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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery
Indexed/Abstracted in: EMBASE, Scopus
Otorinolaringologia 2002 June;52(2):53-6
Pharmacological topodiagnosis of tinnitus induced by cervical trauma
Giuliano D. A. 1, Saraniti C. 2, Dispenza C. 2, Caramanna C. 2
Università degli Studi di Palermo, Palermo 1Clinica Otorinolaringoiatrica Base e 2R
Background. The subjective tinnitus due to a cervical trauma is frequently attributed to Neri-Barrè-Lièou syndrome, an otoneurologic disease whose cochleovestibular symptoms may have two origins: a nervous and a vascular one. The aim of this paper is to assess the prevalence of cytoneural synaptic dysfunction induced by a cervical sympathetic involvement and of cochlear disorders due to a labyrinthine hypoperfusion in a group of subjects with tinnitus related to cervical trauma, using the pharmacological topodiagnostic methods proposed by Risey and Seidmann.
Methods. Twelve patients, 8 women and 4 men (mean age ± SD: 40.2±8.5; range 28-54 years) with suspected Neri-Barrè-Lièou syndrome, whose prevalent symptom was tinnitus, have been examined. Each patient, after hearing assessment, was submitted to Furosemide test, consisting in the administration of 500 mg of Furosemide slowly i.v. in 500 cc of physiological solution, and, one week later, to Amantadine test, which involves two administrations of 100 mg of Amantadine at a distance of twelve hours one after the other. In both tests a reduction of tinnitus in excess of 30%, reported by the patient not later than 24 hours, has been regarded as significant.
Results. The Furosemide test has been found positive in 5 cases whereas other 3 patients responded to Amantadine test. Statistically significant differences regarding the response of the patients examined to 2 different pharmacological tests, have not been observed (p>0.05).
Conclusions. A significant prevalence of nervous over vascular factors or vice-versa in the etiopathogenesis of cervical trauma-related tinnitus doesn’t exist. Both factors take part to the same extent in inducing this symptom even if clinical and experimental findings suggest to ascribe more importance to labyrinthine microcircle disorders.