MD Degree and ENT Residency at the University of Campinas / UNICAMP. PhD Degree at the Ribeirão Preto Medical School (FMRP-USP). ENT Board Certified by the Brazilian Association of Otorhinolaryngology. Research Fellowship in Otopathology at the University of Minnesota. Otology Fellowship (Fisch International Microsurgery Foundation). Reviewer of several ENT International Journals.
Tinnitus is defined as a sound a person hears that is generated by the body, rather than by outside source. The word tinnitus is derived from the Latin “tinnire” meaning “to ring” and is perceived as ringing, buzzing, or hissing in or around the ear(s). Approximately 50 million Americans are affected, while there is a prevalence of 10% in the United Kingdom among adult population. It has multiple etiologies and is sometimes idiopathic. Tinnitus may vary widely to pitch, loudness, description of sound, special localization, and temporal pattern. Most often, tinnitus is associated with other aural symptoms, such as hearing loss and hyperacusis. Tinnitus may result in sleep disturbances, work impairments, distress. Males are more likely to suffer from tinnitus. In the mechanically demanding and biochemically active environment of the temporomandibular joint (TMJ), therapeutic approaches are capable of restoring joint functionality. TMJ treatments including splints, occlusal adjustments, and jaw exercises have been shown to be more effective than no treatment. The following chapter presents a synopsis of etiology, current treatment methods, and the future of tissue engineering for repairing and/or replacing diseased joint components, specifically the mandibular condyle and TMJ disc.
Part of the book: Management of Tinnitus
Meniere’s disease represents one of the most frequent vestibulopathy, with prevalence of 46–200 cases per 100,000, without difference between genders and manifests in fourth decade of life. Features include dizziness/vertigo, hearing loss, tinnitus, and ear fullness. Individuals with Meniere’s disease have poor quality of life due to dizziness, regarding physical, functional, and emotional aspects. The therapeutic measures are proposed, depending on the stage of the disease. About 95% of the patients are well controlled with conservative clinical treatment. The remaining 5% have incapacitating symptoms. These patients are candidates for surgical treatments classics, decompression of the endolymphatic sac, vestibular neurectomy, or labyrinthectomy. Intratympanic gentamicin injections emerged as an alternative to surgical treatments, whose risk and benefit ratio has been shown to be much more satisfactory. Aminoglycosides, such as gentamicin have been used since the decade of 1950 for the vestibular chemical ablation in cases of intractable vertigo. The drawback is that gentamicin causes irreversible destruction to cochlear hair cells with hearing loss. The selective vestibulotoxicity in the treatment of Meniere’s disease can be used in the treatment of the vertigo promoting a chemical labyrinthectomy.
Part of the book: Meniere's Disease