwannomas. We evaluated clinical, imaging, and treatment characteristics and assessed treatment outcome. Inclusion criteria were tumor size of ≥4 cm3 and follow-up of at least 6 months. Patients with neurofibromatosis type 2 were excluded. Primary outcomes measured were tumor control rate, hearing and facial function preservation rate, and complications. All possible factors were analyzed to assess clinical significance. RESULTS: Sixty-eight patients met inclusion criteria. Median follow-up was 47 months (range, 6-125 months). Baseline hearing was serviceable in 60%. M...

Tinnitus often occurs along with some hearing loss. However around one in every three people with tinnitus does not have any problem with their hearing. 2. Exposure to loud noise: Noise exposure is one of the most common causes of hearing loss. A single incident of loud noise exposure experienced at close range may permanently damage your

OBJECTIVETo determine the short‐term effects of latanoprost, a selective FP prostanoid receptor agonist, in Meniere's disease.STUDY DESIGN AND METHODSLatanoprost was administered by intratympanic injection once daily for 3 days. Before the first injection (day 1) and on days 5 and 15, hearing and tinnitus were determined. The patients assessed vertigo on a visual analogue scale on days 1‐15. The study was randomized, doubleblind, and placebo‐controlled.RESULTSLatanoprost reduced vertigo/dysequilibrium around 30% (P >0.05), and improved speech discrimination around 15% (P >0.05). Tinnitus loudness deteriorated after injection of placebo (P >0.01) but not after latanoprost. Side effects were few.CONCLUSION AND SIGNIFICANCELatanoprost alleviated vertigo/dysequilibrium and improved hearing. The results indicate that the drug potentially could be useful for treatment of Meniere's disease.

The clinical evaluation of subjects with occupational noise exposure has been difficult due to the discrepancy between auditory complaints and auditory test results. This study aimed to evaluate the contralateral acoustic reflex thresholds of workers exposed to high levels of noise, and to compare these results to the subjects' auditory complaints. Methods: This clinical retrospective study evaluated 364 workers between 1998 and 2005; their contralateral acoustic reflexes were compared to auditory complaints, age, and noise exposure time by chi-squared, Fisher's, and Spearman's tests. Results: The workers' age ranged from 18 to 50 years (mean = 39.6), and noise exposure time from one to 38 years (mean = 17.3). We found that 15.1% (55) of the workers had bilateral hearing loss, 38.5% (140) had bilateral tinnitus, 52.8% (192) had abnormal sensitivity to loud sounds, and 47.2% (172) had speech recognition impairment. The variables hearing loss, speech recognition impairment, tinnitus, age group, and noise exposure time did not show relationship with acoustic reflex thresholds; however, all complaints demonstrated a statistically significant relationship with Metz recruitment at 3,000 and 4,000 Hz bilaterally Conclusion: There was no significance relationship between auditory complaints and acoustic reflexes.

Background: Traumatic tympanic membrane perforation is a common otologic disorder with associated hearing impairment. Objective: This study aimed at determining the clinico-epidemiological pattern, etiological factors, clinical presentation and management of traumatic tympanic membrane perforation in a Tertiary institution in Nigeria. This was a prospective hospital based study of patients with history of traumatic perforated of tympanic membrane. The study was carried out over a period of 5 years (September 2012 to August 2017). A study proforma was used to obtain detailed history and clinical findings from consenting patients. Data collected were collated and analyzed using SPSS version 16.0. Results: Prevalence of traumatic tympanic membrane perforation in this study was 2.1%. There were 65.5% males and 34.5% females with a male to female ratio of 2:1. The common presenting symptoms among the patients were hearing impairment in 68.3%, otalgia in 62.7% and tinnitus in 61.3%. Slap on the ear was the commonest cause of traumatic tympanic membrane perforation in 43.7% of the patients followed by self-ear cleaning in 16.9%. Commonest causes of slap in this study were 15.5% from security agent, 12.7% from seniors/boss while 9.9 % are from spouses. Unilateral traumatic perforation was more common in 97.9% than bilateral in 2.1%. The left ear traumatic perforation was more common than right ear tympanic perforation as 53.5% and 44.4% respectively. Grade 2 in 39.4% was the commonest perforation. Majority of the traumatic perforation were 40.8% central and 33.8% anterior central. Commonest comorbid injuries were subconjunctival hemorrhage in 16.2% and fracture temporal bone in 13.8%. Conductive hearing impairment in 69.7% and sensorineural hearing impairment in 17.6% were the commonest type of hearing impairment in our patients. Commonest degrees of hearing impairment were mild and moderate which accounted for 47.9% and 26.8% respectively. Commonest complications of traumatic tympanic membrane perforation were 68.3% hearing impairment and 26.1% tinnitus. Majority (73.9%) of the patients had conservative/medical therapy and 74.6% traumatic perforation healed at the end of 3 months. Traumatic perforation arises mainly from direct injuries in this study. The patients tend to present with hearing loss and unilateral involvement is the most common. There is the need to educate the public on the dangers of intentional trauma to the ear To cite this article [

