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Ali Ismail AM. Lipid Profile Response to Acupuncture in Obese Patients with Subjective Tinnitus: a Randomized Controlled Trial. J Acupunct Meridian Stud 2023; 16:11-19. [PMID: 36804817 DOI: 10.51507/j.jams.2023.16.1.11] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/19/2022] [Accepted: 01/04/2023] [Indexed: 02/22/2023] Open
Abstract
Background Blood lipid levels have been reported as novel biomarkers for chronic subjective tinnitus (CST), with their levels being higher in patients with CST. Objectives This trial aimed to determine the change in lipid profile and tinnitus-related quality of life (TR-QoL) responses to 8-week acupuncture treatment in patients with CST. Methods Sixty obese patients with CST were randomly assigned to group A (treatment group; n = 30; mean age = 44.10 ± 3.69 years) or group B (sham group; n = 30; mean age = 45.53 ± 3.62 years). Patients in group A (n = 30) received manual stimulation at the TE3, TE5, TE17, TE18, TE19, TE20, TE21, TE22, GB2, GB8, GB20, LI4, LI11, KI3, SP6, ST36, CV4, CV9, and CV12 acupoints through in-site acupuncture needles thrice weekly. Furthermore, the bilateral abdominal ST25 and GB28 acupoints were electrically stimulated through in-site acupuncture needles. Group B (n = 30) received the same acupuncture protocol as group A but the insertion of needles was a sham insertion. Anthropometrics such as body mass index (BMI) and waist circumference (WC), TR-QoL (assessed via tinnitus handicap inventory), blood lipid levels such as high-density lipoprotein (HDLs), low-density lipoprotein (LDLs), cholesterol (C), and triglycerides (TGs), and the visual analogue scale (VAS) score for tinnitus severity, were assessed prospectively. Results Only group A showed significant within-group improvements. Except for HDLs, BMI, and WC, unpaired between-group comparisons showed significantly greater improvements in other outcome measures of all patients with tinnitus (TR-QoL, LDLs, TGs, C, and VAS) in group A than in group B. Conclusion Safe acupuncture treatment not only improves anthropometrics and TR-QoL, but also helps resolve hyperlipidemia and reduces the severity of tinnitus in obese patients with CST.
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Affiliation(s)
- Ali Mohamed Ali Ismail
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Boecking B, Klasing S, Walter M, Brueggemann P, Nyamaa A, Rose M, Mazurek B. Vascular-Metabolic Risk Factors and Psychological Stress in Patients with Chronic Tinnitus. Nutrients 2022; 14:nu14112256. [PMID: 35684056 PMCID: PMC9183085 DOI: 10.3390/nu14112256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/12/2022] [Accepted: 05/17/2022] [Indexed: 02/04/2023] Open
Abstract
Little is known about molecular correlates of chronic tinnitus. We examined interrelationships between vascular−metabolic risk factors, perceived stress, and other routine blood values in patients with chronic tinnitus. Two-hundred patients (51% female) were screened for 49 blood parameters pertaining to vascular−metabolic risk, immune function, and redox processes. They further completed perceived stress- and tinnitus-related distress questionnaires. Following descriptive analyses, gender-specific sets of age- and tinnitus-severity-adjusted regression models investigated associations between perceived stress and blood parameters. Patients reported mildly elevated levels of perceived stress. Elevated levels of total cholesterol (65% and 61% of female and male patients, respectively), non-HDL-c (43/50%), LDL-c (56/59%), and lipoprotein_a (28/14%) were accompanied by high rates of overweight (99/100%) and smoking (28/31%). A low-level inflammatory state was accompanied by reduced reactive oxygen species (ROS)-neutralizing capacity (reduced co-enzyme Q10 and SOD1 levels). Most vascular risk factors were not correlated with perceived stress, except for fibrinogen (ß = −0.34) as well as C-reactive protein (ß = −0.31, p < 0.05) in men, and MCV (ß = −0.26, p < 0.05) in women. Interrelations between blood parameters and stress levels need to be investigated within psychobehavioural frameworks across varying distress levels. Alongside psychological interventions, a low-level inflammatory state may be a route for pharmacological therapeutics.
