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1.
Cochrane Database Syst Rev ; 11: CD013514, 2022 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-36383762

RESUMO

BACKGROUND: Tinnitus is a symptom defined as the perception of sound in the absence of an external source. In England alone there are an estimated ¾ million general practice consultations every year where the primary complaint is tinnitus, equating to a major burden on healthcare services. Clinical management strategies include education and advice, relaxation therapy, tinnitus retraining therapy (TRT), cognitive behavioural therapy (CBT), sound enrichment using ear-level sound generators or hearing aids, and drug therapies to manage co-morbid symptoms such as insomnia, anxiety or depression.  OBJECTIVES: To assess the effects of Ginkgo biloba for tinnitus in adults and children. SEARCH METHODS: The Cochrane ENT Information Specialist searched the Cochrane ENT Register; CENTRAL (2022, Issue 6); Ovid MEDLINE; Ovid Embase; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 7 June 2022. SELECTION CRITERIA: Randomised controlled trials (RCTs) recruiting adults and children with acute or chronic subjective tinnitus. We included studies where the intervention involved Ginkgo biloba and this was compared to placebo, no intervention, or education and information. Concurrent use of other medication or other treatment was acceptable if used equally in each group. Where an additional intervention was used equally in both groups, we analysed this as a separate comparison. The review included all courses of Ginkgo biloba, regardless of dose regimens or formulations, and for any duration of treatment. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. Our primary outcomes were tinnitus symptom severity measured as a global score on a multi-item tinnitus questionnaire and serious adverse effects (bleeding, seizures). Our secondary outcomes were tinnitus loudness (change in subjective perception), tinnitus intrusiveness, generalised depression, generalised anxiety, health-related quality of life and other adverse effects (gastrointestinal upset, headache, allergic reaction). We used GRADE to assess the certainty of the evidence for each outcome. MAIN RESULTS: This review included 12 studies (with a total of  1915 participants). Eleven studies compared the effects of Ginkgo biloba with placebo and one study compared the effects of Ginkgo biloba with hearing aids to hearing aids alone. All included studies were parallel-group RCTs. In general, risk of bias was high or unclear due to selection bias and poor reporting of allocation concealment and blinding of participants, personnel and outcome assessments. Due to heterogeneity in the outcomes measured and measurement methods used, only limited data pooling was possible.  Ginkgo biloba versus placebo When we pooled data from two studies for the primary outcome tinnitus symptom severity, we found that Ginkgo biloba may have little to no effect (Tinnitus Handicap Inventory scores) at three to six months compared to placebo, but the evidence is very uncertain (mean difference (MD) -1.35 (scale 0 to 100), 95% confidence interval (CI) -8.26 to 5.55; 2 studies; 85 participants) (very low-certainty). Ginkgo biloba may result in little to no difference in the risk of bleeding or seizures, with no serious adverse effects reported in either group (4 studies; 1154 participants; low-certainty). For the secondary outcomes, one study found that there may be little to no difference between the effects of Ginkgo biloba and placebo on tinnitus loudness measured with audiometric loudness matching at 12 weeks, but the evidence is very uncertain (MD -4.00 (scale -10 to 140 dB), 95% CI -13.33 to 5.33; 1 study; 73 participants) (very low-certainty). One study found that there may be little to no difference between the effects of Ginkgo biloba and placebo on health-related quality of life measured with the Glasgow Health Status Inventory at three months (MD -0.58 (scale 0 to 100), 95% CI -4.67 to 3.51; 1 study; 60 participants) (low-certainty). Ginkgo biloba may not increase the frequency of other adverse effects (gastrointestinal upset, headache, allergic reaction) at three months compared to placebo (risk ratio 0.91, 95% CI 0.52 to 1.60; 4 studies; 1175 participants) (low-certainty). None of the studies reported the other secondary outcomes of tinnitus intrusiveness or changes in depressive symptoms or depression, anxiety symptoms or generalised anxiety. Gingko biloba with concurrent intervention versus concurrent intervention only One study compared Ginkgo biloba with hearing aids to hearing aids only. It assessed the mean difference in the change in Tinnitus Handicap Inventory scores and tinnitus loudness using a 10-point visual analogue scale (VAS) at three months. The study did not report adverse effects, tinnitus intrusiveness, changes in depressive symptoms or depression, anxiety symptoms or generalised anxiety, or health-related quality of life. This was a single, very small study (22 participants) and for all outcomes the certainty of the evidence was very low. We were unable to draw meaningful conclusions from the numerical results. AUTHORS' CONCLUSIONS: There is uncertainty about the benefits and harms of Ginkgo biloba for the treatment of tinnitus when compared to placebo. We were unable to draw meaningful conclusions regarding the benefits and harms of Ginkgo biloba when used with concurrent intervention (hearing aids). The certainty of the evidence for the reported outcomes, assessed using GRADE, ranged from low to very low. Future research into the effectiveness of Ginkgo biloba in patients with tinnitus should use rigorous methodology. Randomisation and blinding should be of the highest quality, given the subjective nature of tinnitus and the strong likelihood of a placebo response. The CONSORT statement should be used in the design and reporting of future studies. We also recommend the use of validated, patient-centred outcome measures for research in the field of tinnitus.


