Effectiveness of transcranial magnetic stimulation application in treatment of tinnitus.

OBJECTIVE: Pathophysiology of tinnitus known to accompany nearly all disorders in hearing system has not been fully understood, and therefore, there are some difficulties in evaluation and treatment thereof. The objective of the current study is to research the effectiveness of transcranial magnetic stimulation (TMS) application in treatment of tinnitus. MATERIALS AND METHODS: Sixty patients aged between 15 and 70 years who applied to a polyclinic of Ear-Nose-Throat Department, Cerrahpasa Medical Faculty, Istanbul University, because of the complaint of tinnitus between January 2009 and July 2009 were selected using simple random sampling method. The treatment group and the placebo group were separated randomly as to include 30 patients. The tinnitus loudness, tinnitus frequency, tinnitus subjective score, and tinnitus handicap inventory results were compared before application of TMS and after 1 month. FINDINGS: It was found that the difference of tinnitus handicap inventory score within the TMS group (before the treatment: mean, 52.76; SD, 15.8; after the treatment: mean, 44.4; SD, 13.57) was statistically significant (P < 0.0001) and the difference of tinnitus handicap inventory score within the placebo group (before the treatment: mean, 51.46; SD, 15.41; after the treatment: mean, 51.13; SD, 16.86) was significantly insignificant (P = 0.848). When tinnitus severities determined at the beginning and end of the treatment were evaluated within each group, it was found that the difference of loudness within the group subjected to TMS was statistically significant (P < 0.0001) but the difference of loudness within the placebo group was statistically insignificant (P = 0.490). When tinnitus subjective scores were evaluated within each group before and after the treatment, the difference of subjective score within the group subjected to transcranial magnetic stimulation was statistically significant (P < 0.0001), and the difference of subjective score within the placebo group was statistically significant (P = 0.168). CONCLUSIONS: The studies showed that low-frequency repeating TMS is useful in the treatment of chronic tinnitus. In the current study performed on the patients with chronic tinnitus, it was shown that low-frequency repeating TMS has a statistically significant success when compared with the placebo group.

Alveolar soft part sarcoma of the larynx.

Alveolar soft part sarcoma (ASPS) is a rare malignancy. It has generally a poor prognosis. Survival depends on the presence of metastases. Approximately, one-fourth of the cases are encountered in the head and neck region, mostly in the orbits and tongue. Surgery is accepted as the most effective treatment, radiotherapy and chemotherapy may be used as adjuvant treatments. Since it is a highly vascular tumor, profuse bleeding may occur during surgery. In this article, we report a case of ASPS occurring in the larynx, an extremely rare location for this rather unusual tumor. To our knowledge, only three cases of laryngeal ASPS have been previously reported in the English literature.