- n.
WordNet
- a ringing or booming sensation in one or both ears; a symptom of an ear infection or Menieres disease
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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/05/19 12:25:25」(JST)
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For the Norwegian radio show, see Tinitus (radio show).
| Tinnitus | |
|---|---|
| Tinnitus often results in the sound of ringing. | |
| Pronunciation |
|
| Specialty | Otorhinolaryngology, audiology |
| Symptoms | Hearing sound when no external sound is present[1] |
| Complications | Depression, anxiety, poor concentration[2] |
| Usual onset | Gradual[3] |
| Causes | Noise-induced hearing loss, ear infections, disease of the heart or blood vessels, Ménière's disease, brain tumors, emotional stress[2][4] |
| Diagnostic method | Based on symptoms, audiogram, neurological exam[1][3] |
| Treatment | Counseling, sound generators, hearing aids[5][2] |
| Frequency | ~12.5%[5] |
|
[edit on Wikidata]
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Tinnitus is the hearing of sound when no external sound is present.[1] While often described as a ringing, it may also sound like a clicking, hiss or roaring.[2] Rarely, unclear voices or music are heard.[3] The sound may be soft or loud, low pitched or high pitched and appear to be coming from one ear or both.[2] Most of the time, it comes on gradually.[3] In some people, the sound causes depression, anxiety or interferes with concentration.[2]
Tinnitus is not a disease but a symptom that can result from a number of underlying causes. One of the most common causes is noise-induced hearing loss. Other causes include: ear infections, disease of the heart or blood vessels, Ménière's disease, brain tumors, emotional stress, exposure to certain medications, a previous head injury, and earwax.[2][4] It is more common in those with depression.[3]
The diagnosis of tinnitus is usually based on the person's description. A number of questionnaires exist that assess how much tinnitus is interfering with a person's life.[3] The diagnosis is commonly assisted with an audiogram and neurological exam.[1][3] If certain problems are found, medical imaging, such as with MRI, may be performed. Other tests are suitable when tinnitus occurs with the same rhythm as the heartbeat. Occasionally, the sound may be heard by someone else using a stethoscope, in which case it is known as objective tinnitus.[3]
Prevention involves avoiding loud noise.[2] If there is an underlying cause, treating it may lead to improvements.[3] Otherwise, typically, management involves talk therapy.[5] Sound generators or hearing aids may help some.[2] As of 2013, there are no effective medications.[3] It is common, affecting about 10-15% of people. Most, however, tolerate it well, with it being a significant problem in only 1–2% of people.[5] The word tinnitus is from the Latin tinnīre which means "to ring".[3]
Contents
- 1 Signs and symptoms
- 1.1 Course
- 1.2 Psychological
- 2 Causes
- 2.1 Subjective tinnitus
- 2.1.1 Hearing loss
- 2.1.2 Associated factors
- 2.2 Objective tinnitus
- 2.2.1 Pulsatile tinnitus
- 2.1 Subjective tinnitus
- 3 Pathophysiology
- 4 Diagnosis
- 4.1 Audiology
- 4.2 Psychoacoustics
- 4.3 Severity
- 4.4 Pulsatile tinnitus
- 4.5 Auditory evoked response
- 4.6 Differential diagnosis
- 5 Prevention
- 6 Management
- 6.1 Psychological
- 6.2 Medications
- 6.3 Other
- 6.4 Alternative medicine
- 7 Prognosis
- 8 Epidemiology
- 8.1 Children
- 9 See also
- 10 References
- 11 External links
Signs and symptoms
Tinnitus can be perceived in one or both ears or in the head. Tinnitus is the description of a noise inside a person’s head in the absence of auditory stimulation. The noise can be described in many different ways but the most common description of the tinnitus is a pure tone sound. It is usually described as a ringing noise but, in some patients, it takes the form of a high-pitched whining, electric buzzing, hissing, humming, tinging or whistling sound or as ticking, clicking, roaring, "crickets" or "tree frogs" or "locusts (cicadas)", tunes, songs, beeping, sizzling, sounds that slightly resemble human voices or even a pure steady tone like that heard during a hearing test and, in some cases, pressure changes from the interior ear.[6] It has also been described as a "whooshing" sound because of acute muscle spasms, as of wind or waves.[7] Tinnitus can be intermittent or it can be continuous: in the latter case, it can be the cause of great distress. In some individuals, the intensity can be changed by shoulder, head, tongue, jaw or eye movements.[8]
