Tinnitus and event related potentials: a systematic review

IntroductionTinnitus is sound perception in the absence of a sound source. Changes in parameters of latency and amplitude on the auditory event related potentials or long latency potentials waves have been cited in tinnitus patients when compared to a control group.ObjectiveTo perform an assessment of scientific evidence that verifies the possibility of alterations in latency or amplitude of the waves of event related potentials in individuals with tinnitus.MethodsBy using SciELO, Lilacs, ISI Web and PubMed, scientific databases, a review was performed. Articles published in English, Portuguese, French and Spanish that correlated tinnitus with changes in event related potentials were included in this review.ResultsTwelve articles were located, however only eight fulfilled the criteria for inclusion.ConclusionThe sample of selected studies demonstrate that the long latency auditory evoked potentials related to events between the control and tinnitus patients showed some changes in latency and or amplitude in tinnitus patients. There are changes in event-related potentials when comparing patients with tinnitus and the control group. These changes take place considering the severity of tinnitus, tinnitus site of lesion, and capacity for changes after interventions. The event related potentials can help to determine the neurotransmitter involved in tinnitus generation and evaluate tinnitus treatments.     

Tinnitus: a management model

A comprehensive model of tinnitus management is proposed. As it is rarely possible to abolish the symptom, management of the tinnitus patient must aim at precipitating the habituation process. The model is split into 'evaluation' and 'remediation' sections. In each section the various aspects of management are discussed. Together with traditional factors, the importance of psychological processes is stressed. The role of the expectations of the patient in limiting remedial possibilities is also discussed.     

Tinnitus: a management model

A comprehensive model of tinnitus management is proposed. As it is rarely possible to abolish the symptom, management of the tinnitus patient must aim at precipitating the habituation process. The model is split into ‘evaluation’ and ‘remediation’ sections. In each section the various aspects of management are discussed. Together with traditional factors, the importance of psychological processes is stressed. The role of the expectations of the patient in limiting remedial possibilities is also discussed.     

Tinnitus: a philosophical problem

Anatomical, physiological and metabolic properties of tinnitus have been identified and a comprehensive theory is immerging. The key elements and their interaction are presented in a general fashion highlighting areas of concern such as needed details of individual biosusceptibility and the need for continued tinnitus modeling for predictions as an aid in the development of effective treatment modalities. Nonetheless, there remains something of the uniqueness of tinnitus as a personal experience. The use of the final common pathway (FCP) as a unifying principle in diagnosis and treatment is presented.     

Tinnitus: a new management

Tinnitus Clinic was established at the University of Oregon Medical School and the result of treatment for 158 patients is discussed. Patients received three forms of masking as treatment: masking from hearing aids, masking from the Tinnitus Masker, and FM-Masking. Conditions leading to each kind of recommendation are discussed. The examination procedures used in the Tinnitus Clinic are presented. The phenomenon of residual inhibition is explained and discussed in relation to possible long-term or permanent relief of tinnitus. Future plans for the clinic and needs of tinnitus patients are presented.     

Distorted olfactory perception: a systematic review

The sense of smell provides people with valuable input from the chemical environment around them. The human sense of smell generally fails in three ways; one is an intensity reduction and the other two are the quality of changes. Smell disorders can be classified into central or peripheral depending on their origin. Central causes can be related to an area of hyper-functioning brain cells generating this odor perception, thus olfactory distortions have also been observed with epilepsy and migraine. In this paper, we present a review of the current clinical understanding of olfactory distortions and discuss how they can be evaluated and therapies to treat this debilitating condition.     