Jugular foramen meningiomas are exceedingly rare tumors of the fossa jugularis. These meningiomas are characterized by an invasive growth pattern with extensive skull base infi ltra-skull base infi ltra-skull base infiltration in all directions and by the mixed permeative-sclerotic appearance of the bone margins of the jugular foramen. We report an unusual case of a primary jugular foramen meningioma in a 30-year-old woman. The unenhanced highresolution CT of the temporal bones revealed extensive bone destruction around the left jugular foramen as well as bone destruction of the basilar part of the left occipital bone without sclerosis. These findings are unusual for meningiomas and correspond more to glomus jugulare tumors. In the literature, we did not find a case similar to ours. Conclusion. MRI and CT imaging provide accurate distinction between meningioma and glomus tumors or schwannomas in most cases. From high-resolution CT scans, in the case where a permeative-destructive pattern is dominant, and with the absence of hyperostosis and bone thickening around the jugular foramen, the differential diagnosis between jugular foramen meningiomas and other tumors, especially glomus jugulare tumors, is difficult. In that case the correct diagnosis should be based on the MRI findings.

Tinnitus is characterized as a perception of numerous auditory sounds in absence of external stimulus. Tinnitus can have a considerable consequence on a person's quality of life, and is considered to be very complicated to quantify. The aim of this study was to investigate the reliability and validity of Urdu translation of the Tinnitus Handicap Inventory (THI) in Pakistan. It was designed to assess the presence of various auditory sounds without the external stimulus. Scale consisted of 25 items having three subscales functional, emotional, and catastrophic. The study comprised into two stages, preliminary and main studies. The results of preliminary study revealed that the overall scale had high internal consistency [alpha coefficient of Urdu version of THI (THI-U)= 0.99, alpha coefficient of English version of THI=0.98]. The overall scale had test-retest correlation over a fifteen days period of interval (0.99). Main study was performed on 110 tinnitus patients. The results o...

Systemic sclerosis (SSc) is a collagenosis with a substrate of chronic inflammation, which is determined by autoimmunity. The pathogenesis of this disease involves microvasculopathy (small vessel pathology) followed by excessive cutaneous and visceral fibrosis. Although acoustic and vestibular impairment is not classified as being a secondary pathology of SSc, several studies have identified cases of SSc that associate hearing loss and especially vertigo and tinnitus. This paper presents data from the medical literature that have identified vestibular and auditory symptoms among patients with SSc, associating the clinical case presentation of a patient suffering from SSc, which is associated with hearing loss. The need for additional studies on larger groups of patients is underlined, in order to clarify the impact of vasculopathy and fibrosis on the acoustic and vestibular analyzer in patients with SSc.

