Zumbido e intolerância a sons : evidência e experiência de um grupo brasileiro

Introdução Zumbido e intolerância a sons são queixas frequentes e subjetivas que podem ter impacto na qualidade de vida do paciente. Objetivo Apresentar uma revisão dos principais pontos, inclusive conceitos, fisiopatologia, diagnóstico e abordagem do paciente com zumbido e sensibilidade a sons. Método Revisão da literatura com levantamento bibliográfico na base de dados da LILACS, SciELO, Pubmed e MEDLINE. Foram selecionados artigos e capítulos de livros sobre zumbido e sensibilidade a sons. Os diversos tópicos foram discutidos por um grupo de profissionais brasileiros e as conclusões, descritas. Resultado A prevalência de zumbido tem aumentado ao longo dos anos, muitas vezes associado a perda auditiva, fatores metabólicos e erros alimentares. A avaliação médica deve ser feita minuciosamente no sentido de orientar a solicitação de exames subsidiários. Os tratamentos disponíveis atualmente variam de medicamentos ao uso de sons com características específicas e técnicas de meditação, com resultados variáveis. Conclusão Foi apresentada uma revisão sobre os temas que permitindo ao leitor uma visão ampla da abordagem dos pacientes com zumbido e sensibilidade auditiva baseada em evidências científicas e experiência nacional.Introduction Tinnitus and sound intolerance are frequent and subjective complaints that may have an impact on a patient's quality of life. Objective To present a review of the salient points including concepts, pathophysiology, diagnosis and approach of the patient with tinnitus and sensitivity to sounds. Methods Literature review with bibliographic survey in LILACS, SciELO, Pubmed and MEDLINE database. Articles and book chapters on tinnitus and sound sensitivity were selected. The several topics were discussed by a group of Brazilian professionals and the conclusions were described. Results The prevalence of tinnitus has increased over the years, often associated with hearing loss, metabolic factors and inadequate diet. Medical evaluation should be performed carefully to guide the request of subsidiary exams. Currently available treatments range from medications to the use of sounds with specific characteristics and meditation techniques, with variable results. Conclusion A review on tinnitus and auditory sensitivity was presented, allowing the reader a broad view of the approach to these patients, based on scientific evidence and national experience

Potenciais Auditivos De Longa Latência Para Avaliação Do Tratamento Medicamentoso Do Zumbido

Objective: To Verify If Long-Latency Evoked Potentials Present Changes In Their Latency And Or Amplitude That May Help To Measure, With The Thi (Tinnitus Handicap Inventory) And The Vas (Visual-Analogue Scale) Questionnaire, Any Characteristics Objectives Of A Drug Treatment For Tinnitus. Method: Eighty-Eight Patients Complaining Of Tinnitus Were Randomized Into Two Groups Of Drugs: Central Drugs With Different Mechanisms Of Action In The Neurotransmitters Involved In The Auditory Pathways And A Drug With Peripheric. Its Effects On The Negative Reaction Of The Tinnitus Symptom Were Evaluated By The Event-Related Auditory Potentials At Three Moments: Premedication (T1), At The End Of The Drug Treatment (T2) And After A Wash-Out Period (T3) And Compared With The Results Of The Eva And The Thi Questionnaire Results: In The Compromised Ears, The Erps Did Not Show, Over Time, Significant Changes In The Total Sample. Conclusion: The Use Of Long-Latency Auditory Evoked Potentials In Patients With Chronic Tinnitus SuObjetivo: Verificar Se Os Potenciais Evocados De Longa Latência Apresentam Mudanças Em Sua Latência E Ou Amplitude Que Possam Ajudar A Mensurar, Em Conjunto Com O Questionário Thi (Tinnitus Handicap Inventory) E A Eva(Escala Visual-Analógica) Eventuais Características Objetivas De Um Tratamento Medicamentoso Para O Zumbido. Método: Oitenta E Oito Pacientes Com Queixa De Zumbido Foram Randomizados Em Dois Grupos De Medicamentos: Medicamentos De Ação Central Com Diferentes Mecanismos De Ação Nos Neurotransmissores Envolvidos Nas Vias Auditivas E Medicamento De Ação Periférica. Seus Efeitos Quanto À Reação Negativa Do Sintoma Zumbido Foram Avaliados Pelos Potenciais Auditivos Relacionados A Eventos, Em Três Momentos: Pré-Medicamento (T1), Ao Final Do Tratamento Medicamentoso (T2) E Após Um Período De Washout (T3) E Comparados Com Os Resultados Da Eva E Do Questionário Thi Resultados: Nas Orelhas Comprometidas, Os Erp's Não Apresentaram Alterações Significantes Na Amostra Total Ao Longo Do Tempo. Conclusão: O UsoDados abertos - Sucupira - Teses e dissertações (2018