Most people with tinnitus have some degree of hearing loss:[9] they are often unable to clearly hear external sounds that occur within the same range of frequencies as their "phantom sounds".[10] This has led to the suggestion that one cause of tinnitus might be a homeostatic response of central dorsal cochlear nucleus auditory neurons that makes them hyperactive in compensation to auditory input loss.[11]
The sound perceived may range from a quiet background noise to one that can be heard even over loud external sounds. The specific type of tinnitus called pulsatile tinnitus is characterized by hearing the sounds of one's own pulse or muscle contractions, which is typically a result of sounds that have been created from the movement of muscles near to one's ear, changes within the canal of one's ear or issues related to blood flow of the neck or face.[12]
Course
There has been little research on the course of tinnitus and most research has been retrospective. An Australian study of participants aged 49–97 years found that 35% of participants reported that their tinnitus was present all the time and 4% rated their tinnitus as annoying. Findings from a retrospective National Study of Hearing found that, for 25% of people surveyed, the perceived volume of their tinnitus increased over time while, for 75%, it did not. The rate of annoyance decreased for 31% of people from onset of tinnitus to the middle time. A study of the natural history of tinnitus in older adults found that, for women, tinnitus increased for 25%, decreased in 58%, leaving 17% unchanged. The study found that, for men, tinnitus increased in 8%, decreased in 39%, leaving 53% unchanged. Information about the course of tinnitus would benefit from prospective studies investigating change over time as these studies may potentially be more accurate.[13]
Psychological
Persistent tinnitus may cause irritability, fatigue and, on occasions, clinical depression[14][15] and musical hallucinations.[16]
Tinnitus annoyance is more strongly associated with psychological condition than loudness or frequency range.[17][18][19] Other psychological problems such as depression, anxiety, sleep disturbances and concentration difficulties are common in those with worse tinnitus.[17][20][21] 45% of people with tinnitus have an anxiety disorder at some time in their life.[22]
As part of the idea that the central-auditory-system may be implicated into the tinnitus development, serotonin has also been implicated. Indeed, serotonin has been postulated to be involved in plastic changes in the brain. Serotonin re-uptake inhibitors (such as some anti-depressant drugs) have often been used for this reason.[23] However those medications do not benefit in a consistent fashion on non-depressant people.[24]
Psychological research has looked at the tinnitus distress reaction (TDR) to account for differences in tinnitus severity.[20] Research has stigmatized people with severe tinnitus by implying they have personality disorders, such as neuroticism, anxiety sensitivity, and catastrophic thinking, which all predispose increased TDR.[25][26][27] These findings suggest that at the initial perception of tinnitus, conditioning links tinnitus with negative emotions, such as fear and anxiety from unpleasant stimuli at the time. This enhances activity in the limbic system and autonomic nervous system, thus increasing tinnitus awareness and annoyance.[28]
Causes
There are two types of tinnitus: subjective tinnitus and objective tinnitus.[3] Tinnitus is usually subjective, meaning that others cannot hear it.[3] Subjective tinnitus has been also called "tinnitus aurium" "nonauditory" and "nonvibratory" tinnitus. Occasionally, tinnitus may be heard by someone else using a stethoscope: in which case, it is objective tinnitus.[3] Objective tinnitus has been called "pseudo-tinnitus" or "vibratory" tinnitus.
