Neurotological Findings at a Health Unit for Adults with Cervicalgia

Abstract

Introduction The cervical spine is a flexible link between the sensory platform of the skull and torso. The fundamental principle of its operation is due to the balance between muscle strength and flexibility, and any dysfunction of this balance causes neck pain, known as cervicalgia.

Objective The objective of this study is to analyze the most prevalent neurotological findings in adults with neck pain.

Method A cross-sectional study in which 33 adults from 50 to 83 years of age with neck pain were evaluated and underwent the following procedures: anamnesis, as well as ENT, audiological, and vestibular exams.

Results The most evident neurotological symptoms were dizziness (75.7%), tinnitus, neck cracking, tingling in the extremities, and auditory problems (36.3% for each). The most frequently reported clinical symptoms were related to cardiovascular (69.7%), endocrine-metabolic (48.5%), and rheumatic (30.3%) systems. In the audiological assessment, 30 subjects (91.0%) presented hearing impairment in at least one ear, with sensorineural impairment being the most prevalent (88.0%). In the vestibular assessment, there were alterations in 13 subjects (39.0%) found in the caloric test. There was a prevalence of alterations in the peripheral vestibular system with a predominance of irritative peripheral vestibular dysfunction.

Conclusion Neurotological complaints were frequent in this population, verifying the importance of these tests in the dysfunctions of the cervical region or the craniocervical junction.

Keywords

neck pain - postural balance - vestibular function tests - dizziness - tinnitus

• References

• 1 Natour J. [org.]. Coluna vertebral: conhecimentos básicos. 2nd ed. São Paulo: Etcetera; 2004
• 2 Mercúrio R. Dor. São Paulo: Manole; 1997
• 3 Teixeira JM, Barros Filho T, Lin TY, Hamani C, Teixeira WGJ. Cervicalgias. Rev Med 2001; 80: 307-316
• 4 Goldenberg J. Coluna ponto e vírgula: colocando um ponto final nas dúvidas, colocando vírgulas nos mitos. São Paulo: Atheneu; 2003
• 5 Souza GS, Gonçalves DF, Pastre CM. Propriocepção cervical e equilíbrio: uma revisão. Fisioter Mov 2006; 19 (4) 33-40
• 6 Herdman SJ. Reabilitação Vestibular. São Paulo: Manole; 2002
• 7 Silva A, Silva M, Pereira J. Vertigem cervicogênica: considerações sobre o diagnóstico funcional e a fisioterapia labiríntica. Fisioter Bras 2002; 3 (4) 258-263
• 8 Reid SA, Rivett DA. Manual therapy treatment of cervicogenic dizziness: a systematic review. Man Ther 2005; 10 (1) 4-13
• 9 Reis FJJ, Mafra B, Mazza D, Marcato G, Ribeiro M, Absalâo T. Avaliação dos distúrbios do controle sensório-motor em pessoas com dor cervical: uma revisão. Fisioter Mov 2010; 23 (4) 617-626
• 10 Davis H, Silverman RS. Hearing and deafness. 3 ed. New York: Ed. Holt, Rinehart & Wilson; 1970
• 11 Silman S, Silverman CA. Basic audiology testing. In: Silman S, Silverman CA. Auditory diagnosis, principles and applications. San Diego: Singular Publishing Group; 1997. . p. 38–58.
• 12 Mangabeira-Albernaz PL, Ganança MM, Pontes PAL. Modelo operacional do aparelho vestibular. In: (Org) Mangabeira-albernaz PL, Ganança, MM. Vertigem. 2 ed. São Paulo: Moderna; 1976
• 13 Costa KCF, Silva SMR, Ganança CF. Estudo das provas oculomotoras e vestibulares por meio da vectonistagmografia. Distúrbios Comum 2005; 17: 315-322
• 14 Ekvall Hansson E, Månsson NO, Ringsberg KA, Håkansson A. Dizziness among patients with whiplash-associated disorder: a randomized controlled trial. J Rehabil Med 2006; 38 (6) 387-390
• 15 Lin YC, Lai CH, Chang WH, Tu LW, Lin JC, Chou SW. Immediate effects of ischemic compression on neck function in patients with cervicogenic cephalic syndrome. J Manipulative Physiol Ther 2012; 35 (4) 301-307
• 16 Araujo CAF, Silva ARA, Moura AAS. Como melhorar a qualidade de vida dos pacientes vestibulopatas com alterações da coluna cervical através da reabilitação vestibular. Rev SORL-RJ 2009; 1 (1) 1-12
• 17 Kristjansson E, Treleaven J. Sensorimotor function and dizziness in neck pain: implications for assessment and management. J Orthop Sports Phys Ther 2009; 39 (5) 364-377
• 18 Moreira MD, Marchiori LLM, Costa VSP, Damasceno EC, Gibrin PCD. Zumbido: possível associação com as alterações cervicais em idosos. Int Arch Otorhinolaryngol 2011; 15 (3) 333-337
• 19 Gatterman MI. Foundations of chiropractic: subluxation. 2. ed. Missouri: Mosby Year Book; 2005
• 20 Pinelli LAP, Montandon AAB, Boschi A, Fais LMG. Prevalência de doenças crônicas em pacientes geriátricos. Rev Odonto Ciência 2005; 20 (47) 69-74
• 21 Felipe L, Simões LC, Gonçalves DU, Mancini PC. Avaliação do efeito da cafeína no teste vestibular. Rev Bras Otorrinolaringol (Engl Ed) 2005; 71 (6) 758-762
• 22 Fukuda Y. Zumbido e suas corelações otoneurológicas. In: Ganança M. Vertigem tem cura?. São Paulo: Lemo; 1998. . p.171–6.
• 23 Jastreboff PJ, Sasaki CT. An animal model of tinnitus: a decade of development. Am J Otol 1994; 15 (1) 19-27
• 24 Sanchez TG, Zonato AI, Bittar RSM, Bento RF. Controvérsias sobre a fisiologia do zumbido. Arq Int Otorhinolaryngol 1997; 1 (1) 2-8
• 25 Ganança MM, Caovilla HH, Gazzola JM, Ganança CF, Ganança FF. Betaistina no tratamento do zumbido em pacientes com distúrbios vestibulares. Braz J Otorhinolaryngol 2011; 77 (4) 499-503
• 26 Órfão CAS, Bonaldi LV, Lemos M, Floriano SL. Achados vestibulares em portadores de zumbido. Arq Int Otorhinolaryngol 2001; 5 (4) 1-4
• 27 Tiensoli LO, Couto ER, Mitre EI. Fatores associados à vertigem ou tontura em indivíduos com exame vestibular normal. Rev CEFAC 2004; 6 (1) 94-100
• 28 Greters ME, Bittar RSM, Bottino MA, Greters PM. Avaliação do tratamento fisioterápico na vertigem cervical: estudo preliminar. Arq Int Otorhinolaryngol 2007; 11 (4) 406-410
• 29 Montfoort I, Kelders WP, van der Geest JN , et al. Interaction between ocular stabilization reflexes in patients with whiplash injury. Invest Ophthalmol Vis Sci 2006; 47 (7) 2881-2884
• 30 Yahia A, Ghroubi S, Jribi S , et al. Chronic neck pain and vertigo: Is a true balance disorder present?. Ann Phys Rehabil Med 2009; 52 (7–8) 556-567