Objective: To evaluate the prevalence of misdiagnosis of the hearing impaired children, in order to investigate the existence of Auditory Neuropathy Spectrum Disorder. Methods: Analytical, prospective study conducted with 15 participants (30 ears) aged 10-12 years, with bilateral sensorineural hearing loss, attending a Hearing Rehabilitation Center, accompanied by a multidisciplinary team with otolaryngologist, audiologist, psychologist, teacher and social worker. The participants underwent ENT examination and audiological assessment: tympanometry, acoustic reflexes, otoacoustic emissions test and Auditory Evoked response. Results: From the total sample (30 ears), 8 ears (26.7%) presented absent responses in the Auditory Evoked response with the presence of cochlear microphonism. Within the selected eight ears, six (75%) showed presence of otoacoustic emissions test in isolated frequencies and two (25%) ears had otoacoustic emissions test even in the presence of the isolated frequencies. It was found that 26.7% of the ears tested presented results that are compatible with Auditory Neuropathy Spectrum Disorder. The results of this study have identified characteristics related to ANSD in 26.7% of ears tested, 6 participants with age over 10 years old, showing that misdiagnosis in hearing loss patients is still very frequent.

Results: After adjusting for age and sex, the presence of tinnitus was significantly associated with subjective olfactory dysfunction, poor olfactory test results, hearing deterioration, vertigo, and headache. Additionally, high serum calcium levels and a low albumin/globulin ratio were significantly associated with low physical activity and nutrition. Women scored higher than men in olfactory and hearing examinations, but there was no gender di erence in vision examinations. Subjective smell dysfunction and poor smell test results were significantly associated with tinnitus complaints. Hearing and vision were associated even after adjusting for age and sex. These findings suggest that evaluating the mutual relationships among sensory organs is important when evaluating the influence of sensory dysfunctions on cognitive function.

Background: The aim of this study was to identify the prevalence of tinnitus in a sample of people with early stages of Ménière's disease. Material and methods: A postal survey was sent to 256 patients all judged to fulfil the criteria of early unilateral Ménière's disease established by the American Academy of Otolaryngology Committee on Hearing and Equilibrium. Of these 256 patients, 136 had probable Ménière's disease and 120 had early possible Ménière's disease. The same questionnaire was mailed and administered to 60 control subjects with no history of vestibular dysfunction. A total of 158 subjects completed the questionnaire. Results: Tinnitus was found in 54 (63%) of the 72 members of the final unilateral vestibular Ménière's disease group and 61 (85 %) of the 72 members of the final unilateral probable Ménière's disease group. Conclusion: The prevalence of tinnitus as determined by a questionnaire survey was significantly greater in patients with probable Ménière's disease than in patients with early vestibular Ménière's disease or in control subjects. However, the prevalence of tinnitus as determined by a questionnaire survey was significantly greater in patients with early vestibular Ménière's disease than in control subjects.

Tinnitus is attributed to partial sensory deafferentation resulting in a central maladaptive neuroplasticity. Unfortunately, the agent of deafferentation is usually unknown or irreversible. In patients with unilateral vestibular schwannoma (VS), however, the auditory nerve is affected by a benign tumor. Hence, removal of the tumor can cease the tinnitus. In turn, sustaining complaints after surgery indicate cortical neuroplasticity. The present study is a cross sectional study which aims to track cortical structural changes by surface-based morphometry in 46 VS patients with sustained (i.e. centralized) or ceased (i.e. peripheral) tinnitus after surgery. A volumetric analysis of cortical and subcortical gray matter (GM) anatomy was performed on preoperative high-resolution MRI and related to the presence of hearing impairment, pre-and/or postoperative tinnitus. Patients with sustained (i.e. chronic) tinnitus showed an increased GM volume of the bilateral caudate nucleus, the contralateral superior colliculus, the middle frontal and middle temporal gyrus, the fusiform gyrus as well as the ipsilateral pars orbitalis when compared to those patients in whom tinnitus ceased postoperatively. Chronic tinnitus in VS patients is associated with characteristic structural changes in frontal, temporal and subcortical areas. Notably, a significant GM change of the caudate nucleus was detected providing further support for the striatal gaiting model of tinnitus. Abbreviations VS Vestibular schwannoma VBM Voxel-based morphometry MRI Magnetic resonance imaging PET Positron emission tomography SBM Surface-based morphometry CSF Cerebrospinal fluid GM Gray matter WM White matter The current pathophysiological concept of tinnitus attributes spurious auditory signals after partial sensory deafferentation to the onset of the symptom 1-6 . After chronification, however, tinnitus perpetuation is theorized to depend on central maladaptive neuroplasticity as a consequence of the disturbed signal-to-noise ratio. These neuroplastic changes are thought to cause a neuronal hyperexcitability for the residual auditory input resulting in the subjective misperception 7-10 . To validate this theory of the pathophysiological origin of tinnitus, there is an increasing interest in magnetic resonance imaging (MRI) techniques, such as voxel-based (VBM) or surfacebased (SBM) morphometry, to determine structural changes in the brain of tinnitus patients. Although a various

