The chronic ear/ [edited by] John L. Dornhoffer, Michael B. Gluth.

Includes bibliographical references and index.The Chronic Ear -- Title Page -- Copyright -- Dedication -- Contents -- Preface -- Acknowledgments -- Contributors -- Master Glossary -- Part 1. The Fundamentals of Chronic Ear Disease -- 1. Chronic Ear Disease in the Modern Era: Evolution of Treatment, Epidemiology, and Classification -- 2. Eustachian Tube Dysfunction, Mucosal Gas Exchange, and Effusion -- 3. Tympanic Membrane Wound Healing and Epithelial Migration -- 4. Pathophysiology of Cholesteatoma -- 5. Microbiology of Chronic Ear Disease -- 6. Histopathology of Chronic Otitis Media -- 7. Surgical Anatomy Relevant to the Chronic Ear -- 8. Biomaterials in Tympanomastoid Surgery -- 9. Middle Ear Mechanics in Hearing Reconstruction -- Part 2. Clinical Evaluation and Office Management of Chronic Ear Disease -- 10. Pearls in Audiovestibular Assessment -- 11. Radiographic Evaluation of Chronic Ear Disease -- 12. Inflammatory Conditions and Systemic Diseases Affecting the Middle Ear -- 13. Myringitis -- 14. Office Evaluation and Management of a CanalWall-Down Mastoid Cavity -- 15. Tubo-Tympanic Diseases: Retraction, Atelectasis, and Middle Ear Effusion -- 16. Evaluation and Nonsurgical Management of Chronic Suppurative Otitis Media -- 17. Intratemporal and Intracranial Complications of Otitis Media -- Part 3. Introduction to Surgical Management of Chronic Ear Disease -- 18. General Principles of Surgery for Chronic Ear Disease -- 19. Tympanostomy Tubes -- 20. Canalplasty and Meatoplasty -- 21. Cholesteatoma Dissection: Problems and Solutions -- Part 4. Roundtable on Tympanic Membrane Reconstruction -- 22. Overview and Introduction -- 23. Underlay and Related Techniques -- 24. Overlay Tympanoplasty Technique -- 25. Cartilage Tympanoplasty -- Part 5. Roundtable on Ossiculoplasty -- 26. Overview and Introduction -- 27. Reconstruction of the Incudostapedial Articulation.28. Autograft Ossicular Reconstruction -- 29. Ossiculoplasty with Synthetic PORPS and TORPS -- 30. The Malleus in Ossicular Reconstruction -- 31. Surgical Management of the Fixed Stapes in Chronic Ear Disease -- Part 6. Roundtable on Tympanomastoidectomy -- 32. Overview and Introduction -- 33. Canal Wall-Up Techniques -- 34. Epitympanectomy -- 35. Canal Wall-Down Mastoidectomy -- Part 7. Roundtable on Hybrid Tympanomastoid Surgical Techniques -- 36. Overview and Introduction -- 37. Retrograde Technique for Management of Cholesteatoma -- 38. Canal Wall Removal and Replacement with Obliteration -- 39. Soft-Wall Canal Reconstruction -- 40. Canal Wall Reconstruction Using the Titanium Mesh Cage -- Part 8. Special Topics and New Horizons in Surgery for Chronic Ear Disease -- 41. Mastoid Cavity Obliteration -- 42. Skull Base Approaches in Chronic Ear Surgery -- 43. Implantable Hearing Devices and Chronic Otitis Media -- 44. Endoscopic Ear Surgery -- 45. Eustachian Tuboplasty -- 46. Tympanic Membrane Tissue Engineering -- 47. Chronic Otitis Media in the Setting of Congenital Ear Disease -- 48. Skin Grafting in the Management of Chronic Ear Disease -- Index.1 online resource (xxii, 349 pages)

Controversy: Does repetitive transcranial magnetic stimulation/ transcranial direct current stimulation show efficacy in treating tinnitus patients?

Background: Tinnitus affects 10% of the population, its pathophysiology remains incompletely understood, and treatment is elusive. Functional imaging has demonstrated a relationship between the intensity of tinnitus and the degree of reorganization in the auditory cortex. Experimental studies have further shown that tinnitus is associated with synchronized hyperactivity in the auditory cortex. Therefore, targeted modulation of auditory cortex has been proposed as a new therapeutic approach for chronic tinnitus. Methods: Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are noninvasive methods that can modulate cortical activity. These techniques have been applied in different ways in patients with chronic tinnitus. Single sessions of high-frequency rTMS over the temporal cortex have been successful in reducing the intensity of tinnitus during the time of stimulation and could be predictive for treatment outcome of chronic epidural stimulation using implanted electrodes. Results: Another approach that uses rTMS as a treatment for tinnitus is application of low-frequency rTMS in repeated sessions, to induce a lasting change of neuronal activity in the auditory cortex beyond the duration of stimulation. Beneficial effects of this treatment have been consistently demonstrated in several small controlled studies. However, results are characterized by high interindividual variability and only a moderate decrease of the tinnitus. The role of patient-related (for example, hearing loss, tinnitus duration, age) and stimulation-related (for example, stimulation site, stimulation protocols) factors still remains to be elucidated. Conclusions: Even in this early stage of investigation, there is a convincing body of evidence that rTMS represents a promising tool for pathophysiological assessment and therapeutic management of tinnitus. Further development of this technique will depend on a more detailed understanding of the neurobiological effects mediating the benefit of TMS on tinnitus perception. Moreover clinical studies with larger sample sizes and longer follow-up periods are needed. © 2008 Elsevier Inc. All rights reserved