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• W2394538765 abstract "In Reply: We appreciate the interest of the authors in our study. Cervicogenic somatic tinnitus (CST) is indeed a frequently encountered challenge. As the authors mentioned, the scientific background for CST is indeed based on animal studies. We add moreover to the concept of CST that several studies (1–3) have found positive effects of cervical spine treatment on tinnitus complaints. It was up to then unclear which cervical dysfunctions were present in these patients. Therefore, we aimed to investigate cervical spine dysfunction in patients with tinnitus (including CST and non-CST). Both were included because neck pain is indeed very common and can easily exist as a separate entity from tinnitus complaints. This is reflected in the equal percentages of reported neck pain in the CST and non-CST groups. The results of our clinical tests, carried out by a blinded rater, were however significantly different between both groups. This can be indicative of an underlying cervical dysfunction. As stated in our article (4), the diagnosis of CST was made after a thorough ENT examination (including micro-otoscopy, audiologic assessment, and brain magnetic resonance imaging) to exclude other causes of tinnitus. In case no other cause was found, the CST diagnosis was made based on all diagnostic criteria for CST (5). The association between onset or exacerbation of tinnitus and neck complaints was an important but not exclusive criterion for the diagnosis. Indeed, diagnostic criteria should be based on more than medical history. Therefore, our article (4) also suggests further research to provide more detailed and more objective diagnostic criteria. Within this framework, we can mention a recently accepted paper (6), where we elaborate on the potential diagnostic support of clinical cervical spine tests in CST. The Neck Bournemouth Questionnaire consists of seven questions, of which two address perceived stress and depression. These can consequently influence the Neck Bournemouth Questionnaire scores. To take this into account, we used a 14-point cutoff. This rationale was applied previously in a sample of neck pain patients, where it has shown high sensitivity (83.3%) and specificity (90.9%) in identifying patients with neck disorders (7). Possible explanations for the unexpected equal numbers of CST and non-CST patients to report modulation of the tinnitus were provided in the Discussion of our article (4). Finally, as clearly stated in our article (4), we agree that caution is needed when using cervical spine problems as a first indicator for CST diagnosis because cervical spine dysfunction can also be present in non-CST patients. Sarah Michiels, M.Sc. Department of Rehabilitation Sciences and Physiotherapy Faculty of Medicine and Health Sciences University of Antwerp Antwerp, Belgium [email protected] Department of Otorhinolaryngology Antwerp University Hospital Edegem, Belgium Willem De Hertogh, Ph.D. Department of Rehabilitation Sciences and Physiotherapy Faculty of Medicine and Health Sciences University of Antwerp Antwerp, Belgium Paul Van de Heyning, Ph.D., M.D. Department of Otorhinolaryngology Antwerp University Hospital Edegem, Belgium Multidisciplinary Motor Centre Antwerp University of Antwerp Antwerp, Belgium Department of Translational Neurosciences Faculty of Medicine and Health Sciences University of Antwerp Antwerp, Belgium The authors report no conflicts of interest." @default.
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• W2394538765 date "2015-09-01" @default.
• W2394538765 modified "2023-10-16" @default.
• W2394538765 title "Response to Letter to the Editor" @default.
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• W2394538765 doi "https://doi.org/10.1097/mao.0000000000000828" @default.
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