Objective: Tinnitus is one of the most common symptoms before and/or after the surgical removal of a vestibular schwannoma (VS) affecting almost half of the patients. Although there is increasing evidence for the association of hearing impairment and VS-associated tinnitus, the effect of hearing deterioration due to surgery and its relation to the postoperative tinnitus (postTN) is poorly investigated. This knowledge, however, might (i) enlighten the pathophysiology of VS-associated tinnitus (i.e., peripheral or central origin) and (ii) improve preoperative patient counseling. The aim of this study was to understand the predisposition factors for a postTN in relation to hearing outcome after surgery. Methods: This retrospective study analyzed the presence of tinnitus in 208 patients with unilateral VS before and after surgical removal. A binomial logistic regression was performed to ascertain the effect of pre-and postoperative hearing as well as age, gender, tumor side, and size, and intraoperative cochlear nerve resection (CNR) on the likelihood of postoperative VS-associated tinnitus. results: Preoperative tinnitus was the strongest predictor of postTN. In addition, deterioration of functional hearing was increasing, while functional deafferentation (i.e., postoperative hearing loss) of non-functional hearing was reducing the risk of postTN. At the same time, patients with no preoperative tinnitus but complete hearing loss had the lowest risk to suffer from postTN. Patient age, gender, tumor side, and size as well as CNR played a subordinate role. conclusion: While the presence of preoperative tinnitus was the strongest predictor of postTN, there is a distinct relationship between hearing outcome and postTN depending on the preoperative situation. Functional or anatomical deafferentation due to surgical tumor removal does not prevent postTN per se.

Medulloblastoma, a grade IV malignant brain tumor, represents a rare but significant clinical challenge, especially in pediatric populations. This case report highlights a unique presentation of medulloblastoma in a three-year-old male child, focusing on audiological evaluation. The child exhibited progressive bilateral sensorineural hearing loss (SNHL), hypotonia, visual deficits, and developmental delays. Audiological assessments, including otoscopy, pure-tone audiometry, tympanometry, otoacoustic emissions (OAE), and auditory brainstem responses (ABR), revealed progressive hearing impairment culminating in bilateral profound hearing loss. Imaging studies identified a recurrent lesion with leptomeningeal spread post-craniotomy and ventriculoperitoneal shunting. Multidisciplinary evaluations corroborated the diagnosis, with ABR proving critical in assessing auditory pathway integrity. Despite attempts with hearing aids, audiometric responses remained outside the speech spectrum. This case underscores the importance of considering intrinsic brainstem lesions like medulloblastoma in pediatric SNHL presentations and the role of comprehensive audiological and neurological evaluations in timely diagnosis and management.

Conclusion: Impairment and symptoms-related goals predominated as primary goals in our population. The majority of patients achieved the goals established for the treatment cycle. GAS proved to be a useful and sensitive tool to measure treatment outcome with the focus on the needs and expectations of patients/carers, establishing realistic and clear treatment goals, and leading to good achievement rates.

The aim of this study is to develop a diagnostic-therapeutic algorithm for those suffering from tinnitus who seek emergency aid. A literature review has been performed on articles from the last 30 years. It is important to activate medical or surgical diagnostic and therapeutic strategies, in order to safeguard and rehabilitate the various functions affected. Psychiatric comorbidity is the most frequent pathological condition of those with serious or catastrophic tinnitus. In these cases, mortality risk is linked to suicide, morbidity to tinnitus-correlated distress. Tinnitus, mainly linked to loss of hearing, is a frequent symptom among the population at large. About 7% of those affected by tinnitus turn to their doctor to solve their problem, while between 0.5 and 2% request urgent medical assistance. Their cry for help may be the result of an acute onset of tinnitus or the rapid impairment of an already chronic condition. Tinnitus is not considered an urgent ear, nose and throat ...