Unusual complications of tonsillectomy: a systematic review

AIMS: Common complications of tonsillectomy are well recognized and are frequently explained to patients during the process of informed consent. This systematic review serves as a reminder of the unusual complications of this routine procedure. METHODS: Studies were located using systematic searches in Medline, Embase, Cinahl, and the Cochrane Library electronic databases, together with hand searching of key texts, references, and reviews relevant to the field. Keywords used included the terms tonsillectomy, complications, unusual, and rare. References from the relevant articles were also searched for. INCLUSION CRITERIA: The review was limited to English-language articles. Because of the low incidence of these complications, all cases were included regardless of age. EXCLUSION CRITERIA: Complications of tonsillectomy in children with various syndromes were excluded. RESULTS: Based on our criteria, 20 articles were identified. Only 10 articles were found suitable for review. All articles were either single case reports or small case series. Because of the small study cohort, the patients' ages ranged widely, from 3 to 21 years, with no sex dominance. The complications were categorized into intraoperative and immediate postoperative (<24 hours), intermediate (<2 weeks), and long-term (>2 weeks) unusual complications. Rare complications reviewed include intraoperative vascular injury, subcutaneous emphysema, mediastinitis, Eagle syndrome, atlantoaxial subluxation, cervical osteomyelitis, and taste disorders. CONCLUSIONS: It is important that the otolaryngologist is aware that although the complications discussed are rare and interesting, they are associated with significant morbidity and mortality risks. Tonsillectomy, a very common ear, nose, and throat procedure, may not be so straightforward after all.     

Grisel's syndrome in otolaryngology: a systematic review

AIMS: to assess etiology, treatment and outcome of Grisel's syndrome. METHODS: A Medline search was performed using the terms Grisel's syndrome, spontaneous atlantoaxial subluxation, head, neck, ear, nose and throat. A systematic review of the literature was performed. Case series of both adult and pediatric cases were included. Only papers focusing on true non-traumatic atlantoaxial subluxation were included. RESULTS: Seventy-one papers have been published from 1950 to 2006. Forty-eight of these fulfilled our inclusion criteria, totaling 103 patients for review. The main causes of Grisel's syndrome were infection (48%) and post-adenotonsillectomy (31%). Less common causes included other postoperative cases such as pharyngoplasty and ear operations. Neurosurgical consultation was paramount in all cases. In the majority of cases conservative management in the form of bedrest, antibiotics, muscle relaxants, traction and collar was effective; in a few cases only surgery in the form of arthrodesis was deemed necessary. Morbidity was significant in those cases where diagnosis was delayed, with the most devastating consequence a permanent neurological deficit in one case. CONCLUSIONS: Grisel's syndrome is a rare but dangerous complication that can go unnoticed in its early phase and can be a major cause of morbidity and mortality following infection or head and neck procedures/interventions. Early recognition of any cervical complication following routine otolaryngological operations together with early neurosurgical consultation is mandatory to prevent devastating consequences.     

Gusher in stapes surgery: a systematic review

European Archives of Oto-Rhino-Laryngology - The aim of this study is to perform a systematic literature review on the occurrence of gusher during stapes surgery, to understand its surgical...     

Ear-acupressure for allergic rhinitis: a systematic review

Clin. Otolaryngol. 2010, 35 , 6–12. Background: Allergic rhinitis affects 10–40% of the population globally with a substantial health and economic impact on the community. Objective of review: To assess the effectiveness and safety of ear-acupuncture or ear-acupressure for the treatment of allergic rhinitis by reviewing randomised controlled trials and quasi-randomised controlled trials. Type of review: This review followed the methods specified in the Cochrane Handbook for Systematic Reviews of Interventions. Search strategy: A total of 21 electronic English and Chinese databases were searched from their respective inceptions to April 2008. Key words used in the search included the combination of ear, auricular, acupuncture, acupressure, acupoint, allergic, allergy, rhinitis, hayfever, randomised clinical trial and their synonyms. Evaluation method: The methodological quality was assessed using Jadad’s scale. The effect size analysis was performed to explore the difference between interventional groups. Results: Ninety-two research papers were identified and seven of them referring to five studies met the inclusion criteria. All included studies involved ear-acupressure treatment. These studies mentioned randomisation, but no details were given. None of the five studies used blinding or intention-to-treat analysis. Ear-acupressure was more effective than herbal medicine, as effective as body acupuncture or antihistamine for short-term effect, but it was more effective than anti-histamine for long-term effect. Conclusions: The benefit of ear-acupressure for symptomatic relief of allergic rhinitis is unknown due to the poor quality of included studies.     

