Evaluation of Eye Movement Desensitization and Reprocessing in the management of tinnitus. An observational study

ObjectivesTinnitus can induce disabling psychological suffering, requiring an integrative multimodal approach, combining neuromodulation and psychotherapeutic methods. We sought to evaluate the therapeutic efficacy and acceptability of Eye Movement Desensitization and Reprocessing (EMDR) in tinnitus.Materials and methodsThis was a single-center prospective non-comparative study. Inclusion criteria comprised: adult patient, with chronic tinnitus, Tinnitus Handicap Inventory (THI) score > 17, causing psychological distress motivating active treatment after ineffective “classic” treatment (combining advice, sound therapy and first-line drug treatment), and agreement to EMDR therapy. Therapeutic efficacy was defined by a decrease in THI or Visual Analog Scale (VAS) scores. Treatment acceptability was defined by the rate of included patients who completed therapy.ResultsThirty-eight patients were included. There was a significant reduction of 53.5% in THI score in 78.9% of patients (P < 0.0001; 64.8 ± 20.8 before versus 31.8 ± 24.7 after treatment), and of 51% in VAS score in 76.3% of patients (P < 0.0001; 7.24 ± 2.12 before versus 3.58 ± 2.03 after treatment). The treatment acceptability was 86.8%.ConclusionEMDR appeared to be an effective alternative that was acceptable to the majority of patients, after failure of “classic” first-line treatment, improving quality of life in tinnitus patients and thus relieving disability.     

聪耳通窍汤联合耳针对老年神经性耳鸣近远期疗效观察

目的探讨聪耳通窍汤联合耳针治疗老年神经性耳鸣患者的近远期疗效。方法选取耳鼻喉科门诊收治的老年神经性耳鸣患者136例,按随机数字表法分组,对照组68例予以耳针治疗,研究组68例在对照组基础上予以聪耳通窍汤治疗。检测比较两组间近、远期临床疗效、甲襞微循环指标、血液流变学指标以及不良反应发生率。结果治疗后,对照组总有效率为67.64%(46/68)低于研究组总有效率83.82%(57/68),具有统计学意义(P<0.05);随访6个月后,对照组总有效率64.71%(44/68)低于研究组总有效率89.71%(61/68),具有统计学意义(P<0.05);与对照组比较,研究组治疗后甲襞微循环襻周积分、管襻积分、流态积分及总积分较低,治疗后血浆黏度、高切全血黏度、低切全血黏度及红细胞压积较低,差异具有统计学意义(P<0.05);治疗中出现的不良反应为恶心、腹胀、针刺部位疼痛,两组间不良反应发生率无统计学差异(P>0.05)。结论聪耳通窍汤联合耳针治疗老年神经性耳鸣患者的近远期疗效均较好,能明显改善患者微循环状态及血液流变学指标,减轻内耳循环障碍,具有较高安全性。     

持续性特发性耳鸣严重程度的相关因素分析

目的 探讨导致持续性特发性耳鸣严重程度的相关因素。 方法 分析870例持续性特发性主观性耳鸣患者的一般资料、病史、听力学结果、耳鸣匹配实验、耳鸣残疾量表、匹兹堡睡眠质量指数量表和焦虑自评量表,应用多因素Logistic回归分析研究与患者耳鸣严重程度相关的因素。 结果 (1)性别(P<0.001)、年龄(P=0.010)、耳鸣主调声频率(P=0.005)、听力损失(P=0.037)、焦虑程度(P<0.001)、睡眠状况(P<0.001)在THI分级上差异有统计学意义(P<0.05);(2)病程(P=0.053)、侧别(P=0.437)、主调声响度(P=0.120)在THI分级上差异均无统计学意义(P>0.05)。 结论 女性患者特发性耳鸣的程度较男性更为严重;低频较高频更扰人;焦虑程度和睡眠状况是影响耳鸣严重程度的因素,而病程、侧别、耳鸣主调声响度不是影响患者特发性耳鸣严重程度的因素。     

Deep Brain Stimulation——A new treatment for tinnitus

Intractable tinnitus can lead to serious consequences. Study evidence indicates that the central nervous system is involved in generation and maintenance of chronic tinnitus and that tinnitus and other neurologic symptoms such as chronic pain may share similar mechanisms. Brain ablation and stimulation are used to treat chronic pain with success. Recent studies showed that ablation and stimulation in non-auditory areas resulted in tinnitus improvement. Deep brain stimulation (DBS) may be an alternative treatment for intractable tinnitus and deserves further study.     

