TANIT GANZ SANCHEZ
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Otorrinolaringologia e Oftalmologia, Faculdade de Medicina - Docente
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Diagnostic Criteria for Somatosensory Tinnitus: A Delphi Process and Face-to-Face Meeting to Establish Consensus(2018) MICHIELS, Sarah; SANCHEZ, Tanit Ganz; ORON, Yahav; GILLES, Annick; HAIDER, Haula F.; ERLANDSSON, Soly; BECHTER, Karl; VIELSMEIER, Veronika; BIESINGER, Eberhard; NAM, Eui-Cheol; OITICICA, Jeanne; MEDEIROS, Italo Roberto T. de; ROCHA, Carina Bezerra; LANGGUTH, Berthold; HEYNING, Paul Van de; HERTOGH, Willem De; HALL, Deborah A.Since somatic or somatosensory tinnitus (ST) was first described as a subtype of subjective tinnitus, where altered somatosensory afference from the cervical spine or temporomandibular area causes or changes a patient's tinnitus perception, several studies in humans and animals have provided a neurophysiological explanation for this type of tinnitus. Due to a lack of unambiguous clinical tests, many authors and clinicians use their own criteria for diagnosing ST. This resulted in large differences in prevalence figures in different studies and limits the comparison of clinical trials on ST treatment. This study aimed to reach an international consensus on diagnostic criteria for ST among experts, scientists and clinicians using a Delphi survey and face-to-face consensus meeting strategy. Following recommended procedures to gain expert consensus, a two-round Delphi survey was delivered online, followed by an in-person consensus meeting. Experts agreed upon a set of criteria that strongly suggest ST. These criteria comprise items on somatosensory modulation, specific tinnitus characteristics, and symptoms that can accompany the tinnitus. None of these criteria have to be present in every single patient with ST, but in case they are present, they strongly suggest the presence of ST. Because of the international nature of the survey, we expect these criteria to gain wide acceptance in the research field and to serve as a guideline for clinicians across all disciplines. Criteria developed in this consensus paper should now allow further investigation of the extent of somatosensory influence in individual tinnitus patients and tinnitus populations.
- 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.
- Long-lasting total remission of tinnitus: A systematic collection of cases(2021) SANCHEZ, Tanit Ganz; VALIM, Caroline C. A.; SCHLEE, WinfriedBackground: Clinical observation suggests that total remission of tinnitus may exist, but a systematic analysis of these cases is missing. We aimed to identify subjects with long lasting total remission of tinnitus. Methods: By publishing announcements, we included volunteers of any gender and age who have had daily perception of tinnitus for over 3 months and have been in total remission (lack of tinnitus perception, even in silence and with deliberate attention to it) for over 6 months. We excluded individuals in a state of habituation or masking. We applied a structured interview to standardize information about tinnitus and its remission. Follow-up interviews took place after 6, 12, and 18 months. Results: Eighty individuals (56 females; age = 54.2 +/- 16.8 years) were included. History of bilateral tinnitus accounted for 51.4% of cases. Total remission occurred in subjects whose tinnitus lasted for 49.0 +/- 73.5 months. Remission occurred gradually in 78.6% of cases and suddenly in 22%. During the further 18-month follow-up, 7.9% reported recurrence of tinnitus and 92.1% remained symptom free. Conclusion: Different than the knowledge obtained from clinical trials, this study showed that long-lasting total remission of tinnitus may occur. This status was reached by individuals of any gender and age range, with any location and duration of tinnitus, mostly as a gradual process. Future studies should better clarify how each treatment modality may achieve the best results.