Background: Tympanic membrane perforation is the most common primary blast injury in the current conflicts and occurs in approximately one tenth of service members wounded by combat explosions. We wanted to determine the severity of perforation and its effect on hearing and combat readiness. This analysis is a retrospective study of US service members injured in combat explosions in Afghanistan or Iraq and treated at our institution between March 2003 and July 2006. Data captured included location and grade of perforation, symptoms, healing rates, audiogram results, need for hearing aids, and loss of eligibility for military service. Results: Of 436 explosion-wounded patients admitted to our facility, 65 (15%) patients had tympanic membrane perforation diagnosed by the otolaryngology service. A total of 97 tympanic membrane perforations occurred among 65 patients. The average surface area involved was 41% ؎ 32% (right) and 35% ؎ 34% (left). More than one third of perforations were grade 4. The most common locations were central and anterior-inferior. Most (83%) patients reported symptoms, most commonly diminished hearing (77%) and tinnitus (50%). Outcome data were available for 77% of perforations. Spontaneous healing occurred in 48%. The remainder (52%) had surgical intervention. The most common audiogram abnormality was mild high frequency hearing loss. Ultimately, three patients (5%) required hearing aids and one discharge from military service. Conclusions: Tympanic membrane perforation occurs in 16% of explosioninjured patients. Most patients are symptomatic and many have large perforations requiring operative intervention. Longterm hearing loss is uncommon but does impact ability to continue military service.

Tinnitus refers to the perception of ringing sounds in the ear that are not heard by others. Counseling plays a vital role in tinnitus intervention. Counseling provides correct information about tinnitus and hearing loss, corrects any misunderstandings related to tinnitus, and suggests precise alternative interventions for tinnitus. In this review, we aimed to examine the counseling contents in Tinnitus Retraining Therapy (TRT), Cognitive Behavioral Therapy (CBT), and Tinnitus Activities Treatment (TAT) to identify information that could be useful for counseling approaches and contents for the various tinnitus intervention methods. We searched Web of Science, Embase, Science Direct, and PubMed for relevant articles. Of the 5,283 articles, 31 were included in the final review of counseling contents for TRT, CBT, and TAT. Based on our findings, we were able to summarize the main contents of counseling in TRT, CBT, and TAT. Although the contents of counseling may vary depending on the ...

Background: Meniere disease (MD) is characterized by recurrent episodes of vertigo, accompanied by tinnitus and hearing loss. Although MD has attracted increasing research interest, the intellectual structure of MD research is not clear when combined with scientific indicators. Objectives: This study aims to examine the structure of MD research through scientometric indicators and social network analysis (SNA). Materials & Methods: Documents related to MD were searched in the topic search (TS) format indexed in the Scopus database from 1970 until 2023. Then, co-word, co-authorship analysis and SNA were employed to create a platform for visualizing the MD research network. Results: The annual growth rate of MD documents is 2.92% and the average citations per doc is 16.97. The trend of the publication year was relatively upward. Otolaryngologica journal obtained the first rank in MD publications with more productivity (879 docs). The United States was the most influential country in producing and collaborating documents. Paparella MM, Nakashima T and Kitahara M were ranked 1 to 3 with 86, 83 and 81 documents, respectively. Nevertheless, Strupp M, Nakashima T and Naganawa S. received 4064, 3906 and 3870 citations in co-authorship analysis, respectively. Applying co-word analysis led to the formation of 6 clusters and "related comorbidities on the severity of MD" was well developed, had the highest occurrence of keywords, and held the most significant position in impact. Conclusion: Tracing the research landscape in MD can help researchers identify more specific research focus within this field and provide a reference for the study of MD research in otolaryngology and head and neck surgery.

