Mindfulness-based stress reduction for long-term physical conditions: A systematic review

Conclusion: Although there is some preliminary support for the use of mindfulness-based stress reduction in physical health conditions, further research is required before it could be considered an effective intervention for improving physical health outcomes. (Source: Australian and New Zealand Journal of Psychiatry)

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Temporal bone MRI with 3D-FIESTA in the evaluation of facial and audiovestibular dysfunction

Conclusion Although the use of MRI of the temporal bone using 3D-FIESTA shows positive findings in only 18.37% of patients, it provides important information in those with facial and audiovestibular dysfunction. However, for patients with normal MRI of the temporal bone, other etiological factors should be investigated in order to clarify or elucidate the cause of clinical manifestations. (Source: Diagnostic and Interventional Imaging)

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A cohort study examining headaches among veterans of Iraq and Afghanistan wars: Associations with traumatic brain injury, PTSD, and depression.

CONCLUSIONS: Our results indicate that TBI alone is a strong predictor of headache in the first year of VA care among IAV and that comorbid psychiatric comorbidities increase the likelihood of headache among individuals with TBI. However, among those with baseline headache, only tinnitus, insomnia, and vertigo were baseline clinical predictors of headache persistence. These results suggest that attention to other symptoms and conditions early in the diagnosis and treatment of headaches may be important for understanding prognosis. These comorbidities offer potential targets for intervention strategies that may help address postdeployment headaches. PMID: 26688427 [PubMed - as supplied by publisher] (Source: Headache)

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Hearing and tinnitus in head and neck cancer patients after chemoradiotherapy

Abstract Head and neck cancer patients treated with high-dose cisplatin and radiotherapy will suffer from hearing deficits. The current low-dose regimen seldom causes hearing threshold decrease. Tinnitus in this patient population has not been investigated earlier. We aimed to evaluate the possible ototoxicity of low-dose (40 mg/m2) weekly administered cisplatin with concomitant radiotherapy. Twenty-two patients with locally advanced head and neck cancer were prospectively recruited to participate the study after treatment recommendation for chemoradiotherapy with low-dose cisplatin and intensity-modulated radiotherapy. They filled in a Tinnitus Handicap Inventory and undertook audiologic evaluations before and after treatment. Ototoxicity was determined by >10 dB threshold s…

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Acupuncture in treating sudden sensorineural hearing loss: a report of 2 cases.

CONCLUSION: Acupuncture may be worth trying in patients with SSHL who do not respond to routine medical treatment. PMID: 25231566 [PubMed - indexed for MEDLINE] (Source: Forschende Komplementarmedizin)

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Cervicogenic somatosensory tinnitus: an indication for manual therapy? Part 1: Theoretical concept

Tinnitus can be evoked or modulated by input from the somatosensory and somatomotor systems. This means that the loudness or intensity of tinnitus can be changed by sensory or motor stimuli such as muscle contractions, mechanical pressure on myofascial trigger points, transcutaneous electrical stimulation or joint movements. The neural connections and integration of the auditory and somatosensory systems of the upper cervical region and head have been confirmed by many studies. These connections can give rise to a form of tinnitus known as somatosensory tinnitus. (Source: Manual Therapy)

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Tinnitus: Mayo Clinic Radio Health Minute

Bothered by a ringing or buzzing in your ears?  Dr. Janalene Niichel has some answers about tinnitus. To listen, click the link below. Tinnitus (Source: News from Mayo Clinic)

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Enhancing Rehabilitative Therapies with Vagus Nerve Stimulation

Abstract Pathological neural activity could be treated by directing specific plasticity to renormalize circuits and restore function. Rehabilitative therapies aim to promote adaptive circuit changes after neurological disease or injury, but insufficient or maladaptive plasticity often prevents a full recovery. The development of adjunctive strategies that broadly support plasticity to facilitate the benefits of rehabilitative interventions has the potential to improve treatment of a wide range of neurological disorders. Recently, stimulation of the vagus nerve in conjunction with rehabilitation has emerged as one such potential targeted plasticity therapy. Vagus nerve stimulation (VNS) drives activation of neuromodulatory nuclei that are associated with plasticity, including the c…

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Prognostic value of mean platelet volume on tinnitus.