Assuntos
Hipersensibilidade , Zumbido , Adulto , Criança , Humanos , Ginkgo biloba , Cefaleia , Convulsões , Zumbido/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
J Am Acad Audiol ; 33(4): 220-223, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-36400037

RESUMO

BACKGROUND: Tinnitus, the phantom perception of sound, shares many properties with phantom limb pain, in that both may arise as a consequence of sensory deprivation. Prediction errors in multisensory integration, such as induced with mirror box therapy in phantom pain, can reduce phantom percepts. PURPOSE: We evaluated if a device that swaps sound from the right pinna to the left ear canal, and from the left pinna to the right ear canal, can reduce tinnitus. We call this auditory mirror therapy (AMT). RESEARCH DESIGN: Uncontrolled trial. STUDY SAMPLE: Twenty subjects with chronic tinnitus. INTERVENTION: An AMT device consisting of a modified ear defender device with microphones that swaps sounds from left pinna to the right ear canal and from the right pinna to the left ear canal. Participants used the device at home for 2 weeks. DATA COLLECTION AND ANALYSIS: Tinnitus Handicap Inventory (THI), Tinnitus Reaction Questionnaire, and visual analog scale ratings of symptoms were collected at baseline and posttreatment. Repeated measures t-test were performed, Bonferroni corrected for multiple comparisons. RESULTS: There was a significant reduction in THI and in awareness of tinnitus after the AMT intervention. CONCLUSION: Exposing the audiovisual integration system to prediction errors can help retrain phantom percepts and reduce tinnitus handicap. Further studies on this concept are warranted.


Assuntos
Zumbido , Humanos , Zumbido/terapia , Zumbido/diagnóstico , Projetos Piloto , Terapia de Espelho de Movimento , Inquéritos e Questionários , Som
3.
S Afr J Commun Disord ; 69(1): e1-e12, 2022 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-36226975

RESUMO

BACKGROUND:  Counselling manages the psychosocial effects of presbycusis and associated tinnitus, which is best conducted through patient-centred care (PCC). However, there is a paucity of research on implementing PCC within audiology and on patients' perceptions of counselling practice, making the focus on patient benefit and satisfaction crucial. Furthermore, PCC has been documented to be suitable in addressing the psychosocial effects of hearing loss and associated tinnitus, as it focuses on the adult patient playing an integral part of the management processes, providing improved patient outcomes. OBJECTIVES:  This study aimed to explore patients' perceptions of presbycusis and associated tinnitus counselling practices by audiologists within KwaZulu-Natal (KZN). METHOD:  Qualitative phenomenological semi-structured telephonic interviews were conducted through purposive sampling, consisting of seven patients with presbycusis and associated tinnitus who were recruited from private and public facilities in KZN. Data were analysed through hybrid thematic analysis following Braun and Clark's steps. RESULTS:  Six categories were identified: perceptions on counselling methods, efficacy and tools, audiological rehabilitative training, multicultural sensitivity, patient satisfaction and recommendations on improving counselling practices as PCC adaptation. Themes were then extracted from these categories. The overall outcome of the study found that patients had positive perceptions of methods and tools, and audiologists were viewed as adequately trained. Furthermore, they were satisfied and benefitted from counselling practices and found clinicians to be culturally sensitive in their practice. However, recommendations were made towards linguistic sensitivity and satisfaction evaluations. CONCLUSION:  Therefore, implementing PCC into counselling practice may achieve positive patient perceptions, thus highlighting the need to identify barriers and improve the implementation of PCC into practice, especially in resource-constrained contexts.