Subjective tinnitus
Subjective tinnitus is the most frequent type of tinnitus. It can have many possible causes but, most commonly, results from hearing loss. A frequent cause of subjective tinnitus is noise exposure which damages hair cells in the inner ear causing tinnitus. Subjective tinnitus can only be heard by the affected person and is caused by otology, neurology, infection or drugs.[29]
There is a growing body of evidence suggesting that tinnitus is a consequence of neuroplastic alterations in the central auditory pathway. These alterations are assumed to result from a disturbed sensory input, caused by hearing loss.[30] Hearing loss could indeed cause a homeostatic response of neurons in the central auditory system, and therefore cause tinnitus.[31]
Despite the opinion amongst researchers that tinnitus is primarily a central nervous system pathology, there certainly exists a class of people whose tinnitus is peripherally based.[32]
Hearing loss
The most common cause of tinnitus is noise-induced hearing loss. Hearing loss may be implicated even for people with normal audiograms.[31]
Hearing loss may have many different causes; but among tinnitus subjects, the major cause is cochlear damage.[30]
Ototoxic drugs (such as aspirin) can also cause subjective tinnitus, as they may cause hearing loss, or increase the damage done by exposure to loud noise. Those damages can occur even at doses that are not considered ototoxic.[33] Tinnitus is also a classical side effect of quinidine, a Class IA anti-arrhythmic. Over 260 medications have been reported to cause tinnitus as a side effect.[34] In many cases, however, no underlying cause can be identified.[2]
Tinnitus can also occur due to the discontinuation of therapeutic doses of benzodiazepines. It can sometimes be a protracted symptom of benzodiazepine withdrawal and may persist for many months.[35][36]
Associated factors
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Factors associated with tinnitus include:[37]
- ear problems and hearing loss:
- conductive hearing loss
- external ear infection
- acoustic shock
- loud noise or music[38]
- cerumen (earwax) impaction
- middle ear effusion
- superior canal dehiscence
- sensorineural hearing loss
- excessive or loud noise
- presbycusis (age-associated hearing loss)
- Ménière's disease
- endolymphatic hydrops
- acoustic neuroma
- mercury or lead poisoning
- ototoxic medications
- conductive hearing loss
- neurologic disorders:
- Arnold–Chiari malformation
- multiple sclerosis
- head injury
- skull fracture
- closed head injury
- whiplash injury
- temporomandibular joint dysfunction
- giant cell arteritis
- metabolic disorders:
- thyroid disease
- hyperlipidemia
- vitamin B12 deficiency[39]
- iron deficiency anemia
- psychiatric disorders
- depression
- anxiety disorders
- other factors:
- tension myositis syndrome
- fibromyalgia
- vasculitis
- hypertonia (muscle tension)
- thoracic outlet syndrome
- Lyme disease
- hypnagogia
- migraine
- sleep paralysis
- glomus tympanicum tumor
- anthrax vaccines which contain the anthrax protective antigen
- Some psychedelic drugs can produce temporary tinnitus-like symptoms as a side effect
- 5-MeO-DET[40]
- diisopropyltryptamine (DiPT)[41]
- benzodiazepine withdrawal[35][36]
- nasal congestion
- intracranial hyper or hypotension caused by, for example, encephalitis or a cerebrospinal fluid leak
Objective tinnitus
Objective tinnitus can be detected by other people and is usually caused by myoclonus or a vascular condition. In some cases, tinnitus is generated by a self-sustained oscillation within the ear. This is called objective tinnitus which can arise from muscle spasms around the middle ear.[42] Homeostatic control mechanisms exist to correct the problem within a minute after onset and is normally accompanied by a slight reduction in hearing sensitivity followed by a feeling of fullness in the ear.[43]
Objective tinnitus can most often can be heard as a sound outside the ear, as spontaneous otoacoustic emissions (SOAEs) that can form beats with and lock into external tones.[44] The majority of the people are unaware of their SOAEs; whereas portions of 1-9% perceive a SOAE as an annoying tinnitus.[45]
Pulsatile tinnitus
