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
4 resultados
Resultados de Busca
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- 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.
- Theoretical Tinnitus Framework: A Neurofunctional Model(2016) GHODRATITOOSTANI, Iman; ZANA, Yossi; DELBEM, Alexandre C. B.; SANI, Siamak S.; EKHTIARI, Hamed; SANCHEZ, Tanit G.Subjective tinnitus is the conscious (attended) awareness perception of sound in the absence of an external source and can be classified as an auditory phantom perception. Earlier literature establishes three distinct states of conscious perception as unattended, attended, and attended awareness conscious perception. The current tinnitus development models depend on the role of external events congruently paired with the causal physical events that precipitate the phantom perception. We propose a novel Neurofunctional Tinnitus Model to indicate that the conscious (attended) awareness perception of phantom sound is essential in activating the cognitive-emotional value. The cognitive-emotional value plays a crucial role in governing attention allocation as well as developing annoyance within tinnitus clinical distress. Structurally, the Neurofunctional Tinnitus Model includes the peripheral auditory system, the thalamus, the limbic system, brainstem, basal ganglia, striatum, and the auditory along with prefrontal cortices. Functionally, we assume the model includes presence of continuous or intermittent abnormal signals at the peripheral auditory system or midbrain auditory paths. Depending on the availability of attentional resources, the signals may or may not be perceived. The cognitive valuation process strengthens the lateral-inhibition and noise canceling mechanisms in the mid-brain, which leads to the cessation of sound perception and renders the signal evaluation irrelevant. However, the ""sourceless"" sound is eventually perceived and can be cognitively interpreted as suspicious or an indication of a disease in which the cortical top-down processes weaken the noise canceling effects. This results in an increase in cognitive and emotional negative reactions such as depression and anxiety. The negative or positive cognitive-emotional feedbacks within the top-down approach may have no relation to the previous experience of the patients. They can also be associated with aversive stimuli similar to abnormal neural activity in generating the phantom sound. Cognitive and emotional reactions depend on general personality biases toward evaluative conditioning combined with a cognitive-emotional negative appraisal of stimuli such as the case of people with present hypochondria. We acknowledge that the projected Neurofunctional Tinnitus Model does not cover all tinnitus variations and patients. To support our model, we present evidence from several studies using neuroimaging, electrophysiology, brain lesion, and behavioral techniques.
- Tinnitus and sound intolerance: evidence and experience of a Brazilian group(2018) ONISHI, Ektor Tsuneo; COELHO, Claudia Couto de Barros; OITICICA, Jeanne; FIGUEIREDO, Ricardo Rodrigues; GUIMARAES, Rita de Cassia Cassou; SANCHEZ, Tanit Ganz; GURTLER, Adriana Lima; VENOSA, Alessandra Ramos; SAMPAIO, Andre Luiz Lopes; AZEVEDO, Andreia Aparecida; PIRES, Anna Paula Batista de Avila; BARROS, Bruno Borges de Carvalho; OLIVEIRA, Carlos Augusto Costa Pires de; SABA, Clarice; YONAMINE, Fernando Kaoru; MEDEIROS, Italo Roberto Torres de; ROSITO, Leticia Petersen Schmidt; RATES, Marcelo Jose Abras; KII, Marcia Akemi; FAVERO, Mariana Lopes; SANTOS, Monica Alcantara de Oliveira; PERSON, Osmar Clayton; CIMINELLI, Patricia; MARCONDES, Renata de Almeida; MOREIRAW, Ronaldo Kennedy de Paula; TORRES, Sandro de Menezes SantosIntroduction: Tinnitus and sound intolerance are frequent and subjective complaints that may have an impact on a patient's quality of life. Objective: To present a review of the salient points including concepts, pathophysiology, diagnosis and approach of the patient with tinnitus and sensitivity to sounds. Methods: Literature review with bibliographic survey in LILACS, SciELO, Pubmed and MEDLINE database. Articles and book chapters on tinnitus and sound sensitivity were selected. The several topics were discussed by a group of Brazilian professionals and the conclusions were described. Results: The prevalence of tinnitus has increased over the years, often associated with hearing loss, metabolic factors and inadequate diet. Medical evaluation should be performed carefully to guide the request of subsidiary exams. Currently available treatments range from medications to the use of sounds with specific characteristics and meditation techniques, with variable results. Conclusion: A review on tinnitus and auditory sensitivity was presented, allowing the reader a broad view of the approach to these patients, based on scientific evidence and national experience. (C) 2017 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
- 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.