Tinnitus is not a disease on its own; rather, it is a symptom that can stem from various underlying conditions. It is characterized as the perception of sound when there is no external source, and it is a prevalent otologic symptom that can be associated with both physical and psychological disorders, significantly impacting the quality of life. Research into the pathophysiology and treatment of tinnitus remains active. There is a growing need for short-term treatments that are minimally invasive yet offer long-lasting relief. Music therapy has emerged as a promising addition to the treatment options. It involves using specially modified music tailored to each patient's hearing profile to mask the tinnitus. In addition, music therapy promotes relaxation, creating a comfortable listening environment for patients. This review article discusses the epidemiology, etiology, impact of tinnitus on quality of life, therapeutic approach, music therapy, procedure of music therapy, and limitations of music therapy in clinical practice.

improved by 63%, 49.6%, 4.2% and 27.3% respectively. In the non-affected limb, HY ratings changed by 18.9% from 8.8 prior the first tDCS session to 7.14 after the 5th session of the first block. During following four blocks, HY ratings in the non-affected limb were as follows: decreased by 66%, increased by 13% (worsening), decreased by 31.1%, and 39.9% respectively. AL improved only after the 4th and 5th block, by 54.2% and 40.2% (from 7.2 to 3.3 and from16.7 to 10.0) respectively in the affected limb and by 63.9% and 27.2% in the contralateral limb. Conclusions: To our knowledge, this the first study assessing hyperalgesia and allodynia in a patient receiving tDCS treatment.

Bilateral objective tinnitus is a rare accompanying manifestation of an underlying palatal tremor (PT). PT can either be secondary to a lesion in the triangle of Guillain and Mollaret, or it can present without a causal organic lesion. In this report, we present an unusual case of a young female with objective tinnitus revealing a PT.

Background:Hallucinogen Persistent Perception Disorder (HPPD) is a condition where the effects of hallucinogenic drugs reoccur long after the acute effects have stopped. No established risk factors or mechanisms for HPPD have been identified. However, reports have suggested a risk phenotype for HPPD due to associations with other perceptual disturbances. With the recent increase in therapeutic psychedelic drug use, it is essential to consider the existence of HPPD risk factors. Therefore, exploring potential links between HPPD and other perceptual disturbances, such as tinnitus and migraine with aura, is a necessary first step. This study aimed to investigate the association between HPPD and other perceptual disorders.Methods:One hundred thirty-eight individuals with HPPD and 116 controls participated in a survey that assessed the prevalence of various perceptual disturbances, including photosensitivity, phonosensitivity, tinnitus, migraine with aura, vertigo, paraesthesia, and syna...

Introduction Recently, there has been increasing concern about the adverse health effects of long-term occupational exposure to low-level blast in military personnel. Occupational blast exposure occurs routinely in garrison through use of armaments and controlled blast detonations. In the current study, we focused on a population of breaching instructors and range staff. Breaching is a tactical technique that is used to gain entry into closed spaces, often through the use of explosives. Materials and Methods Initial measurements of blast overpressure collected during breaching courses found that up to 10% of the blasts for range staff and up to 32% of the blasts for instructors exceeded the recommended 3 psi exposure limit. Using a cross-sectional design, we used tests of balance, ataxia, and hearing to compare a sample of breachers (n = 19) to age-and sex-matched military controls (n = 19). Results There were no significant differences between the two groups on the balance and atax...

High velocity flow jet in an up-stream stenosis in the transverse sinus directed at the SSD opening, 2. Flow jet into the SSD along the long axis of the SSD, either anteriorly or laterally directed, 3. Vortex of flow in the SSD, 4. Prominent vortex component of flow in the sigmoid sinus downstream from SSD, 5. Vortex of flow in the jugular bulb Three of the patients had simulated post-coil treatment models developed excluding the SSD from the models. CFD showed no flow in SSD and decreased vortex component of flow in the sigmoid sinus downstream from the SSD. Conclusion PT caused by SSD may be caused by a unique flow pattern in the SSD and sinuses as visualized on both MRV and CFD.

