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Chronic Cervicogenic Tinnitus Rapidly Resolved by Intermittent Use of Cervical Collar

INTRODUCTION: Cervicogenic tinnitus is not a generally accepted pathogenetic subtype, which might be subsumed under the concept of somatosensory tinnitus. After the personal experience of therapy-resistant tinnitus in context with a cervical pain syndrome (CPS) and successful add-on treatment with c...

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Autores principales: Bechter, Karl, Wieland, Martin, Hamann, Gerhard F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803736/
https://www.ncbi.nlm.nih.gov/pubmed/27047399
http://dx.doi.org/10.3389/fpsyt.2016.00043
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author Bechter, Karl
Wieland, Martin
Hamann, Gerhard F.
author_facet Bechter, Karl
Wieland, Martin
Hamann, Gerhard F.
author_sort Bechter, Karl
collection PubMed
description INTRODUCTION: Cervicogenic tinnitus is not a generally accepted pathogenetic subtype, which might be subsumed under the concept of somatosensory tinnitus. After the personal experience of therapy-resistant tinnitus in context with a cervical pain syndrome (CPS) and successful add-on treatment with cervical collar (CC), the idea was pursued in several individual treatments in patients. PATIENTS AND METHODS: Reporting one particular case with chronic tinnitus, considered untreatable, that rapidly improved with exclusive treatment by CC use. Thereafter, tinnitus was experimentally replicated by head inclination, the respective neck–head angles, and cerebral blood flow was measured. RESULTS: Chronic subjective tinnitus of a 20 years duration completely disappeared within 4 weeks with an intermittent short time application of CC. Thereafter, tinnitus was deliberately again induced by head inclination, set on with anterior tilt of 14°, reaching maximum strength by 23°. Tinnitus stopped with return to neutral head position. Blood flow in the vertebral arteries on both sides was unchanged during head inclination with prevalent tinnitus; however, blood flow was physiologically reduced with head rotation though not accompanied by tinnitus. DISCUSSION: In a single case of chronic tinnitus, we found that treatment with CC rapidly led to full remission. Blood flow reduction in vertebral arteries was unrelated to tinnitus. However, tinnitus could be resumed by constrained head postures. Experimental tinnitus replication (by inclination) points to an underscored role of upper posterior cervical muscle groups, matching with animal experiments, also in concert with other triggers including psychological factors.
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spelling pubmed-48037362016-04-04 Chronic Cervicogenic Tinnitus Rapidly Resolved by Intermittent Use of Cervical Collar Bechter, Karl Wieland, Martin Hamann, Gerhard F. Front Psychiatry Psychiatry INTRODUCTION: Cervicogenic tinnitus is not a generally accepted pathogenetic subtype, which might be subsumed under the concept of somatosensory tinnitus. After the personal experience of therapy-resistant tinnitus in context with a cervical pain syndrome (CPS) and successful add-on treatment with cervical collar (CC), the idea was pursued in several individual treatments in patients. PATIENTS AND METHODS: Reporting one particular case with chronic tinnitus, considered untreatable, that rapidly improved with exclusive treatment by CC use. Thereafter, tinnitus was experimentally replicated by head inclination, the respective neck–head angles, and cerebral blood flow was measured. RESULTS: Chronic subjective tinnitus of a 20 years duration completely disappeared within 4 weeks with an intermittent short time application of CC. Thereafter, tinnitus was deliberately again induced by head inclination, set on with anterior tilt of 14°, reaching maximum strength by 23°. Tinnitus stopped with return to neutral head position. Blood flow in the vertebral arteries on both sides was unchanged during head inclination with prevalent tinnitus; however, blood flow was physiologically reduced with head rotation though not accompanied by tinnitus. DISCUSSION: In a single case of chronic tinnitus, we found that treatment with CC rapidly led to full remission. Blood flow reduction in vertebral arteries was unrelated to tinnitus. However, tinnitus could be resumed by constrained head postures. Experimental tinnitus replication (by inclination) points to an underscored role of upper posterior cervical muscle groups, matching with animal experiments, also in concert with other triggers including psychological factors. Frontiers Media S.A. 2016-03-23 /pmc/articles/PMC4803736/ /pubmed/27047399 http://dx.doi.org/10.3389/fpsyt.2016.00043 Text en Copyright © 2016 Bechter, Wieland and Hamann. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Bechter, Karl
Wieland, Martin
Hamann, Gerhard F.
Chronic Cervicogenic Tinnitus Rapidly Resolved by Intermittent Use of Cervical Collar
title Chronic Cervicogenic Tinnitus Rapidly Resolved by Intermittent Use of Cervical Collar
title_full Chronic Cervicogenic Tinnitus Rapidly Resolved by Intermittent Use of Cervical Collar
title_fullStr Chronic Cervicogenic Tinnitus Rapidly Resolved by Intermittent Use of Cervical Collar
title_full_unstemmed Chronic Cervicogenic Tinnitus Rapidly Resolved by Intermittent Use of Cervical Collar
title_short Chronic Cervicogenic Tinnitus Rapidly Resolved by Intermittent Use of Cervical Collar
title_sort chronic cervicogenic tinnitus rapidly resolved by intermittent use of cervical collar
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803736/
https://www.ncbi.nlm.nih.gov/pubmed/27047399
http://dx.doi.org/10.3389/fpsyt.2016.00043
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