Assuntos
Presbiacusia , Zumbido , Adulto , Audiologistas/psicologia , Aconselhamento , Humanos , África do Sul , Zumbido/terapia
4.
S Afr J Commun Disord ; 69(1): e1-e11, 2022 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-36226976

RESUMO

BACKGROUND:  Counselling plays an integral part in the management of presbycusis and tinnitus. Counselling can be conducted by implementing patient-centred care (PCC), showing improved patient outcomes; however, it has been poorly implemented in healthcare in South Africa (SA), particularly in the field of audiology for this condition. OBJECTIVES:  This study aimed to report on audiologists' presbycusis and tinnitus counselling practices as guided by the PCC framework within KwaZulu-Natal (KZN). METHOD:  Quantitative semi-structured online surveys were conducted using purposive sampling of 41 audiologists practising in both the public and private sectors within KZN. RESULTS:  This study revealed that 7.3% (n = 3) of participants provided only compensation for hearing loss without counselling, and only 2.4% (n = 1) of participants offered group counselling. Apart from this, 7.9% (n = 3) reported that tools and resources in counselling were not useful, whilst 12.5% (n = 5) reported that counselling was not multiculturally sensitive. Furthermore, a p = 0.044 suggests the public sector reported a dire need for improved training in counselling as compared with the private sector. CONCLUSION:  Audiologists have been providing services within PCC to the best of their capabilities and their environments; however, there is still room to better implement PCC for improved patient outcomes. PCC has not been fully implemented into counselling practices in terms of patient preferences, emotional support, involvement of significant others, integrated care and education.


Assuntos
Presbiacusia , Zumbido , Atitude do Pessoal de Saúde , Audiologistas/psicologia , Humanos , África do Sul , Zumbido/terapia
5.
Dan Med J ; 69(10)2022 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-36205164

RESUMO

INTRODUCTION: Consensus about which questionnaire to use is necessary when it comes to evaluation of tinnitus. In Denmark, the Tinnitus Handicap Index is currently used. However, for evaluating treatment-related outcomes, the Tinnitus Functional Index (TFI) has been optimised for this and is being used in several countries. In this study, we aimed to provide validation of a professionally translated Danish version of the TFI to safely implement this questionnaire in clinical and scientific settings. METHODS: At the Department of Audiology at Hospital West Jutland, Denmark, 133 adult patients suffering from tinnitus with or without hearing loss completed the Danish version of the TFI questionnaire (TFI-Da). Internal consistency was evaluated by Cronbach's alpha and test-retest reliability with Pearson's correlation. RESULTS: Internal consistency was calculated for the total TFI score producing an excellent Crohnbach's alpha of 0.96. Crohnbach's alpha scores were also acceptable for all subgroups with values > 0.7. The test-retest reliability in terms of Pearson's correlation coefficient was 0.848 for the total TFI scores and was acceptable for all subgroups. CONCLUSION: Our study showed a very high internal consistency and test-retest reliability when using the Danish version of the TFI questionnaire. Therefore, we recommend TFI-Da as the standard questionnaire for tinnitus patients in Denmark, especially for evaluation of treatment impact. FUNDING: none. TRIAL REGISTRATION: not relevant.


Assuntos
Zumbido , Adulto , Dinamarca , Humanos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Inquéritos e Questionários , Zumbido/diagnóstico , Zumbido/terapia
6.
Biomed Res Int ; 2022: 9236822, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36212710

RESUMO

Objective: Tinnitus, as a common clinical symptom, has the characteristics of high incidence and great heterogeneity among different patients. As one of the common treatment strategies for tinnitus, this study is aimed at exploring the factors influencing tinnitus sound therapy and the correlation between different tinnitus acoustic characteristics. Methods: 315 patients with chronic tinnitus were enrolled and divided into three groups according to the tinnitus multielement integration sound therapy (T-MIST): (1) vanishing, (2) remission, and (3) unchanged. The general characteristics, psychoacoustic scores (tinnitus handicap inventory (THI) and visual analog scale (VAS)), residual inhibition (RI), degree of hearing loss, and tinnitus characteristics of each group were compared. Finally, we analyze the predictive significance of different features for acoustic effects. Results: The frequency of tinnitus in the vanishing group was higher than that in the remission and unchanged groups (P < 0.05). There were no differences in age, initial onset time, course of the disease, and VSAD between the vanishing group and the unchanged group (P > 0.05). High-frequency tinnitus may predict the vanishing of tinnitus after treatment (P < 0.05), but the degree of hearing loss, tinnitus characteristics (loudness and frequency), and psychoacoustic score (THI and VAS) were only weakly correlated (P < 0.05). Residual inhibition test (RI) was an independent risk factor for the efficacy of acoustic therapy (P < 0.001). Conclusion: The patients were divided into three groups by T-MIST treatment effect; Kruskal-Wallis test and chi-square test were used to compare the baseline information of each group. Then, we analyzed the correlation between patient characteristics and psychoacoustic scores. Finally, logistic regression was performed to explore predictors that might influence the treatment effect. High-frequency tinnitus may have a better therapeutic effect; age, disease course, and other factors can not be stable explanation factors for a poor therapeutic effect of tinnitus. The residual inhibition (RI) test was an independent factor in predicting the efficacy of T-MIST.


