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Papers by Henk Koning

Research paper thumbnail of Pulsed Radiofrequency of the Auriculotemporal Nerve to Reduce the Intensity of Tinnitus

˜The œinternational tinnitus journal, 2023

Research paper thumbnail of Pulsed Radiofrequency of the Auricular Branch of the Vagal Nerve in Tinnitus Patients

International Tinnitus Journal, Dec 31, 2022

Research paper thumbnail of Tibial Nerve Block as Treatment of Chronic Foot Pain

Anesthesiology and Pain Medicine

Background: Minimally invasive therapies can alleviate pain and improve walking in individuals wi... more Background: Minimally invasive therapies can alleviate pain and improve walking in individuals with persistent foot and ankle pain. Objectives: The current study aimed to define the protracted consequences of tibial nerve blocks with steroids for individuals with persistent foot pain and to investigate the link between the thermography of the plantar foot and the beneficial effect of a tibial nerve block with steroids. Methods: All patients with chronic foot pain (n = 45) in this cohort underwent a block of the tibial nerve in the Department of Pain Therapy of Pain Clinic De Bilt, Utrecht, Netherlands, within November 2019 to April 2020. The thermographic images of patients were taken before and after injection. Results were retrospectively evaluated after 18 months. Results: In this study, 53% of the patients had pain relief at 7 weeks of follow-up with a unilateral or bilateral block of the tibial nerve. An improvement in walking distance was reported by 22% of the patients. Side ...

Research paper thumbnail of Pain in relationship to Tinnitus and Hearing Loss

The international tinnitus journal, 2022

INTRODUCTION Cervical and lower back pain are noteworthy in the manner of development of tinnitus... more INTRODUCTION Cervical and lower back pain are noteworthy in the manner of development of tinnitus. OBJECTIVES The focus of this research was to indicate the consequence of the severity of neck pain and pain of the lower back and/or lower limbs in tinnitus patients. DESIGN A retrospective analysis of 61 patients with tinnitus as main complaint during a three month period. RESULTS In this study, we found two groups of tinnitus patients defined by the existence of postural instability. Patients with tinnitus and postural unsteadiness were characterized by predominant female, self-perceived hearing loss, a higher intensity of tinnitus, cervical pain, and pain of the lower back and/or of the lower limbs, and more hearing deficit from 250 Hz to 4 kHz. CONCLUSIONS In patients with tinnitus one should be aware that hearing loss can be a consequence of high intensity cervical pain. Stimulation of the proprioceptive input pathways due to cervical pain can result in a higher intensity of tinni...

Research paper thumbnail of Pulsed Radiofrequency of the Vagal Nerve for Tinnitus –A Case-Study

The International Tinnitus Journal, 2021

Tinnitus Background: Vagal nerve stimulation is a promising therapy for tinnitus. Pulsed radiofre... more Tinnitus Background: Vagal nerve stimulation is a promising therapy for tinnitus. Pulsed radiofrequency is a minimally invasive neuromodulator technique that could be applied repeatedly without damage to neural tissue. In this case-study we document the use of pulsed radiofrequency of the vagal nerve as a successful therapy without harm for patients with tinnitus. Methods: A 22-gauge, 60 mm-long needle with a 5 mm active tip was placed percutaneously at the inner side of the tragus. The auricular branch of the vagal nerve was subjected to pulsed radiofrequency at 42 V, 2 Hz, and 10 milliseconds for 10 minutes. Results: Pulsed radiofrequency of the vagal nerve can reduce tinnitus and improve hearing in a patient with severe tinnitus and hearing loss. The intensity of the tinnitus was reduced to 5% of the original intensity at the left side and to 20% at the right side. An improved hearing of 20 to 30 dB from 250 Hz to 8 kHz in the left ear and from 250 Hz to 2 kHz in the right ear was objectivated in the audiogram. Conclusions: This case-study document that PRF of the vagal nerve can reduce tinnitus and improve hearing in a patient with severe tinnitus and hearing loss. However, further research of PRF of the vagal nerve in tinnitus patients is needed.

Research paper thumbnail of A different approach to treatment-resistant tinnitus: pulsed radiofrequency to the ganglion C2

International Tinnitus Journal, 2012

Tinnitus represents one of the most common and distressing otologic problems, and it causes vario... more Tinnitus represents one of the most common and distressing otologic problems, and it causes various somatic and psychological disorders that interfere with the quality of life. Treatments for tinnitus include pharmacotherapy, cognitive and behavioral therapy, sound therapy, music therapy, tinnitus retraining therapy, massage and stretching, and electrical suppression. In this case report we present a potential treatment, namely pulsed radiofrequency to the ganglion C2.