Retropharyngeal internal carotid artery: case report

Introduction: Variations to the course of carotid arteries may lead to abnormal pharyngeal protrusions, to which the otorhinolaryngologist should always attentive. Objective: To report a case of abnormal pharyngeal protrusion due to vascular anomaly in the course of the internal carotid artery, with literature review. Case Report: A 73- year-old woman complained of globus pharyngeus and intermittent dysphonia. A pulsating convexity was observed at the right part of the oropharynx, associated to laryngoscopic signals of pharyngo-laryngeal reflux. The pharyngeal computed tomography scan showed an abnormal tortuous internal carotid in the retropharyngeal space. The patient was sent to the vascular surgeon, who, after a normal blood flow finding at the Doppler, opted for an expectation conduct. The pharyngeal symptoms improved with the antireflux treatment. Final Comments: Internal carotid vascular anomalies must always be recalled in the pharyngeal wall convexity differential diagnosis

Tinnitus Treatment with Oxytocin: A Pilot Study

Introduction: Tinnitus is the perception of sound in the absence of an external stimulus. It is a frequent condition for which there is as yet no pharmacological treatment approved. Auditory and non-auditory pathways are involved in tinnitus' pathophysiology. Oxytocin is a neurohormone and eventual neurotransmitter that plays a complex role in social cognition and behavior. Objective: To evaluate the potential of oxytocin as a tinnitus treatment. Study design: Two studies were performed. Study 1 was a long-term open pilot study, while study 2 investigated short-term effects with a double-blinded placebo-controlled cross-over study. Setting: Ambulatory ENT care. Subjects and method: In study 1, 15 patients were investigated over a 10-week period in an open pilot study. In study 2, 16 patients were included in a placebo-controlled crossover trial to investigate short-term effects following a single dose. Results: For the long-term study (study 1), analysis of variance revealed a significant decrease in tinnitus sensation, both for the Tinnitus Handicap Inventory and Clinical Global Impression (CGI). Also, the short-term effects in study 2 revealed a significant reduction of tinnitus because of the oxytocin nasal spray as measured with the Visual Analog Scale and the CGI Scale. Conclusion: These preliminary studies demonstrated that oxytocin may represent a helpful tool for treating tinnitus and further larger controlled studies are warranted

Tratamento da criptosporidiase, em pacientes com AIDS, por meio da paromomicina

A criptosporidíase de 25 pacientes adultos, com síndrome da imunodeficiência adquirida (AIDS) foi tratada por meio da paromomicina, sendo administrados, por via oral, 500mg quatro vezes ao dia, durante duas semanas. Houve boa resposta clínica, representada por redução considerável ou cessação da diarréia em 19 (76%), tendo a tolerância sido satisfatória. Somente em um (4%) doente ocorreram tonturas e, em outro (4%), surgiram náuseas e vômitos, possivelmente devido à medicação. Controle parasitológico de cura teve lugar em 20, verificando-se na maioria deles (75%) persistência do agente causal. Apesar do freqüente insucesso quanto à eliminação do parasita, a melhoria obtida na maioria das vezes e a apreciável tolerância ao medicamento, tornam a paromomicina opção muito útil na terapêutica da infecção intestinal causada pelo Cryptosporidium sp nos indivíduos com AIDS.The authors treated with paromomycin 25 patients, with AIDS and cryptosporidiasis. The drug was given orally in a doses of 500mg qid, for a period of 14 days. Tolerance was good, with just two cases of mild side-effects. Clinical improvement was obtained in 19 (76%) patients. Parasitological cure, however, occurred only in a low percentage (25%). In some cases where initial success was observed, recrudescence occurred after some weeks or few months, but with retreatment again clinical improvement was obtained. Even if it does not lead to frequent parasite eradication, the good clinical results and tolerance permit us to consider paromomycin one of the few drugs effective for the treatment of cryptosporidial diarrhea in AIDS patients. Studies with maintainance therapy are indicated