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Affiliation(s)
- Benjamin Boecking
- Tinnitus Center, Charité, Universitätsmedizin Berlin, 10117 Berlin, Germany; (B.B.); (S.K.); (P.B.); (A.N.)
| | - Sven Klasing
- Tinnitus Center, Charité, Universitätsmedizin Berlin, 10117 Berlin, Germany; (B.B.); (S.K.); (P.B.); (A.N.)
| | - Michael Walter
- Institute of Clinical Chemistry and Laboratory Medicine, Universitätsmedizin Rostock, 18057 Rostock, Germany;
| | - Petra Brueggemann
- Tinnitus Center, Charité, Universitätsmedizin Berlin, 10117 Berlin, Germany; (B.B.); (S.K.); (P.B.); (A.N.)
| | - Amarjargal Nyamaa
- Tinnitus Center, Charité, Universitätsmedizin Berlin, 10117 Berlin, Germany; (B.B.); (S.K.); (P.B.); (A.N.)
| | - Matthias Rose
- Medical Department, Division of Psychosomatic Medicine, Charité, Universitätsmedizin Berlin, 10117 Berlin, Germany;
| | - Birgit Mazurek
- Tinnitus Center, Charité, Universitätsmedizin Berlin, 10117 Berlin, Germany; (B.B.); (S.K.); (P.B.); (A.N.)
- Correspondence:
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Objective and Measurable Biomarkers in Chronic Subjective Tinnitus. Int J Mol Sci 2021; 22:ijms22126619. [PMID: 34205595 PMCID: PMC8235100 DOI: 10.3390/ijms22126619] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 12/18/2022] Open
Abstract
Tinnitus is associated with increased social costs and reduced quality of life through sleep disorders or psychological distress. The pathophysiology of chronic subjective tinnitus, which accounts for most tinnitus, has not been clearly elucidated. This is because chronic subjective tinnitus is difficult to evaluate objectively, and there are no objective markers that represent the diagnosis or therapeutic effect of tinnitus. Based on the results of studies on patients with chronic subjective tinnitus, objective and measurable biomarkers that help to identify the pathophysiology of tinnitus have been summarized. A total of 271 studies in PubMed, 303 in EMBASE, and 45 in Cochrane Library were found on biomarkers related to chronic subjective tinnitus published until April 2021. Duplicate articles, articles not written in English, review articles, case reports, and articles that did not match our topic were excluded. A total of 49 studies were included. Three specimens, including blood, saliva, and urine, and a total of 58 biomarkers were used as indicators for diagnosis, evaluation, prognosis, and therapeutic effectiveness of tinnitus. Biomarkers were classified into eight categories comprising metabolic, hemostatic, inflammatory, endocrine, immunological, neurologic, and oxidative parameters. Biomarkers can help in the diagnosis, measure the severity, predict prognosis, and treatment outcome of tinnitus.
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Assessment of Intravenous Lidocaine for the Treatment of Subjective Tinnitus. EAR, NOSE & THROAT JOURNAL 2019. [DOI: 10.1177/014556130308201011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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The clinical value of a thorough diagnostic evaluation for neurotologic complaints. Am J Otolaryngol 2019; 40:16-21. [PMID: 30243840 DOI: 10.1016/j.amjoto.2018.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 09/14/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE Determine the clinical efficacy of comprehensive neurotologic testing in patients presenting with complaints of hearing loss, tinnitus and/or dizziness. METHODS This is a retrospective analysis of 1170 consecutive charts of patients who presented between 1980 and 2013 with neurotologic complaints. Demographic data, chief complaint, diagnostic imaging, audiograms, and blood tests were evaluated. RESULTS Retrospective analysis of 1170 patient charts was performed. 762/1170 (65%) patients presented with subjective hearing loss, 575/1170 (49%) with dizziness, and 657/1170 (56%) with tinnitus. Audiometric testing revealed hearing loss in 1059/1169 (91%) patients. 536/1120 (48%) patients had abnormalities on Magnetic Resonance Imaging, and 343/1087 (32%) on Computed Tomography imaging. Endocrine and immunologic testing revealed 108/1135 (9.5%) patients were hyperglycemic; 125/1124 (11%) patients had elevated TSH; 149/1141 (13%) patients had a positive ANA; and 82/1133 (7.2%) patients were positive for RF. 198/1083 (18%) of patients were positive for HLA-B35, 246/1083 (23%) for HLA-Cw4, 454/1083 (42%) for HLA-Cw7, and 747/1060 (70%) of patients had absent HLA-DR4. 112/1085 (10%) of patients were positive for anti-68kD antibodies and 154/936 (17%) for protein 0. Many patients were diagnosed with previously unrecognized medical conditions. CONCLUSION Comprehensive neurotological workup results in diagnoses that would go unrecognized otherwise, allowing patients to receive prompt treatment for medically important conditions, some of which may be causally related to their neurotologic complaints. However, the value of each study for routine testing of patients with neurotologic complaints remains controversial; and the evidence presented herein should help practitioners determine what studies should be included in their patient assessments.
