Somatic (Craniocervical) tinnitus and the dorsal cochlear nucleus hypothesis
Somatic (Craniocervical) tinnitus and the dorsal cochlear nucleus hypothesis
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DOI：
10.1016/s0196-0709(99)90074-1
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发表时间：
1999-11-01
影响因子：
2.5
通讯作者：
Levine, RA
中科院分区：
文献类型：
--
作者：
Levine, RA
目的：在所有非听觉感觉系统中，似乎只有体感系统与耳鸣有关（例如颞下颌关节综合症和颈椎扭伤）。本研究的目的是描述与躯体事件相关的耳鸣的显着特征，并利用这些特征开发躯体性耳鸣的神经学模型。材料和方法：病例系列。结果：一些有耳鸣但没有其他听力主诉的患者具有一些共同的临床特征，包括（1）头部或上颈的相关躯体疾病，（2）耳鸣定位于躯体疾病同侧的耳朵，（3）无前庭主诉，以及(4)神经系统检查无异常。两只耳朵的纯音和言语测听始终是对称的，并且通常在正常范围内。基于这些临床特征，有人提出，躯体（颅颈）耳鸣与耳鸣一样，是由同侧耳蜗背核去抑制引起的。细胞体位于同侧髓质体感核团中的神经纤维介导这种效应。这些神经元接收来自附近三叉神经束、楔状束以及支配中耳和外耳的面部神经、迷走神经和舌咽神经纤维的输入。结论：耳蜗背核的体细胞（颅颈）调节可能解释了耳鸣的许多以前知之甚少的方面，并提出了新的耳鸣治疗方法。版权所有 a 1999 by W.B.桑德斯公司。
Purpose: Of all nonauditory sensory systems, only the somatosensory system seems to be related to tinnitus (eg, temporomandibular joint syndrome and whiplash). The purpose of this study is to describe the distinguishing characteristics of tinnitus associated with somatic events and to use these characteristics to develop a neurological model of somatic tinnitus.Materials and Methods: Case series.Results: Some patients with tinnitus, but no other hearing complaints, share several clinical features including (1) an associated somatic disorder of the head or upper neck, (2) localization of the tinnitus to the ear ipsilateral to the somatic disorder, (3) no vestibular complaints, and (4) no abnormalities on neurological examination. Pure tone and speech audiometry of the 2 ears is always symmetric and usually within normal limits. Based on these clinical features, it is proposed that somatic (craniocervical) tinnitus, like otic tinnitus, is caused by disinhibition of the ipsilateral dorsal cochlear nucleus. Nerve fibers whose cell bodies lie in the ipsilateral medullary somatosensory nuclei mediate this effect. These neurons receive inputs from nearby spinal trigeminal tract, fasciculus cuneatus, and facial, vagal, and glossopharyngeal nerve fibers innervating the middle and external ear.Conclusions: Somatic (craniocervical) modulation of the dorsal cochlear nucleus may account for many previously poorly understood aspects of tinnitus and suggests novel tinnitus treatments. Copyright a 1999 by W.B. Saunders Company.