ABSTRACT
CONCLUSION: Based on the Tinnitus Handicap Inventory (THI) and visual analog scale (VAS) scores, transcutaneous electrical stimulation (TENS) can provide relief from tinnitus. Response to electrical stimulation was best seen in patients with low-frequency tinnitus and with mild hearing loss. OBJECTIVE: TENS is known to alleviate symptoms of tinnitus. However, study of the effectiveness of TENS for tinnitus has produced variable results, and it is still unclear what kind of patients with tinnitus would respond best to TENS. Here, we assessed the effects of TENS on the perception of tinnitus using the THI and VAS questionnaires. METHODS: A total of 65 patients with tinnitus were divided into two groups: 45 patients received TENS and 20 patients received placebo (sham stimulation) twice a week over 4 weeks. THI and VAS scores were assessed before and after electrical stimulation. We also evaluated the effects of TENS on the degree of initial hearing loss and tinnitus frequency. RESULTS: Twenty-eight of 45 patients (62.2%) revealed subjective improvement in tinnitus with TENS. TENS was more effective in patients with low-frequency tinnitus or with mild hearing loss. Symptomatic improvement in the electrical stimulation group was achieved for 1 month in most patients.
Subject(s)
Tinnitus/therapy , Transcutaneous Electric Nerve Stimulation , Analysis of Variance , Chronic Disease , Female , Hearing Loss/etiology , Hearing Loss/therapy , Humans , Male , Middle Aged , Patient Satisfaction , Prospective Studies , Severity of Illness Index , Single-Blind Method , Visual Analog ScaleABSTRACT
OBJECTIVES: Toll-like receptors (TLRs) detect microbial infections and they can directly induce innate host defense responses. TLR 2 has been shown to be primarily involved in the recognition of peptidoglycans and lipoteichoic acid of gram positive bacteria. TLR 4 recognizes lipopolysaccharides and lipoteichoic acids from both gram-negative and gram-positive bacteria. Both mutations lead a reduced capacity to elicit inflammation and they increase the risk for gram-positive and negative infections. This study was performed to investigate the expressions of TLR 2 and 4 and their mutations in patients suffering with otitis media and middle ear effusion. METHODS: Middle ear fluid samples were collected from 40 otitis media effusion (OME) patients who had ventilating tubes inserted. Bacteria in the effusion fluid were detected by standard bacterial culture. The secreted IgG, IgA and IgM were measured by Enzyme-linked immunosorbent assay. TLR 2 and 4 were assessed by performing RT-PCR. The genomic DNA from each patient was isolated from the middle ear fluid samples that were collected from 60 OME patients, and the presence of mutations was determined by performing restriction digestion and DNA sequencing analysis. RESULTS: Among the 40 middle ear fluid samples, bacteria were detected in 13 middle ear fluid samples. The amounts of IgM, IgA, and IgG were 151.20+/-60.94 ng/mL, 21.59+/-7.96 ng/mL and 11.55+/-16.98 ng/mL, respectively. TLR 2 and 4 were expressed in the middle ear fluid and the expression of TLR 2 was higher than that of TLR 4. However, there was no correlation between the expressions of TLR 2 and 4, and the concentration of immunoglobulin or the presence of bacteria (P>0.05). There ware no mutations of TLR 2 (Arg753Gln, Arg677Trp) and TLR 4 (Asp299Gly, Thr399Ile). CONCLUSION: TLR 2 and 4 were expressed in all the middle ear fluid samples of OME, but the mutations of TLR 2 and 4 were not detected. TLR 2 and 4 may play a vital role in the immunological responses of patients with OME.