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Introduction: About 15% of the population suffers from tinnitus but only in 2-3% of cases the tinnitus is severe with great functioning difficulties. The distress caused by tinnitus is mostly caused by the reaction to the tinnitus and not by the tinnitus itself., Aims: Methods to alleviate the tinnitus distress are presented with emphasis on the importance of the primary detailed explanation to the patient., Methods: The management of the severe response to tinnitus is based on the ability to control it instead of being controlled by it. This task is accomplished by explaining the essence of the tinnitus and imbuing the patient with control of three things: the way of thinking, the mental stress and attention ability., Conclusions: The methods to mitigate tinnitus distress are presented. The importance of the primary detailed explanation to the patient is emphasized. The treatment is based on providing methods of mastering the way of thinking, controlling mental stress and managing the attention ability using the CBT technique., Discussion: Ear, nose, and throat (E.N.T) practitioners lack knowledge of treatment of the emotional reaction to tinnitus which results in frustration when dealing with the patient's complaints. In this article the basic tools of Cognitive Behavioral Therapy (CBT) treatment method are presented, along with explanations about the method with regard to coping with the emotional reaction to tinnitus.

Introduction: Sudden sensorineural hearing loss (SSNHL] can be the presenting symptom of an acoustic neurinoma. High sensitivity and specificity rates define magnetic resonance imaging (MRI) of the brain and internal acoustic canal as the gold standard for the diagnosis of retro-cochlear pathologies. A previous study revealed low compliance rates (49%] for performing an MRI after an episode of SSNHL; 15% of patients who had an MRI were diagnosed with a retro-cochlear pathology., Aim of Study: To evaluate current compliance rates for performing an MRI of the brain and internal acoustic canal after an episode of SSNHL., Material and Methods: The study cohort included 41 patients, 24 females and 17 male, with an average age of 49.8 +/- 16.8 years (range, 16-78 years), who were diagnosed with SSNHL and admitted for treatment between December 2009 and June 2010., Results: Two months after discharge from hospitalization, only 29 patients (70.7%) returned for the scheduled followup. Only 21 patients (51.2% of those admitted) had an MRI of the brain and internal acoustic canal, as was recommended upon their discharge. Three of those who had an MRI were diagnosed with a retro-cochlear pathology. In 20 patients [48.8%) who did not perform an MRI, a retro-cochlear pathology could not be ruled out., Conclusions: Compliance rates for performing an MRI after an episode of SSNHL haven't changed in recent years. The main reason seems to be poor patients' compliance, as well as their general practitioners and health insurance companies. Ruling out retro-cochlear pathologies by means of MRI is highly important and considered common medical practice. Guidelines regarding the importance of MRI after an episode of SSNHL should be updated and reinforced.

We evaluated the efficacy of ciprofloxacin eardrops compared to tobramycin and to a placebo in the treatment of chronic suppurative otitis media. 60 ears were randomly assigned to treatment for 3 weeks with ciprofloxacin, tobramycin or placebo eardrops. The organism most commonly isolated from the ear discharge was Pseudomonas aeruginosa. The clinical responses were 78.9% and 72.2%, respectively, in the ciprofloxacin and tobramycin groups, while it was only 41.2% in the placebo group. Treatment with ciprofloxacin eardrops seemed to be at least as efficient as treatment with tobramycin. Considering the lack of ototoxicity of ciprofloxacin, this treatment may be best for chronic otitis media.

Histological and functional derangement of the vestibular system has been reported in laboratory animals exposed to high levels of noise. However, reports of clinical series give contradictory results with regard to vestibular disturbances in industrial workers and military personnel suffering from noise-induced hearing loss (NIHL). This study evaluates vestibular function in 22 men with documented NIHL and in 21 matched controls, using electro-nystagmography (ENG) and the smooth harmonic acceleration (SHA) test. There was a significantly lower vestibulo-ocular reflex gain (p = 0.05), and a tendency towards decreased caloric response in the patients. There were no differences between patient and control groups in: incidence of vertigo and of spontaneous, positional and positioning nystagmus; directional preponderance and canal paresis in the ENG; or in phase and asymmetry parameters in the SHA test. These results demonstrated a symmetrical, centrally compensated decrease in vestibular end-organ response associated with symmetrical hearing loss in the patients. Statistically significant correlations were found between average hearing loss, and decrease in average vestibulo-ocular reflex gain (p = 0.01) and ENG caloric lateralization (p = 0.02). These correlations might indicate a single mechanism for both cochlear and vestibular NIHL. The results imply subclinical, well compensated malfunction of the vestibular system associated with NIHL.