Assuntos
Surdez , Perda Auditiva , Zumbido , Humanos , Som , Zumbido/terapia , Escala Visual Analógica
7.
Orv Hetil ; 163(42): 1682-1689, 2022 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-36244011

RESUMO

INTRODUCTION: Tinnitus is a sound without an external sound stimulus, usually only perceived by the sufferer. Inner ear damage might be found in its background, although many other possible causes exist. Therefore, there is a need for a detailed examination in all cases. METHOD: In the present investigation, 100 patients (38 men, 62 women; mean age ± SD: 59 years ± 11.3) suffering from tinnitus were enrolled. The data and examination results of these patients were analysed in detail. The outcomes of the brain MRI, carotid-vertebral ultrasound, cervical X-ray, pure-tone audiometry, and tinnitometry were analyzed regarding the detailed examinations. RESULTS: In terms of tinnitus laterality, left-sided (34%) and both-sided (53%) were the most frequent ones. The frequency of the examinations was the following: audiometry and tinnitometry (100%), cervical X-ray (80%), cerebral MRI (76%) and carotid-vertebral Doppler ultrasound (21%). Cervical spondylosis/spondyloarthrosis (69 patients), vascular encephalopathy (56 patients) and atherosclerosis of the carotid artery (20 patients) were observed as the most common aberrations. Using the audiometry, normal hearing was detected in 14%, slight sensorineural hearing loss in 25%, moderate sensorineural hearing loss in 44% and severe sensorineural hearing loss in 17%. Tinnitometry detected tinnitus with a mean frequency of 4200 ± 2200 Hz and intensity of 40 ± 14.4 dB. CONCLUSION: The detailed examination of patients suffering from tinnitus is essential in multidisciplinary therapy planning. Possible complications in other organs can also be detected using the carotid-vertebral ultrasound as screening method. Based on the cervical X-ray, the somatosensory tinnitus form can be observed. Pure-tone audiometry and tinnitometry help detect hearing loss combined with tinnitus, pitch, and loudness, which are also essential in therapy planning. Orv Hetil. 2022; 163(42): 1682-1689.


Assuntos
Perda Auditiva Neurossensorial , Perda Auditiva , Zumbido , Estimulação Acústica , Audiometria de Tons Puros/efeitos adversos , Audiometria de Tons Puros/métodos , Feminino , Perda Auditiva Neurossensorial/diagnóstico , Humanos , Masculino , Zumbido/diagnóstico , Zumbido/etiologia , Zumbido/terapia
8.
Nutrients ; 14(20)2022 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-36297004

RESUMO

Despite the fact that chronic diseases usually occur together with a spectrum of possible comorbidities that may differ strongly between patients, they are classically still viewed as distinct disease entities and, consequently, are often treated with uniform therapies. Unfortunately, such an approach does not take into account that different combinations of symptoms and comorbidities may result from different pathological (e.g., environmental, genetic, dietary, etc.) factors, which require specific and individualised therapeutic strategies. In this opinion paper, we aim to put forward a more differentiated, systems medicine approach to disease and patient treatment. To elaborate on this concept, we focus on the interplay of tinnitus, depression, and chronic pain. In our view, these conditions can be characterised by a variety of phenotypes composed of variable sets of symptoms and biomarkers, rather than distinct disease entities. The knowledge of the interplay of such symptoms and biomarkers will provide the key to a deeper, mechanistic understanding of disease pathologies. This paves the way for prediction and prevention of disease pathways, including more personalised and effective treatment strategies.


Assuntos
Zumbido , Humanos , Zumbido/epidemiologia , Zumbido/terapia , Comorbidade , Doença Crônica , Biomarcadores , Análise de Sistemas
9.
Neural Plast ; 2022: 5114721, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36304208

RESUMO

Neurofeedback (NFB) is a relatively novel approach to the treatment of tinnitus, and prior studies have demonstrated that the increases in alpha activity rather than reduced delta power seem to drive these NFB-related improvements in tinnitus symptoms. The present study was therefore designed to explore whether the implementation of an alpha training protocol with a portable neurofeedback apparatus would achieve improvements in tinnitus patient symptoms. In this study, 38 tinnitus patients underwent NFB training while 18 were enrolled in a control group. The study was single-blinded such that only participants were not aware of their group assignments. Those in the NFB group underwent 15 NFB training sessions over 5 weeks, in addition to pre- and posttraining tests including the Tinnitus Handicap Inventory (THI), Tinnitus Handicap Questionnaire (THQ), visual analog scales (VAS), electroencephalography (EEG), and functional magnetic resonance imaging (fMRI). Our result find that when the THI, THQ, and VAS scores of patients in the two groups were assessed after a 5-week training period, these scores were unchanged in control patients whereas they had significantly improved in the NFB group patients. EEG analyses revealed that the alpha band was increased in the occipital lobe following NFB treatment, while fMRI indicated an increase in regional homogeneity (ReHo) in the right frontal lobe of patients in the NFB group after treatment that was negatively correlated with THI and VAS scores. The results of this analysis indicate that alpha NFB training can be effectively used to reduce tinnitus-related distress and sound perception in patients.


