J M Aparicio

Publications (10)3.01 Total impact

• Article: Auditory discrimination training for tinnitus treatment: the effect of different paradigms.

  Carlos Herraiz, I Diges, P Cobo, J M Aparicio, A Toledano
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  ABSTRACT: Acoustic deprivation, i.e. hearing loss, is responsible for a cascade of processes resulting in reorganisation of the cortex. Tinnitus mechanisms are explained by synchronization of the neural spontaneous activity and might be related to cortical re-mapping. Auditory discrimination training (ADT) has demonstrated in both animals and humans to induce tonotopical changes in the auditory pathways through neural plasticity. We hypothesize that ADT could have some effect on tinnitus perception. The objective of this study is to compare the effect on tinnitus following two paradigms of ADT. Only patients from 20 to 60 years of age were recruited. Inclusion criteria were pure tone tinnitus of mild or moderate handicap according to the Tinnitus Handicap Inventory score (<56). ADT patients were randomized in two groups: SAME (ADT in the same frequency of tinnitus pitch, 20 patients) and NONSAME (ADT in the frequency one-octave below tinnitus pitch, 21 patients). Groups of pair of tones (70% standard tones ST, 30% deviant tones ST + 0.1-0.5 kHz) were randomly mixed for 20 min/day during 1 month. Patient had to mark when the two sounds of the pair were similar or different. Control group included 26 patients from the waiting list (WLG). Patients were also divided according to the trained frequency and the deepest hearing-impaired frequency. Outcome parameters were set up according to the answer to the question "is your tinnitus better, same, or worse with the treatment?" (RESP), the tinnitus handicap inventory (THI) and the visual analogue scale from 1 to 10 on tinnitus intensity (VAS). Tinnitus improved in 42.2% of the patients (RESP). VAS and THI scores were reduced but only THI differences were statistically significant (P = 0.003). ADT patients improved significantly compared with WLG in RESP and THI scores (P < 0.01). Training frequencies one-octave below the tinnitus pitch (NONSAME) decreased significantly THI scores compared with patients trained frequencies similar to tinnitus pitch (SAME, P = 0.035). RESP and VAS scores decreased more in NONSAME group though differences were not significant. We did not find any differences when comparing the group training the deepest hearing-impaired frequency and the group who trained other frequencies. Auditory discrimination training significantly improved tinnitus handicap compared to a waiting list group. Those patients who trained frequencies one octave below the tinnitus pitch had better outcome than those who performed the ADT with frequencies similar to the tinnitus pitch (P = 0.035).
  Archives of Oto-Rhino-Laryngology 07/2010; 267(7):1067-74. · 1.29 Impact Factor
• Article: Auditory discrimination therapy (ADT) for tinnitus managment: preliminary results.

  C Herraiz, I Diges, P Cobo, G Plaza, J M Aparicio
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  ABSTRACT: This clinical assay has demonstrated the efficacy of auditory discrimination therapy (ADT) in tinnitus management compared with a waiting-list group. In all, 43% of the ADT patients improved their tinnitus, and its intensity together with its handicap were statistically decreased (EMB rating: B-2). To describe the effect of sound discrimination training on tinnitus. ADT designs a procedure to increase the cortical representation of trained frequencies (damaged cochlear areas with a secondary reduction of cortical stimulation) and to shrink the neighbouring over-represented ones (corresponding to tinnitus pitch). This prospective descriptive study included 14 patients with high frequency matched tinnitus. Tinnitus severity was measured according to a visual analogue scale (VAS) and the Tinnitus Handicap Inventory (THI). Patients performed a 10-min auditory discrimination task twice a day for 1 month. Discontinuous 8 kHz pure tones were randomly mixed with 500 ms 'white noise' sounds through a MP3 system. ADT group results were compared with a waiting-list group (n=21). In all, 43% of our patients had improvement in their tinnitus. A significant improvement in VAS (p=0.004) and THI mean scores was achieved (p=0.038). Statistical differences between ADT and the waiting-list group have been proved, considering patients' self-evaluations (p=0.043) and VAS scores (p=0.004). A non-significant reduction of THI was achieved (p=0.113).
  Acta oto-laryngologica. Supplementum 01/2007;
• Article: [The use of Quality of Life Questionnaire in patients with nasal polyposis].

  A Toledano, C Herráiz, E García, C Navas, J M Aparicio, M García Simal, M Navarro, A Néstor Galindo
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  ABSTRACT: Polyposis handicap evaluation through Spanish validation of the Rhinosinusitis Disability Index. Spanish validation of the Polyposis Disability Index (PDI). One hundred and fifty one patients referred to our Nose Unit in Fundación Hospital Alcorcón. The Spanish version of the PDI was administered after translation and retrotranslation. Internal consistency and reliability were established. Spanish adaptation of the PDI and ists subscales (functional, emotional and physical) showed a high reliability and internal consistency (Cronbach's alfa: 0,90). Spanish adaptation of the PDI is valid, reliable and can be used in a clinical setting to quantify the impact of polyposis on patient's quality of life.
  Acta Otorrinolaringológica Española 12/2006; 57(9):401-4.
• Article: [Mechanisms and management of hyperacusis (decreased sound tolerance)].