- Tinnitus and tinnitus disorder: Theoretical and operational definitions (an international multidisciplinary proposal)(2021) RIDDER, Dirk De; SCHLEE, Winfried; VANNESTE, Sven; LONDERO, Alain; WEISZ, Nathan; KLEINJUNG, Tobias; SHEKHAWAT, Giriraj Singh; ELGOYHEN, Ana Belen; SONG, Jae-Jin; ANDERSSON, Gerhard; ADHIA, Divya; AZEVEDO, Andreia Aparecida de; BAGULEY, David M.; BIESINGER, Eberhard; BINETTI, Ana Carolina; BO, Luca Del; CEDERROTH, Christopher R.; CIMA, Rilana; EGGERMONT, Jos J.; FIGUEIREDO, Ricardo; FULLER, Thomas E.; GALLUS, Silvano; GILLES, Annick; HALL, Deborah A.; HEYNING, Paul Van de; HOARE, Derek J.; KHEDR, Eman M.; KIKIDIS, Dimitris; KLEINSTAEUBER, Maria; KREUZER, Peter M.; LAI, Jen-Tsung; LAINEZ, Jose Miguel; LANDGREBE, Michael; LI, Lieber Po-Hung; LIM, Hubert H.; LIU, Tien-Chen; LOPEZ-ESCAMEZ, Jose Antonio; MAZUREK, Birgit; MOLLER, Aage R.; NEFF, Patrick; PANTEV, Christo; PARK, Shi Nae; PICCIRILLO, Jay F.; POEPPL, Timm B.; RAUSCHECKER, Josef P.; SALVI, Richard; SANCHEZ, Tanit Ganz; SCHECKLMANN, Martin; SCHILLER, Axel; SEARCHFIELD, Grant D.; TYLER, Richard; VIELSMEIER, Veronika; VLAEYEN, Johan W. S.; ZHANG, Jinsheng; ZHENG, Yiwen; NORA, Matteo de; LANGGUTH, BertholdAs for hypertension, chronic pain, epilepsy and other disorders with particular symptoms, a commonly accepted and unambiguous definition provides a common ground for researchers and clinicians to study and treat the problem. The WHO's ICD11 definition only mentions tinnitus as a nonspecific symptom of a hearing disorder, but not as a clinical entity in its own right, and the American Psychiatric Association's DSM-V doesn't mention tinnitus at all. Here we propose that the tinnitus without and with associated suffering should be differentiated by distinct terms: ""Tinnitus"" for the former and ""Tinnitus Disorder"" for the latter. The proposed definition then becomes ""Tinnitus is the conscious awareness of a tonal or composite noise for which there is no identifiable corresponding external acoustic source, which becomes Tinnitus Disorder ""when associated with emotional distress, cognitive dysfunction, and/or autonomic arousal, leading to behavioural changes and functional disability."". In other words ""Tinnitus"" describes the auditory or sensory component, whereas ""Tinnitus Disorder"" reflects the auditory component and the associated suffering. Whereas acute tinnitus may be a symptom secondary to a trauma or disease, chronic tinnitus may be considered a primary disorder in its own right. If adopted, this will advance the recognition of tinnitus disorder as a primary health condition in its own right. The capacity to measure the incidence, prevalence, and impact will help in identification of human, financial, and educational needs required to address acute tinnitus as a symptom but chronic tinnitus as a disorder.
- Treatment options for subjective tinnitus: Self reports from a sample of general practitioners and ENT physicians within Europe and the USA(2011) HALL, Deborah A.; LAINEZ, Miguel J. A.; NEWMAN, Craig W.; SANCHEZ, Tanit Ganz; EGLER, Martin; TENNIGKEIT, Frank; KOCH, Marco; LANGGUTH, BertholdBackground: Tinnitus affects about 10-15% of the general population and risks for developing tinnitus are rising through increased exposure to leisure noise through listening to personal music players at high volume. The disorder has a considerable heterogeneity and so no single mechanism is likely to explain the presence of tinnitus in all those affected. As such there is no standardized management pathway nor singly effective treatment for the condition. Choice of clinical intervention is a multi-factorial decision based on many factors, including assessment of patient needs and the healthcare context. The present research surveyed clinicians working in six Westernized countries with the aims: a) to establish the range of referral pathways, b) to evaluate the typical treatment options for categories of subjective tinnitus defined as acute or chronic, and c) to seek clinical opinion about levels of satisfaction with current standards of practice. Methods: A structured online questionnaire was conducted with 712 physicians who reported seeing at least one tinnitus patients in the previous three months. They were 370 general practitioners (GPs) and 365 ear-nose-throat specialists (ENTs) from the US, Germany, UK, France, Italy and Spain. Results: Our international comparison of health systems for tinnitus revealed that although the characteristics of tinnitus appeared broadly similar across countries, the patient's experience of clinical services differed widely. GPs and ENTs were always involved in referral and management to some degree, but multi-disciplinary teams engaged either neurology (Germany, Italy and Spain) or audiology (UK and US) professionals. For acute subjective tinnitus, pharmacological prescriptions were common, while audiological and psychological approaches were more typical for chronic subjective tinnitus; with several specific treatment options being highly country specific. All therapy options were associated with low levels of satisfaction. Conclusions: Despite a large variety of treatment options, the low success rates of tinnitus therapy lead to frustration of physicians and patients alike. For subjective tinnitus in particular, effective therapeutic options with guidelines about key diagnostic criteria are urgently needed.