Objective: To evaluate the frequency of tinnitus onset (in normal subjects) and modulation (in tinnitus patients) during muscle contractions, estimating possible risk factors. Material and Method: This case-control study enrolled 121 tinnitus patients and 100 healthy volunteers who underwent medical history, ENT examination and 16 maneuvers of muscular contraction (head, neck and limbs). Modulation data were compared between patients with and without normal audiometry, well-defined diagnosis and symptoms of craniomandibular disorders. Results: The ability to modulate tinnitus (65.3%) was significantly higher than that to originate tinnitus (14.0%). The head and neck musculature was significantly more efficient than that of the limbs. Audiometric pattern, well-defined etiology and symptoms of craniomandibular disorders showed no relation to tinnitus modulation. Conclusions: Somatic modulation is a characteristic aspect of tinnitus.

FORMA DE ESTUDO: Estudo de corte transversal. MATERIAL E MÉTODOS: Os autores avaliaram 55 pacientes que procuraram o Ambulatório de Otoneurologia Geriátrica do Hospital das Clínicas do HCFMUSP com queixa de desequilíbrio e/ou tontura entre agosto de 2001 e março de 2003, caracterizando o perfil dessa população de idosos quanto a idade, sexo, fatores etiológicos relacionados à alteração do equilíbrio, conduta terapêutica adotada e resultados parciais de tratamentos propostos. RESULTADOS: O paciente idoso com alteração do equilíbrio corporal apresentou mais de uma etiologia relacionada ao seu problema em 51% dos casos, sendo as patologias mais freqüentes: Insuficiência Vértebro-Basilar - IVB (40%), Alteração Metabólica relacionada a metabolismo de açúcar e colesterol (40%), Síndrome do Desequilíbrio de Idoso - SDI (30%), Vertigem Posicional Paroxística Benigna - VPPB (14,5%), Vestibulopatia Cervical (7,2%) e Alterações Hormonais (5,4%), entre outras. CONCLUSÃO: Estes achados corroboram dados prévios da literatura e chamam a atenção para a necessidade de uma abordagem multidisciplinar para a compreensão do desequilíbrio e seu adequado tratamento na população idosa.

Patients with tinnitus and normal hearing showed similar characteristics when compared to those with hearing loss. However, the age of the patients and the interference over concentration and emotional status were significantly lower in this group.

Maneuvers of head and neck muscle contractions evoked tinnitus modulation in a frequent and reliable manner. Also, the repetition of such maneuvers for 2 months altered the pattern of modulation.

Palavras-chave: implante coclear, audição, cirurgia, limiar auditivo.

This study makes this questionnaire available in Brazilian Portuguese. For parents of Brazilian children with cochlear implants, lexical development(acquisition and use of words) is the variable that relates most to the quality of life of their children.

Autografting is the gold-standard method for facial nerve repair with tissue loss. Its association with high-quality scaffolds and cell implants has disclosed distinct experimental outcomes. The aim of this study was to evaluate the functional and histological effects of bone marrow stem cells (BMSC) combined with polyglycolic acid tube (PGAt) in autografted rat facial nerves. After neurotmesis of the mandibular branch of the rat facial nerve, surgical repair consisted of nerve autografting (groups A-E) contained in pGAT (groups B-E), filled with basement membrane matrix (groups C-E) with undifferentiated BMSC (group D) or Schwann-like cells that had differentiated from BMSC (group E). Axon morphometrics and an objective compound muscle action potentials (CMAP) analysis were conducted. Immunofluorescence assays were carried out with Schwann cell marker S100 and anti-β-galactosidase to label exogenous cells. Six weeks after surgery, animals from either cell-containing group had mean CMAP amplitudes significantly higher than control groups. Differently from other groups, facial nerves with Schwann-like cell implants had mean axonal densities within reference values. This same group had the highest mean axonal diameter in distal segments. We observed expression of the reporter gene lacZ in nerve cells in the graft and distally from it in groups D and E. Group-E cells had lacZ coexpressed with S100. In conclusion, regeneration of the facial nerve was improved by BMSC within PGAt in rats, yet Schwann-like cells were associated with superior effects. Accordingly, groups D and E had BMSC integrated in neural tissue with maintenance of former cell phenotype for six weeks.

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