Client-centered hypnotherapy for tinnitus: who is likely to benefit?

Inadvertent adverse consequences of clinical and forensic hypnosis: minimizing the risks

Hypnosis is a psychological intervention tool that can make a gamut of psychological, medical, and dental treatments work more rapidly and effectively. It can also be used profitably with some witnesses, victims, and defendants in forensic and investigative contexts as a data gathering tool. As with any other power tool, its use entails some risks. Since risks cannot be totally avoided, this article examines some ways to minimize the risks of inadvertent adverse or negative consequences as a result of the use of the hypnosis tool. Fundamentals of hypnosis risk management are covered as a foundation for beginners and as a review for experienced practitioners. Various straightforward safeguards that should be heeded by all practitioners are discussed.

Complementary and alternative medicine in otolaryngology

The widespread interest in and use of complementary and alternative medicine (CAM) by patients in the United States has been established by multiple surveys. One-third of the U.S. population uses some form of CAM, and an estimated 23 billion dollars is spent annually on these therapies. Because of prevalent usage of CAM among patients, it is important that physicians have some knowledge of this subject. With this purpose in mind, this report reviews the current research on CAM as it relates to common disorders of the head and neck: rhinitis, sinusitis, tinnitus, vertigo, and head and neck oncology.

Current concepts in the clinical management of patients with tinnitus

The current management in tinnitus of sensorineural origin is reviewed. Epidemiological data demonstrates that 90% of patients with hearing loss experience some tinnitus. Approximately 1% of the population suffer from a chronic tinnitus that causes severe distress and requires some type of management intervention. Present non-surgical therapies include masking techniques, psychological counseling, and biofeedback. There are also a number of drugs that have been applied, the most common being antidepressants. These have had the most success in managing patients with tinnitus, although it is currently felt that antidepressants treat underlying psychological problems rather than directly affect the tinnitus. The other large class of drugs include benzodiazopans, in addition to a new synthetic analog of a natural prostaglandin E1, misoprostol. Despite the many drugs now available, none has been approved by the United States Food and Drug Administration for the treatment of tinnitus. Many surgical therapies have been advocated but are directed towards the treatment of concurrent vertigo or for tumors of the cerebellopontine angle, with tinnitus sometimes being relieved by the operation. Specific surgical procedures such as cochlear resection and microvascular decompressions lack clear-cut efficacy. Despite author bias and a myriad of treatment modalities at present, there is still no specific therapy that definitively relieves tinnitus clinically.