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Yamanaka T, Fukuda T, Shirota S, Sawai Y, Murai T, Fujita N, Hosoi H. The prevalence and characteristics of metabolic syndrome in patients with vertigo. PLoS One 2013; 8:e80176. [PMID: 24312461 PMCID: PMC3848922 DOI: 10.1371/journal.pone.0080176] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 10/10/2013] [Indexed: 02/06/2023] Open
Abstract
Objectives/Hypothesis Metabolic syndrome (MetS) is a condition that increases the risk of coronary artery disease and cerebral infarction. We determined the prevalence of MetS in vertigo patients and clinically investigated the association between MetS and vertigo. Study Design Case-control study Methods The subjects were 333 patients, including 107 males and 226 females, who presented with vertigo as a primary symptom. MetS was diagnosed according to the International Diabetes Federation definition, which is based on waist circumference, blood serum levels, and blood pressure. Results MetS was detected in 53 (15.9%) of 333 vertigo patients, including 24 males (22.4%) and 29 females (12.8%); i.e., the frequency of MetS was significantly higher among the male patients than the female patients. The overall prevalence of MetS (15.9%) among vertigo patients did not differ from that observed among general adults in previous Japanese surveillance studies; however, MetS was significantly more common among the vertigo patients in males than general adult males. The prevalence of MetS was also examined in five types of vertigo, Concomitant MetS was noted in many males with vertebrobasilar insufficiency (VBI) and isolated vertigo of unknown etiology. Conclusion It was suggested that MetS is involved in the development of vertigo in males. MetS might be a risk factor for vascular vertigo such as VBI in males. The high frequency of MetS among males with vertigo of unknown etiology suggested that the pathogenesis of metabolic syndrome is involved in this type of isolated vertigo.
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Affiliation(s)
- Toshiaki Yamanaka
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University School of Medicine, Kashihara, Nara, Japan
- * E-mail:
| | - Takehiko Fukuda
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University School of Medicine, Kashihara, Nara, Japan
| | - Shiho Shirota
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University School of Medicine, Kashihara, Nara, Japan
| | - Yachiyo Sawai
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University School of Medicine, Kashihara, Nara, Japan
| | - Takayuki Murai
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University School of Medicine, Kashihara, Nara, Japan
| | - Nobuya Fujita
- Department of Otorhinolaryngology, Nara Prefectural Hospital, Nara, Japan
| | - Hiroshi Hosoi
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University School of Medicine, Kashihara, Nara, Japan
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Simpson AN, Matthews LJ, Dubno JR. Lipid and C-reactive protein levels as risk factors for hearing loss in older adults. Otolaryngol Head Neck Surg 2013; 148:664-70. [PMID: 23322627 DOI: 10.1177/0194599812473936] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To determine the role of cardiovascular disease (CVD) markers, lipids and C-reactive protein, in age-related hearing loss over time. STUDY DESIGN Prospective cohort study. SETTING Research laboratories at an academic medical center. SUBJECTS AND METHODS In total, 837 older adults (mean age 67.5 years) were included. Primary dependent variables were pure-tone thresholds (pure-tone average [PTA]), including "narrow" PTA (0.5, 1, 2, 4 kHz), "broad" PTA (0.5, 1, 2, 3, 4, 6, 8 kHz), low-frequency PTA (0.25, 0.5, 1 kHz), and high-frequency PTA (2, 3, 4, 6, 8 kHz). Repeated-measures mixed regression modeling was used to assess the relationship between C-reactive protein (CRP) and lipid levels with PTAs over time. RESULTS In a cross-sectional sample of 837 subjects, modest associations were found between triglycerides and all PTAs. Weak associations were observed between the ratio of total cholesterol and high-density lipoprotein and narrow PTA, broad PTA, and high-frequency PTA. However, when assessing changes in hearing and lipids over time in a longitudinal analysis, no significant associations between hearing and lipids remained. PTAs and CRP were not statistically associated when controlling for age and sex. CONCLUSION Associations between hearing and blood lipids have been the focus of scientific inquiry for more than 50 years. The current results suggest that the association is either spurious or too small to be of consequence in the assessment and treatment of hearing loss in older adults. Inquiry into other potential risk factors for age-related hearing loss and associations with CVD may prove more fruitful.