Research paper thumbnail of The eight cervical nerve and its role in tinnitus

The international tinnitus journal, 2020

INTRODUCTION The eight cervical nerve might be a source of input to the auditory system. OBJECTIV... more INTRODUCTION The eight cervical nerve might be a source of input to the auditory system. OBJECTIVES The object was to assess the efficacy of infiltration of the eight cervical nerve root for treating tinnitus patients and to find indicators for a successful result. DESIGN Retrospective cohort study. Subjects were 79 tinnitus patients visiting our clinic in a three-year period and who were treated with infiltration of the eight cervical nerve root. RESULTS Twenty-six percent of the tinnitus patients had a reduction of their tinnitus following an infiltration of the eight cervical nerve root. Most of the successfully treated patients rated the effect of therapy as a moderate reduction of 25% to 50%. Fifty percent of the successful treated patients still had benefit at 6.6 months. In 5% of the patients, their tinnitus was aggravated after the infiltration of the eight cervical nerve roots. Patients with a hearing loss at 500 Hz that exceed the hearing loss at 2 kHZ responded the most t...

Research paper thumbnail of Somatosensory-Auditory Processing of the Fifth Cervical Nerve in Tinnitus

The international tinnitus journal, 2021

INTRODUCTION Cervical spinal nerve projections influence auditory responses and play a role in th... more INTRODUCTION Cervical spinal nerve projections influence auditory responses and play a role in the pathology of tinnitus. OBJECTIVES The intention of our research was to lay down the amenity of treatment of the fifth (C5) cervical nerve to lessen tinnitus and to obtain specifications associated with a long-term effect of this method. DESIGN Subjects were 54 tinnitus patients who were treated with infiltration of the fifth cervical nerve. Clinical data form these patients were reviewed retrospectively. An independent perceiver evaluated the long-term effect of the therapy by telephone interview. RESULTS Treating the C5 is beneficial for 30% of the tinnitus patients. The majority of patients with a beneficial result rated the tinnitus reduction of 50% or more. At 9 months, half of the patients still had benefit. Less hearing at 1 kHz together with a large spur in front of the fifth cervical vertebrae forecasted a beneficial effect of the C5 therapy on tinnitus at 7 weeks. CONCLUSIONS ...

Research paper thumbnail of Upper Cervical Nerves Can Induce Tinnitus

The international tinnitus journal, 2020

INTRODUCTION Treating cervical spine disorders can result in a reduction of tinnitus. OBJECTIVES ... more INTRODUCTION Treating cervical spine disorders can result in a reduction of tinnitus. OBJECTIVES The object of the study was to ascertain the benefit of therapy of the third and fourth cervical nerves in reducing tinnitus and to assess parameters indicating a long-term relief. DESIGN Subjects were 37 tinnitus patients who were treated with infiltration of the third and fourth cervical nerves. Clinical data form these patients were reviewed retrospectively. An independent perceiver evaluated the long-term effect of the therapy by telephone interview. RESULTS In a group of tinnitus patients, 19% of the patients reported less tinnitus after therapy of the third and fourth cervical nerves. Most of the patients had a moderate reduction of 25% to 50%. At 3.8 months, 50% of the successful treated patients still had a positive effect. No adverse events of the procedure were observed. The combination of an evident anterior spur at the third cervical vertebrae together with less hearing at 2 ...

Research paper thumbnail of Is Pain Harder To Withstand Than Tinnitus?

The international tinnitus journal, 2021

OBJECTIVES The object of the study was to compare the perception of tinnitus with the perception ... more OBJECTIVES The object of the study was to compare the perception of tinnitus with the perception of pain and to find specific factors that could influence the perception of both pain and tinnitus. DESIGN A retrospective analysis of 124 patients with tinnitus as main complaint and 300 patients with cervical pain as main complaint who visited our clinic in a two-year period. RESULTS This study indicates that it is harder to withstand cervical pain than tinnitus with a higher prevalence of fatigue and impaired work performance in cervical pain patients. Our analyses highlight the importance of fatigue as a potential mediator of the deleterious effects of pain and tinnitus on individual functioning. Female gender and the presence of cervical pain makes patients more accessible for fatigue. Tolerance against tinnitus depends on the perceived maximal intensity of tinnitus, but also of the presence of cervical pain. Cervical pain may reinforce the irritating awareness of tinnitus. CONCLUSI...

Research paper thumbnail of Cervical Nerve Projections to the Auditory Pathway in Tinnitus

INTRODUCTION Cervical spinal nerves project to the auditory system and take part in the pathology... more INTRODUCTION Cervical spinal nerves project to the auditory system and take part in the pathology of tinnitus. OBJECTIVES The intention of our research was to estimate the outcome of treatment of C6 and C7 to lessen tinnitus intensity and to find criteria for a long-term success. DESIGN Subjects were 78 tinnitus patients who were treated with infiltration of the sixth and seventh cervical nerve. Clinical data form these patients were reviewed retrospectively. An independent perceiver evaluated the long-term effect of the therapy by telephone interview. RESULTS In a cohort of tinnitus patients, 18% had less tinnitus after treatment of C6 and C7. The majority of the patients announced a moderate easing of their tinnitus. At 2,5 months, half of the patients with a positive response still had benefit. The combination of hearing loss at 8 kHz and the highness of the intervertebral disc at C4-C5 forecasted a beneficial result of therapy of C6 and C7 with a longer period of relief. CONCLUS...

