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
3 resultados
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- Tinnitus is associated with reduced sound level tolerance in adolescents with normal audiograms and otoacoustic emissions(2016) SANCHEZ, Tanit Ganz; MORAES, Fernanda; CASSEB, Juliana; COTA, Jaci; FREIRE, Katya; ROBERTS, Larry E.Recent neuroscience research suggests that tinnitus may reflect synaptic loss in the cochlea that does not express in the audiogram but leads to neural changes in auditory pathways that reduce sound level tolerance (SLT). Adolescents (N = 170) completed a questionnaire addressing their prior experience with tinnitus, potentially risky listening habits, and sensitivity to ordinary sounds, followed by psychoacoustic measurements in a sound booth. Among all adolescents 54.7% reported by questionnaire that they had previously experienced tinnitus, while 28.8% heard tinnitus in the booth. Psychoacoustic properties of tinnitus measured in the sound booth corresponded with those of chronic adult tinnitus sufferers. Neither hearing thresholds (<= 15 dB HL to 16 kHz) nor otoacoustic emissions discriminated between adolescents reporting or not reporting tinnitus in the sound booth, but loudness discomfort levels (a psychoacoustic measure of SLT) did so, averaging 11.3 dB lower in adolescents experiencing tinnitus in the acoustic chamber. Although risky listening habits were near universal, the teenagers experiencing tinnitus and reduced SLT tended to be more protective of their hearing. Tinnitus and reduced SLT could be early indications of a vulnerability to hidden synaptic injury that is prevalent among adolescents and expressed following exposure to high level environmental sounds.
- 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.
- Total remission or persistence of tinnitus and decreased sound level tolerance in adolescents with normal audiograms: A follow-up study(2021) SANCHEZ, Tanit Ganz; ROBERTS, Larry E.Background: Tinnitus may reflect hidden cochlear synaptic injury that does not express in the audiogram, but leads to neuroplastic changes in auditory pathways that, in turn, reduce tolerance to sounds. Such injury may follow the exposure to loud sounds. The aim of this study was to follow-up adolescents enrolled in a private school to evaluate the prevalence of tinnitus and reduced sound level tolerance (SLT) with 1-year interval, as well as to observe rates of tinnitus persistence, remission and incidence of new cases by repeat measurements. Methods: In Study 1 (Sanchez et al., 2016), we evaluated 170 adolescents by a questionnaire about tinnitus and reduced tolerance to ordinary sounds and by measurements in a sound booth: audiometry (0.25-16kHz), Loudness Discomfort Levels (LDL, 0.5-4kHz) and tinnitus pitch/loudness matching (if present). Tinnitus measured in the booth was then called ""confirmed tinnitus."" In Study 2, we revaluated 54 adolescents who returned voluntarily 1 year later to repeat all measurements. Results: From Study 1 to 2, the prevalence of confirmed tinnitus reduced from 28.8% (49/170) to 14.9% (8/54) in retested subjects, which includes the cases of persisting tinnitus (confirmed tinnitus in both studies, n = 6/54 = 11.2%) and the new cases of tinnitus (confirmed tinnitus just at Study 2, n = 2/54 = 3.7%). Among the 15 adolescents with confirmed tinnitus at Study 1 who returned for Study 2, 40% had persistent tinnitus (n = 6) and 60% did not (remitted tinnitus, n = 9). SLT was reduced by 17.3dB in cases with persistent tinnitus (P < 0.0002), similar to the findings of Study 1, and returned to normal levels in subjects with remitted tinnitus. Hearing thresholds averaged 4.37dBHL and were <20dBHL in 97% of ears and all frequencies. At 14 and 16kHz thresholds were bilaterally elevated at Study 1 (5.07dB) and 2 (5.56dB) in adolescents with confirmed tinnitus. Conclusions: Tinnitus and reduced sound tolerance could feature early signals of hidden synaptic injury that is prevalent among adolescents and hidden from the audiogram. The strong relationship between both symptoms, in addition to low-level increases in hearing thresholds at high frequencies in the extended audiogram, poses a challenge for future hearing health and should be further evaluated as a possible intrinsic vulnerability for lesions following exposure to loud sounds. Moreover, the relationship between their spontaneous remissions may signal a possible synaptic repair, which has been reported in animal models.