11/26. tinnitus in childhood.All of 1,420 children seen for clarification of a hearing disorder or to follow up for known difficulty in hearing were questioned as to whether they experienced tinnitus. The interview was carried out after a hearing test was conducted, which was based on play audiometry or normal pure-tone threshold audiometry, depending on the age of the child. When being interviewed, 102 children reported that tinnitus had appeared or was still present. Seventy-five children (73.5%) demonstrated difficulty in hearing in one or both ears, whereas 27 children (26.5%) had normal hearing in both ears. The most frequently obtained information (29.4%) was the progression of an existing hearing loss. meningitis is an important cause of hearing loss and of tinnitus and could be identified in 20% of our patients. We also considered as a cause of tinnitus skull or brain trauma, acute hearing loss, and stapes surgery. However, the mechanisms of tinnitus development were not immediately clear in a large proportion of the children studied: Problems included central sensory perception (14.7%) and emotional factors (11.8%). No additional information that might lead to an understanding of the hearing loss was available for 14.7% of the patients studied. tinnitus is a frequent symptom in childhood and, because children seldom complain about their tinnitus, such hearing problems that they report must always be taken seriously. The diagnosis should exclude metabolic disturbances, possible damage to the sensory level of the central nervous system, and circulatory disturbances. In addition, the physician should always consider emotional problems and disturbances of perception.- - - - - - - - - - ranking = 1keywords = perception (Clic here for more details about this article) |
12/26. Auditory and electrophysiological patterns of a unilateral lesion of the lateral lemniscus.Auditory disorders resulting from focal brainstem lesions are rarely symptomatic. Isolated lesions of the inferior colliculus have previously been reported, whereas no detailed description of a localized involvement of the lateral lemniscus is yet available. We report a unilateral lesion of the lateral lemniscus by a bleeding in a cavernoma. Symptoms included strictly contralateral tinnitus and auditory impairment, with normal pure-tone and speech audiometry. Conversely, the dichotic listening test revealed an extinction of contralateral ear input. The brainstem auditory evoked potentials disclosed a reduced and delayed wave V only after contralateral ear stimulation, while the middle latency evoked potentials were normal. This observation shows that a unilateral lesion of the lateral lemniscus can produce auditory symptoms. The dysfunction of auditory pathways is associated with specific electrophysiological abnormalities that can be assessed by evoked potential recording.- - - - - - - - - - ranking = 0.26125948854347keywords = speech (Clic here for more details about this article) |
13/26. tinnitus evoked by speech.Modulation of tinnitus by a variety of somatosensory stimuli and alteration of gaze has been described. We present two cases of tinnitus induced by speech (voice). The tinnitus was troublesome in both patients, and both had hearing loss and ischemic changes in the central nervous system documented by magnetic resonance imaging. We discuss cross-modal plasticity and how it may explain the tinnitus in these two patients.- - - - - - - - - - ranking = 1.3062974427173keywords = speech (Clic here for more details about this article) |
14/26. Repetitive transcranial magnetic stimulation for tinnitus: a case study.OBJECTIVES/HYPOTHESIS: Correlate subjective improvements in tinnitus severity with restoration of cortical symmetry and sustained attention after neuronavigated low-frequency, repetitive transcranial magnetic stimulation (rTMS). STUDY DESIGN: Case study. methods: Positron emission tomography and computed tomography imaging (PET-CT) guided rTMS was performed on a 43-year-old white male with more than a 30 year history of bilateral tinnitus. rTMS was administered to the area of increased cortical activation visualized on PET-CT at a rate of 1 Hz for 30 minutes (1,800 pulses/session) for each of 5 consecutive days, with optimization applied on day 5 using single pulses of TMS to temporarily alter tinnitus perception. Subjective tinnitus severity was rated before and after rTMS using the tinnitus severity index with analogue scale. attention and vigilance were assessed before and after therapy using the psychomotor vigilance task (PVT), a simple reaction time test that is sensitive to thalamocortical contributions to sustained attention. Posttherapy PET-CT was used to evaluate any change in asymmetric cortical activation. RESULTS: The most marked reduction in tinnitus severity occurred after rTMS optimization; this persisted up to 4 weeks after rTMS. PVT testing showed the patient exhibited a statistically significant improvement in mean slowest 10% reaction times after rTMS (P = .004). PET-CT imaging 2 days after the cessation of rTMS showed no changes in cortical blood flow or metabolic asymmetries. CONCLUSIONS: Low-frequency rTMS applied to the primary auditory cortex can reduce tinnitus severity, with rTMS optimization yielding the most favorable results. Beneficial changes occurring in the patient's slowest reaction times suggest that attentional deficits associated with tinnitus may also respond to low-frequency rTMS.- - - - - - - - - - ranking = 0.5keywords = perception (Clic here for more details about this article) |