Assessing Tinnitus and Prospective Tinnitus Therapeutics Using a Psychophysical Animal Model

Subjective tinnitus is a common and often debilitating disorder that is difficult to study because it is a perceptual state without an objective stimulus correlate. Studying tinnitus in humans is further complicated by the heterogeneity of tinnitus quality, severity, and associated hearing loss. As a consequence, the pathophysiology of tinnitus is poorly understood and treatments are often unsuccessful. In the present study, an animal psychophysical model was developed to reflect several features of tinnitus observed in humans. Chronic tinnitus was induced in rats by a single intense unilateral exposure to noise. The tinnitus was measured using a psychophysical procedure, which required the animals to discriminate between auditory test stimuli consisting of tones, noise, and 0 dB. Tinnitus was indicated by a frequency-specific shift in discrimination functions with respect to control subjects not exposed to noise. The psychophysical consequences of the noise exposure were best explained by a tinnitus hypothesis and could not be explained easily by other consequences of noise exposure such as hearing loss. The qualitative features of the tinnitus were determined and related to the duration of noise exposure and the associated cochlear trauma. The tinnitus was found to persist and intensify over 17 months of testing. Finally, the tinnitus was reversibly attenuated by treatment with gabapentin, a GABA agonist. It was concluded that this model reflected several features of human tinnitus, such as its tonality and persistence, and could be useful as a screen for potential therapeutics as well as a tool to help unravel the pathophysiology of the disorder of phantom auditory perception.     

Tinnitus: Development of a neurophysiologic correlate

Although tinnitus severely afflicts 7.2 million Americans, the pathophysiology of this problem remains obscure because there presently exists no good animal model in which to study the phenomenon. We have examined changes in activity in the guinea pig auditory pathway using an autoradiographic method of functional brain mapping after short-term and long-term cochlear ablations which can, in humans, initiate the occurrence of tinnitus. With this method we have observed a reduction in activity in various nuclei in the auditory pathway between 4 hrs and 10 days after unilateral cochlear ablation. In contrast to these findings we have found a return of activity in these same nuclei if they are observed from 12 to 48 days following the lesion. These preliminary data suggest that this return of activity in the absence of sensory input may be a valid experimental analogue for tinnitus in humans. Such evidence for auditory plasticity may represent a significant first step toward understanding this common and profound otologic symptom.     

鼻咽部少见肿瘤系统文献回顾

鼻咽部位置隐匿,不易窥查,同时也是肿瘤的好发部位.2003年6月至2008年4月,我们遇到4例鼻咽部少见肿瘤,为能全面了解鼻咽部肿瘤的发病情况,通过PUBMED对鼻咽部肿瘤作了系统性文献检索,现将4例病例及检索文献结果介绍如下.     

Complications of tracheostomy in children: a systematic review

IntroductionTracheostomy is a procedure that can be associated with several well-described complications in the literature, which can be divided into transoperative, early postoperative and late postoperative. When performed in children, these risks are more common than in adults.ObjectiveTo perform a systematic review of complications, including deaths, in tracheostomized pediatric patients.MethodsA search was carried out for articles in the Latin American and Caribbean Health Sciences Literature and PubMed databases. Cohort studies and series reports were selected, in addition to systematic reviews, published between January 1978 and June 2020, with patients up to 18 years old, and written in English, Spanish or Portuguese.Results1560 articles were found, of which 49 were included in this review. The average complication rate was 40%, which showed an association with age, birth weight, prematurity, comorbidities, and emergency procedures. The most common complications were cutaneous lesions and granulomas. Mortality related to the procedure reached up to 6% in children and was mainly related to cannula obstruction or accidental decannulation.ConclusionPediatric tracheostomy is associated with several complications. The tracheostomy-related mortality rate is low, but the overall mortality of tracheostomized patients is not negligible.