1/26. Ototoxicity associated with vinblastine.OBJECTIVE: To describe a patient with ototoxicity associated with vinblastine chemotherapy. CASE SUMMARY: A 29-year-old white man with recurrent Hodgkin's disease received doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy once every two weeks for 12 cycles. He reported tinnitus after each treatment, with an onset of about six hours and a duration of seven to 10 days. This interfered with reading, watching television, and general concentration. Symptoms returned to baseline prior to the beginning of each subsequent cycle. Audiograms performed before and after several cycles showed mild sensorineural hearing loss in the high-decibel range, but no loss of speech recognition. DISCUSSION: No reported cases of ototoxicity or tinnitus from ABVD were found. All concomitant medications were eliminated as possible causes either due to lack of temporal association with the symptoms or no reports of ototoxicity in the literature. vincristine, a more commonly used vinca alkaloid very similar to vinblastine, was noted to have caused several cases of sensorineural hearing loss. CONCLUSIONS: This case suggests that vinblastine may cause ototoxicity.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
2/26. Cutaneous-evoked tinnitus. I. Phenomenology, psychophysics and functional imaging.DC00166e and acute unilateral deafferentation of the auditory periphery (auditory and vestibular afferents) can induce changes in the central nervous system that may result in unique forms of tinnitus. These tinnitus perceptions can be controlled (turned on and off) or modulated (changed in pitch or loudness) by performing certain overt behaviors in other sensory/motor systems. Clinical reports from our laboratory and several other independent sources indicate that static change in eye gaze, from a neutral head-referenced position, is one such behavior that can evoke, modulate and/or suppress these phantom auditory events. This report deals with a new clinical entity and a form of tinnitus that can be evoked directly by cutaneous stimulation of the upper hand and fingertip regions. In 2 adults, cutaneous-evoked tinnitus was reported following neurosurgery for space-occupying lesions at the base of the skull and posterior craniofossa, where hearing and vestibular functions were lost completely and acutely in one ear (unilateral deafferentation) and facial nerve paralysis (unilateral deefferentation) was present either immediately following neurosurgery or had occurred as a delayed-onset event. Herein, we focus on the phenomenology of this discovery, provide perceptual correlates using contemporary psychophysical methods and document in one individual cutaneous-evoked tinnitus-related neural activity using functional magnetic resonance imaging. In a companion paper, neuroanatomical and physiological interactions between auditory and somatosensory systems, possible mechanistic accounts and relevant functional neuroimaging studies are reviewed.- - - - - - - - - - ranking = 1.9138060890631keywords = perception (Clic here for more details about this article) |
3/26. Somatic (craniocervical) tinnitus and the dorsal cochlear nucleus hypothesis.PURPOSE: Of all nonauditory sensory systems, only the somatosensory system seems to be related to tinnitus (eg, temporomandibular joint syndrome and whiplash). The purpose of this study is to describe the distinguishing characteristics of tinnitus associated with somatic events and to use these characteristics to develop a neurological model of somatic tinnitus. MATERIALS AND methods: Case series. RESULTS: Some patients with tinnitus, but no other hearing complaints, share several clinical features including (1) an associated somatic disorder of the head or upper neck, (2) localization of the tinnitus to the ear ipsilateral to the somatic disorder, (3) no vestibular complaints, and (4) no abnormalities on neurological examination. Pure tone and speech audiometry of the 2 ears is always symmetric and usually within normal limits. Based on these clinical features, it is proposed that somatic (craniocervical) tinnitus, like otic tinnitus, is caused by disinhibition of the ipsilateral dorsal cochlear nucleus. nerve fibers whose cell bodies lie in the ipsilateral medullary somatosensory nuclei mediate this effect. These neurons receive inputs from nearby spinal trigeminal tract, fasciculus cuneatus, and facial, vagal, and glossopharyngeal nerve fibers innervating the middle and external ear. CONCLUSIONS: Somatic (craniocervical) modulation of the dorsal cochlear nucleus may account for many previously poorly understood aspects of tinnitus and suggests novel tinnitus treatments.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
4/26. Masking of tinnitus through a cochlear implant.The relief of tinnitus has been effected in a cochlear-implant patient by presenting masking sounds to the microphone of the implant. Oddly enough, the presence of the masking sound improved the clarity of speech and music.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
5/26. Regional cerebral blood flow during tinnitus: a PET case study with lidocaine and auditory stimulation.brain imaging of tinnitus has suggested central correlates of tinnitus perception. This study presents positron emission tomographic (PET) measurements of regional cerebral blood flow (rCBF) in a female tinnitus patient with bilateral left dominant tinnitus. lidocaine infusion (75 mg during 5 min (0.2 mg/kg/min)) resulted in a 75% reduction of tinnitus and a temporary abolition of the dominant tinnitus in her left ear. Regional CBF was measured in four conditions: i) at rest while concentrating on tinnitus, ii) following maximum effect of lidocaine, iii) during sound stimulation, and iv) the following day at rest while concentrating on tinnitus. Subtraction analyses showed that tinnitus was associated with increased rCBF in the left parieto-temporal auditory cortex, including the primary and secondary auditory cortex with a focus in the parietal cortex (Brodmann areas 39, 41, 42, 21, 22). Activations were also found in right frontal paralimbic areas (Brodmann areas 47, 49 and 15). sound stimulation resulted in bilateral activation of auditory areas. It is suggested that tinnitus is processed in primary, secondary and integrative auditory cortical areas. tinnitus perception may involve areas related to auditory attention, while emotional processing relates to temporofrontal paralimbic areas.- - - - - - - - - - ranking = 3.8276121781262keywords = perception (Clic here for more details about this article) |