CONCLUSION: The clinical findings indicated that tinnitus patients had a higher mean platelet volume than the healthy control subjects; however, the pathophysiological mechanism remains unclear. PMID: 26653396 [PubMed - as supplied by publisher] (Source: Journal of Laryngology and Otology)

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Acoustic sound engineer killed himself after 'fearing chronic tinnitus could lose him his job'

Dr Mark Lawson, who had a PhD in acoustics, felt ‘desperate’ after developing the condition (Source: Telegraph Health)

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Emotion processing in brain changes with tinnitus severity

People with tinnitus who are less bothered by their symptoms use different brain regions when processing emotional information, new research indicates. Tinnitus, otherwise known as ringing in the ears, affects nearly one-third of adults over age 65. (Source: ScienceDaily Headlines)

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Exhausted, moody and suffer from headaches? It COULD be your hip replacement...

Howard Piper developed a series of debilitating symptoms, from chronic tiredness and irritability to tinnitus. It was a long struggle before he was able to identify the cause: his hip replacement. (Source: the Mail online | Health)

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Study: Emotion processing in the brain changes with tinnitus severity

(University of Illinois at Urbana-Champaign) A new study reveals that people with tinnitus who are less bothered by their symptoms use different brain regions when processing emotional information. (Source: EurekAlert! - Medicine and Health)

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Tinnitus prevalence in New Zealand.

CONCLUSION: This is the first nationally representative study of tinnitus prevalence in New Zealand and largest study sample internationally for tinnitus prevalence to date. Tinnitus is a public health problem affecting approximately 207,000 people in the New Zealand population aged ≥14 years. This study has highlighted the importance of sex and age in defining a high-risk tinnitus population, but our knowledge falls short of profiling their ethnic and social-economic characteristics. PMID: 26645752 [PubMed - in process] (Source: New Zealand Medical Journal)

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Tinnitus healthcare in New Zealand.

Authors: Wise KJ, Bird PA, O'Beirne GA PMID: 26645751 [PubMed - in process] (Source: New Zealand Medical Journal)

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Vestibular paroxysmia associated with paroxysmal pulsatile tinnitus: a case report and review of the literature.

CONCLUSION: The pulsatile nature of the patient’s tinnitus implied that the auditory nerve was being compressed by a pulsating artery and was found to consolidate the causal relationship between NVCC and vestibular paroxysmia. PMID: 24030039 [PubMed - indexed for MEDLINE] (Source: Acta Neurologica Taiwanica)

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[The epidural blood patch technique for the management of headache due to spontaneous intracranial hypotension].

Authors: Güldoğuş F, Kelsaka E Abstract Spontaneous intracranial hypotension is a clinical entity characterized by orthostatic headache, low CSF pressure and specific cranial imaging techniques. Headache can be accompanied by the symptoms such as tinnitus, vertigo, diplopia, nausea and vomiting. It is important for the diagnosis to show the level of CSF leakage. Epidural blood patch should be planned for the treatment of patients with no reduction of the complaints following conservative treatment. In this case report, we have discussed the diagnostic methods of spontaneous intracranial hypotension and the importance of an epidural blood patch for its treatment in the light of the literature. PMID: 24104537 [PubMed - indexed for MEDLINE] (Source: Agri Dergisi)

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[Postspinal subacute subdural hematoma: case report].

Authors: Doğanay F, Pirbudak L, Gül R, Alptekin M, Kaplan N Abstract The development of intracranial subdural hematoma after spinal anesthesia is a rare and serious complication that can be fatal if untreated. Needle puncture to the dura mater can cause leakage of cerebrospinal fluid, and lead to stretching and rupture of the meningeal blood vessels with resultant bleeding. A 24-year-old patient, with a completely normal history and laboratory analysis, has got a L4-5 level spinal anesthesia well done at first try, using a Quinke 25 G needle and 12,5 mg bupivacaine heavy. The first day after spinal anesthesia, the patient started to have a headache. He applied to another hospital where he received conservative treatment with a diagnosis of post-spinal headache. But, persistence o…

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Possible familial presentation in two siblings with carotid fibromuscular dysplasia.