Research paper thumbnail of Proprioception: the missing link in the pathogenesis of tinnitus?

OBJECTIVES The object of this study was to relate cervical spine pathology to the occurrence of t... more OBJECTIVES The object of this study was to relate cervical spine pathology to the occurrence of tinnitus and of cervical pain. DESIGN A retrospective analysis of 124 patients with tinnitus as main complaint and 300 patients with cervical pain as main complaint who visited our clinic in a two-year period. RESULTS In patients with tinnitus as main complaint, 64% of the patients have also cervical pain, and in patients with cervical pain as main complaint, 44% of the patients have tinnitus. Both groups of patients have in common a high prevalence of postural instability and dizziness, degeneration of the intervertebral disc between the fifth and seventh cervical vertebrae, and a large anterior spur in front of the fifth cervical vertebrae. Patients with cervical pain as main complaint have more degeneration of the intervertebral disc between the third and fourth cervical vertebrae, a larger anterior spur in front of the third cervical vertebrae and more loss of cervical lordosis. CONCL...

Research paper thumbnail of A different approach to treatment-resistant tinnitus: pulsed radiofrequency to the ganglion C2

Tinnitus represents one of the most common and distressing otologic problems, and it causes vario... more Tinnitus represents one of the most common and distressing otologic problems, and it causes various somatic and psychological disorders that interfere with the quality of life. Treatments for tinnitus include pharmacotherapy, cognitive and behavioral therapy, sound therapy, music therapy, tinnitus retraining therapy, massage and stretching, and electrical suppression. In this case report we present a potential treatment, namely pulsed radiofrequency to the ganglion C2.

Research paper thumbnail of Amplifiers in Tinnitus Patients

INTRODUCTION High tinnitus loudness can be provoked by peripheral disorders of the somatosensory ... more INTRODUCTION High tinnitus loudness can be provoked by peripheral disorders of the somatosensory and/or auditory system. OBJECTIVES The object of our study was to compare high tinnitus loudness patients with low tinnitus loudness patients and to find specific factors associated with high tinnitus loudness. DESIGN A retrospective cohort analysis of 234 patients with tinnitus as main complaint who visited our clinic in a four-year period. METHODS Data obtained from the subjects were age, sex, the loudness of tinnitus estimated by the VAS, and the outcomes of the audiogram and the cervical spine radiograph. RESULTS High tinnitus loudness was associated with a higher prevalence of females, more dizziness, less self-perceived hearing loss, more cervical disc degeneration at C3 to C6, and a larger anterior spur of cervical vertebrae C3 to C6. Females had a lower prevalence of tinnitus but a higher chance on high tinnitus loudness. Gender, the size of the largest anterior spur from C3 to C...

Research paper thumbnail of Pulsed radiofrequency of C2 dorsal root ganglion in patients with tinnitus

The International Tinnitus Journal

Introduction: The second cervical nerve ganglion bar appears to be beneficial in patients with tr... more Introduction: The second cervical nerve ganglion bar appears to be beneficial in patients with treatment safe tinnitus. As far as anyone is concerned, the viability of this methodology in patients with tinnitus has never been evaluated. Objectives: The point of this investigation was to decide the adequacy of beat radiofrequency of C2 dorsal root ganglion for treating patients with tinnitus, and all the more explicitly, to survey the parameters related with a long haul advantage so as to improve understanding determination. Design: Subjects were 61 back to back patients who went to our facility from October 2016 to October 2018 for discussions on their tinnitus that endured for one month or more and were treated with beat radiofrequency of C2 dorsal root ganglion. Clinical information structure these patients were explored reflectively. An autonomous spectator assesses the long haul impact of the treatment by phone meet. Results: In a partner of patients with tinnitus that persevered for one month or more, 25% of the patients reacted with a decrease of their tinnitus after a beat radiofrequency of C2 dorsal root ganglion. The vast majority of the patients with a positive reaction appraised the impact of treatment as a decrease of half or more. At 13.5 months, half of at first effective treated patients still encountered an advantage. Unfavorable occasions of the beat radiofrequency of C2 dorsal root ganglion at 7 weeks of follow-up were an expansion of the force of the tinnitus in 7% of the patients. In patients with an age under 43 years at the time tinnitus began, 45% of them had a decrease of their tinnitus at 7 weeks following treatment with beat radiofrequency of C2 dorsal root ganglion. Conclusion: Pulsed radiofrequency of C2 dorsal root ganglion can lessen the power of tinnitus extensively and for the long haul in 25% of the patients with tinnitus without genuine antagonistic impacts. We prescribe this treatment in patients with an age under 43 years at the time tinnitus began

