Textbook of Tinnitus

Springer Science & Business Media
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Groundbreaking, comprehensive, and developed by a panel of leading international experts in the field, Textbook of Tinnitus provides a multidisciplinary overview of the diagnosis and management of this widespread and troubling disorder. Importantly, the book emphasizes that tinnitus is not one disease but a group of rather diverse disorders with different pathophysiology, different causes and, consequently, different treatments. This comprehensive title is written for clinicians and researchers by clinicians and researchers who are active in the field. It is logically organized in six sections and will be of interest to otolaryngologists, neurologists, psychiatrists, neurosurgeons, primary care clinicians, audiologists and psychologists. Textbook of Tinnitus describes both the theoretical background of the different forms of tinnitus and it provides detailed knowledge of the state-of-the-art of its treatment. Because of its organization and its extensive subject index, Textbook of Tinnitus can also serve as a reference for clinicians who do not treat tinnitus patients routinely.
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Springer Science & Business Media
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Published on
Nov 16, 2010
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Medical / Clinical Medicine
Medical / Family & General Practice
Medical / Internal Medicine
Medical / Neurology
Medical / Otorhinolaryngology
Medical / Practice Management & Reimbursement
Medical / Psychiatry / General
Medical / Surgery / Neurosurgery
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Tinnitus is a common disorder and traditional treatment approaches such as medication, active or passive sound enhancement, and cognitive behavioral therapy have limited efficacy. Thus, there is an urgent need for more effective treatment approaches. Functional imaging studies in patients with tinnitus have revealed alterations in neuronal activity of central auditory pathways, probably resulting as a consequence of sensory deafferentation. However, nonauditory brain areas are also involved. These nonauditory brain areas might represent both an “awareness” network involved in the conscious perception of the tinnitus signal as well as areas related to a nontinnitus-specific distress network consisting of the anterior cingulate cortex, anterior insula, and amygdala. Moreover, memory mechanisms involving the hippocampus and the parahippocampal region may play a role in the persistence of the awareness of the phantom percept, as well as in the reinforcement of the associated distress. All of these networks represent potential targets for treatment via pharmacological treatment or noninvasive and invasive brain stimulation. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive method of applying electromagnetic fields to the brain that can induce alterations of neuronal activity that outlast the stimulation period. Single sessions of rTMS over the temporal or temporoparietal cortex have been successful in transiently reducing tinnitus perception. Repeated sessions of rTMS have resulted in tinnitus relief in a subgroup of patients, lasting from several days to several months. However, effect sizes of rTMS in the treatment of tinnitus are only moderate, and interindividual variability is high. Larger and longer lasting effects have been observed with direct electrical stimulation of the auditory cortex via implanted epidural electrodes. Transcranial direct current stimulation (tDCS) has also shown potential for the treatment of tinnitus. Both auditory and frontal tDCS have shown tinnitus reduction in a subgroup of patients. In spite of the promising results of the different brain stimulation approaches, further research is needed before these techniques can be recommended for routine clinical use.
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