Consensus for tinnitus patient assessment and treatment outcome measurement: Tinnitus Research Initiative meeting, Regensburg, July 2006.

There is widespread recognition that consistency between research centres in the ways that patients with tinnitus are assessed and outcomes following interventions are measured would facilitate more effective co-operation and more meaningful evaluations and comparisons of outcomes. At the first Tinnitus Research Initiative meeting held in Regensburg in July 2006 an attempt was made through workshops to gain a consensus both for patient assessments and for outcome measurements. It is hoped that this will contribute towards better cooperation between research centres in finding and evaluating treatments for tinnitus by allowing better comparability between studies.

Craniomandibular disorders in patients with Menière's disease: a controlled study.

This study compares the frequency of signs and symptoms of craniomandibular disorders and dental conditions in patients diagnosed with Menière's disease and in control subjects from a population sample. Thirty-one patients (12 men, 19 women) diagnosed with Menière's disease were referred from three otolaryngologic clinics for clinical examination and possible treatment of craniomandibular disorders. Thirty-one control subjects were selected from the population in the same area of Sweden (Ystad). Both groups were subjected to a screening of their symptoms with a self-administered questionnaire and to a routine stomatognathic examination. The function of the masticatory system was further calculated according to the index of Helkimo for both anamnestic dysfunction (Ai) and clinical dysfunction state (Di). Clinical symptoms of craniomandibular disorders such as pain in the face or jaw; pain on movement of the mandible; fatigue of the jaws; and pain located in the vertex area, the neck/shoulder area, and the temples all occurred significantly more often in the patient group. Findings at the clinical examination included a statistically higher frequency of tenderness to palpation of the masticatory muscles, the temporomandibular joint, and the upper part of the trapezius muscle in the patient group compared to that of the control group. The findings indicate a much higher prevalence of signs and symptoms of craniomandibular disorders in patients diagnosed with Menière's disease than in the general population.

Cervical signs and symptoms in patients with Meniere's disease: a controlled study.

This study compares the frequency of signs and symptoms from the cervical spine in 24 patients diagnosed with Meniere's disease and 24 control subjects from a population sample. From a previous controlled comparative study concerning signs and symptoms of craniomandibular disorders, 24 patients diagnosed with Meniere's disease (10 males and 14 females) and their 24 matched control subjects participated in this investigation on the state of the cervical spine. Symptoms of cervical spine disorders, such as head and neck/shoulder pain, were all significantly more frequent in the patient group than in the control group. Most of the patients (75%) reported a strong association between head neck movements in the atlanto-occipital and atlanto-axial joints and triggered attacks of vertigo. Also, 29% of the patients could influence their tinnitus by mandibular movements. Signs of cervical spine disorders, such as limitations in side-bending and rotation movements, were significantly more frequent in the patient group than in the control group. Tenderness to palpation of the transverse processes of the atlas and the axis, the upper and middle trapezius, and the levator scapulae muscle were also significantly more frequent in the patient group. The study shows a much higher prevalence of signs and symptoms of cervical spine disorders in patients diagnosed with Meniere's disease compared with control subjects from the general population.

Recurrence of cluster headache after carotid thrombendarterectomy.

The pathophysiology of cluster headache is largely unknown. One important contributing factor may be an abnormal intracranial-extracranial hemodynamic state. A male patient suffered from chronic left-sided cluster headache for about 15 years. After the institution of lithium therapy the symptoms abated. He was completely free from cluster headache for more than 20 years, until the first postoperative day after a thrombo-endarterectomy for symptomatic 70% carotid stenosis. This case report indicates the importance of abrupt carotid hemodynamic changes along with dysfunction of the cephalic sympathetic nervous system in the initiation of cluster headache.