Research paper thumbnail of Psychosocial consequences of the loudness of tinnitus

The International Tinnitus Journal

Introduction: Tinnitus distress is associated with the perceived loudness of the tinnitus. Object... more Introduction: Tinnitus distress is associated with the perceived loudness of the tinnitus. Objectives: To evaluate the psychosocial problems in tinnitus patients and to explore any relation with the tinnitus loudness. Design: From all patients who were treated in our clinic from January 2017 to September 2019 for their tinnitus, patients chart and a questionnaire with the psychosocial variables were studied retrospectively. Results: Almost half of the tinnitus patients could not withstand their tinnitus and they were faced with disturbed concentration and feeling depressed. Psychosocial problems were related to the maximal loudness of the tinnitus. If the perceived maximal loudness of the tinnitus was above 73 millimetre on the visual analogue scale the prevalence of psychosocial problems raised. If it was above 83 millimetre the majority of these patients had psychosocial problems. Conclusion: Psychosocial problems were related to the maximal loudness of the tinnitus. We recommend patients suffering from severe tinnitus distress that therapy should be aimed at a reduction of the maximal loudness of tinnitus to less than 73 mm on the visual analogue scale.

Research paper thumbnail of Anterior Cervical Osteophytes and Sympathetic Hyperactivity in Patients with Tinnitus: Size Matters

The International Tinnitus Journal

Context: Pathological changes secondary to degeneration of the cervical intervertebral disc may c... more Context: Pathological changes secondary to degeneration of the cervical intervertebral disc may cause irritation of sympathetic nerve fibers, leading to sympathetic symptoms and tinnitus. Objectives: The aim of this study was to relate the effect of percutaneous radiofrequency treatment of superior cervical sympathetic ganglion in patients with tinnitus to cervical pathology. Method: A retrospective study of 74 consecutive patients who underwent treatment of the superior cervical sympathetic ganglion for tinnitus that persisted for 1 month or longer from October 2016 to January 2018. The work-up of a patient with tinnitus consisted of a standardized clinical history, a bilateral audiogram and a cervical spine radiograph. Results: All patients had a test blockade of superior cervical sympathetic ganglion first, and 54% of these patients (n=40) responded with a reduction of their tinnitus. These patients underwent a radiofrequency lesion and 53% (n=21) responded with a reduction of their tinnitus at 7 weeks following treatment. The size of anterior osteophyte at the fifth cervical vertebrae was related to a positive response at 7 weeks following this treatment. Patients with tinnitus and an anterior osteophyte at vertebrae C5 more than 17% of the width of those vertebrae had a success rate of 52% following treatment of the superior cervical sympathetic ganglion, compared to 13%, when the anterior osteophyte at C5 was 17% or less. Conclusions: The size of anterior cervical osteophytes is associated with a higher success rate of radiofrequency lesions of the superior sympathetic ganglion for tinnitus. The current results imply a role for cervical sympathetic nervous system irritation in the development of tinnitus in a subgroup of patients.

Research paper thumbnail of Meningitis After Invasive Treatment of the Trigeminal Ganglion Two Case Reports and a Review of the Literature

The Clinical Journal of Pain, Jun 23, 2011

The objective of this case is to report the rare complication of a meningitis after an invasive t... more The objective of this case is to report the rare complication of a meningitis after an invasive treatment of the trigeminal ganglion. In this case report, two cases of meningitis due to oral streptococci are reported and a review of literature is presented. This complication should be recognized as early as possible to prevent deterioration of the situation. Meningitis must be suspected when a patient reports headache and fever within days after an invasive treatment of the trigeminal ganglion.

Research paper thumbnail of A different approach to treatment-resistant tinnitus: pulsed radiofrequency to the ganglion C2

The International Tinnitus Journal, 2012

Tinnitus represents one of the most common and distressing otologic problems, and it causes vario... more Tinnitus represents one of the most common and distressing otologic problems, and it causes various somatic and psychological disorders that interfere with the quality of life. Treatments for tinnitus include pharmacotherapy, cognitive and behavioral therapy, sound therapy, music therapy, tinnitus retraining therapy, massage and stretching, and electrical suppression. In this case report we present a potential treatment, namely pulsed radiofrequency to the ganglion C2.

