Andréia Aparecida de Azevedo

Consensus for tinnitus patient assessment and treatment outcome measurement: Tinnitus Research Initiative meeting, Regensburg, July 2006.

There is widespread recognition that consistency between research centres in the ways that patients with tinnitus are assessed and outcomes following interventions are measured would facilitate more effective co-operation and more meaningful evaluations and comparisons of outcomes. At the first Tinnitus Research Initiative meeting held in Regensburg in July 2006 an attempt was made through workshops to gain a consensus both for patient assessments and for outcome measurements. It is hoped that this will contribute towards better cooperation between research centres in finding and evaluating treatments for tinnitus by allowing better comparability between studies.

Methodological aspects of clinical trials in tinnitus: A proposal for an international standard

Chronic tinnitus is a common condition with a high burden of disease. While many different treatments are used in clinical practice, the evidence for the efficacy of these treatments is low and the variance of treatment response between individuals is high. This is most likely due to the great heterogeneity of tinnitus with respect to clinical features as well as underlying pathophysiological mechanisms. There is a clear need to find effective treatment options in tinnitus, however, clinical trials differ substantially with respect to methodological quality and design. Consequently, the conclusions that can be derived from these studies are limited and jeopardize comparison between studies. Here, we discuss our view of the most important aspects of trial design in clinical studies in tinnitus and make suggestions for an international methodological standard in tinnitus trials. We hope that the proposed methodological standard will stimulate scientific discussion and will help to improve the quality of trials in tinnitus.

Tinnitus treatment with memantine

Objective To evaluate efficacy and safety of memantine in the treatment of tinnitus. Study Design Prospective, randomized, double-blind crossover study. Subjects and Methods A total of 60 patients with tinnitus were randomized into a double-blind, placebo-controlled, prospective crossover study. Patients each received up to 20 mg memantine and placebo for 90 days, separated by a 30-day washout period. Treatment effects were assessed by using the Tinnitus Handicap Inventory (THI). A total of 43 patients completed the trial. Results There was no significant improvement of THI score after memantine treatment compared with placebo. A possible tendency for delayed effects of memantine was observed. The incidence of side effects during memantine treatment was 9.4 percent, leading to interruption of treatment in all cases. Conclusion This study does not provide evidence to recommend memantine for the treatment of tinnitus. A possible late effect of the drug should be evaluated in further studies with longer observation periods.

Nasal foreign bodies: description of types and complications in 420 cases

UNLABELLED Nasal cavities foreign bodies are common accidents in children, sometimes leading, in accordance with the literature, to complications such as epistaxis and bronchoaspiration. Diagnosis is often made with anterior rhinoscopy, but sometimes nasal fibroendoscopy and imaging may be useful. AIM To evaluate 420 cases of nasal foreign bodies removed in ENT Service of Souza Aguiar Hospital, Rio de Janeiro, as related to sex, age, type of foreign body and complications. MATERIALS AND METHOD 420 cases of nasal foreign bodies removed in the ENT service of Souza Aguiar Hospital between December 1992 and December 1998 were evaluated according to the parameters related above. RESULTS We found higher incidence between 0 and 4 years of age, and the most frequently found foreign bodies were foam fragments, plastic pieces of little toys, beans and paper fragments. Complications occurred in 9.05% of the cases, epistaxis and vestibulitis being the commonest. CONCLUSION Nasal foreign bodies are especially found between the ages of 0 and 4 years. In our study, foam fragments and small plastic objects were the most frequent foreign bodies found. Complications were found in 9.05% of the cases, headed by epistaxis and nasal vestibulitis.

Correlation analysis of the visual-analogue scale and the Tinnitus Handicap Inventory in tinnitus patients

UNLABELLED One of the most challenging topics in tinnitus clinical studies is the measuring method used. Visual Analogue Scales (VAS) and Tinnitus Handicap Inventory (THI) are frequently used in tinnitus. AIM To verify the relationship between VAS and THI scores in tinnitus patients in a prospective study. MATERIALS AND METHODS 43 patients classified their tinnitus according to VAS and THI, and both scores were compared through the Spearmans correlation coefficient test. RESULTS There was a correlation between the VAS and THI scores. CONCLUSION There is correlation between VAS and THI scores in patients with sensorineural tinnitus.

Tinnitus treatment with acamprosate: double-blind study.