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Affiliation(s)
- Annie N Simpson
- Department of Healthcare Leadership and Management, Medical University of South Carolina, Charleston, South Carolina 29425-5500, USA
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Chávez-Delgado ME, Vázquez-Granados I, Rosales-Cortés M, Velasco-Rodríguez V. Disfuncion cócleo-vestibular en pacientes con diabetes mellitus, hipertensión arterial sistémica y dislipidemia. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2012; 63:93-101. [DOI: 10.1016/j.otorri.2011.09.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2011] [Revised: 08/21/2011] [Accepted: 09/14/2011] [Indexed: 01/08/2023]
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Chávez-Delgado ME, Vázquez-Granados I, Rosales-Cortés M, Velasco-Rodríguez V. Cochleovestibular Dysfunction in Patients With Diabetes Mellitus, Hypertension, and Dyslipidemia. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.otoeng.2012.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ren J, Zhao P, Chen L, Xu A, Brown SN, Xiao X. Hearing Loss in Middle-aged Subjects with Type 2 Diabetes Mellitus. Arch Med Res 2009; 40:18-23. [DOI: 10.1016/j.arcmed.2008.10.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Accepted: 09/22/2008] [Indexed: 10/21/2022]
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Guo Y, Zhang C, Du X, Nair U, Yoo TJ. Morphological and functional alterations of the cochlea in apolipoprotein E gene deficient mice. Hear Res 2005; 208:54-67. [PMID: 16051453 DOI: 10.1016/j.heares.2005.05.010] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2005] [Accepted: 05/02/2005] [Indexed: 11/17/2022]
Abstract
The relationship between hyperlipidemia and sensorineural hearing loss remains obscure. In this study, we elucidate for the first time the cochlear morphological and auditory alterations and their relationships with hyperlipidemia, atherosclerosis, and endothelial dysfunction in apolipoprotein-E knockout (ApoE-KO) mice. Ten-week-old ApoE-KO mice were fed either atherosclerotic diet (1.25% cholesterol) or normal diet. Wild type mice (C57BL/6J) served as normal controls. Fourteen weeks later, marked hyperlipidemia, atherosclerosis, endothelial dysfunction, and hearing impairment, especially in the high frequencies, had developed in ApoE-KO mice as compared with C57BL/6J mice (P<0.001). A high positive correlation between hearing loss and the extent of atherosclerosis and plasma total cholesterol levels was found. Hearing loss, especially at high frequencies, was detected in all ApoE-KO mice. Hair cell loss mainly at the base turn, thickening of vascular intima, and lumen stenosis of the spiral modiolar artery (SMA) in cochlea were also found; these histological changes were exacerbated by the atherosclerotic diet. Furthermore, endothelial nitric oxide synthase (eNOS) in aortic wall and cochlea was distinctly reduced in ApoE-KO mice. These results demonstrate that hyperlipidemia and atherosclerosis can induce alterations in cochlear morphology and function. The stenosis of SMA, which may cause cochlear ischemia and hypoxia, endothelial dysfunction, and low eNOS activity, may contribute to hearing loss.