Research paper thumbnail of Review article : Renal function and open-heart surgery

Perfusion

Renal function and open-heart surgery HM Koning Medical Centre, Leeuwarden lntroduction Postopera... more Renal function and open-heart surgery HM Koning Medical Centre, Leeuwarden lntroduction Postoperative acute renal failure is a frequent complication of open-heart surgery, associated with a high mortality rate. While the acute circulatory and respiratory complications of openheart surgery can be successfully managed, the prognosis and mortality of renal complications remain disappointing. In the postoperative period

Research paper thumbnail of Pulsed Radiofrequency of the Auriculotemporal Nerve to Reduce the Intensity of Tinnitus

˜The œinternational tinnitus journal, 2023

Research paper thumbnail of Pulsed Radiofrequency of the Auricular Branch of the Vagal Nerve in Tinnitus Patients

International Tinnitus Journal, Dec 31, 2022

Research paper thumbnail of Tibial Nerve Block as Treatment of Chronic Foot Pain

Anesthesiology and Pain Medicine

Background: Minimally invasive therapies can alleviate pain and improve walking in individuals wi... more Background: Minimally invasive therapies can alleviate pain and improve walking in individuals with persistent foot and ankle pain. Objectives: The current study aimed to define the protracted consequences of tibial nerve blocks with steroids for individuals with persistent foot pain and to investigate the link between the thermography of the plantar foot and the beneficial effect of a tibial nerve block with steroids. Methods: All patients with chronic foot pain (n = 45) in this cohort underwent a block of the tibial nerve in the Department of Pain Therapy of Pain Clinic De Bilt, Utrecht, Netherlands, within November 2019 to April 2020. The thermographic images of patients were taken before and after injection. Results were retrospectively evaluated after 18 months. Results: In this study, 53% of the patients had pain relief at 7 weeks of follow-up with a unilateral or bilateral block of the tibial nerve. An improvement in walking distance was reported by 22% of the patients. Side ...

Research paper thumbnail of Pain in relationship to Tinnitus and Hearing Loss

The international tinnitus journal, 2022

INTRODUCTION Cervical and lower back pain are noteworthy in the manner of development of tinnitus... more INTRODUCTION Cervical and lower back pain are noteworthy in the manner of development of tinnitus. OBJECTIVES The focus of this research was to indicate the consequence of the severity of neck pain and pain of the lower back and/or lower limbs in tinnitus patients. DESIGN A retrospective analysis of 61 patients with tinnitus as main complaint during a three month period. RESULTS In this study, we found two groups of tinnitus patients defined by the existence of postural instability. Patients with tinnitus and postural unsteadiness were characterized by predominant female, self-perceived hearing loss, a higher intensity of tinnitus, cervical pain, and pain of the lower back and/or of the lower limbs, and more hearing deficit from 250 Hz to 4 kHz. CONCLUSIONS In patients with tinnitus one should be aware that hearing loss can be a consequence of high intensity cervical pain. Stimulation of the proprioceptive input pathways due to cervical pain can result in a higher intensity of tinni...

Research paper thumbnail of Pulsed Radiofrequency of the Vagal Nerve for Tinnitus –A Case-Study

The International Tinnitus Journal, 2021

Tinnitus Background: Vagal nerve stimulation is a promising therapy for tinnitus. Pulsed radiofre... more Tinnitus Background: Vagal nerve stimulation is a promising therapy for tinnitus. Pulsed radiofrequency is a minimally invasive neuromodulator technique that could be applied repeatedly without damage to neural tissue. In this case-study we document the use of pulsed radiofrequency of the vagal nerve as a successful therapy without harm for patients with tinnitus. Methods: A 22-gauge, 60 mm-long needle with a 5 mm active tip was placed percutaneously at the inner side of the tragus. The auricular branch of the vagal nerve was subjected to pulsed radiofrequency at 42 V, 2 Hz, and 10 milliseconds for 10 minutes. Results: Pulsed radiofrequency of the vagal nerve can reduce tinnitus and improve hearing in a patient with severe tinnitus and hearing loss. The intensity of the tinnitus was reduced to 5% of the original intensity at the left side and to 20% at the right side. An improved hearing of 20 to 30 dB from 250 Hz to 8 kHz in the left ear and from 250 Hz to 2 kHz in the right ear was objectivated in the audiogram. Conclusions: This case-study document that PRF of the vagal nerve can reduce tinnitus and improve hearing in a patient with severe tinnitus and hearing loss. However, further research of PRF of the vagal nerve in tinnitus patients is needed.

Research paper thumbnail of A different approach to treatment-resistant tinnitus: pulsed radiofrequency to the ganglion C2

International Tinnitus Journal, 2012

Tinnitus represents one of the most common and distressing otologic problems, and it causes vario... more Tinnitus represents one of the most common and distressing otologic problems, and it causes various somatic and psychological disorders that interfere with the quality of life. Treatments for tinnitus include pharmacotherapy, cognitive and behavioral therapy, sound therapy, music therapy, tinnitus retraining therapy, massage and stretching, and electrical suppression. In this case report we present a potential treatment, namely pulsed radiofrequency to the ganglion C2.