6/26. Central tinnitus: a case report.We report a case of acute-onset unilateral tinnitus in a 25-year-old woman. Analysis of imaging studies indicated that the tinnitus was likely caused by an acute hemorrhage of a small cavernous angioma that was located adjacent to the contralateral primary auditory cortex. This case provides substantial support for the concept that central tinnitus might indeed represent a pathologic activation of neural networks of nonspecific auditory perception.- - - - - - - - - - ranking = 1.9138060890631keywords = perception (Clic here for more details about this article) |
7/26. Steroid perfusion of the inner ear for sudden sensorineural hearing loss after failure of conventional therapy: a pilot study.The aim of this study was to determine if high-dose delivery of methylprednisolone to the round window can improve hearing after the failure of conventional treatment for sudden sensorineural hearing loss (SSHL). In 6 patients with SSHL an Intraear microcatheter was placed in the round window niche and methylprednisolone (62.5 mg/ml) was infused at a rate of 10 microl/h for 8-10 days. Audiometric assessments (including measurement of speech discrimination) were made at presentation, either every day or every other day during treatment and 5 days after the completion of perfusion. perfusion of methylprednisolone was beneficial for all 6 patients, with a 16.25-25 dB improvement in hearing threshold. A dramatic improvement in speech discrimination was also noted in all patients. In conclusion, methylprednisolone perfused at the level of the round window membrane resulted in significant recovery of hearing function after the failure of standard treatment of SSHL.- - - - - - - - - - ranking = 896.52784475861keywords = speech discrimination, discrimination, speech (Clic here for more details about this article) |
8/26. Neuronavigated rTMS in a patient with chronic tinnitus. Effects of 4 weeks treatment.Clinical, neurophysiological and neuroimaging data suggest that chronic tinnitus resembles neuropsychiatric syndromes characterised by focal brain activation. Low frequency repetitive transcranial magnetic stimulation (rTMS) has been proposed as an efficient method in treating brain hyperexcitability disorders. In one patient suffering from chronic tinnitus, [18F]deoxyglucose PET revealed increased metabolic activity in a circumscript area of the left primary auditory cortex (PAC). The effect of MRI and PET guided neuronavigated 1 Hz rTMS of this area was evaluated in a single-blind, sham-controlled, cross-over manner, followed by a 4-week open treatment. Following active stimulation there was a remarkable effect, enduring several weeks, on tinnitus sensation, which was paralleled by altered cortical excitability. These findings suggest that neuronavigated rTMS of increased PAC activity might offer a new option for treating auditory phantom perceptions like chronic tinnitus.- - - - - - - - - - ranking = 1.9138060890631keywords = perception (Clic here for more details about this article) |
9/26. hearing loss after direct blunt neck trauma.OBJECTIVE: To report for the first time hearing impairment resulting from blunt neck trauma. STUDY DESIGN: Retrospective chart review of clinical, pure tone, and speech audiometric findings. The first obtained within 3 months and the follow-up ones between 6 and 12 months after injury. Three representative examples are given. patients: Eighty-three patients (166 ears) who reported hearing impairment after blunt neck trauma. RESULTS: Twenty of the 166 ears (12%) had normal hearing and 137 ears (81.3%) showed an acoustic trauma-like hearing impairment. Eight ears (4.8%) had a hearing loss of at least 30 dB in the speech frequencies (500-2,000 Hz) and two ears (1.2%) had additional impairment in the higher frequencies. Only one ear (0.8%) had a conductive hearing loss. No speech discrimination score was poorer than 80%. Forty-six subjects (55.4%) reported tinnitus. CONCLUSIONS: Blunt neck trauma, like whiplash injury, may cause objectively measurable hearing impairment.- - - - - - - - - - ranking = 450.26392237931keywords = speech discrimination, discrimination, speech (Clic here for more details about this article) |
10/26. Neuronavigated repetitive transcranial magnetic stimulation in patients with tinnitus: a short case series.BACKGROUND: Clinical as well as neurophysiological and neuroimaging data suggest that chronic tinnitus resembles neuropsychiatric syndromes characterized by focal brain activation. Low-frequency repetitive transcranial magnetic stimulation (rTMS) has been proposed as an efficient method in treating brain hyperexcitability disorders by reducing cortical excitability. methods: In three patients suffering from chronic tinnitus, the effect of magnetic resonance imaging and positron emission tomography guided neuronavigated 1 Hz rTMS on auditory cortex activity was evaluated, using a sham controlled double-blind crossover design. RESULTS: Two of three patients revealed clearly increased metabolic activity in circumscript areas of the primary auditory cortex (PAC), allowing a selective stimulation of these cortical areas with low-frequency rTMS. Considerable improvement in tinnitus was achieved in these patients. CONCLUSIONS: Neuronavigated rTMS of increased PAC activity may help to better understand the neuronal basis of chronic tinnitus and might offer a new option for treating auditory phantom perceptions like chronic tinnitus.- - - - - - - - - - ranking = 1.9138060890631keywords = perception (Clic here for more details about this article) |
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