京剧器乐的听力损伤（附55例调查报告）

本文对从事京剧打击乐的55人（110耳）进行了听力调查及动态观察。利用图表进行对比分析，发现110耳中高频听力损伤89耳，占81％；语频听力损伤32耳，占29.1%；其中伴有高频耳鸣78耳，占70．9％。动态观察30人（60耳），均为永久性听阈阈移。高频听力损伤最早出现的频率是4kHz，并见典型“V”谷，符合噪声性聋的诊断。     

肌源性耳鸣的声导抗测试特征（附3例报告）

本文报道了１１例病例,并以３例典型病例就肌源性耳鸣的声导抗测试的基本方法和特征作了探讨。腭肌阵挛的幅度较大,在鼓室导抗图和声反射曲线上均可出现锯齿状波。镫骨肌阵挛在表情肌运动时可诱发,为持续性,镫骨肌声反射对其无影响或可掩盖之。鼓膜张肌阵挛与面部三叉神经受刺激有关,易疲劳,表现为一短暂的声顺变化波形。     

Otological trauma resulting from the Soho Nail Bomb in London,April 1999

Otological trauma resulting from the Soho Nail Bomb in London, April 1999 We report the otological effects of the April 1999 Soho Nail Bomb on 17 patients. Twenty‐one (62%) tympanic membranes were perforated (pars tensa only); 78% closed spontaneously within 6 months. The mean size of the perforation in the tympanic membrane nearer to the blast was significantly larger than the opposite side [33% ± 8.3 (mean ± SD) and 13% ± 4.1 respectively; P = 0.02]. All patients reported hearing losses that were mixed conductive and sensorineural but mainly high‐frequency sensorineural (4, 6 and 8 kHz, pure tone average 42.3 dB ± 20.5). The sensorineural hearing loss correlated inversely with the distance from the explosion but not with the size of perforation. There was no significant difference in the hearing loss between the ear facing the blast and the opposite ear. Fifteen patients (88%) had temporary tinnitus. No patient complained of any vestibular symptoms. The otological effects of a nail bomb in an enclosed space have not been previously reported. Furthermore, an inverse correlation between hearing loss and distance from the explosion and a significant difference in perforation size facing the blast, compared with the opposite side, are also presented for the first time. The high spontaneous closure rate of perforations and minimal ongoing disability from sensorineural losses favour conservative management in most cases.     

超选择动脉栓塞治疗血管搏动性耳鸣（附2例报告）

采用数字减影血管造影技术超选择性动脉栓塞治愈２例血管搏动怀耳鸣，并就发病原因、机理、治疗措施、临床特征进行讨论。     

利多卡因穴位注射治疗耳鸣的疗效观察

目的观察利多卡因穴位注射治疗耳鸣的疗法。方法应用2%利多卡因穴位注射(穴注组)的方法治疗主观性耳鸣50例,并以50例用扩血管等药物口服做对照(对照组)。结果穴注组有效率为86%,对照组有效率为44%,穴注组疗效明显优于对照组(P<0!01),除一过性面部麻木及少数病人出现短暂的面瘫及眩晕外,未发现其他副作用。结论该方法是治疗主观性耳鸣安全有效的方法。     

Original Papers · Travaux originaux: Factors Affecting the Prevalence of Tinnitus

The prevalence of tinnitus was studied in a large population of noise-exposed workers. It was found that 6.6% had tinnitus which was more than momentary. Results of two other studies were compared. Factors possibly relating to the prevalence of tinnitus were studied. The single most important factor found to be related to tinnitus is hearing level. The higher the hearing level, the faster the rate of increase in the prevalence of tinnitus. Other factors such as sex, age, laterality, smoking and shooting do not seem to have a significant, direct relationship with tinnitus, but they are related to the prevalence of tinnitus indirectly through the influence they have on hearing loss.

La prévalence des acouphènes a été étudiée dans une large population de travailleurs exposés aux bruits industriels. On a relevé que 6,6% des travailleurs avaient des acouphènes plus que passagers. Les résultats de deux autres recherches ont été comparés à celle-ci. Les facteurs associés à la prévalence des acouphènes ont été étudiés et seul le degré de surdité a paru lié. Une surdité importante augmente la probabilité d'acouphènes chez les travailleurs. D'autres facteurs comme le sexe, l'aˇge, la latéralité, le fait de fumer ou de tirer ne semblent pas avoir de rapport direct ou significatif avec les acouphènes mais peuvent ětre liés à ceux-ci indirectement à travers leur influence sur la surdité.