Pulsatile tinnitus can be a symptom of intracranial vascular abnormalities and should be evaluated for bruits. Some people experience a sound that beats in time with their pulse (pulsatile tinnitus, or vascular tinnitus).[46] Pulsatile tinnitus is usually objective in nature, resulting from altered blood flow, increased blood turbulence near the ear (such as from atherosclerosis, venous hum,[47] but it can also arise as a subjective phenomenon from an increased awareness of blood flow in the ear.[46] Rarely, pulsatile tinnitus may be a symptom of potentially life-threatening conditions such as carotid artery aneurysm[48] or carotid artery dissection.[49] Pulsatile tinnitus may also indicate vasculitis, or more specifically, giant cell arteritis. Pulsatile tinnitus may also be an indication of idiopathic intracranial hypertension.[50]
Pathophysiology
One of the possible mechanisms relies on otoacoustic emissions. The inner ear contains tens of thousands of minute inner hair cells with stereocilia which vibrate in response to sound waves and outer hair cells which convert neural signals into tension on the vibrating basement membrane. The sensing cells are connected with the vibratory cells through a neural feedback loop, whose gain is regulated by the brain. This loop is normally adjusted just below onset of self-oscillation, which gives the ear spectacular sensitivity and selectivity. If something changes, it is easy for the delicate adjustment to cross the barrier of oscillation and, then, tinnitus results. Exposure to excessive sound kills hair cells and studies have shown that, as hair cells are lost, different neurons are activated, activating auditory parts of the brain and giving the perception of sound.[citation needed]
Another possible mechanism underlying tinnitus is damage to the receptor cells. Although receptor cells can be regenerated from the adjacent supporting Deiters cells after injury in birds, reptiles and amphibians, it is believed that, in mammals, they can be produced only during embryogenesis. Although mammalian Deiters cells reproduce and position themselves appropriately for regeneration, they have not been observed to transdifferentiate into receptor cells except in tissue culture experiments.[51][52] Therefore, if these hairs become damaged, through prolonged exposure to excessive sound levels, for instance, then deafness to certain frequencies results. In tinnitus, they may relay information that an externally audible sound is present at a certain frequency when it is not.
The mechanisms of subjective tinnitus are often obscure. While it is not surprising that direct trauma to the inner ear can cause tinnitus, other apparent causes (e.g., temporomandibular joint dysfunction and dental disorders) are difficult to explain. Research has proposed there are two distinct categories of subjective tinnitus: otic tinnitus, caused by disorders of the inner ear or the acoustic nerve, and somatic tinnitus, caused by disorders outside the ear and nerve, but still within the head or neck. It is further hypothesized somatic tinnitus may be due to "central crosstalk" within the brain, as certain head and neck nerves enter the brain near regions known to be involved in hearing.[53]
It may be caused by increased neural activity in the auditory brainstem where the brain processes sounds, causing some auditory nerve cells to become over-excited. The basis of this theory is most people with tinnitus also have hearing loss,[9] and the frequencies they cannot hear are similar to the subjective frequencies of their tinnitus.[10] Models of hearing loss and the brain support the idea a homeostatic response of central dorsal cochlear nucleus neurons could result in them being hyperactive in a compensation process to the loss of hearing input.[11]
Diagnosis
Even when tinnitus is the primary complaint, audiological evaluation is usually preceded by examination by an ENT to diagnose treatable conditions like middle ear infection, acoustic neuroma, concussion, otosclerosis, etc.[54]
Evaluation of tinnitus will include a hearing test (audiogram), measurement of acoustic parameters of the tinnitus like pitch and loudness, and psychological assessment of comorbid conditions like depression, anxiety, and stress that are associated with severity of the tinnitus.
The accepted definition of chronic tinnitus, as compared to normal ear noise experience, is five minutes of ear noise occurring at least twice a week.[55] However, people with chronic tinnitus often experience the noise more frequently than this and can experience it continuously or regularly, such as during the night when there is less environmental noise to mask the sound.