Authors: Topal H, Lemmens R, Fourneau I Abstract Fibromuscular dysplasia (FMD) is a nonatherosclerotic, noninflammatory vascular disease which can affect the cervical, renal and visceral arteries. Here we report on two sisters diagnosed with carotid FMD at the same age, presenting with similar symptoms of pulsating tinnitus. The familial presentation of this rare disorder attracted our attention and was suggestive of a genetic etiology. Conservative treatment with aspirin was initiated. Carotid FMD is a rare disorder of which the exact pathophysiology is not known. A review of the literature on the clinical presentation, diagnosis and management is presented. In addition possible etiological factors and the genetic nature of the disease are discussed. PMID: 26021798 [PubMed - …

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Outcomes After Cochlear Implantation in the Very Elderly

Conclusion: Postoperative disequilibrium was commonly observed in this elderly population, yet patients still benefited with improved speech perception after cochlear implantation. Elderly patients can benefit from cochlear implantation, and age should not be a limitation for CI surgery. Cochlear implantation can be done safely and provides significant patient benefits. (Source: Otology and Neurotology)

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Pulsatile tinnitus as the presenting symptom in a patient with posterior reversible encephalopathy syndrome

Conclusion Pulsatile tinnitus can be the presenting symptom of neurovascular disorders, some of which might have serious sequelae if not treated promptly. Detailed neurological and cardiovascular history is recommended in addition to radiological investigations in patients presenting with pulsatile tinnitus. (Source: European Archives of Oto-Rhino-Laryngology)

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Otological complications associated with hyperbaric oxygen therapy

The objective of the present study was to clarify the features of otological complications for hyperbaric oxygen therapy (HBOT) and the risk factors for these complications. We enrolled 1115 patients (776 males and 339 females; age 5–89 years) who underwent HBOT. All otological symptoms experienced during HBOT sessions were evaluated, and risk factors were analysed using multivariate logistic regression analysis. Otoscopic findings and interventions for otological complications were assessed in 58 symptomatic patients who visited the Otolaryngology Department. Otological symptoms were experienced by 165 (14.8 %) of the 1115 patients. The multivariate logistic regression analysis identified ages of >60 years and female sex as independent risk factors, whereas patients with sports i…

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[Review] Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions

Idiopathic intracranial hypertension is a disorder characterised by raised intracranial pressure that predominantly affects young, obese women. Pathogenesis has not been fully elucidated, but several causal factors have been proposed. Symptoms can include headaches, visual loss, pulsatile tinnitus, and back and neck pain, but the clinical presentation is highly variable. Although few studies have been done to support evidence-based management, several recent advances have the potential to enhance understanding of the causes of the disease and to guide treatment decisions. (Source: Lancet Neurology)

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Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions

Publication date: January 2016 Source:The Lancet Neurology, Volume 15, Issue 1 Author(s): Keira A Markey, Susan P Mollan, Rigmor H Jensen, Alexandra J Sinclair Idiopathic intracranial hypertension is a disorder characterised by raised intracranial pressure that predominantly affects young, obese women. Pathogenesis has not been fully elucidated, but several causal factors have been proposed. Symptoms can include headaches, visual loss, pulsatile tinnitus, and back and neck pain, but the clinical presentation is highly variable. Although few studies have been done to support evidence-based management, several recent advances have the potential to enhance understanding of the causes of the disease and to guide treatment decisions. Investigators of the Idiopathic Intracranial Hypertensi…

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Otologic Manifestations of Autosomal Recessive Congenital Ichthyosis in Children

Conclusions The involvement of both dermatologists and ENT specialists in the management of patients with ichthyosis is crucial to ensure the application of the best therapeutic and preventive measures. More studies are needed to assess the prevalence and impact on quality of life of ear involvement in patients with ichthyosis and to determine the optimal interval between ENT visits for these patients. (Source: Actas Dermo-Sifiliograficas)

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Bimodal stimulus timing-dependent plasticity in primary auditory cortex is altered after noise exposure with and without tinnitus

Central auditory circuits are influenced by the somatosensory system, a relationship that may underlie tinnitus generation. In the guinea pig dorsal cochlear nucleus (DCN), pairing spinal trigeminal nucleus (Sp5) stimulation with tones at specific intervals and orders facilitated or suppressed subsequent tone-evoked neural responses, reflecting spike timing-dependent plasticity (STDP). Furthermore, after noise-induced tinnitus, bimodal responses in DCN were shifted from Hebbian to anti-Hebbian timing rules with less discrete temporal windows, suggesting a role for bimodal plasticity in tinnitus. Here, we aimed to determine if multisensory STDP principles like those in DCN also exist in primary auditory cortex (A1), and whether they change following noise-induced tinnitus. Tone-evoked and s…

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Is Hypozincemia Related to Tinnitus?: A Population Study Using Data From the Korea National Health and Nutrition Examination Survey.