Research paper thumbnail of The eight cervical nerve and its role in tinnitus

The international tinnitus journal, 2020

INTRODUCTION The eight cervical nerve might be a source of input to the auditory system. OBJECTIV... more INTRODUCTION The eight cervical nerve might be a source of input to the auditory system. OBJECTIVES The object was to assess the efficacy of infiltration of the eight cervical nerve root for treating tinnitus patients and to find indicators for a successful result. DESIGN Retrospective cohort study. Subjects were 79 tinnitus patients visiting our clinic in a three-year period and who were treated with infiltration of the eight cervical nerve root. RESULTS Twenty-six percent of the tinnitus patients had a reduction of their tinnitus following an infiltration of the eight cervical nerve root. Most of the successfully treated patients rated the effect of therapy as a moderate reduction of 25% to 50%. Fifty percent of the successful treated patients still had benefit at 6.6 months. In 5% of the patients, their tinnitus was aggravated after the infiltration of the eight cervical nerve roots. Patients with a hearing loss at 500 Hz that exceed the hearing loss at 2 kHZ responded the most t...

Research paper thumbnail of Somatosensory-Auditory Processing of the Fifth Cervical Nerve in Tinnitus

The international tinnitus journal, 2021

INTRODUCTION Cervical spinal nerve projections influence auditory responses and play a role in th... more INTRODUCTION Cervical spinal nerve projections influence auditory responses and play a role in the pathology of tinnitus. OBJECTIVES The intention of our research was to lay down the amenity of treatment of the fifth (C5) cervical nerve to lessen tinnitus and to obtain specifications associated with a long-term effect of this method. DESIGN Subjects were 54 tinnitus patients who were treated with infiltration of the fifth cervical nerve. Clinical data form these patients were reviewed retrospectively. An independent perceiver evaluated the long-term effect of the therapy by telephone interview. RESULTS Treating the C5 is beneficial for 30% of the tinnitus patients. The majority of patients with a beneficial result rated the tinnitus reduction of 50% or more. At 9 months, half of the patients still had benefit. Less hearing at 1 kHz together with a large spur in front of the fifth cervical vertebrae forecasted a beneficial effect of the C5 therapy on tinnitus at 7 weeks. CONCLUSIONS ...

Research paper thumbnail of Upper Cervical Nerves Can Induce Tinnitus

The international tinnitus journal, 2020

INTRODUCTION Treating cervical spine disorders can result in a reduction of tinnitus. OBJECTIVES ... more INTRODUCTION Treating cervical spine disorders can result in a reduction of tinnitus. OBJECTIVES The object of the study was to ascertain the benefit of therapy of the third and fourth cervical nerves in reducing tinnitus and to assess parameters indicating a long-term relief. DESIGN Subjects were 37 tinnitus patients who were treated with infiltration of the third and fourth cervical nerves. Clinical data form these patients were reviewed retrospectively. An independent perceiver evaluated the long-term effect of the therapy by telephone interview. RESULTS In a group of tinnitus patients, 19% of the patients reported less tinnitus after therapy of the third and fourth cervical nerves. Most of the patients had a moderate reduction of 25% to 50%. At 3.8 months, 50% of the successful treated patients still had a positive effect. No adverse events of the procedure were observed. The combination of an evident anterior spur at the third cervical vertebrae together with less hearing at 2 ...

Research paper thumbnail of Is Pain Harder To Withstand Than Tinnitus?

The international tinnitus journal, 2021

OBJECTIVES The object of the study was to compare the perception of tinnitus with the perception ... more OBJECTIVES The object of the study was to compare the perception of tinnitus with the perception of pain and to find specific factors that could influence the perception of both pain and tinnitus. DESIGN A retrospective analysis of 124 patients with tinnitus as main complaint and 300 patients with cervical pain as main complaint who visited our clinic in a two-year period. RESULTS This study indicates that it is harder to withstand cervical pain than tinnitus with a higher prevalence of fatigue and impaired work performance in cervical pain patients. Our analyses highlight the importance of fatigue as a potential mediator of the deleterious effects of pain and tinnitus on individual functioning. Female gender and the presence of cervical pain makes patients more accessible for fatigue. Tolerance against tinnitus depends on the perceived maximal intensity of tinnitus, but also of the presence of cervical pain. Cervical pain may reinforce the irritating awareness of tinnitus. CONCLUSI...

Research paper thumbnail of Cervical Nerve Projections to the Auditory Pathway in Tinnitus

INTRODUCTION Cervical spinal nerves project to the auditory system and take part in the pathology... more INTRODUCTION Cervical spinal nerves project to the auditory system and take part in the pathology of tinnitus. OBJECTIVES The intention of our research was to estimate the outcome of treatment of C6 and C7 to lessen tinnitus intensity and to find criteria for a long-term success. DESIGN Subjects were 78 tinnitus patients who were treated with infiltration of the sixth and seventh cervical nerve. Clinical data form these patients were reviewed retrospectively. An independent perceiver evaluated the long-term effect of the therapy by telephone interview. RESULTS In a cohort of tinnitus patients, 18% had less tinnitus after treatment of C6 and C7. The majority of the patients announced a moderate easing of their tinnitus. At 2,5 months, half of the patients with a positive response still had benefit. The combination of hearing loss at 8 kHz and the highness of the intervertebral disc at C4-C5 forecasted a beneficial result of therapy of C6 and C7 with a longer period of relief. CONCLUS...