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Affiliation(s)
- Yunkai Guo
- Division of Allergy and Immunology, Departments of Medicine, Molecular Sciences and Otolaryngology and Neuroscience Institute, College of Medicine, VA Medical Center, Memphis, TN 38104, USA
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Bittar RSM, Bottino MA, Zerati FE, Moraes CLDO, Cunha AU, Bento RF. Prevalência das alterações metabólicas em pacientes portadores de queixas vestibulares. ACTA ACUST UNITED AC 2003. [DOI: 10.1590/s0034-72992003000100011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
FORMA DE ESTUDO: Clínico prospectivo. MATERIAL E MÉTODO: Os autores avaliam a prevalência de alterações metabólicas em 325 pacientes que procuraram o Setor de Otoneurologia do Hospital das Clínicas da FMUSP com queixas vestibulares. Os pacientes foram consecutivamente atendidos entre janeiro de 1997 e janeiro de 2002. Foram avaliados os primeiros exames referentes ao protocolo clássico de investigação das tonturas, que compreende a dosagem de LDL colesterol, TSH, T3 e T4 e glicemia de jejum. As alterações encontradas foram então comparadas às observadas na população geral. As alterações mais significativas encontradas foram a elevação dos níveis de LDL colesterol, a presença de níveis alterados de hormônios tireoideanos e a maior freqüência do diabetes mellitus na população estudada. CONCLUSÃO: Conclui-se que é válida a investigação destes dados, visto que são mais freqüentes na população de risco e que a correta abordagem dessas alterações melhora o prognóstico e o controle da tontura.
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Satar B, Ozkaptan Y, Sürücü HS, Oztürk H. Ultrastructural effects of hypercholesterolemia on the cochlea. Otol Neurotol 2001; 22:786-9. [PMID: 11698796 DOI: 10.1097/00129492-200111000-00012] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HYPOTHESIS The goals of this study were to identify the effects of hypercholesterolemia on the cochlea and to find out where the pathologic changes first occur. BACKGROUND Some authors have stated that hypercholesterolemia alone does not produce auditory dysfunction. Others propose that auditory dysfunction is caused by glycogen accumulation and other alterations on cochlear ultrastructure. METHODS Twenty guinea pigs were classified as a control group fed with a normal diet, and a cholesterol group of 24 animals was given a diet composed of 1 g cholesterol per day for 4 months. The hearing acuity of the animals before the diets was compared with that after the diets by means of auditory brainstem responses. The basal and apical turns of the cochleas were examined by light microscopy and transmission electron microscopy. RESULTS The control group showed normal cochlear ultrastructures consistent with normal hearing thresholds, whereas the cholesterol group had profound edema in the strial marginal layer and slight edema in the outer hair cells, in line with data from auditory brainstem responses revealing changes in hearing sensitivity in various degrees. The pathologic changes in the basal turn and the stria vascularis were qualitatively prominent in comparison with those of the apical turn and the outer hair cell. CONCLUSIONS These observations confirm that hypercholesterolemia alone may cause auditory dysfunction if dietary cholesterol is kept at a high level for a long time. Alterations attributed to hypercholesterolemia begin in the stria vascularis and then spread over the outer hair cells, mainly in the basal turn.
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Affiliation(s)
- B Satar
- Department of Otolaryngology, Head and Neck Surgery, Gülhane Military Medical Academy, 06010 Etlik-Ankara, Turkey
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Abstract
Tinnitus is an extremely prevalent condition that impinges on the lives of sufferers to varying degrees. In some people, it is a fairly minor irritation but, for many, the tinnitus intrudes to such a degree that it affects their ability to lead a normal life, and in some very extreme cases has resulted in suicide. Insomnia, inability to concentrate and depression are commonly reported to accompany the condition. Relief can be reliably obtained using intravenous lignocaine, which indicates that pharmacology can provide a route for effective alleviation of the condition. In this article, Julie Simpson and Ewart Davies review the potential pharmacological therapies, and emphasize that clinical research has been hampered by the absence of a reliable objective assessment of the tinnitus and by the variable nature of the complaint.
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Affiliation(s)
- J J Simpson
- Department of Pharmacology, Medical School, University of Birmingham, UK
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