Audiology
Since most persons with tinnitus also have hearing loss, a pure tone hearing test resulting in an audiogram may help diagnose a cause, though some persons with tinnitus do not have hearing loss. An audiogram may also facilitate fitting of a hearing aid in those cases where hearing loss is significant. The pitch of tinnitus is often in the range of the hearing loss. A hearing aid boosting the attentuated frequencies may at least partly mask tinnitus by raising the background level of sound in the tuned frequency range.
Psychoacoustics
Acoustic qualification of tinnitus will include measurement of several acoustic parameters like pitch, or frequency in cases of monotone tinnitus, or frequency range and bandwidth in cases of narrow band noise tinnitus, loudness in dB above hearing threshold at the indicated frequency, mixing-point, and minimum masking level.[56] In most cases, tinnitus pitch or frequency range is between 5000 Hz and 8000 Hz, and loudness less than 10 dB above the hearing threshold.[medical citation needed]
Another relevant parameter of tinnitus is residual inhibition, the temporary suppression and/or disappearance of tinnitus following a period of masking. The degree of residual inhibition may indicate how effective tinnitus maskers would be as a treatment modality.[57]
An assessment of hyperacusis, a frequent accompaniment of tinnitus, may also be made. The measured parameter is Loudness Discomfort Level in dB, the subjective level of acute discomfort at specified frequencies over the frequency range of hearing. This defines a dynamic range between the hearing threshold at that frequency and the loudnes discomfort level. A compressed dynamic range over a particular frequency range is associated with subjectve hyperacusis.[58] Normal hearing threshold is generally defined as 0–20 decibels (dB). Normal loudness discomfort levels are 85–90+ dB, with some authorities citing 100 dB. A dynamic range of 55 dB or less is indicative of hyperacusis.
Severity
The condition is often rated on a scale from "slight" to "catastrophic" according to the effects it has, such as interference with sleep, quiet activities and normal daily activities.[59] In an extreme case a man committed suicide after being told there was no cure.[60]
Assessment of psychological processes related to tinnitus involves measurement of tinnitus severity and distress (i.e. nature and extent of tinnitus-related problems), measured subjectively by validated self-report tinnitus questionnaires.[20] These questionnaires measure the degree of psychological distress and handicap associated with tinnitus, including effects on hearing, lifestyle, health and emotional functioning.[61][62][63][64] A broader assessment of general functioning, such as levels of anxiety, depression, stress, life stressors and sleep difficulties, is also important in the assessment of tinnitus due to higher risk of negative well-being across these areas, which may be affected by and/or exacerbate the tinnitus symptoms for the individual.[65] Overall, current assessment measures are aimed to identify individual levels of distress and interference, coping responses and perceptions of tinnitus in order to inform treatment and monitor progress. However, wide variability, inconsistencies and lack of consensus regarding assessment methodology are evidenced in the literature, limiting comparison of treatment effectiveness.[66] Developed to guide diagnosis or classify severity, most tinnitus questionnaires have also been shown to be treatment-sensitive outcome measures.[67]
Pulsatile tinnitus
If the examination reveals a bruit (sound due to turbulent blood flow), imaging studies such as transcranial doppler (TCD) or magnetic resonance angiography (MRA) should be performed.[68]
Auditory evoked response
Tinnitus can be evaluated with most auditory evoked potentials: however, results may be inconsistent. Results must be compared to age and hearing matched control subjects to be reliable. This inconsistent reporting may be due to many reasons: differences in the origin of the tinnitus, ABR recording methods and selection criteria of control groups. Since research shows conflicting evidence, more research on the relationship between tinnitus and auditory evoked potentials should be carried out before these measurements are used clinically.
Differential diagnosis
Other potential sources of the sounds normally associated with tinnitus should be ruled out. For instance, two recognized sources of high-pitched sounds might be electromagnetic fields common in modern wiring and various sound signal transmissions. A common and often misdiagnosed condition that mimics tinnitus is radio frequency (RF) hearing, in which subjects have been tested and found to hear high-pitched transmission frequencies that sound similar to tinnitus.[69]
Prevention
Prolonged exposure to loud sound or noise levels can lead to tinnitus.[70] Ear plugs or other measures can help with prevention.