Tratamento da criptosporidiase, em pacientes com AIDS, por meio da paromomicina

A criptosporidíase de 25 pacientes adultos, com síndrome da imunodeficiência adquirida (AIDS) foi tratada por meio da paromomicina, sendo administrados, por via oral, 500mg quatro vezes ao dia, durante duas semanas. Houve boa resposta clínica, representada por redução considerável ou cessação da diarréia em 19 (76%), tendo a tolerância sido satisfatória. Somente em um (4%) doente ocorreram tonturas e, em outro (4%), surgiram náuseas e vômitos, possivelmente devido à medicação. Controle parasitológico de cura teve lugar em 20, verificando-se na maioria deles (75%) persistência do agente causal. Apesar do freqüente insucesso quanto à eliminação do parasita, a melhoria obtida na maioria das vezes e a apreciável tolerância ao medicamento, tornam a paromomicina opção muito útil na terapêutica da infecção intestinal causada pelo Cryptosporidium sp nos indivíduos com AIDS

Tinnitus and Tinnitus Disorder: Theoretical and Operational Definitions (An International Multidisciplinary Proposal)

As for hypertension, chronic pain, epilepsy and other disorders with particular symptoms, a commonly accepted and unambiguous definition provides a common ground for researchers and clinicians to study and treat the problem. The WHO\u27s ICD11 definition only mentions tinnitus as a nonspecific symptom of a hearing disorder, but not as a clinical entity in its own right, and the American Psychiatric Association\u27s DSM-V doesn\u27t mention tinnitus at all. Here we propose that the tinnitus without and with associated suffering should be differentiated by distinct terms: Tinnitus for the former and Tinnitus Disorder for the latter. The proposed definition then becomes Tinnitus is the conscious awareness of a tonal or composite noise for which there is no identifiable corresponding external acoustic source, which becomes Tinnitus Disorder when associated with emotional distress, cognitive dysfunction, and/or autonomic arousal, leading to behavioural changes and functional disability. . In other words Tinnitus describes the auditory or sensory component, whereas Tinnitus Disorder reflects the auditory component and the associated suffering. Whereas acute tinnitus may be a symptom secondary to a trauma or disease, chronic tinnitus may be considered a primary disorder in its own right. If adopted, this will advance the recognition of tinnitus disorder as a primary health condition in its own right. The capacity to measure the incidence, prevalence, and impact will help in identification of human, financial, and educational needs required to address acute tinnitus as a symptom but chronic tinnitus as a disorder

Tinnitus and sound intolerance: evidence and experience of a Brazilian group

<div><p>Abstract Introduction Tinnitus and sound intolerance are frequent and subjective complaints that may have an impact on a patient's quality of life. Objective To present a review of the salient points including concepts, pathophysiology, diagnosis and approach of the patient with tinnitus and sensitivity to sounds. Methods Literature review with bibliographic survey in LILACS, SciELO, Pubmed and MEDLINE database. Articles and book chapters on tinnitus and sound sensitivity were selected. The several topics were discussed by a group of Brazilian professionals and the conclusions were described. Results The prevalence of tinnitus has increased over the years, often associated with hearing loss, metabolic factors and inadequate diet. Medical evaluation should be performed carefully to guide the request of subsidiary exams. Currently available treatments range from medications to the use of sounds with specific characteristics and meditation techniques, with variable results. Conclusion A review on tinnitus and auditory sensitivity was presented, allowing the reader a broad view of the approach to these patients, based on scientific evidence and national experience.</p></div