15/26. Objective tinnitus of vascular origin with hearing improvement after treatment.Objective tinnitus occurs as a result of muscular contraction or vascular pulsations. The literature is reviewed and we present two case reports of vascular objective tinnitus and its diagnostic and therapeutic modalities. One patient was treated with embolization alone; the other, with embolization and surgical ligation. Both patients achieved an improvement in sensorineural hearing thresholds in their affected ears; one patient experienced an improvement in speech reception threshold of 30 decibels. Measures useful to diagnosis and evaluation of therapy and reasons for the observed improved hearing thresholds are discussed.- - - - - - - - - - ranking = 0.26125948854347keywords = speech (Clic here for more details about this article) |
16/26. aspirin abolishes tinnitus caused by spontaneous otoacoustic emissions. A case study.A series of experimental tests are presented indicating that numerous spontaneous otoacoustic emissions (SOAEs) are likely to provide the basis of monaural tinnitus for one female patient. For this patient, (1) the tinnitus disappeared only when all SOAE components were suppressed, (2) with all but one emission suppressed, the frequency of an external tone said to match the pitch of the tinnitus was close to the frequency of the unsuppressed SOAE, and (3) the isomasking contour for the tinnitus was frequency specific. All these tests indicated that the patient was likely to be hearing SOAEs. During subsequent aspirin administration, her SOAEs disappeared and her perception of her tinnitus was radically altered. The tinnitus was no longer described as monaural and "tonal" but instead was described as being "noise in the head."- - - - - - - - - - ranking = 0.5keywords = perception (Clic here for more details about this article) |
17/26. Objective tinnitus associated with abnormal mastoid emissary vein.tinnitus may be defined as the perception of sound in the absence of environmental input. It can be subjective. Objective tinnitus may be caused by clearly definable mechanical or vascular abnormalities, and as such may be amenable to specific management. We report a case of objective tinnitus associated with an abnormal mastoid emissary vein. A review of the literature identified only one other report of objective tinnitus associated with an emissary vein. That report involved a posterior condylar emissary vein. The venous drainage of the sigmoid sinus was studied on 50 human skulls demonstrating three possible emissary veins of each sigmoid sinus. The postauricular region was dopplered on 30 asymptomatic human subjects. None was found to have dopplered emissary vein flow.- - - - - - - - - - ranking = 0.5keywords = perception (Clic here for more details about this article) |
18/26. Acoustic neuromas with normal pure tone hearing levels.From 1966 through 1983, 408 patients underwent primary removal of an acoustic neuroma at the Mayo Clinic. Of these, 21 had preoperative pure tone hearing levels of 25 dB hearing loss or better at 500, 1000, and 2000 Hz, which for this study was defined as normal pure tone hearing. Fourteen patients (67%) had dysequilibrium and 13 (62%) had subjective hearing impairment. Nystagmus was the most common physical finding. Five patients (23%) had completely symmetric pure tone hearing levels through all frequencies tested. The mean speech discrimination score was 90%. Mean tumor size was 2.4 cm. brain stem evoked response audiometry was the most helpful of the special tests in the evaluation of these patients with normal pure tone hearing levels. Our results suggest that 5% of patients with acoustic neuromas have normal pure tone hearing levels. A careful history, a thorough physical examination, and an appropriate selection of tests will identify these patients.- - - - - - - - - - ranking = 117.11320309331keywords = speech discrimination, discrimination, speech (Clic here for more details about this article) |
19/26. Audiological characteristics of hearing loss following meningitis.meningitis is one of the leading causes of acquired sensorineural hearing loss in childhood, and many retrospective and prospective studies and case reports have been published. However, they have seldom discussed the nature of postmeningitic hearing loss from the audiological point of view. This study reports the results of audiological examinations performed on 5 patients suffering from hearing loss following meningitis. Extremely poor word discrimination scores as compared with pure-tone audiograms were common in all 5 cases. Type IV Bekesy tracings were observed in 2 cases. Discrepancies between pure-tone audiograms and subjective hearing sensation and between pure-tone audiograms and ABR recordings were noted in 2 cases. These results suggest that varying degrees of retrocochlear involvement complicating the inner ear damage are the audiological characteristics of hearing loss following meningitis.- - - - - - - - - - ranking = 2.1046427109302keywords = discrimination (Clic here for more details about this article) |
20/26. Surgical management of acoustic neuromas during the last five years. Part II: Results for facial and cochlear nerve function.Postoperative facial and cochlear nerve function in 83 consecutive patients with acoustic neuromas, who were undergoing their initial surgical procedure during 1980-1984, have been examined. The facial nerve was preserved in anatomic continuity in 71% of cases. Various nerve grafting procedures were used when the facial nerve was divided; the most common of these was a faciohypoglossal anastomosis, which was performed in 20 cases. The facial and cochlear nerves were anatomically preserved in 30.1% of all patients having their initial surgical procedure. Good speech discrimination was preserved in four patients, whereas more crude hearing was preserved in six other patients.- - - - - - - - - - ranking = 117.11320309331keywords = speech discrimination, discrimination, speech (Clic here for more details about this article) |
| <- Previous || Next -> |