Assuntos
Neurorretroalimentação , Zumbido , Humanos , Eletroencefalografia , Imageamento por Ressonância Magnética , Neurorretroalimentação/métodos , Medição da Dor , Zumbido/diagnóstico por imagem , Zumbido/terapia , Método Simples-Cego
10.
Comput Math Methods Med ; 2022: 6764909, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36081433

RESUMO

Objective: To systematically evaluate the efficacy of acupuncture associated with physical and mental intervention when treating idiopathic tinnitus and the improvement of tinnitus symptoms, so as to supply evidence-based medicine for its popularization and adoption. Methods: PubMed, EMBASE, ScienceDirect, Cochrane Library, China knowledge Network Database (CNKI), China VIP Database, Wanfang Database, and China Biomedical Literature Database (CBM) online database were searched for the controlled trial of acupuncture associated with physical and mental intervention when treating idiopathic tinnitus. The retrieval time limit is from January 2010 to March 2022. Separately, two researchers extracted the data, and according to the Cochrane Handbook 5.3, the bias risk of each piece of literature was assessed. The collected data were measured using RevMan5.3 statistical software. Results: Finally, 5 CT articles were included in this study, with a total sample size of 282. Meta-analysis showed that the effective rate of the study group was significantly higher than that of the control group (P < 0.05). The scores of tinnitus disorder scale (THI) after treatment were analyzed by Meta. The THI scores of the study group after treatment were significantly lower than those before treatment. Meta-analysis of the severity of tinnitus after treatment showed that the severity of tinnitus in the observation group after treatment was significantly lower than that before treatment. There is a certain publication deviation in the literature, which may be related to the heterogeneity of the research and the small number of literatures. Conclusion: On the basis of acupuncture treatment, associated with physical and mental intervention is helpful to the recovery of patients with idiopathic tinnitus, can effectively improve their clinical symptoms, and is suitable for clinical application. A popularization of this concept in clinical practice is worth considering, but further research and follow-up with a higher methodological quality and longer intervention time are needed to confirm its efficacy.


Assuntos
Terapia por Acupuntura , Zumbido , China , Humanos , Zumbido/terapia
11.
J Am Acad Audiol ; 33(2): 75-81, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-36049753

RESUMO

BACKGROUND: Tinnitus is a prevalent auditory disorder that can become severely debilitating. Despite decades of investigation, there remains no conclusive cure for tinnitus. Clinical practice guidelines (CPGs) are available for assessing and managing tinnitus. Even though such guidelines have been available for several years, the degree that audiologists adhere to them has remained unexplored. PURPOSE OF STUDY: To determine what clinical practices are commonly used by audiologists in the assessment and management of the patient population with tinnitus, we administered an online survey to audiologists practicing in the United States and Canada. RESULTS: Among the audiologists that completed the survey and were included in the final analysis (n = 61), 70% were from the United States and 30% were from Canada. The audiologists represented a wide range of clinical experience (1-35 years). On average, those who completed the survey were relatively confident in their ability to assess and manage tinnitus patients indicated by a 0 to 100 Likert scale, with 0 representing no confidence (mean 72.5, ± 21.5 standard deviation). The most commonly reported tinnitus assessment tools were pure tone audiogram (0.25-8 kHz), administration of standardized questionnaires, and tinnitus pitch and loudness matching. Approximately half (55%) of audiologists indicated they include otoacoustic emissions, while less audiologists (<40%) reported measuring high-frequency thresholds, minimum masking levels, or loudness discomfort levels. The most common recommendation for tinnitus patients was amplification (87%), followed by counseling (80%) and sound therapy (79%). CONCLUSION: Few audiologists administer a truly comprehensive tinnitus assessment and ∼20% indicated not recommending counseling or sound therapy to manage tinnitus. The results are discussed in the context of what is explicitly indicated in published CPGs, professional organization recommendations, and recent findings of peer-reviewed literature.


