Livros e Capítulos de Livros - LIM/32
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A coleção de Livros e Capítulos de Livros reúne capítulos e resumos de obras produzidas por autores do sistema FMUSP-HC que inclui a Faculdade de Medicina da Universidade de São Paulo (FMUSP), o Hospital das Clínicas da FMUSP e demais institutos associados.
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- Algorithm for the diagnostic and therapeutic management of tinnitus(2011) LANGGUTH, B.; BIESINGER, E.; BO, L. Del; RIDDER, D. De; GOODEY, R.; HERRAIZ, C.; KLEINJUNG, T.; LAINEZ, M. J. A.; LANDGREBE, M.; PAOLINO, M.; QUESTIER, B.; SANCHEZ, T. G.; SEARCHFIELD, G. D.Keypoints: 1. Tinnitus can be a symptom of a wide range of different underlying pathologies and accompanied by many different comorbidities, indicating the need for comprehensive multidisciplinary diagnostic assessment. 2. Basic diagnostics should include a detailed case history, assessment of tinnitus severity, clinical ear examination, and audiological measurement of hearing function. For a considerable number of patients, these first diagnostic steps in combination with counseling will be sufficient. 3. Further diagnostic steps are indicated if the findings of basic diagnostics point to acute tinnitus onset, a potentially dangerous underlying condition (e.g., carotid dissection), a possible causal treatment option, or relevant subjective impairment. 4. Further diagnostic management should be guided by clinical features. There is increasing evidence that phenomenologic and etiologic aspects determine the pathophysiology and the clinical course of tinnitus. In a hierarchical diagnostic algorithm, the first differentiation should be between pulsatile vs. non-pulsatile tinnitus. In case of non-pulsatile tinnitus, differentiation between acute tinnitus with hearing loss, paroxysmal tinnitus, and chronic tinnitus is recommended. Further diagnostic procedures of constant non-pulsatile tinnitus will depend on concomitant symptoms and etiological conditions. 5. All diagnostic and therapeutic steps should be accompanied by empathic and insightful counseling. 6. The ultimate treatment goal is the complete relief from tinnitus. If causally oriented treatment options are available, these should be preferred. However, in many cases, only symptomatic therapies can be offered, and then the treatment goal in clinical practice will be defined as the best possible reduction of unpleasant hearing sensations and accompanying symptoms, that is, to improve quality of life. © Springer Science+Business Media, LLC 2011.
- Diagnosis of somatosensory tinnitus(2011) SANCHEZ, T. G.; ROCHA, C. B.Keypoints: 1. The contribution of non-auditory pathways to the pathology of tinnitus has become more and more evident. 2. Because many different stimuli can modulate tinnitus (forceful muscle contractions of the head and neck, eye movements, pressure of myofascial trigger points, cutaneous stimulation of the face, orofacial movements, etc.), it is important to diagnose somatosensory tinnitus and somatosensory modulation of tinnitus. 3. This chapter discusses how somatosensory tinnitus and somatosensory modulation of tinnitus can be diagnosed, mostly by means of anamnesis and physical evaluation. The chapter provides practical information to the health care professionals regarding such diagnosis. © Springer Science+Business Media, LLC 2011.
- Tinnitus caused and influenced by the somatosensory system(2011) SANCHEZ, T. G.; ROCHA, C. B.Keypoints: 1. It is now recognized that many forms of tinnitus-related neural activity are much more complex and multimodal than ever thought. 2. It has become evident that contribution of non-auditory pathways is involved in eliciting or modulating many forms of tinnitus. 3. Many forms of tinnitus can be modulated by different actions such as forceful muscle contractions of the head and neck as well as eye movements. 4. Somatosensory stimulation such as that from pressure of myofascial trigger points, cutaneous stimulation at specific locations, electrical stimulation of the median nerve and hand, finger movements, and orofacial movements can also modulate or cause tinnitus, as can pressure applied to the temporomandibular joint or lateral pterygoid muscle. 5. This chapter discusses the causes of somatosensory tinnitus and in particular the influence from both head and neck regions on the auditory pathways in individuals with tinnitus. © Springer Science+Business Media, LLC 2011.
- Treatment of somatosensory tinnitus(2011) SANCHEZ, T. G.; ROCHA, C. B.Keypoints: 1. Treatment of somatosensory tinnitus often needs a multidisciplinary approach. 2. Treatment of patients who have signs of bone problems, muscular tension in the temporomandibular joint area or neck, should be directed to correct these problems as the first option. 3. If correction of bone or muscular disorders of -temporomandibular joint and neck fails in relieving tinnitus, symptomatic treatment should be initiated. © Springer Science+Business Media, LLC 2011.
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