Research paper thumbnail of Proprioception: the missing link in the pathogenesis of tinnitus?

OBJECTIVES The object of this study was to relate cervical spine pathology to the occurrence of t... more OBJECTIVES The object of this study was to relate cervical spine pathology to the occurrence of tinnitus and of cervical pain. DESIGN A retrospective analysis of 124 patients with tinnitus as main complaint and 300 patients with cervical pain as main complaint who visited our clinic in a two-year period. RESULTS In patients with tinnitus as main complaint, 64% of the patients have also cervical pain, and in patients with cervical pain as main complaint, 44% of the patients have tinnitus. Both groups of patients have in common a high prevalence of postural instability and dizziness, degeneration of the intervertebral disc between the fifth and seventh cervical vertebrae, and a large anterior spur in front of the fifth cervical vertebrae. Patients with cervical pain as main complaint have more degeneration of the intervertebral disc between the third and fourth cervical vertebrae, a larger anterior spur in front of the third cervical vertebrae and more loss of cervical lordosis. CONCL...

Research paper thumbnail of A different approach to treatment-resistant tinnitus: pulsed radiofrequency to the ganglion C2

Tinnitus represents one of the most common and distressing otologic problems, and it causes vario... more Tinnitus represents one of the most common and distressing otologic problems, and it causes various somatic and psychological disorders that interfere with the quality of life. Treatments for tinnitus include pharmacotherapy, cognitive and behavioral therapy, sound therapy, music therapy, tinnitus retraining therapy, massage and stretching, and electrical suppression. In this case report we present a potential treatment, namely pulsed radiofrequency to the ganglion C2.

Research paper thumbnail of Amplifiers in Tinnitus Patients

INTRODUCTION High tinnitus loudness can be provoked by peripheral disorders of the somatosensory ... more INTRODUCTION High tinnitus loudness can be provoked by peripheral disorders of the somatosensory and/or auditory system. OBJECTIVES The object of our study was to compare high tinnitus loudness patients with low tinnitus loudness patients and to find specific factors associated with high tinnitus loudness. DESIGN A retrospective cohort analysis of 234 patients with tinnitus as main complaint who visited our clinic in a four-year period. METHODS Data obtained from the subjects were age, sex, the loudness of tinnitus estimated by the VAS, and the outcomes of the audiogram and the cervical spine radiograph. RESULTS High tinnitus loudness was associated with a higher prevalence of females, more dizziness, less self-perceived hearing loss, more cervical disc degeneration at C3 to C6, and a larger anterior spur of cervical vertebrae C3 to C6. Females had a lower prevalence of tinnitus but a higher chance on high tinnitus loudness. Gender, the size of the largest anterior spur from C3 to C...

Research paper thumbnail of Pulsed radiofrequency of C2 dorsal root ganglion in patients with tinnitus

The International Tinnitus Journal

Introduction: The second cervical nerve ganglion bar appears to be beneficial in patients with tr... more Introduction: The second cervical nerve ganglion bar appears to be beneficial in patients with treatment safe tinnitus. As far as anyone is concerned, the viability of this methodology in patients with tinnitus has never been evaluated. Objectives: The point of this investigation was to decide the adequacy of beat radiofrequency of C2 dorsal root ganglion for treating patients with tinnitus, and all the more explicitly, to survey the parameters related with a long haul advantage so as to improve understanding determination. Design: Subjects were 61 back to back patients who went to our facility from October 2016 to October 2018 for discussions on their tinnitus that endured for one month or more and were treated with beat radiofrequency of C2 dorsal root ganglion. Clinical information structure these patients were explored reflectively. An autonomous spectator assesses the long haul impact of the treatment by phone meet. Results: In a partner of patients with tinnitus that persevered for one month or more, 25% of the patients reacted with a decrease of their tinnitus after a beat radiofrequency of C2 dorsal root ganglion. The vast majority of the patients with a positive reaction appraised the impact of treatment as a decrease of half or more. At 13.5 months, half of at first effective treated patients still encountered an advantage. Unfavorable occasions of the beat radiofrequency of C2 dorsal root ganglion at 7 weeks of follow-up were an expansion of the force of the tinnitus in 7% of the patients. In patients with an age under 43 years at the time tinnitus began, 45% of them had a decrease of their tinnitus at 7 weeks following treatment with beat radiofrequency of C2 dorsal root ganglion. Conclusion: Pulsed radiofrequency of C2 dorsal root ganglion can lessen the power of tinnitus extensively and for the long haul in 25% of the patients with tinnitus without genuine antagonistic impacts. We prescribe this treatment in patients with an age under 43 years at the time tinnitus began