Several medicines have ototoxic effects, and can have a cumulative effect that can increase the damage done by noise. If ototoxic medications must be administered, close attention by the physician to prescription details, such as dose and dosage interval, can reduce the damage done.[71]
Management
If there is an underlying cause, treating it may lead to improvements.[3] Otherwise, the primary treatment for tinnitus is talk therapy[5] and sound therapy; there are no effective medications.[3]
Psychological
The best supported treatment for tinnitus is a type of counseling called cognitive behavioral therapy (CBT) which can be delivered via the internet or in person.[5][72] It decreases the amount of stress those with tinnitus feel.[73] These benefits appear to be independent of any effect on depression or anxiety in an individual.[72] Acceptance and commitment therapy (ACT) also shows promise in the treatment of tinnitus.[74] Relaxation techniques may also be useful.[3] A clinical protocol called Progressive Tinnitus Management for treatment of tinnitus has been developed by the United States Department of Veterans Affairs.[75]
Medications
As of 2014[update] there were no medications effective for tinnitus.[3][70] There is not enough evidence to determine if antidepressants[76] or acamprosate is useful.[77] While there is tentative evidence for benzodiazepines, it is insufficient to support usage.[3] Anticonvulsants have not been found to be useful.[3] Steroids injections into the middle ear also do not seem to be effective.[78][79]
Botulinum toxin injection has been tried with some success in cases of objective tinnitus from a palatal tremor.[80]
Other
The use of sound therapy by either hearing aids or tinnitus maskers helps the brain ignore the specific tinnitus frequency. Although these methods are poorly supported by evidence, there are no negative effects.[3][81] There is some tentative evidence supporting tinnitus retraining therapy.[3] There is little evidence supporting the use of transcranial magnetic stimulation.[3][82] It is thus not recommended.[70]
Alternative medicine
Ginkgo biloba does not appear to be effective.[83] The American Academy of Otolaryngology recommends against taking melatonin or zinc supplements to relieve symptoms of tinnitus.[70] In addition, a 2016 Cochrane Review concluded that evidence is not sufficient to support taking zinc supplements to reduce symptoms associated with tinnitus.[84]
Prognosis
While there is no cure, most people with tinnitus get used to it over time; for a minority, it remains a significant problem.[5]
Epidemiology
Tinnitus affects 10–15% of people.[5] About a third of North Americans over 55 experience tinnitus.[85] Tinnitus affects one third of adults at some time in their lives, whereas ten to fifteen percent are disturbed enough to seek medical evaluation.[86]
Children
Tinnitus is commonly thought of as a symptom of adulthood, and is often overlooked in children. Children with hearing loss have a high incidence of tinnitus, even though they do not express the condition or its effect on their lives.[87] Children do not generally report tinnitus spontaneously and their complaints may not be taken seriously.[88] Among those children who do complain of tinnitus, there is an increased likelihood of associated otological or neurological pathology such as migraine, juvenile Meniere’s disease or chronic suppurative otitis media.[89] Its reported prevalence varies from 12% to 36% in children with normal hearing thresholds and up to 66% in children with a hearing loss and approximately 3–10% of children have been reported to be troubled by tinnitus.[90]
See also
- Medicine portal
- Hyperacusis
- List of people with tinnitus
- List of unexplained sounds
- Noise health effects
- Ringxiety
- Zwicker tone
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About 75% of new cases are related to emotional stress as the trigger factor rather than to precipitants involving cochlear lesions.
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External links
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| External resources |
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| Wikimedia Commons has media related to Tinnitus. |
- "Tinnitus". London, UK: Deafness Research UK. 22 October 2012. Retrieved 2 November 2012. Information about Tinnitus and the latest research work being done.
