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Yu HZ, Gong JM, Hong GW, Zhou RQ, Fu XP, Fan T, Zheng YQ, Peng YQ, Li J, Wang YF. The Effect of Physical Therapy on Somatosensory Tinnitus. J Clin Med 2024; 13:3496. [PMID: 38930025 PMCID: PMC11204550 DOI: 10.3390/jcm13123496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/01/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
Objective: The objective of this work was to assess the effect of physical therapy in patients with somatosensory tinnitus (ST) and explore the influence of physical therapy on clinical variables obtained before treatment. Methods: A total of 43 patients with ST were randomized to the immediate-start group (n = 20) and delayed-start group (n = 23). All patients received physical therapy for 1 week (seven sessions). Each session lasted 60 min. The Visual Analogue Scale (VAS), Tinnitus Handicap Inventory (THI), and numerical pain rating scale (NPRS) scores were documented at baseline and after treatment (week 1) for all patients. For subjects in the immediate-start group, the THI, VAS, and NPRS scores were measured after therapy (weeks 6, 9, and 12, respectively). Medical history characteristic functional activity scale (HCFA) scores were measured at baseline to assess the association between somatic symptoms and tinnitus. Results: At week 1, VAS, THI, and NPRS scores of patients in the immediate-start group were improved by 1.25 ± 1.59, 11.10 ± 15.10, and 0.95 ± 1.54 points, respectively, and were significantly higher than those in the delayed-start group (p < 0.05). The change in VAS, THI, and NPRS scores in the treatment group was significantly positively correlated with the scores of the HCFA before treatment (r = 0.786, p < 0.001; r = 0.680, p = 0.001; r = 0.796, p < 0.001). There was no significant difference in THI, VAS, and NPRS scores among patients in the immediate-start group between weeks 1, 6, 9, and 12 after treatment (p > 0.05). Conclusions: Although more participants were necessary in the further study, the study implies that physical therapy can reduce physical pain, improve tinnitus symptoms, and quality of life in ST patients without hearing loss, and the short-term curative effect is stable, especially for tinnitus patients with clear somatic symptoms.
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Affiliation(s)
- Hong-Zhe Yu
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Jia-Min Gong
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
| | - Guo-Wei Hong
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
| | - Ruo-Qiao Zhou
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Xin-Ping Fu
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
| | - Ting Fan
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Yu-Qing Zheng
- Department of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, China;
| | - Ying-Qiu Peng
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Jian Li
- Clinical Laboratory Center, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai 201102, China
| | - Yun-Feng Wang
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
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Michiels S. Somatosensory Tinnitus: Recent Developments in Diagnosis and Treatment. J Assoc Res Otolaryngol 2023; 24:465-472. [PMID: 37794291 PMCID: PMC10695899 DOI: 10.1007/s10162-023-00912-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/11/2023] [Indexed: 10/06/2023] Open
Abstract
Somatosensory tinnitus (ST) is a type of tinnitus where changes in somatosensory input from the head-neck area are one of the influencing factors of a patient's tinnitus. As there are often several influencing factors, identifying a clear somatosensory influence on an individual patient's tinnitus is often a challenge. Therefore, a decision tree using four clinical criteria has been proposed that can help diagnose ST with an accuracy of 82.2%, a sensitivity of 82.5%, and a specificity of 79%. Once correctly diagnosed, patients can be successfully treated using a musculoskeletal physical therapy treatment. This type of treatment can either be directed at cervical spine dysfunctions, temporomandibular disorders, or both and consists of a combination of counseling, exercises, and manual techniques to restore normal function of the cervical spine and temporomandibular area. Other techniques have been suggested but need further investigation in larger RCTs. In most cases, ST treatment shows a decrease in tinnitus severity or loudness, but in rare cases, total remission of the tinnitus is achieved.
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Affiliation(s)
- Sarah Michiels
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, BE, Belgium.
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium.
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Haider HF, Hoare DJ, Costa RFP, Potgieter I, Kikidis D, Lapira A, Nikitas C, Caria H, Cunha NT, Paço JC. Pathophysiology, Diagnosis and Treatment of Somatosensory Tinnitus: A Scoping Review. Front Neurosci 2017; 11:207. [PMID: 28503129 PMCID: PMC5408030 DOI: 10.3389/fnins.2017.00207] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Accepted: 03/27/2017] [Indexed: 11/13/2022] Open
Abstract
Somatosensory tinnitus is a generally agreed subtype of tinnitus that is associated with activation of the somatosensory, somatomotor, and visual-motor systems. A key characteristic of somatosensory tinnitus is that is modulated by physical contact or movement. Although it seems common, its pathophysiology, assessment and treatment are not well defined. We present a scoping review on the pathophysiology, diagnosis, and treatment of somatosensory tinnitus, and identify priority directions for further research. Methods: Literature searches were conducted in Google Scholar, PubMed, and EMBASE databases. Additional broad hand searches were conducted with the additional terms etiology, diagnose, treatment. Results: Most evidence on the pathophysiology of somatosensory tinnitus suggests that somatic modulations are the result of altered or cross-modal synaptic activity within the dorsal cochlear nucleus or between the auditory nervous system and other sensory subsystems of central nervous system (e.g., visual or tactile). Presentations of somatosensory tinnitus are varied and evidence for the various approaches to treatment promising but limited. Discussion and Conclusions: Despite the apparent prevalence of somatosensory tinnitus its underlying neural processes are still not well understood. Necessary involvement of multidisciplinary teams in its diagnosis and treatment has led to a large heterogeneity of approaches whereby tinnitus improvement is often only a secondary effect. Hence there are no evidence-based clinical guidelines, and patient care is empirical rather than research-evidence-based. Somatic testing should receive further attention considering the breath of evidence on the ability of patients to modulate their tinnitus through manouvers. Specific questions for further research and review are indicated.
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Affiliation(s)
- Haúla F. Haider
- ENT Department, Hospital Cuf Infante Santo—Nova Medical SchoolLisbon, Portugal
| | - Derek J. Hoare
- NIHR Nottingham Biomedical Research Centre, Division of Clinical Neuroscience, School of Medicine, University of NottinghamNottingham, UK
| | - Raquel F. P. Costa
- Centro em Rede de Investigação em Antropologia (CRIA), Network Centre for Research in Anthropology, Universidade Nova de LisboaLisbon, Portugal
| | - Iskra Potgieter
- NIHR Nottingham Biomedical Research Centre, Division of Clinical Neuroscience, School of Medicine, University of NottinghamNottingham, UK
| | - Dimitris Kikidis
- First Department of Otorhinolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Hippocrateion General HospitalAthens, Greece
| | - Alec Lapira
- Institute of Health Care, Mater Dei HospitalMsida, Malta
| | - Christos Nikitas
- First Department of Otorhinolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Hippocrateion General HospitalAthens, Greece
| | - Helena Caria
- Deafness Research Group, BTR Unit, BioISI, Faculty of Sciences, University of LisbonLisbon, Portugal
- ESS/IPS–Biomedical Sciences Department, School of Health, Polytechnic Institute of SetubalLisbon, Portugal
| | - Nuno T. Cunha
- ENT Department, Hospital Pedro Hispano—MatosinhosLisbon, Portugal
| | - João C. Paço
- ENT Department, Hospital Cuf Infante Santo—Nova Medical SchoolLisbon, Portugal
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