CONCLUSION: It was concluded that hypozincemia is not related to tinnitus in a large population. PMID: 26622950 [PubMed - as supplied by publisher] (Source: Clinical and Experimental Otorhinolaryngology)

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Taming TBI-Associated Tinnitus: Regardless of the tinnitus sound (itself), tinnitus can be especially challenging for clients when paired with traumatic brain injury and post-traumatic stress. Research offers insight into how clinicians can help clients manage this co-occurrence.

(Source: The ASHA Leader Online)

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Neural substrates of tinnitus in animal and human cortex : cortical correlates of tinnitus.

Authors: Eggermont JJ Abstract Animal models of tinnitus complement human findings and potentially deepen our insight into the neural substrates of tinnitus. The fact that animal data are largely based on recordings from the auditory system, in particular from subcortical structures, makes comparison with human electrophysiological data from predominantly cortical areas difficult. Electro/magnetoencephalography and imaging data extend beyond the auditory cortex. The most challenging link to be made is the one between the macroscopic data in humans and the microscopic (single neuron action potentials) and mesoscopic (local field potentials) results obtained in animal models. Since invasive recordings in humans are rare, a bridge needs to be built on the basis of changes in brain rhy…

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Stress and tinnitus.

Authors: Mazurek B, Szczepek AJ, Hebert S Abstract Emotional stress is a constant companion of tinnitus patients, since this phantom sound can unfortunately be a very effective stressor. However, the mechanism of stress contribution to the onset or progression of tinnitus remains unknown. Here, we review the pathways induced by emotional stress and the outcome of their induction: corticosteroid-dependent changes in gene expression, epigenetic modulations, and impact of stress on neuronal plasticity and neurotransmission. Using clinical examples, we demonstrate the presence of emotional stress among tinnitus patients and we present methods to measure the degree of stress. The evidence causally linking emotional stress with tinnitus is still indirect-the main difficulty lies in the i…

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25 years of tinnitus retraining therapy.

Authors: Jastreboff PJ Abstract This year marks 25 years of tinnitus retraining therapy (TRT), the approach that aims to eliminate tinnitus as a problem by extinguishing functional connections between the auditory and the limbic and autonomic nervous systems to achieve habituation of tinnitus-evoked reactions and subsequently habituation of perception. TRT addresses directly decreased sound tolerance (DST) as well as tinnitus. TRT consists of counseling and sound therapy, both based on the neurophysiological model of tinnitus. The main goal of retraining counseling is to reclassify tinnitus into the category of a neutral stimulus, while the main goal of sound therapy is to decrease the strength of tinnitus-related neuronal activity. A unique aspect of TRT is that because treatment …

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Intra-individual variability in tinnitus patients : current thoughts and perspectives.

Authors: Dauman N, Erlandsson S, Lundlin L, Dauman R Abstract Most tinnitus studies have attempted to compare groups of individuals, thus revealing inter-individuals differences, i.e., variations between compared subjects. For methodological reasons, inter-individual studies cannot take into account the variability of tinnitus experience, which has been known for decades to be relevant in daily practice with tinnitus patients. The concept of intra-individual variability has been promoted in the research literature, in order to shed light on this aspect of individual perception. In previous studies, unrelated to hearing, the concept of intra-individual variability implied inclusion of the environment (i.e., physical and social interactions) as a factor of individual performance. In …

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[Tinnitus and psychiatric comorbidities].

Authors: Goebel G Abstract Tinnitus is an auditory phantom phenomenon characterized by the sensation of sounds without objectively identifiable sound sources. To date, its causes are not well understood. The perceived severity of tinnitus correlates more closely to psychological and general health factors than to audiometric parameters. Together with limbic structures in the ventral striatum, the prefrontal cortex forms an internal “noise cancelling system”, which normally helps to block out unpleasant sounds, including the tinnitus signal. If this pathway is compromised, chronic tinnitus results. Patients with chronic tinnitus show increased functional connectivity in corticolimbic pathways. Psychiatric comorbidities are common in patients who seek help for tinnitus or hyperacusis…

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[Current treatment of sensorineural hearing loss and chronic tinnitus].

Authors: Zenner HP PMID: 26031714 [PubMed - in process] (Source: HNO)

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[Cochlear implants and tinnitus].

Authors: Olze H Abstract The cochlear implant became a very successful method of hearing rehabilitation for patients with profound sensorineural hearing loss. The benefits of the CI extend beyond the medical success and positively influence social and psychosocial areas, reflected by an improved HRQoL. Furthermore, variety of studies demonstrated that the tinnitus severity improves in 46-95 % of cases following the cochlear implantation. However, the parameters investigated in such studies are not always standardized or addressed by validated questionnaires, which explains the high outcome variation between the studies. The relationships between HRQoL and tinnitus distress before and after cochlear implantation have not been well studied. Nevertheless, it is believed that the imp…

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[Newest therapeutic approaches for chronic tinnitus].