Assuntos
Audiologistas , Zumbido , Audiometria , Testes Auditivos , Humanos , Inquéritos e Questionários , Zumbido/diagnóstico , Zumbido/terapia , Estados Unidos
12.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 2655-2658, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-36085810

RESUMO

Tinnitus is the conscious perception of a phantom sound in absence of an external or internal stimulus. More than 1 in 7 adults in the EU experience tinnitus and for a large proportion of them tinnitus is an intrusive, persistent, and disabling condition, which impairs their life quality. Therefore, tinnitus is posed as a major global burden, which requires a precision-medicine approach in terms of treatments that are tailored to individual patients, due to its high heterogeneity. UNITI is a research and innovation project which aims towards this goal, unifying treatments and interventions for tinnitus. In the context UNITI, a randomized controlled trial (RCT) is being conducted and all the participants' data will be utilized for the development of a clinical decision support system (CDSS). This CDSS will predict the optimal therapeutic intervention for a tinnitus patient based on their profile. In this paper, we present a preliminary study of the CDSS model development process. We describe the available input data, the pre-processing steps conducted, the algorithms tested to model the CDSS' prediction, the models' results, and the future work in the context of this project. The R2 score of the selected model is currently 0.65, indicating that its development process is in the right direction but further tuning and hyperparameter optimization is needed. Clinical Relevance- The proposed model will be integrated in a CDSS aiming at indicating the optimal treatment strategy for a tinnitus patient based their personal profile.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Zumbido , Adulto , Algoritmos , Cegueira , Humanos , Som , Zumbido/diagnóstico , Zumbido/terapia
13.
Otolaryngol Clin North Am ; 55(5): 1017-1033, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36150941

RESUMO

Migraine headaches frequently coexist with vestibular symptoms such as vertigo, motion sickness, and gait instability. Migraine-related vasospasm can also damage the inner ear, which results in symptoms such as sudden sensorineural hearing loss and resultant tinnitus. The pathophysiology of these symptoms is not yet fully understood, and despite their prevalence, there is no universally approved management. This review summarizes the data on complementary and integrative medicine in treating patients with migrainous ear disorders.


Assuntos
Orelha Interna , Perda Auditiva Neurossensorial , Transtornos de Enxaqueca , Zumbido , Humanos , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/terapia , Zumbido/diagnóstico , Zumbido/etiologia , Zumbido/terapia , Vertigem/diagnóstico , Vertigem/etiologia , Vertigem/terapia
14.
J Stroke Cerebrovasc Dis ; 31(11): 106718, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36116219

RESUMO

BACKGROUND: Pulsatile tinnitus occurs due to turbulent blood flow through a stenotic vessel including the internal carotid artery. The presence of sensorineural hearing loss suggests involvement of the posterior circulation vasculature. CLINICAL PRESENTATION: A 58-year-old woman presented to the ear, nose and throat clinic with acute onset of right ear pulsations and high-pitched tinnitus. An audiogram demonstrated mild sensorineural hearing loss in the right ear. Her computed tomography angiogram revealed moderate stenosis of the right internal carotid artery and she underwent revascularization with angioplasty and stent placement. A repeat audiogram demonstrated improvement in sensorineural hearing loss in the right. CONCLUSION: Pulsatile tinnitus and unilateral sensorineural hearing loss maybe a reversible manifestation of a stenotic internal carotid artery.


Assuntos
Estenose das Carótidas , Perda Auditiva Neurossensorial , Zumbido , Humanos , Feminino , Pessoa de Meia-Idade , Estenose das Carótidas/complicações , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/terapia , Zumbido/diagnóstico por imagem , Zumbido/etiologia , Zumbido/terapia , Artéria Carótida Interna/diagnóstico por imagem , Artéria Carótida Interna/cirurgia , Angioplastia , Perda Auditiva Neurossensorial/diagnóstico por imagem , Perda Auditiva Neurossensorial/etiologia , Stents
15.
Sci Data ; 9(1): 500, 2022 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-35977951

RESUMO

The present database provides demographic (age and sex), clinical (hearing loss and acoustic properties of tinnitus), psychometric (based on Tinnitus Handicapped Inventory and Hospital Anxiety and Depression Scale) and electroencephalographic information of 89 tinnitus sufferers who were semi-randomly treated for eight weeks with one of five acoustic therapies. These were (1) placebo (relaxing music), (2) tinnitus retraining therapy, (3) auditory discrimination therapy, (4) enriched acoustic environment, and (5) binaural beats therapy. Fourteen healthy volunteers who were exposed to relaxing music and followed the same experimental procedure as tinnitus sufferers were additionally included in the study (control group). The database is available at https://doi.org/10.17632/kj443jc4yc.1 . Acoustic therapies were monitored one week after, three weeks after, five weeks after, and eight weeks after the acoustic therapy. This study was previously approved by the local Ethical Committee (CONBIOETICA19CEI00820130520), it was registered as a clinical trial (ISRCTN14553550) in BioMed Central (Springer Nature), the protocol was published in 2016, it attracted L'Oréal-UNESCO Organization as a sponsor, and six journal publications have resulted from the analysis of this database.