Research paper thumbnail of Psychosocial consequences of the loudness of tinnitus

The International Tinnitus Journal

Introduction: Tinnitus distress is associated with the perceived loudness of the tinnitus. Object... more Introduction: Tinnitus distress is associated with the perceived loudness of the tinnitus. Objectives: To evaluate the psychosocial problems in tinnitus patients and to explore any relation with the tinnitus loudness. Design: From all patients who were treated in our clinic from January 2017 to September 2019 for their tinnitus, patients chart and a questionnaire with the psychosocial variables were studied retrospectively. Results: Almost half of the tinnitus patients could not withstand their tinnitus and they were faced with disturbed concentration and feeling depressed. Psychosocial problems were related to the maximal loudness of the tinnitus. If the perceived maximal loudness of the tinnitus was above 73 millimetre on the visual analogue scale the prevalence of psychosocial problems raised. If it was above 83 millimetre the majority of these patients had psychosocial problems. Conclusion: Psychosocial problems were related to the maximal loudness of the tinnitus. We recommend patients suffering from severe tinnitus distress that therapy should be aimed at a reduction of the maximal loudness of tinnitus to less than 73 mm on the visual analogue scale.

Research paper thumbnail of Anterior Cervical Osteophytes and Sympathetic Hyperactivity in Patients with Tinnitus: Size Matters

The International Tinnitus Journal

Context: Pathological changes secondary to degeneration of the cervical intervertebral disc may c... more Context: Pathological changes secondary to degeneration of the cervical intervertebral disc may cause irritation of sympathetic nerve fibers, leading to sympathetic symptoms and tinnitus. Objectives: The aim of this study was to relate the effect of percutaneous radiofrequency treatment of superior cervical sympathetic ganglion in patients with tinnitus to cervical pathology. Method: A retrospective study of 74 consecutive patients who underwent treatment of the superior cervical sympathetic ganglion for tinnitus that persisted for 1 month or longer from October 2016 to January 2018. The work-up of a patient with tinnitus consisted of a standardized clinical history, a bilateral audiogram and a cervical spine radiograph. Results: All patients had a test blockade of superior cervical sympathetic ganglion first, and 54% of these patients (n=40) responded with a reduction of their tinnitus. These patients underwent a radiofrequency lesion and 53% (n=21) responded with a reduction of their tinnitus at 7 weeks following treatment. The size of anterior osteophyte at the fifth cervical vertebrae was related to a positive response at 7 weeks following this treatment. Patients with tinnitus and an anterior osteophyte at vertebrae C5 more than 17% of the width of those vertebrae had a success rate of 52% following treatment of the superior cervical sympathetic ganglion, compared to 13%, when the anterior osteophyte at C5 was 17% or less. Conclusions: The size of anterior cervical osteophytes is associated with a higher success rate of radiofrequency lesions of the superior sympathetic ganglion for tinnitus. The current results imply a role for cervical sympathetic nervous system irritation in the development of tinnitus in a subgroup of patients.

Research paper thumbnail of Meningitis After Invasive Treatment of the Trigeminal Ganglion Two Case Reports and a Review of the Literature

The Clinical Journal of Pain, Jun 23, 2011

The objective of this case is to report the rare complication of a meningitis after an invasive t... more The objective of this case is to report the rare complication of a meningitis after an invasive treatment of the trigeminal ganglion. In this case report, two cases of meningitis due to oral streptococci are reported and a review of literature is presented. This complication should be recognized as early as possible to prevent deterioration of the situation. Meningitis must be suspected when a patient reports headache and fever within days after an invasive treatment of the trigeminal ganglion.

Research paper thumbnail of A different approach to treatment-resistant tinnitus: pulsed radiofrequency to the ganglion C2

The International Tinnitus Journal, 2012

Tinnitus represents one of the most common and distressing otologic problems, and it causes vario... more Tinnitus represents one of the most common and distressing otologic problems, and it causes various somatic and psychological disorders that interfere with the quality of life. Treatments for tinnitus include pharmacotherapy, cognitive and behavioral therapy, sound therapy, music therapy, tinnitus retraining therapy, massage and stretching, and electrical suppression. In this case report we present a potential treatment, namely pulsed radiofrequency to the ganglion C2.

Research paper thumbnail of Review article : Renal function and open-heart surgery

Perfusion

Renal function and open-heart surgery HM Koning Medical Centre, Leeuwarden lntroduction Postopera... more Renal function and open-heart surgery HM Koning Medical Centre, Leeuwarden lntroduction Postoperative acute renal failure is a frequent complication of open-heart surgery, associated with a high mortality rate. While the acute circulatory and respiratory complications of openheart surgery can be successfully managed, the prognosis and mortality of renal complications remain disappointing. In the postoperative period