S U M M A R Y Cervical somatosensory evoked potentials, brainstem evoked potentials, visual evoked potentials, and the cerebral contingent negative variation were recorded in patients with definite multiple sclerosis before, during, and after spinal cord stimulation. Improvements were seen in the cervical somatosensory and brainstem evoked potentials but neither the visual evoked potential nor the contingent negative variation changed in association with spinal cord stimulation. The results indicate that spinal cord stimulation acts at spinal and brainstem levels and that the clinical improvements seen in patients are caused by an action at these levels rather than by any cerebral arousal or motivational effect. The evoked potentials were not useful in predicting which patients were likely to respond to stimulation.

BackgroundTinnitus is a common symptom, affecting about 10–15% of the adult population. When input from the somatosensory system can influence and/or elicit tinnitus, this type of subjective tinnitus is called somatosensory tinnitus. Recently, a new type of bimodal neurostimulation treatment has shown promising results for a specific subgroup within the somatosensory tinnitus population. It is, however, not clear if this bimodal stimulation is also effective in patients with other types of subjective tinnitus.AimThe aim of this study was to evaluate the feasibility and efficacy of non-invasive bimodal auditory-somatosensory stimulation in reducing tinnitus severity among a general population of people with subjective tinnitus.MethodsChronic subjective tinnitus patients were recruited from the ENT department of the Antwerp University Hospital. Somatosensory stimulation was delivered by Transcutaneous Electrical Nerve Stimulation (TENS), and it was combined with auditory stimulation via headphones. The therapy comprised six sessions of thirty minutes twice a week for a period of 3 consecutive weeks. Follow up measurements were scheduled 9–12 weeks after the last treatment session. The change of the Tinnitus Functional Index (TFI) score, a questionnaire evaluating tinnitus burden and effects on the quality of life, was the primary outcome measure.ResultsTwenty-nine patients were enrolled in the study. A linear mixed-effects model was used to analyze the efficacy of bimodal treatment. The results of this analysis showed a statistically significant decrease (by 6, 9 points) in average TFI score at the follow up visit when compared to baseline. The ability to modulate tinnitus did not have an influence on the treatment results.ConclusionOur study showed that bimodal stimulation is a feasible and safe method of tinnitus treatment. The method might be an effective treatment for some participants with tinnitus, especially those who have accompanying neck/temporomandibular problems, although, the evidence from this trial is quite weak. Additional research is needed toward establishing the optimal treatment protocol, as well as selecting the most appropriate inclusion criteria.

Background: This paper is a review of the literature on electrical stimulation of the ear to treat tinnitus. This method of treatment has been used since the 1970s and different techniques have been explored. The primary aim of this work was to review the literature on electrical stimulation of the ear to suppress tinnitus, with a specific focus on the methods and stimulation parameters used so far and the efficacy of the different methods. A secondary aim was to formulate recommendations on electrical ear stimulation parameters that suppress tinnitus. Material and methods: Four databases were searched: PubMed, Ovid Embase, Web of Science, and Science Direct. Database searches were conducted during November 2018 using the search terms: tinnitus and electrical stimulation. Inclusion criteria: All research articles on invasive and non-invasive electrical stimulation of the ear for suppressing tinnitus were included. Other inclusion criteria were records in English and involving adult human participants. Exclusion criteria: Studies on intracochlear stimulation using cochlear implants and studies where stimulation extended beyond the ear (e.g. transcutaneous electrical nerve stimulation, TENS) were excluded.Results: Twenty publications met the inclusion criteria and were analysed in this review. A comparison was made between invasive and non-invasive electrical ear stimulation in terms of efficacy, type of current used, laterality of stimulation, intensity and frequency of the current, duration of tinnitus suppression, and adverse effects. Due to the non-standardised methodology of the studies, there was only a low level of evidence available in terms of the advantages of a particular technique or stimulation parameter. The difficulties in comparing the effectiveness of the studies were related to many factors, and these are discussed. One factor is the variability in outcome measures, including different definitions of treatment success and limited use of standardised or validated outcome measures. Conclusions:Based on the reviewed literature, it is concluded there is no clear advantage of one stimulation condition over the other in terms of method, stimulation parameter, or effectiveness. This leads us to conclusion that the present body of evidence is insufficient to formulate definite recommendations for electrical ear stimulation.

Introduction: There are many reasons for an increase in volume of the salivary glands, including inflammatory changes due to infection, autoimmune and allergic reactions, endocrine disorder, tumor, or injury.Aim: Presentation of a rare case of a pneumoparotid.Case report: A 54-year-old patient was admitted to the department for diagnosis of a nodular swelling in the area of the left parotid gland. The swelling had appeared about 3 weeks earlier, initially with pain, and had gradually increased in size. He denied head or neck injury, problems with chewing or swallowing food, or a dry mouth. Laryngological examination revealed swelling of the cheek in the left preauricular area, palpably soft, oval-shaped (about 20 x 15 mm), slightly painful when pressed, non-fluctuant, and with no associated skin changes. Fine-needle aspiration biopsy and contrast CT scan of the neck revealed a pneumoparotid on the left side. After decompression of the pneumoparotid, conservative treatment (a pressure dressing) was applied in an outpatient mode. Due to lack of therapeutic effect, the patient was qualified for surgical excision of the left pneumoparotid.Conclusions: A pneumoparotid of the salivary glands is a rare pathology affecting the parotid glands and is associated with an increase in intraoral pressure. Treatment is primarily avoidance of the triggering factor and pressure dressings, but sometimes surgery is necessary. The pathology in most cases does not cause permanent damage to the salivary glands and the effects of treatment are good.