Assuntos
Estimulação Acústica , Bases de Dados Factuais , Zumbido , Estimulação Acústica/métodos , Acústica , Percepção Auditiva , Eletroencefalografia , Humanos , Zumbido/terapia
16.
HNO ; 70(9): 675-684, 2022 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-35920880

RESUMO

BACKGROUND: Tinnitus and vertigo have been studied in many ways. This led to a variety of explanations from multiple medical disciplines. The musculature of the jaw and cervical spine have also been researched in this regard. Dysfunctional musculature can trigger tinnitus and dizziness. This subtype of tinnitus is called cervicogenic somatosensory tinnitus. OBJECTIVE: The aim of the present study was to investigate the effect of manual therapy on subject-reported, individually perceived impairment due to cervicogenic somatosensory tinnitus (Tinnitus Handicap Inventory), dizziness (Dizziness Handicap Inventory), and hypertonia of the musculature of the head and cervical spine. MATERIALS AND METHODS: In a prospective randomized trial, 80 patients (40 in the intervention group/40 in the control group) were medically examined and interviewed. Afterwards, they received targeted manual therapy. RESULTS: After manual therapy, there were significant differences in the Tinnitus Handicap Inventory, Dizziness Handicap Inventory, and muscular hypertonia between the groups, all in favor of the intervention group. CONCLUSION: Manual examination and therapy proved to be effective. It should be increasingly applied in the absence of ENT pathology and suspected cervicogenic somatosensory tinnitus. The role of individual muscles requires further investigation.


Assuntos
Zumbido , Tontura/diagnóstico , Tontura/etiologia , Tontura/terapia , Humanos , Hipertonia Muscular , Projetos Piloto , Estudos Prospectivos , Zumbido/diagnóstico , Zumbido/terapia
17.
Clin Otolaryngol ; 47(6): 672-679, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35996981

RESUMO

OBJECTIVES: Tinnitus is a complex and debilitating phenomenon with potentially significant implications on quality of life. New presentations can be resource and time intensive for clinicians. Validated comprehensive tinnitus questionnaires may lack practical utility in the high-volume clinical setting. Concise, targeted questionnaires may offer an efficient alternative. This study aimed to assess the validity of the FiveQ, a novel five question construct designed to measure tinnitus severity. Convergent validity was assessed through correlating FiveQ against two comprehensive validated questionnaires, the Tinnitus Handicap Questionnaire (THQ) and Tinnitus Handicap Inventory (THI). DESIGN: Cross-sectional study with prospective recruitment. The 117 voluntarily recruited participants completed the FiveQ, THI and THQ questionnaires. Results were comparatively analysed. SETTING: Recruitment was via electronic and print media, audiology clinics and public and private otolaryngology outpatient clinics. Surveys were completed electronically. PARTICIPANTS: Members of the public aged over 18 with subjective tinnitus were invited to participate. MAIN OUTCOME MEASURED: Analyses for establishing the content validity, construct validity, internal consistency, explorary factor analysis, and responsiveness of FiveQ was performed. RESULTS: FiveQ demonstrated a high positive correlation with both the THI (r = 0.773, p < .001) and THQ (r = 0.808, p < .001). Internal consistency for FiveQ reached an acceptable threshold (Cronbach's alpha 0.86). Exploratory factor analysis demonstrated that one latent factor underlies the five items of the FiveQ. FiveQ demonstrated better responsiveness than both the THI and THQ after a 6 week interval repeat measurement. CONCLUSION: FiveQ demonstrated high-positive correlations with existing validated tinnitus questionnaires as well as acceptable internal consistency and factor analysis. The concise construct of FiveQ allows clinicians to efficiently estimate tinnitus severity, target treatment towards dominant symptoms and establish a reliable estimation of treatment response following interventions.


Assuntos
Zumbido , Adolescente , Adulto , Estudos Transversais , Avaliação da Deficiência , Humanos , Estudos Prospectivos , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Inquéritos e Questionários , Zumbido/diagnóstico , Zumbido/terapia
18.
J Integr Bioinform ; 19(3)2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36039680