Summary Nowadays, the treatment of tinnitus is still a great challenge for the otolaryngologists. Many facts remain unknown in its pathophysiology, leading to many different therapies, with irregular results. Acamprosate is a drug used in alcoholism treatment, due to its regulating effects in glutamatergic and GABA neurotransmission, and has never been used before in the treatment of tinnitus Aim: To evaluate efficacy and safety of the acamprosate in the treatment of sensorineural tinnitus. Study design: randomized clinical trial. Material and Method: 50 patients with sensorineural tinnitus were divided into two groups: 25 received acamprosate and 25 placebo, for a period of 3 months, in a prospective double-blind study, being analyzed for its efficacy and safety by the subjective score from 1 to 10 given by the patient. Results: We found a high index of success in the relief of tinnitus, about 86.9%. In 47.8% of the cases we found more than 50% relief. The incidence of side effects was low, 12%, all of them mild. Conclusion: Acamprosate, a drug used in the treatment of alcoholism, is a safe and successful alternative for sensorineural tinnitus’ treatment.

Corpos estranhos de fossas nasais: descrição de tipos e complicações em 420 casos

Corpos estranhos de fossas nasais sao acidentes comuns em criancas, podendo, de acordo com a literatura, levar a complicacoes supurativas e bronco-aspiracao do corpo estranho. O diagnostico e feito quase sempre pela rinoscopia anterior, mas a nasofibroscopia e exames radiologicos podem ser uteis. OBJETIVO: Analisar um total de 420 casos de corpos estranhos de fossas nasais removidos no servico de ORL-EPO do Hospital Municipal Souza Aguiar quanto a varios parâmetros como sexo, idade, tipo e complicacoes. MATERIAL E METODO: 420 casos de corpos estranhos de fossas nasais removidos no servico de Otorrinolaringologia e Endoscopia Per-oral (ORL-EPO) do Hospital Municipal Souza Aguiar, no periodo de dezembro de 1992 a dezembro de 1998, quanto aos parâmetros acima referidos. RESULTADOS: Foi encontrada uma maior incidencia na faixa etaria de 0 a 4 anos, sendo os mais comuns, pela ordem fragmentos de espuma, fragmentos de material plastico, graos de feijao e fragmentos de papel. As complicacoes ocorreram em 9,05% dos casos, sendo as mais comuns a epistaxe e a vestibulite. CONCLUSAO: Os corpos estranhos de fossas nasais sao acidentes encontrados principalmente na faixa etaria de 0 a 4 anos, sendo os mais comuns, em nossa casuistica, os fragmentos de espuma e pequenos artefatos de plastico. Complicacoes nao sao frequentes, sendo as mais encontradas a epistaxe e vestibulite nasal.

Incidence of tinnitus in mp3 player users

UNLABELLED Exposure to loud noise is one of the main causes of tinnitus. AIM To analyze the incidence of tinnitus in mp3 player users and non-users. MATERIAL AND METHOD One hundred subjects aged from 15 to 30 years were enrolled, 54 of them were regular mp3 player users and 46 were not. Patients with continuous tinnitus for at least 6 months completed the Tinnitus Handicap Inventory (THI) and were tested with high frequency audiometry and transient-evoked otoacoustic emissions (TAOE). STUDY DESIGN A cross-sectional cohort study. RESULTS The incidence of tinnitus in non-users was about 8 %; in mp3 player users it was about 28 %, a statistically significant difference. Hearing thresholds at 8 kHz were significantly higher in tinnitus patients that used mp3 portable players.TAOE were reduced at 2 kHz in the users group. No statistically significant difference was found in the THI scores between the two groups. CONCLUSION Tinnitus was more frequent in teenagers and young adults who regularly listen to mp3 music in players. Moreover, the incidence of tinnitus among mp3 player users was associated with higher hearing thresholds at 8 kHz and lower TOAE at 2 kHz.

Análise da correlação entre a escala visual-análoga e o Tinnitus Handicap Inventory na avaliação de pacientes com zumbido

One of the most challenging topics in tinnitus clinical studies is the measuring method used. Visual Analogue Scales (VAS) and Tinnitus Handicap Inventory (THI) are frequently used in tinnitus. AIM: To verify the relationship between VAS and THI scores in tinnitus patients in a prospective study. MATERIALS AND METHODS: 43 patients classified their tinnitus according to VAS and THI, and both scores were compared through the Spearmans correlation coefficient test. RESULTS: There was a correlation between the VAS and THI scores. CONCLUSION: There is correlation between VAS and THI scores in patients with sensorineural tinnitus.

Treatment of tinnitus with acamprosate

Acamprosate, a drug used to treat alcohol dependence, was first reported as a potential treatment for tinnitus in 2005. The drug may improve tinnitus by a dual mechanism of action, acting both as a glutamate antagonist and as a GABA agonist. It is suggested that its action may be both on the ear and the nervous system.