Tishreen University Journal. Med. Sciences Series ٢٠٠٨ (٣ ... · Tishreen University Journal....

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٣ Tishreen University Journal for Research and Scientific Studies - Medical Sciences Series Vol. (30) No. (٣) 2008 2008 40 1 100 3 600 1200 150 Generated by Foxit PDF Creator © Foxit Software http://www.foxitsoftware.com For evaluation only.

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Page 1: Tishreen University Journal. Med. Sciences Series ٢٠٠٨ (٣ ... · Tishreen University Journal. Med. Sciences Series ٢٠٠٨ (٣) دﺪﻌﻟا (٣٠) ﺪﻠﺠﻤﻟا ﺔﯿﺤﺼﻟا

Tishreen University Journal. Med. Sciences Series ٢٠٠٨) ٣(العدد ) ٣٠(العلوم الصحیة المجلد مجلة جامعة تشرین

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Tishreen University Journal for Research and Scientific Studies - Medical Sciences Series Vol. (30) No. (٣) 2008

2008

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بكري ،إبراھیم ،الرستم

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Tishreen University Journal for Research and Scientific Studies - Medical Sciences Series Vol. (30) No. (٣) 2008

Medical Management of Tinnitus

Dr. Muhammad Al-Rustum* Dr. Mustafa Ibraheem** Ebtihal Haj Bakri***

(Received 21 / 5/ 2008. Accepted 16/7/2008)

ABSTRACT

Tinnitus is considered to be one of the most important diseases in E.N.T. It represents a complicated diagnostic and therapeutic problem. We must examine the patient carefully to reach the reason. This study is designed to find an effective treatment of tinnitus through comparison between Intratympanic instillation of Methylprednisolone (40mg/1cc) and medical treatment with Carbamazepine in increased doses from 100mg three times a day to 600 or 1200 mg a day divided into three doses. The study involved (150) patients from Alassad Hospital ,E.N.T. clinic. After the observation we find that Carbamazepine is

a good treatment and the combination between them has better results.2

Keywords:tinnitus,objectivetinnitus,subjectivetinnitus,carbamazepine, methylprednisolone.

* professor, Department of Otolaryngology, Faculty of Medicine, Tishreen University, Lattakia, Syria. ** professor, Department of Otolaryngology, Faculty of Medicine, Tishreen University, Lattakia, Syria. *** Postgraduate Student, Department of Otolaryngology, Faculty of Medicine, Tishreen University,

Lattakia, Syria.

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Tishreen University Journal. Med. Sciences Series ٢٠٠٨) ٣(العدد ) ٣٠(العلوم الصحیة المجلد مجلة جامعة تشرین

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tinnitus

2006

methylprednisolone

SHULMAN, A.,2006

carbamazepine,2001MEYERHOFF ,W.L

2007 2008 1508763

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Tishreen University Journal. Med. Sciences Series ٢٠٠٨) ٣(العدد ) ٣٠(العلوم الصحیة المجلد مجلة جامعة تشرین

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Tishreen University Journal. Med. Sciences Series ٢٠٠٨) ٣(العدد ) ٣٠(العلوم الصحیة المجلد مجلة جامعة تشرین

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1- COLES,R.R.A - Scott-Browns Tinnitus ,causes, evaluation. volume 2, chapter 18, 9th edition, Butterworth – Heinemann, London, 2004, p1 .

2- GLASSCOCK, M.; SHAMBAUGH,G. - Surgery Of the Ear. fi�h edi�on,2002,p116. 3- LEE,K.J.-Essential Otolaryngology, Head & Neck Surgery, 12th edition, McGraw- Hill,

United States, 2008,pp 60-61. 4- MEYERHOFF ,W.L.; COOPER, J. C.- Diseases of the ear Tinnitus. first edition ,

2001,Chapter 17, p1169. 5- SHULMAN, A. - TINITUS. Diagnosis\Treatment., first edition , LEA & FEBIGER,

pheladelphia, 2006, p 453. 6- VERNON,J. English Otorhinolaryngology volum1,chapter53, Lippincott-Raven,

pheladelphia-Newyork, 1997,p1 . 7- 7-1999.<www.Journals.cambridge.org>

8- 8-2005.www.linkinghub.elsevier.com> 9- 9-2007.<www.ncbi.nlm.nih.gov> 10- 10-2006.<www.otology-neurotology.com> 11-2003.<www.aging.adisonline.com>

12

1999256

-13 1998193

-14

2003

-15

2006328

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