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Palatal Miyoklonusun Oluşturduğu Tinnitusun Botulinum Toksini İle İyileşmesi

Treatment of the Tinnitus Caused by Palatal Myoclonus with Botulinum Toxin

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Abstract (2. Language): 
Introduction: Palatal myoclonus (PM) is a rare cause of objective tinnitus, secondary to rhythmic voluntary or involuntary movements of the soft palate. Cases: We report two cases; nineteen-year-old girl and 18-year-old boy who presented our clinic with bilateral tinnitus and diagnosed as PM. Clinical diagnosis was made on the confirmation of soft palate movements synchronus with an audible clicking noise. Neurologic examination, cranial MR and MR angiography were normal in both patients. Since the systemic drug therapy was unsuccessful, 15 U botulinum neurotoxin A (botox-A) (BOTOX®, Allergan, Inc., Irvine, CA, USA) has injected into both sides of the soft palate in patients. Tinnitus has disappeared immediately after the injections. There were not any complaint after twenty months follow-up. Conclusion: In the light of literature, our findings show that botox-A injection is an effective treatment in PM.
Abstract (Original Language): 
Giriş: Palatal miyoklonus (PM) nadir görülen, palatal kasların istemli veya istemsiz ritmik kasılmaları ile karakterize bir objektif tinnitus nedenidir. Olgular: Bu çalışmada kliniğimizde tedavisi yapılan iki olgu sunuldu. Ondokuz yaşında kadın ve 18 yaşında erkek hasta, her iki kulağında çınlama yakınması ile başvurdu. Yumuşak damakta gözle görülen ritmik kasılmalar ve hasta ve doktor tarafından işitilen çıtırtı sesi ile PM tanısı konuldu. Nörolojik muayene, kraniyal MR ve MR anjiyografide anormallik saptanmadı. Medikal tedaviden fayda görmemeleri nedeniyle her iki hastanın yumuşak damağına 15 U sağa 15 U sola olacak şekilde botulinum nörotoksin A (botoks-A) (BOTOX®, Allergan, Inc., Irvine, CA, USA) enjekte edildi. Enjeksiyonların ardından tinnitus hemen kayboldu ve yirmi aylık izlemde tekrar oluşmadı. Sonuç: Bu bulgular, literatürdeki diğer olgu sonuçları ile birlikte değerlendirildiğinde, botox-A uygulamasının, PM tedavisinde etkili bir yöntem olduğu görülmektedir.
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