  C Herráiz, G Plaza, J M Aparicio
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  ABSTRACT: Hyperacusis is a decreased sound tolerance. Prevalence of the disease is described in 9-15% of the population, but this percentage increases among the tinnitus patients. Pathophysiological mechanisms involve some disruptions in the amplification and regulation processes of the external hair cells or affect the central sound processing at the subcortical level. The role of the serotonin, also involved in other diseases related with hyperacusis (migraine, depression), can be crucial in this disorder. Other theories confirm the effect of the endorphins that activate the excitatory function of the glutamate, the auditory neurotransmitter, increasing its toxicity. The activation of the limbic and autonomic nervous systems produces the emotional reaction of the hyperacusis (anxiety, fear and depression). Proposed treatments are based on acoustic stimulation by a progressive introduction of sound (tinnitus retraining therapy TRT). Noise generators and hearing aids can be fitted in severe cases. The role of some drugs involved in the metabolism of the serotonin open new approaches for the management of hyperacusis.
  Acta Otorrinolaringológica Española 11/2006; 57(8):373-7.
• Article: [Usefulness of the new classification for regional extension on CT of head and neck cancer].

  G Plaza, J M Aparicio, J Ferrando, G de los Santos
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  ABSTRACT: To present the usefulness of the new classification of neck nodes based in commuted tomography (CT). We present several illustrative images showing neck nodes in each of the new levels (Ia, Ib, IIa, IIb, III, IV, Va, Vb, and VI) as an adjunct to nodal classifications. An imaging-based classification for the cervical nodes allows to know much better their distribution along the neck, helping to find correlation between clinical, radiological and surgical findings.
  Acta Otorrinolaringológica Española 03/2004; 55(2):97-101.
• Article: [The Connecticut Chemosensorial Clinical Research Center olfaction test: values in healthy volunteers].

  A Toledano, E González, T J Onrubia, C Herráiz, M A Mate, M García, M Navarro, G Plaza, J M Aparicio, G de los Santos, N Galindo
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  ABSTRACT: To know the values of the olfactory test (CCCRC) performed in healthy people. To analyse how the age and sex affect the test. Descriptive study in 100 volunteers with no olfactory disorders. We used CCCRC olfactory test, which it has an odor threshold component, an odor identification component and a composite score. We analysed how age and sex variables affect olfactory test data, listing a t-Student test. The size sample is calculated to 0.05 alfa error. Threshold test data mean was 5.8. Identification test data mean was 7.5. Composite score mean was 6.7. Age is a significant factor in our study but not sex. Sample size is sufficient to analyze normal values. Our results are similar to other authors.
  Acta Otorrinolaringológica Española 01/2004; 54(10):678-85.
• Article: Mucocele of the middle turbinate: a case report.

  A Toledano, C Herráiz, A Mate, G Plaza, J M Aparicio, G De Los Santos, A N Galindo
  Otolaryngology Head and Neck Surgery 05/2002; 126(4):442-4. · 1.72 Impact Factor
• Article: [Assessment of hyperacusis: the self-rating questionnaire on hypersensitivity to sound].

  C Herráiz, G de los Santos, I Diges, R Díez, J M Aparicio
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  ABSTRACT: Hyperacusis is a decreased sound tolerance. The audiological examination includes the loudness discomfort level measurement and the handicap evaluation, so we introduce the Spanish validation of the german sound intolerance questionnaire. To update the concept of hyperacusis and to evaluate its handicap through a Spanish validation of the Geräuschüberempfindlichkeit (GUF). Forty patients referred to our Tinnitus and Hyperacusis Clinic in the University Hospital, between October 2004 and February 2005. Outcome Measures: The Spanish version of the GUF was performed after transla-tion and retro-translation. Internal consistency and reliability were established. Spanish adaptation of the GUF and its subscales (cognitive, somatic behaviour and emotional reaction) showed a high reliability and internal consistency (Cronbach's alfa: 0.9007). Higher GUF scores were statistically demonstrated in hyperacusis patients with hearing loss (p < 0.05) or tinnitus (p < 0.05). Spanish adaptation of the GUF is valid, reliable and can be used in a clinical setting to quantify the impact of hyperacusis on patient's quality of life.
  Acta Otorrinolaringológica Española 57(7):303-6.
• Article: [Magnetic resonance: first choice test in the screening of internal auditory canal and cerebellopontine angle tumors].

  G Plaza, J López Lafuente, J M Aparicio, C Herraiz, M A Mate, A Toledano, G de los Santos
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  ABSTRACT: Although internal auditory canal (IAC) and cerebellopontine angle (CPA) tumors are rare, their clinical suspicion is quite common in the otolaryngology office. MRI is the imaging modality of choice in diagnosing these tumors. Perceived high costs may prevent clinicians from using it as a screening tool. A protocol designed to improve cost-effectiveness in such diagnosis results in a more rationale clinical practice. Our aim was to evaluate the usefulness of MRI as screening tool in diagnosis of IAC and CPA tumors in our population. Between March 1998 and March 2000, a prospective series of 200 cases had a MRI screening requested. MRI were performed following Fast Spin Echo technique, providing T2-weighted images. Gadolinium enhanced MRI was reserved for selected cases. We report on 190 MRI done. We found 7 neuromas (3.5%), one CPA metastasis, one epidermoid cyst and 9 IAC vascular anomalies. Only 138 cases (69%) had normal MRI images. When used following a designed protocol, MRI is our procedure of choice while screening IAC and CPA tumors because it is a cost-effective tool.
  Acta Otorrinolaringológica Española 52(8):651-6.
• Article: [Basilar artery aneurysm: report of a case].

  A Toledano, T Onrubia, C Herráiz, R Tarriño, G Plaza, M A Mate, J M Aparicio, G De los Santos
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  ABSTRACT: We present a case of a patient with vertigo, disequilibrium and facial palsy. Nistagmus features pointed to a diagnosis of central vertigo. MRI showed a basilar aneurysm that compressed the brain stem and caused a stroke. We review the diagnosis.
  Acta Otorrinolaringológica Española 54(7):533-7.