RESUMO

Tinnitus is an annoying ringing in the ears, in varying shades and intensities. Tinnitus can affect a person's overall health and social well-being (e.g., sleep problems, trouble concentrating, anxiety, depression and inability to work). The diagnostic procedure of tinnitus usually consists of three steps: an audiological examination, psychoacoustic measurement, and a disability evaluation. All steps are performed by physicians, who use specialised hardware/software and administer questionnaires. This paper presents a system, to be used by patients, for the diagnosis and self-management of tinnitus. The system is made up of an app and a device. The app is responsible for executing - through the device - a part of the required audiological and psychoacoustic examinations, as well as administering questionnaires that evaluate disability. The paper reviews the quality of the automated audiometric reporting and the user experience provided by the app. Descriptive and inferential statistics were used to support the findings. The results show that automated reporting is comparable with that of physicians and that user experience was improved by re-designing and re-developing the acufenometry of the app. As for the user experience, two experts in Human-Computer Interaction evaluated the first version of the app: their agreement was good (Cohen's K = 0.639) and the average rating of the app was 1.43/2. Also patients evaluated the app in its initial version: the satisfactory tasks (audiometry and questionnaires) were rated as 4.31/5 and 4.65/5. The unsatisfactory task (acufenometry) was improved and the average rating increased from 2.86/5 to 3.96/5 (p = 0.0005). Finally, the general usability of the app was increased from the initial value of 73.6/100 to 85.4/100 (p = 0.0003). The strengths of the project are twofold. Firstly, the automated reporting feature, which - to the best of our knowledge - is the first attempt in this area. Secondly, the overall app usability, which was evaluated and improved during its development. In summary, the conclusion drawn from the conducted project is that the system works as expected, and despite some weaknesses, also the replication of the device would not be expensive, and it can be used in different scenarios.


Assuntos
Aplicativos Móveis , Autogestão , Zumbido , Humanos , Inquéritos e Questionários , Zumbido/diagnóstico , Zumbido/terapia
19.
J Craniofac Surg ; 33(8): 2586-2588, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36000766

RESUMO

The authors first reported a 42-year-old female patient with carotid-cavernous fistula (CCF) that occurred after maxillary fractures. She developed unilateral exophthalmos, bulbar conjunctival hyperemia, and complained of tinnitus after the operation, and was diagnosed as internal CCF through computerized tomography and Digital Substraction Angiography. After the diagnosis, the internal carotid artery was embolized with a coil under general anesthesia. The treatment effect was satisfactory but the vision of the affected side was eventually lost due to the long course of congestion. Although patients with maxillary fractures can safely undergo surgery, some unexpected complications may occur in trauma, such as internal CCF. Therefore, each patient must be subjected to accurate posttraumatic examinations and inquiries to discover possible clinical complications. Patients with exophthalmos, tinnitus, and conjunctival hyperemia may be accompanied by internal CCF. Once diagnosed, appropriate treatment such as embolization should be carried out in time to eliminate further serious sequelae.


Assuntos
Fístula Carotidocavernosa , Embolização Terapêutica , Exoftalmia , Hiperemia , Fraturas Maxilares , Zumbido , Feminino , Humanos , Adulto , Fraturas Maxilares/complicações , Zumbido/terapia , Fístula Carotidocavernosa/diagnóstico por imagem , Fístula Carotidocavernosa/etiologia , Fístula Carotidocavernosa/terapia , Embolização Terapêutica/métodos , Artéria Carótida Interna/diagnóstico por imagem , Exoftalmia/terapia
20.
Am J Audiol ; 31(3): 567-578, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35973115

RESUMO

PURPOSE: The purpose of this study was to examine progressive tinnitus management (PTM) Level 3 skill utilization among Veterans in the Bay Pines Veterans Affairs Healthcare System 6-10 years after completing the PTM workshops. METHOD: In fiscal year 2020, the Tinnitus Workshop Follow-Up form was mailed to Veterans who completed the workshops during fiscal years 2010-2014. Veterans were identified as receiving care via the traditional face-to-face method or clinical video telehealth (CVT). Data were compiled to determine which, if any, PTM skills were being used 6-10 years later and the impact on self-reported ratings of well-being. RESULTS: More than half of the respondents reported using all four self-management skills up to 10 years postcompletion; relaxation was utilized by more Veterans than the other three skills. Approximately 69% reported improved ability to control reactions to tinnitus. At least half reported ratings of improved well-being. Eighty-eight percent of the respondents said they would recommend the workshops to someone with bothersome tinnitus. Veterans who received care via CVT reported using fewer skills than those who received care face-to-face; however, the CVT respondents reported the same or slightly better ability to cope with tinnitus, less bothersome tinnitus, and improved ratings of well-being. Finally, most participants who responded to an open-ended question about their workshop experience reported it as positive. CONCLUSIONS: This clinical focus project suggests that PTM Level 3 skills continue to be utilized up to 10 years after participation in the workshops. Although there were reductions in the number of skills used, Veterans' ability to manage reactions to tinnitus and improvement in self-reported ratings of well-being indicate successful ongoing tinnitus management efforts. Respondents who received care via CVT did not report lower self-reported ratings of well-being or appear less likely to recommend Level 3 group PTM to other Veterans with bothersome tinnitus.


Assuntos
Telemedicina , Zumbido , Veteranos , Adaptação Psicológica , Humanos , Estudos Retrospectivos , Zumbido/terapia
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