Authors: Hesse G Abstract In the majority of cases, tinnitus derives primarily peripherally, from damage to hair cells in the inner ear; suffering and annoyance, however, are caused by central cortical processing and functional networks of cerebral plasticity. Therefore, new therapeutic approaches aim to influence these structures; whether it be directly by magnetic radiation, or via direct or indirect electrical stimulation. However, these methods can only be efficient if they can integrate and rehabilitate the existing hearing loss. Effective habituation therapies consist of hearing therapy, rehabilitation of hearing loss by hearing aids and psychosomatic stabilisation. In this review, different therapeutic approaches are described and valuated. PMID: 25862622 [PubMed - in pr…

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[On the interdisciplinary S3 guidelines for the treatment of chronic idiopathic tinnitus].

CONCLUSION: No recommendations can be made for drug-based treatment of CIT, audiotherapy, transcranial magnetic or electrical stimulation, specific forms of acoustic stimulation or music therapy; or such recommendations must remain open due to the lack of available evidence. Polypragmatic tinnitus treatment with therapeutic strategies for which there is no evidence of efficacy from controlled studies is to be refused. PMID: 26054729 [PubMed - in process] (Source: HNO)

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Tinnitus: from basic principles to therapy.

Authors: Mazurek B PMID: 25862618 [PubMed - in process] (Source: HNO)

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[Somatosensoric tinnitus].

Authors: Biesinger E, Groth A, Höing R, Hölzl M Abstract Tinnitus can be caused or triggered by functional disorders of the cervical spine, temporomandibular joint or any other musculoskeletal structure of the neck or head. This special form of tinnitus is called somatosensory tinnitus and represents a discrete subgroup among the different kinds of tinnitus. Distinctive for this kind of tinnitus are alterations in volume and frequency during movement or the stimulation of certain muscles and joints. This can be evaluated using a structured testing method. To be able to easily perceive tinnitus modulations, the test must be performed in total silence. Effective treatment modules are physiotherapy, osteopathy, neural therapy, and Qigong for self-help. PMID: 25862620 [PubMed - i…

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[Pre- and posttreatment results of an inpatient neurotologic and psychosomatic tinnitus therapy].

CONCLUSION: With corresponding symptomatic suffering, disorder-specific inpatient tinnitus treatment comprising neurotologic and psychosomatic alignment can achieve medium- to high-range therapeutic effects. PMID: 26219526 [PubMed - in process] (Source: HNO)

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[One-sided facial and cervical swelling with tinnitus].

Authors: Koch A, Delb W, Kruppert H PMID: 26324200 [PubMed - in process] (Source: HNO)

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Deep Brain Stimulation of Heschl Gyrus: Implantation Technique, Intraoperative Localization, and Effects of Stimulation

CONCLUSION: Direct anatomic targeting with physiological verification can be used to implant electrodes directly into primary auditory cortex. If deep brain stimulation proves effective for intractable tinnitus, this technique may be useful to assist with electrode implantation. ABBREVIATIONS: DBS, deep brain stimulator EEG, electroencephalography HG, Heschl gyrus (Source: Neurosurgery)

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Stapedectomy Effects on Tinnitus: Relationship of Change in Loudness to Change in Severity

Conclusion For poststapedectomy patients, a VAS loudness change by 1.5 to 2.0 points averaged for both ears in bilateral tinnitus or ~3 points in unilateral tinnitus has a PPV ~0.64 for a clinically significant change in tinnitus severity. (Source: Otolaryngology - Head and Neck Surgery)

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CT evaluation of sigmoid plate dehiscence causing pulsatile tinnitus

Conclusion SPD causing PT has characteristic CT findings. It may be generated by vascular or intracranial pressure abnormalities and act as a common key to triggering PT’s perception. Key Points • Pulsatile tinnitus (PT) caused by sigmoid plate dehiscence (SPD) may be cured. • SPD causing PT has some characteristic findings on CT. • SPD may be a common key to triggering PT’s perception. • Thin-slice high resolution CT venography is recommended for SPD assessment. • The relationship between intracranial pressure and SPD causing PT should be studied. (Source: European Radiology)

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