To identify all disease-specific health-related quality-of-life (HR-QoL) instruments used to assess tinnitus in clinical trials and detail their psychometric properties. DATA SOURCES: A literature search was performed in the bibliographical databases of PubMed and Embase to identify all articles using specific HR-QoL instruments in tinnitus trials. The HR-QoL instruments used in these articles were investigated in more detail, focusing on characteristics and psychometric values by two independent reviewers. RESULTS: Seventeen studies were identified by the systematic search. The most used HR-QoL questionnaire was the Tinnitus Questionnaire, followed by the Tinnitus Handicap Inventory, the Tinnitus Reaction Questionnaire, and the Tinnitus Handicap Questionnaire. Internal consistency (Cronbach's ␣ Ͼ 0.9) and reproducibility (Ͼ 0.8) were high for all questionnaires, and there was heterogeneity in responses between patients, endorsing the use of these questionnaires for discriminative purposes. However, the responsiveness, i.e., the usefulness of these questionnaires in evaluating treatment effects, is not known yet. CONCLUSION: The HR-QoL instruments used in tinnitus trials appear not to be validated to measure effectiveness of interventions. Using tests or instruments that are valid and reliable is a crucial component of research quality, and both should therefore be studied before final conclusions can be drawn from the questionnaires in upcoming clinical trials.

To identify all disease-specific health-related quality-of-life (HR-QoL) instruments used to assess tinnitus in clinical trials and detail their psychometric properties. DATA SOURCES: A literature search was performed in the bibliographical databases of PubMed and Embase to identify all articles using specific HR-QoL instruments in tinnitus trials. The HR-QoL instruments used in these articles were investigated in more detail, focusing on characteristics and psychometric values by two independent reviewers. RESULTS: Seventeen studies were identified by the systematic search. The most used HR-QoL questionnaire was the Tinnitus Questionnaire, followed by the Tinnitus Handicap Inventory, the Tinnitus Reaction Questionnaire, and the Tinnitus Handicap Questionnaire. Internal consistency (Cronbach's ␣ Ͼ 0.9) and reproducibility (Ͼ 0.8) were high for all questionnaires, and there was heterogeneity in responses between patients, endorsing the use of these questionnaires for discriminative purposes. However, the responsiveness, i.e., the usefulness of these questionnaires in evaluating treatment effects, is not known yet. CONCLUSION: The HR-QoL instruments used in tinnitus trials appear not to be validated to measure effectiveness of interventions. Using tests or instruments that are valid and reliable is a crucial component of research quality, and both should therefore be studied before final conclusions can be drawn from the questionnaires in upcoming clinical trials.

Background: Use/misuse of the opioid combination hydrocodone-acetaminophen has been associated with permanent hearing loss. Although reports have been rare, this potential effect can have significant detrimental effect on patients’ overall quality of life. To date, the ototoxic effect of hydrocodone alone has not been systematically investigated. Objective: In this report, we aimed to evaluate the potential ototoxicity of a novel, singleentity, once-daily, extended-release hydrocodone tablet (Hysingla® ER; HYD). Study Design: Clinical study. Setting: Audiology clinics in US. Methods: Results from 1207 patients in two phase 3 clinical studies were evaluated: A placebo-controlled study with an enriched enrollment, randomized withdrawal design in patients with chronic low back pain, and an open-label, long-term, safety study in patients with chronic nonmalignant and non-neuropathic pain. Comprehensive audiologic assessments (comprising pure-tone air-conduction audiometry in the convent...

Atypical teratoid/rhabdoid tumors (AT/RTs) are rare, highly malignant central nervous system tumors that predominantly occur in young children. A 22-year-old woman presented with a 4-year history of relapsing tinnitus and gradual hearing loss. Neuroimaging revealed an enhanced intrinsic left internal auditory canal mass. The patient underwent radiotherapy treatment. Three years later, the tumor size continued to increase, as observed by imaging, and ultimately evolved into the left cerebellopontine angle. As a consequence, a total tumor resection was performed, and a pathological diagnosis of AT/RT was made. Aggressive radiotherapy and chemotherapy treatment continued; however, the tumor recurred within 11 months after the total tumor resection. The patient died within 4 months of the second operation. Histopathologically, the tumor contained characteristic rhabdoid cells with areas that resembled a classical primitive neuroectodermal tumor. Immunostaining showed loss of INI1 protei...

Giant glomus tumors pose a challenge to the Otologist by virtue of their location and vascularity. A vast majority of them present with tinnitus, conductive hearing loss and cranial nerve palsies. We report the case of a 16-year-old male patient who presented with sudden right-sided sensorineural hearing loss. This is an unusual presentation of a giant glomus tumor. We present the clinical features and management of this unusual case.