İdiyopatik tinnitus tedavisinde kalorik vestibüler stimülasyonun etkinliği

Öz

Amaç: Kalorik vestibüler stimülasyon (KVS), kortikal yapıların aktivasyonunu indükler ve çeşitli hastalıkların tedavisinde bir nöromodülasyon tekniği olarak kullanılır. Bu çalışma, KVS'nin idiyopatik tinnitus tedavisinde yararlı olup olmayacağını araştırmayı amaçlamıştır. Yöntemler: Tek taraflı idiyopatik tinnitusu olan hastalar çalışmaya alındı. Semptomatik kulağa soğuk su (çalışma grubu) ve vücut ısısında su (kontrol grubu) olmak üzere KVS irrigasyonu uygulandı. Tüm hastalara standart odyometrik muayene yapıldı ve görsel analog skala (GAS), tinnitus engellilik anketi (TEA) ve Beck depresyon anketi (BDA) uygulandı. Bulgular: Tinnitus şiddeti ve rahatsız olma GAS değerleri, ortalama TEA ve BDA skorları kontrol grubunda anlamlı bir değişiklik göstermedi. Çalışma grubunda müdahale sonrası ilk haftada hem tinnitus şiddeti hem de rahatsız olma skorlarında anlamlı iyileşme oldu (P<0,001). Çalışma grubunda KVS sonrası dört hafta içinde medyan TEA ve BDA skorlarında ve tinnitus sesinde anlamlı düşüş gözlendi (sırasıyla P<0,001, P<0,001, P=0,004 ve P=0,001). Sonuç: Soğuk su ile yapılan KVS'nin, tinnitus yoğunluğunda önemli bir düşüşe ve tinnitusun ses şiddetinde azalmaya yol açtığı ve ayrıca TEA ve BDA skorlarını iyileştirdiği sonucuna varabiliriz.

Anahtar Kelimeler

• kalorik vestibüler uyarı
• soğuk
• idiyopatik tinnitus
• nöromodülasyon
• tinnitus engellilik anketi

Efficacy of caloric vestibular stimulation for the treatment of idiopathic tinnitus

Abstract

Aim: Caloric vestibular stimulation (CVS) induces the activation of several cortical structures and has been utilized as a neuromodulation technique in the treatment of several disorders. This study purposed to investigate whether CVS would be beneficial in the management of idiopathic tinnitus. Methods: Patients with unilateral idiopathic tinnitus were enrolled in the study. CVS with cold water (study group) and body temperature (control group) irrigation were applied to the symptomatic ear. All patients underwent a standard audiometric examination and visual analogue scale (VAS), the tinnitus handicap inventory (THI) and the Beck depression inventory (BDI) were administered. Results: VAS intensity and disturbance values, mean THI and BDI scores did not show any significant changes in the control group. In the study group, a significant improvement in both the tinnitus intensity and disturbance occurred in the first week post-intervention (P<0.001), and a significant decline was observed in median THI and BDI scores as well as the loudness of the tinnitus in the four weeks post-CVS (P<0.001, P<0.001, P=0.004 and P=0.001) respectively). Conclusion: We can conclude that CVS with cold water leads to a significant decline in the intensity of tinnitus and reduction in the loudness of tinnitus, as well as improving THI and BDI scores.

Keywords

• caloric vestibular stimulation
• cold
• idiopathic tinnitus
• neuromodulation
• tinnitus handicap inventory

Kaynakça

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