Vasküler Loop'un Tinnitus Şiddetine Etkisi

Abstract

Amaç: Yüksek rezolüsyonlu kulak manyetik rezonans görüntüleme MRG ile tanı konulmuş vasküler loop varyasyonlarının tinnitus etiyolojisi ve kliniği üzerine etkisinin olup olmadığını hem tinnitusun özellikleri hem de tinnitus engellilik anketi TEA ile değerlendirmek.Gereç ve Yöntemler: Kliniğimize tek taraflı kronik tinnitus yakınması ile başvuran, işitmesi normal 18-55 yaş arasındaki hastalara tinnitus engellilik anketi uygulandı. Hastalar MRG bulguları ve cinsiyete göre gruplara ayrıldı. Bulgular: MRG bulgularına göre, 47 tip1 vasküler loop olan hasta 26 kadın: grup I, 21 erkek: grup II , 40 tip2 vasküler loop olan hasta 24 kadın: grup III, 16 erkek: grup IV ve 60 normal hasta 34 kadın: grup V, 26 erkek: grup VI vardı. Her grupta kadın hasta sayısı daha fazla ve kadın hastaların TEA ortalamaları daha yüksekti. Tip2 vasküler loopu olan hastaların da TEA ortalamaları daha yüksekti. Ayrıca tip2 vasküler loop olan hastalarda tinnitusun başlama yaşı daha erkendi.Sonuç: Tip2 vasküler loop bir vasküler kompresyon oluşturarak tinnitus kliniğini etkilemektedir. Elde ettiğimiz sonuçlara göre tip2 vasküler loopu oluşturduğu klinik etkiler nedeniyle vasküler kompresyon sendromu olarak değerlendirebiliriz

Keywords

• Vasküler loop, Tinnitus, Tinnitus engellilik anketi, Vasküler bası sendromu

The Effect of Vascular Loop in the Tinnitus Severity

Abstract

Objective: To evaluate the effect of vascular loop variations diagnosed by high resolution ear magnetic resonance imaging MRI on the etiology and clinic of tinnitus with both the features of tinnitus and the tinnitus handicap inventory THI .Material and Methods: The tinnitus handicap inventory was applied to the patients 18-55 years of age who presented to our clinic with the complaint of unilateral chronic tinnitus. Patients were grouped according to MRI findings and gender. Results: There were 47 type I vascular loop patients 26 female: group I, 21 male: group II , 40 type II vascular loop patients 24 female: group III, 16 male: group IV and 60 normal patients 34 female: group V, 26 male: group VI with MRI findings. In each group, the number of female patients was higher and the THI averages of female patients were higher. Patients with type II vascular loop had higher THI averages. In addition, the age of onset of tinnitus was earlier in patients with type II vascular loop.Conclusion: The type II vascular loop affects the tinnitus clinic by creating vascular compression. Our results suggest that it is possible to evaluate a type II vascular loop as a vascular compression syndrome due to its clinical effects

Keywords

• Vascular loop, Tinnitus, Tinnitus handicap inventory, Vascular compression syndrome

References

1. Wu D, Zheng Y, Chen Z, Ma Y, Lu T. Further validation of the Chinese (Mandarin) Tinnitus Handicap Inventory: comparison between patient-reported and clinical- interviewed outcomes. Int J Audiol 2018; 57:440-8.
2. Schlee W, Kleinjung T, Hiller W, Goebel G, Kolassa IT, Langguth B. Does tinnitus distress depend on age of onset? PLoS One 2011; 6:273-9.
3. Formánek M, Migaľová P, Krulová P, Bar M, Jančatová D, Zakopčanová-Srovnalová H, Tomášková H, Zeleník K, Komínek P. Combined transcranial magnetic stimulation in the treatment of chronic tinnitus. Ann Clin Transl Neurol 2018; 5:857-64.
4. Celiker FB, Dursun E, Celiker M, Durakoglugil T, Beyazal M, İnecikli MF, Ozgur A, Terzi S. Evaluation of vascular variations at cerebellopontine angle by 3D T2WI magnetic-resonance imaging in patients with vertigo. J Vestib Res 2017; 27:147-53.
5. Ensari N, Gur OE, Selcuk OT, Renda L, Osma Ü, Eyigör H, Çekiç B. Is presence of vascular loop in magnetic resonance imaging always related to tinnitus? J Craniofac Surg 2017; 28:295-8.
6. Lasisi AO, Gureje O. Prevalence of insomnia and impact on quality of life among community elderly subjects with tinnitus. Ann Otol Rhinol Laryngol 2011; 120:226-30.
7. Zeng X, Li P, Li Z, Cen J, Li Y, Zhang G. Analysis of acutely exacerbated chronic tinnitus by the Tinnitus Handicap Inventory. J Laryngol Otol 2016; 130:38-41.
8. Sharma A, Munjal S, Panda N, Monhanty M. Demographic variations in tinnitus subjects with and without hearing loss: A study of 175 Subjects. Int Tinnitus J 2018; 22:77-83.

9. Oiticica J, Bittar RS. Tinnitus prevalence in the city of São Paulo. Braz J Otorhinolaryngol 2015; 81:167-76.
10. Carhart R, Jerger JF. Preferred method for clinical determination of pure-tone thresholds. J Speech Hear Dis 1959; 24:330-45.
11. Schlauch RS, Koerner TK, Marshall L. Effective identification of functional hearing loss using behavioral threshold measures. J Speech Lang Hear Res 2015; 58:453-65.
12. Aksoy S, Fırat Y, Alpar R. The tinnitus handicap inventory: A study of validity and reliability. Int Tinnitus J 2007; 13:94-8.
13. Heller AJ. Classification and epidemiology of tinnitus. Otolaryngol Clin North Am 2003; 36:239-48.
14. Grocoske FLB, Mendes CG. Neurotology findings in patients with diagnosis of vascular loop of cranial nerves VIII in magnetic resonance imaging. Int Arch Otorhinolaryngol 2011; 15:418-25.
15. Shinn JB, Bush ML, Jones RO. Correlation of central auditory processing deficits and vascular loop syndrome. Ear Nose Throat J 2009; 88:34-7.
16. Hoekstra CE, Prijs VF, van Zanten GA. Diagnostic yield of a routine magnetic resonance imaging in tinnitus and clinical relevance of the anterior inferior cerebellar artery loops. Otol Neurotol 2015; 36:359-65.
17. Gultekin S, Celik H, Akpek S, Oner Y, Gumus T, Tokgoz N. Vascular loops at the cerebellopontine angle: Is there a correlation with tinnitus? AJNR Am J Neuroradiol 2008; 29:1746-9.
18. Guevara N, Deveze A, Buza V, Laffont B, Magnan J. Microvascular decompression of cochlear nerve for tinnitus incapacity: Pre-surgical data, surgical analyses and long-term follow-up of 15 patients. Eur Arch Otorhinolaryngol 2008; 265:397-401.
19. Brookes GB. Vascular-decompression surgery for severe tinnitus. Am J Otol 1996; 17:569-76.
20. Chadha NK, Weiner GM. Vascular loops causing otological symptoms: A systematic review and meta- analysis. Clin Otolaryngol 2008; 33:5-11.
21. De Ridder D, Menovsky T, Van de Heyning P. An otoneurosurgical approach to non-pulsatile and pulsatile tinnitus. B-ENT 2007; 3:79-86.