- Baguley, David; Andersson, Gerhard; McFerran, Don; McKenna, Laurence (March 2013) [2004]. Tinnitus: A Multidisciplinary Approach (2nd ed.). Indianapolis, IN, USA: Wiley-Blackwell. ISBN 978-1-4051-9989-6. LCCN 2012032714. OCLC 712915603.
- Langguth, B.; Hajak, G.; Kleinjung, T.; Cacace, A.; Møller, A.R., eds. (December 2007). Tinnitus : pathophysiology and treatment. Progress in brain research. 166 (1st ed.). Amsterdam ; Boston: Elsevier. ISBN 9780444531674. LCCN 2012471552. OCLC 648331153. Archived from the original on 2007. Retrieved 5 November 2012.
- Møller, Aage R; Langguth, Berthold; Ridder, Dirk; et al., eds. (2011). Textbook of Tinnitus. New York, NY, USA: Springer. doi:10.1007/978-1-60761-145-5. ISBN 9781607611448. LCCN 2010934377. OCLC 695388693, 771366370, 724696022. Archived from the original on 2011. Retrieved 5 November 2012. (subscription required)
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UpToDate Contents
全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.
- 1. 耳鳴の病因および診断 etiology and diagnosis of tinnitus
- 2. 耳鳴の治療 treatment of tinnitus
- 3. 特発性頭蓋内圧亢進症（偽脳腫瘍）：臨床的特徴および診断 idiopathic intracranial hypertension pseudotumor cerebri clinical features and diagnosis
- 4. 老人性難聴 presbycusis
- 5. 麻酔後回復室（PACU）における心血管の障害 cardiovascular problems in the post anesthesia care unit pacu
English Journal
- TMS by double-cone coil prefrontal stimulation for medication resistant chronic depression: A case report.
- Vanneste S, Ost J, Langguth B, De Ridder D.Sourcea Brai2n, Tinnitus Research Initiative Clinic Antwerp & Department of Neurosurgery , University Hospital Antwerp , Belgium.
- Neurocase.Neurocase.2014 Feb;20(1):61-8. doi: 10.1080/13554794.2012.732086. Epub 2012 Oct 11.
- A double-cone coil with large angled windings has been developed to modulate deeper brain areas such as the anterior cingulate cortex (ACC). Abnormal resting state activity in the pregenual ACC (pgACC), dorsal ACC (dACC) and subgenual ACC (sgACC) has been observed in depression. A patient with medic
- PMID 23058173
- High doses of salicylate causes prepulse facilitation of onset-gap induced acoustic startle response.
- Sun W, Doolittle L, Flowers E, Zhang C, Wang Q.SourceCenter for Hearing and Deafness, State University of New York at Buffalo, 3435 Main Street, Buffalo 14214, NY, USA; Department of Communicative Disorders and Sciences, State University of New York at Buffalo, 3435 Main Street, Buffalo 14214, NY, USA. Electronic address: weisun@buffalo.edu.
- Behavioural brain research.Behav Brain Res.2014 Jan 1;258:187-92. doi: 10.1016/j.bbr.2013.10.024. Epub 2013 Oct 19.
- Prepulse inhibition of acoustic startle reflex (PPI), a well-established method for evaluating sensorimotor gating function, has been used to detect tinnitus in animal models. Reduced gap induced PPI (gap-PPI) was considered as a sign of tinnitus. The silent gap used in the test contains both onset
- PMID 24149068
- Using resting state functional connectivity to unravel networks of tinnitus.
- Husain FT, Schmidt SA.SourceDepartment of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA; Neuroscience Program, University of Illinois at Urbana-Champaign, Champaign, IL, USA; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA. Electronic address: husainf@illinois.edu.
- Hearing research.Hear Res.2014 Jan;307:153-62. doi: 10.1016/j.heares.2013.07.010. Epub 2013 Jul 26.
