RESUMO
INTRODUCTION: Tinnitus and sound intolerance are frequent and subjective complaints that may have an impact on a patient's quality of life. OBJECTIVE: To present a review of the salient points including concepts, pathophysiology, diagnosis and approach of the patient with tinnitus and sensitivity to sounds. METHODS: Literature review with bibliographic survey in LILACS, SciELO, Pubmed and MEDLINE database. Articles and book chapters on tinnitus and sound sensitivity were selected. The several topics were discussed by a group of Brazilian professionals and the conclusions were described. RESULTS: The prevalence of tinnitus has increased over the years, often associated with hearing loss, metabolic factors and inadequate diet. Medical evaluation should be performed carefully to guide the request of subsidiary exams. Currently available treatments range from medications to the use of sounds with specific characteristics and meditation techniques, with variable results. CONCLUSION: A review on tinnitus and auditory sensitivity was presented, allowing the reader a broad view of the approach to these patients, based on scientific evidence and national experience.
Assuntos
Zumbido , Estimulação Acústica , Brasil , Medicina Baseada em Evidências , Humanos , Qualidade de Vida , Inquéritos e Questionários , Zumbido/diagnóstico , Zumbido/fisiopatologia , Zumbido/terapiaRESUMO
INTRODUCTION: For many years, excessive caffeine consumption has been touted as an aggravating factor for tinnitus. The pathophysiology behind this effect is probably related to the blockage of adenosine receptors by the action of caffeine on the central nervous system. OBJECTIVE: To evaluate the effects of reduction of coffee consumption on tinnitus sensation and to identify subgroups more prone to benefit from this therapeutic strategy. STUDY DESIGN: Prospective. METHODS: Twenty-six tinnitus patients who consumed at least 150 mL of coffee per day were selected. All were asked to reduce their coffee consumption. The Tinnitus Handicap Inventory (THI) questionnaire was completed by the patients before and after the reduction of coffee consumption, as well as a visual-analog scale (VAS) graduated from 1 to 10. RESULTS: THI and VAS scores were significantly reduced (p<0.05). In the subgroups less than 60 years old, bilateral tinnitus and daily coffee consumption between 150 and 300 mL showed a significantly greater reduction of THI and VAS scores. CONCLUSION: Patients under 60 years of age with bilateral tinnitus and daily coffee consumption between 150 and 300 mL are more prone to benefit from consumption reduction. Thirty-day observation periods may be helpful for a better therapeutical decision.
Assuntos
Cafeína/efeitos adversos , Estimulantes do Sistema Nervoso Central/efeitos adversos , Zumbido/prevenção & controle , Adulto , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Zumbido/induzido quimicamente , Resultado do TratamentoRESUMO
Abstract Introduction Tinnitus and sound intolerance are frequent and subjective complaints that may have an impact on a patient's quality of life. Objective To present a review of the salient points including concepts, pathophysiology, diagnosis and approach of the patient with tinnitus and sensitivity to sounds. Methods Literature review with bibliographic survey in LILACS, SciELO, Pubmed and MEDLINE database. Articles and book chapters on tinnitus and sound sensitivity were selected. The several topics were discussed by a group of Brazilian professionals and the conclusions were described. Results The prevalence of tinnitus has increased over the years, often associated with hearing loss, metabolic factors and inadequate diet. Medical evaluation should be performed carefully to guide the request of subsidiary exams. Currently available treatments range from medications to the use of sounds with specific characteristics and meditation techniques, with variable results. Conclusion A review on tinnitus and auditory sensitivity was presented, allowing the reader a broad view of the approach to these patients, based on scientific evidence and national experience.
Resumo Introdução Zumbido e intolerância a sons são queixas frequentes e subjetivas que podem ter impacto na qualidade de vida do paciente. Objetivo Apresentar uma revisão dos principais pontos, inclusive conceitos, fisiopatologia, diagnóstico e abordagem do paciente com zumbido e sensibilidade a sons. Método Revisão da literatura com levantamento bibliográfico na base de dados da LILACS, SciELO, Pubmed e MEDLINE. Foram selecionados artigos e capítulos de livros sobre zumbido e sensibilidade a sons. Os diversos tópicos foram discutidos por um grupo de profissionais brasileiros e as conclusões, descritas. Resultado A prevalência de zumbido tem aumentado ao longo dos anos, muitas vezes associado a perda auditiva, fatores metabólicos e erros alimentares. A avaliação médica deve ser feita minuciosamente no sentido de orientar a solicitação de exames subsidiários. Os tratamentos disponíveis atualmente variam de medicamentos ao uso de sons com características específicas e técnicas de meditação, com resultados variáveis. Conclusão Foi apresentada uma revisão sobre os temas que permitindo ao leitor uma visão ampla da abordagem dos pacientes com zumbido e sensibilidade auditiva baseada em evidências científicas e experiência nacional.
Assuntos
Humanos , Zumbido/diagnóstico , Zumbido/fisiopatologia , Zumbido/terapia , Qualidade de Vida , Estimulação Acústica , Brasil , Inquéritos e Questionários , Medicina Baseada em EvidênciasRESUMO
INTRODUCTION: For many years, excessive caffeine consumption has been touted as an aggravating factor for tinnitus. The pathophysiology behind this effect is probably related to the blockage of adenosine receptors by the action of caffeine on the central nervous system. OBJECTIVE: To evaluate the effects of reduction of coffee consumption on tinnitus sensation and to identify subgroups more prone to benefit from this therapeutic strategy. Study design: prospective. METHODS: Twenty-six tinnitus patients who consumed at least 150 mL of coffee per day were selected. All were asked to reduce their coffee consumption. The Tinnitus Handicap Inventory (THI) questionnaire was completed by the patients before and after the reduction of coffee consumption, as well as a visual-analogue scale (VAS) graduated from 1 to 10. RESULTS: THI and VAS scores were significantly reduced (p < 0.05). In the subgroups less than 60 years old, bilateral tinnitus and daily coffee consumption between 150 and 300 mL showed a significantly greater reduction of THI and VAS scores. CONCLUSION: Patients under 60 years of age with bilateral tinnitus and daily coffee consumption between 150 and 300 mL are more prone to benefit from consumption reduction. Thirty-day observation periods may be helpful for a better therapeutical decision. .
INTRODUÇÃO: O consumo abusivo de cafeína vem sendo descrito como fator de piora e causa do zumbido há muitos anos. A fisiopatologia deste efeito está provavelmente relacionada ao bloqueio dos receptores inibitórios adenosínicos pela cafeína no sistema nervoso central. OBJETIVO: Avaliar os efeitos da redução do consumo de cafeína na percepção do zumbido e identificar subgrupos de pacientes mais propensos a benefícios com esta proposta. Tipo de estudo: prospectivo. MÉTODO: Selecionados 26 pacientes com zumbido neurossensorial e consumo diário superior a 150 mL de café. Os efeitos da redução do consumo foram avaliados através do Tinnitus Handicap Inventory (THI) e da escala visual-análoga (EVA). RESULTADOS: Houve redução estatisticamente significativa (p < 0,05) nos escores do THI e EVA. Nos subgrupos com idade inferior a 60 anos, zumbido bilateral e consumo diário de café entre 150 e 300 mL apresentaram maior redução dos escores THI e EVA. CONCLUSÃO: Em pacientes com idade inferior a 60 anos, zumbido bilateral e consumo diário de café entre 150 e 300 mL apresentaram benefícios com a redução no consumo diário de cafeína. Períodos observacionais de 30 dias podem ser úteis para a decisão terapêutica. .