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Volume 6, Issue 5 (Suppl) J Pain Relief, an open access journal
ISSN: 2167-0846 Pain Management 2017
October 05-06, 2017
Page 18
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5th International Conference and Exhibition on
October 05-06, 2017 London, UK
Pain Research And Management
Henk M Koning, J Pain Relief 2017, 6:5(Suppl)
DOI: 10.4172/2167-0846-C1-013
Tinnitus: A pain syndrome in search for good therapy
Tinnitus is defined as a phantom auditory perception, namely perception of sound without corresponding vibratory,
mechanical activity in the cochlea. It is now evident that the pathology that causes most forms of tinnitus is in the central
nervous system where some abnormal neural activity is generated and interpreted in a similar way as activity generated when
sound reaches the ear. Hearing loss is believed to trigger the perception of tinnitus in the central auditory system. However,
there is no specific hearing loss associated with the occurrence of tinnitus. Most forms of bilateral tinnitus are caused by
abnormal neural activity in the central nervous system without damage of the ear. The concept of somatic tinnitus is derived
from observations that tinnitus can be evoked or modified by somatic manoeuvres, and that tinnitus can develop acutely after
somatic insults to the face, head or neck. Extensive morphological and physiological evidence suggests that somatosensory-
auditory interactions in the nucleus cochlearis play a significant role in somatic tinnitus. The dorsal root ganglion of the
spinal nerve at the cervical level and the trigeminal ganglion contain the primary somatosensory neurons that project to the
nucleus cochlearis. Although neural plasticity is involved in the pathogenesis of tinnitus, there is also a group of patients with
tinnitus who can be of vascular origin. Tinnitus patients with a hearing loss greater than 22 dB at 250 Hz were found to be
good candidates for a reduction of tinnitus with sympathetic blockade. Sympathetic fibres innervating the cochlea play a role
in control of cochlear blood flow with direct sympathetic-induced vasoconstriction. Blockade of the sympathetic fibres to
the cochlea can lead to increased cochlear blood flow; this has been recommended as therapy for Meniere’s disease, inner ear
deafness, and tinnitus.
Biography
Henk M Koning is an Anesthesiologist who worked for more than 30 years in multidisciplinary pain relief. He has several national and international publications concerning
anesthesiology, intensive care, trauma care and pain. In pain, his expertise is: low back pain, cervical pain, trigeminal neuralgia, painful feet, and tinnitus. He works in the
Pain Clinic De Bilt, De Bilt, The Netherlands.
Henk M Koning
Pain Clinic De Bilt, The Netherlands