- Resting state functional connectivity (rs-fc) using fMRI has become an important tool in examining differences in brain activity between patient and healthy populations. Studies employing rs-fc have successfully identified altered intrinsic neural networks in many neurological and psychiatric disord
- PMID 23895873
Japanese Journal
- 音響物理的処理音による新しい耳鳴り治療システムへの試み
- 外山 竹弥,福本 一朗
- 北里大学保健衛生専門学院紀要 20, 27-33, 2015
- NAID 40020438282
- The Present Indication and Future of Deep Brain Stimulation
- , , , , ,
- Neurologia medico-chirurgica 55(5), 416-421, 2015
- … The established indications for DBS are Parkinson's disease, tremor, and dystonia, whereas global indications of DBS expanded to other neuronal diseases or disorders such as neuropathic pain, epilepsy, and tinnitus. …
- NAID 130005069874
- 中硬膜動静脈瘻を呈した外傷性中硬膜動脈瘤の一治験例
- 南 浩昭,三木 貴徳,垣田 寛人,松本 洋明,富永 正吾,山浦 生也,吉田 泰久
- 脳神経血管内治療 advpub(0), 2015
- 【目的】外傷性動静脈瘻は自然閉塞を来すことがあり時に外傷性動脈瘤を合併する．我々は外傷性中硬膜動静脈瘻が自然閉塞後に中硬膜動脈瘤が認められた稀な1 例を経験したので報告する．【症例】36 歳男性．転落にて受傷しCTにて右側頭骨骨折，MRI では左側頭葉挫傷，MRA では右外頚動脈領域に動静脈瘻を呈した．脳血管撮影では右中硬膜動脈から流入し右中硬膜静脈，右海綿静脈洞へ流出する動静脈瘻を認めた．塞栓術 …
- NAID 130005066497
Related Links
- tinnitusとは。意味や和訳。[名][U]病理(学)耳鳴り. - goo辞書は国語、英和、和英、中国語、百科事典等からまとめて探せる辞書検索サービスです。 ... 辞書すべて 国語 類語 英和 和英 中日 日中 ※「説明文に含む」「見出し語に含む ...
- At Tinnitus.net, we've helped over 10,000 people suffering from tinnitus find the cause of the ringing in their ears and the tinnitus treatment that works best for them.
Related Pictures
★リンクテーブル★
| リンク元 | 「耳鳴」「buzzing」「ear noises」「ringing in the ear」「耳鳴症」 |
| 拡張検索 | 「pulsatile tinnitus」 |
「耳鳴」
- 日
- じめい
- 英
- tinnitus, buzzing, ringing in the ear
- 同
- 耳鳴り
- 関
- 自覚的耳鳴、耳鳴症、他覚的耳鳴、拍動性耳鳴、ear noises
分類
- 非振動性耳鳴：聴覚伝導路を含む聴器に生じた機械的、化学的刺激による。
- 振動性耳鳴：機械的な成因(筋肉性(耳小骨筋、口蓋帆筋)、血管性(コマ音(重症貧血など)、聴器近傍の脳動脈瘤、脳動静脈奇形による拍動性耳鳴)
- IMD.277
- 聴力低下に随伴
- 異常雑音(頭鳴り)
- 血管雑音：頚部動脈狭窄、硬膜動静脈瘤、動静脈奇形
- その他
- てんかん、高血圧、不眠、うつ状態、頭部外傷後遺症
- UCSF
- 老人性難聴：高音性、静かな環境で増悪、聴力低下：補聴器
- 耳管閉塞：呼吸時同調するごうごうという音、仰向けで改善、自分の声が角に強く聞こえる：鼻腔内ステロイド噴霧
- 薬剤性：NSAIDs,抗菌薬,ループ利尿薬：薬剤中止
- 迷路炎：急性発症、最近の頭部外傷/ウイルス感染、めまい
- メニエール病：低音性、変動する聴力低下：美辞かコンサルト
- 中耳炎：耳痛、耳閉感、最近の上気道感染：抗菌薬
- ストレス：問診、ストレス排除、抗うつ薬
問診のポイント
- 連続性 / 拍動性
- 高音性 / 低音性