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
9 resultados
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Agora exibindo 1 - 9 de 9
- Treatment of somatosensory tinnitus(2011) SANCHEZ, T. G.; ROCHA, C. B.Keypoints: 1. Treatment of somatosensory tinnitus often needs a multidisciplinary approach. 2. Treatment of patients who have signs of bone problems, muscular tension in the temporomandibular joint area or neck, should be directed to correct these problems as the first option. 3. If correction of bone or muscular disorders of -temporomandibular joint and neck fails in relieving tinnitus, symptomatic treatment should be initiated. © Springer Science+Business Media, LLC 2011.
- 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.
- 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.
- Diagnosis of somatosensory tinnitus(2011) SANCHEZ, T. G.; ROCHA, C. B.Keypoints: 1. The contribution of non-auditory pathways to the pathology of tinnitus has become more and more evident. 2. Because many different stimuli can modulate tinnitus (forceful muscle contractions of the head and neck, eye movements, pressure of myofascial trigger points, cutaneous stimulation of the face, orofacial movements, etc.), it is important to diagnose somatosensory tinnitus and somatosensory modulation of tinnitus. 3. This chapter discusses how somatosensory tinnitus and somatosensory modulation of tinnitus can be diagnosed, mostly by means of anamnesis and physical evaluation. The chapter provides practical information to the health care professionals regarding such diagnosis. © Springer Science+Business Media, LLC 2011.
- Multidisciplinary Assessment of Patients with Musical Hallucinations, Tinnitus and Hearing Loss(2015) ROCHA, Savya Cybelle Milhomem; KII, Marcia Akemi; PEREIRA, Cristiana Borges; BORELLI, Danilo Totarelli; FORLENZA, Orestes; SANCHEZ, Tanit GanzBackground: Although auditory hallucinations are considered a psychopathological phenomenon, musical hallucinations have been reported in individuals without psychosis but with auditory symptoms (tinnitus and/or hearing loss). Thus, a possible different cognitive functioning may be involved in musical hallucinations. The aim of the study was to characterize patients with tinnitus and musical hallucinations through a multidisciplinary assessment, allowing a better understanding of these concomitant phenomena. Sampling and Methods: As this sample is rare to find, all consecutive patients with tinnitus, hearing loss and musical hallucinations were included over a 3-year period, excluding those unable to respond. All subjects underwent the following assessments: (1) otolaryngological and audiological assessment (physical examination and audiometry), (2) neurological assessment (cognition, electroencephalogram and imaging examination) and (3) psychiatric assessment (structured interview). Results: A total of 16 patients were included (87.5% women; mean age 61.43 +/- 15.99 years). The otolaryngological examination was normal in all cases, but audiometry revealed that the degree of hearing loss was severe to profound in 68.75% of participants. Neurological assessment showed electroencephalogram changes in only 17.6% of cases, while 25% presented with mild attention deficit and 43.75% had small foci of gliosis or ischemia on the imaging examination. Psychiatric assessment showed that 68.75% of cases had depression, 6.25% had anxiety disorder and 25% had no psychiatric conditions. Conclusions: Musical hallucinations were strongly associated with female elderly adults and with mood disorders. Thus, in contrast to common auditory hallucinations, patients with musical hallucinations associated with tinnitus and hearing loss should be offered a more multidisciplinary assessment. (C) 2015 S. Karger AG, Basel
- Tinnitus caused and influenced by the somatosensory system(2011) SANCHEZ, T. G.; ROCHA, C. B.Keypoints: 1. It is now recognized that many forms of tinnitus-related neural activity are much more complex and multimodal than ever thought. 2. It has become evident that contribution of non-auditory pathways is involved in eliciting or modulating many forms of tinnitus. 3. Many forms of tinnitus can be modulated by different actions such as forceful muscle contractions of the head and neck as well as eye movements. 4. Somatosensory stimulation such as that from pressure of myofascial trigger points, cutaneous stimulation at specific locations, electrical stimulation of the median nerve and hand, finger movements, and orofacial movements can also modulate or cause tinnitus, as can pressure applied to the temporomandibular joint or lateral pterygoid muscle. 5. This chapter discusses the causes of somatosensory tinnitus and in particular the influence from both head and neck regions on the auditory pathways in individuals with tinnitus. © Springer Science+Business Media, LLC 2011.
- Transcranial direct current stimulation improves tinnitus perception and modulates cortical electrical activity in patients with tinnitus: A randomized clinical trial(2020) SOUZA, Dayse da Silva; ALMEIDA, Alexandre Alex; ANDRADE, Suellen Marinho dos Santos; MACHADO, Daniel Gomes da Silva; LEITAO, Marcio; SANCHEZ, Tanit Ganz; ROSA, Marine Raquel Diniz daObjectives. -This study aims to determine whether transcranial direct current stimulation (tDCS): a) is effective in the treatment of tinnitus by decreasing its annoyance and severity; b) modulates the cortical electrical activity of such individuals. Methods. -A double-blind, placebo-controlled clinical trial was conducted with 24 patients with tinnitus, randomized into two groups: Group 1 (n =12) received anodal tDCS over the left temporoparietal area (LTA) and cathodal tDCS over the right dorsolateral prefrontal cortex (DLPFC) and Group 2 (n =12) received placebo intervention. Tinnitus perception using a visual analog scale (VAS) and the Tinnitus Handicap Inventory (THI) questionnaire, in addition to electroencephalogram (EEG) was measured with eyes opened and closed at baseline and after the intervention. For the treatment, patients were subjected to five consecutive sessions of tDCS with the anodal electrode over the LTA and cathodal electrode over the right DLPFC (7 x 5 cm, 2 mA for 20 min). tDCS was turned off after 30s in the sham group. Results. -Active tDCS significantly improved tinnitus annoyance and severity. It was associated with decreased beta and theta EEG frequency bands with eyes opened and decreased alpha frequency with eyes closed. sLORETA identified changes in frequency bands in the frontal, temporoparietal, and limbic regions. Finally, there were negative correlations between baseline EEG frequency bands and tDCS-induced change in tinnitus annoyance and severity. Conclusions. - These results demonstrate that tDCS modulates the EEG activity and alleviates tinnitus perception. This effect may be related to baseline EEG activity.