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a correlation between tinnitus and symptoms of anxiety and depression which often affect daily life. Pati- ents report that an increasing level of anxiety also exacerbates tinnitus symptoms. This can be explained neurophysiologically by the effect of the limbic system, cortex and peripheral neuropathways in tinnitus. The aim of this study is to investigate any correlation between tinnitus and anxiety and depressive symp- toms. Materials and methods: The assessment is composed of: Visual Analogical Scales (VAS) for the evalu- ation of tinnitus induced problems; Tinnitus Handicap Inventory (THI); State and Trait Anxiety Inventory-Y (STAI S-T); Beck Depression Inventory (BDI). These instruments were chosen based on their psychome- tric properties, time of administration and validity in many languages; the sample consists of 67 patients. Results: Correlation between anxiety symptoms and THI score is significant (p<0,01); the same signifi- cance was found between depressive symptoms and THI as well as between STAI and BDI. Significant correlation was also found between these questionnaires and the intensity of tinnitus, annoyance and effect on life evaluated by the VAS scale. 23% of the sample had severe tinnitus. Mean anxiety was around the 65th percentile; 35% having an anxiety disorder. 12% of the total sample shows a depressive pathology. 11% of the sample have both anxiety and depression. An inverse correlation between STAI and BDI scores and the duration of tinnitus was observed. Conclusions: Although about 1/3 of patients are suspected of suffering from anxiety, a pathological level of anxiety and depression was found in only about 10% of the sample. The THI questionnaire is a good predictor for patients with higher levels of depression and anxiety.

Cholesterol granuloma surrounding the endolymphatic sac. Auris Nasus Larynx. 2007 Mar;34(1):95-100. Kanzaki S, Araki Y, Okamoto Y, Kurita A, Ogawa K Department of Otorhinolaryngology, School of Medicine, Keio University, Shinjuku, Tokyo 160-8582, Japan. skan@sc.itc.keio.ac.jp

We report a unique case of cholesterol granuloma (CG) surrounding the endolymphatic sac (ES). A 49- year-old man presented with the left side of sensorineural hearing loss, tinnitus, and vertigo. Magnetic resonance and computed tomography imaging revealed a CG surrounding the left ES. The patient initi- ally underwent left transmastoid surgical resection of the tumor. At the time of surgery, brown fluid was aspirated from the tumor, but no other tumors were found. Histopathological examination revealed that the tumor contained cholesterol crystals, confirming the diagnosis of CG. At his 12-month postoperative follow-up, there was no evidence of recurrence. We discuss the radiology, pathology, and surgical remo- val of CGs surrounding ES.

Clinical characterization and genetic analysis of a large Brazilian family with Familial

Migrainous Vertigo. (Abstract of ARO Meeting Denver, Colorado) Fayez Bahmad Jr, M.D.1,2,4,5,6,7 Saumil N. Merchant, MD1,5,6

, Roberta L. Bezerra, M.D., PhD2,4, Jona-

than G. Seidman, Ph.D3,7, Carlos A Oliveira, M.D., Ph.D.2,4 1Massachusetts Eye & Ear Infirmary, 2Brasilia University Hospital, 3Harvard Medical School, 4Department of Otolaryngology, Brasília University Medical School, Brasília, D.F., Brazil, 5Department of Otolaryngo- logy, Massachussetts Eye & Ear Infirmary, Boston, MA, USA, 6Department of Otology, Massachussetts Eye & Ear Infirmary, Harvard Medical School, Boston, MA, USA, 7Seidman Laboratory, Department of Genetics, Harvard Medical School, Boston, MA, USA.

Introduction: Since 1995, we have been studying a large Brazilian family whose members are affected with migrainous vertigo syndrome. Objectives: The aim of this study is to describe clinical features and the natural history of this symptom

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