Association Between Childhood Hearing Disorders and Tinnitus in Adulthood.

PubMed

Aarhus, Lisa; Engdahl, Bo; Tambs, Kristian; Kvestad, Ellen; Hoffman, Howard J

2015-11-01

The association between childhood hearing disorders and adult tinnitus has not been examined in longitudinal cohort studies. To determine the association between different types of childhood hearing loss and tinnitus in adulthood and evaluate whether tinnitus risk is mediated by adult hearing loss. Population-based cohort study of 32 430 adults (aged 20-56 years) who underwent pure-tone audiometry and completed a tinnitus questionnaire in the Nord-Trøndelag Hearing Loss Study, which was a part of the Nord-Trøndelag Health Study 2 (HUNT2). The study was conducted from January 1, 2014, to April 1, 2015. Data analysis was performed from April 1, 2014, to April 1, 2015. As children, the same individuals had undergone screening audiometry in a longitudinal primary school hearing investigation, including ear, nose, and throat examinations when indicated. Pure-tone audiometry, questionnaires, and ear, nose, and throat examinations. Self-reported tinnitus (yes or no) in adulthood measured by questionnaires. Adults who had hearing loss at the time of the school investigation (n = 3026) reported more tinnitus, measured as odds ratio (95% CI), than did adults with normal childhood hearing (n = 29 404) (1.4 [1.3-1.6]). Childhood hearing disorders associated with tinnitus in adulthood included sensorineural hearing loss, chronic suppurative otitis media, and hearing loss associated with a history of recurrent acute otitis media (2.4 [1.9-3.0], 2.4 [1.5-3.9], and 1.6 [1.3-2.0], respectively). These estimates were adjusted for age, sex, and noise exposure in adulthood. After further analyses that included adjustment for adult hearing threshold, none of these childhood hearing disorders remained positively associated with tinnitus. Childhood hearing disorders associated with tinnitus in adulthood include sensorineural hearing loss, chronic suppurative otitis media, and hearing loss associated with a history of recurrent acute otitis media. After adjustment for the

Multidisciplinary assessment of patients with musical hallucinations, tinnitus and hearing loss.

PubMed

Rocha, Savya Cybelle Milhomem; Kii, Marcia Akemi; Pereira, Cristiana Borges; Borelli, Danilo Totarelli; Forlenza, Orestes; Sanchez, Tanit Ganz

2015-01-01

Although auditory hallucinations are considered a psychopathological phenomenon, musical hallucinations have been reported in individuals without psychosis but with auditory symptoms (tinnitus and/or hearing loss). Thus, a possible different cognitive functioning may be involved in musical hallucinations. The aim of the study was to characterize patients with tinnitus and musical hallucinations through a multidisciplinary assessment, allowing a better understanding of these concomitant phenomena. As this sample is rare to find, all consecutive patients with tinnitus, hearing loss and musical hallucinations were included over a 3-year period, excluding those unable to respond. All subjects underwent the following assessments: (1) otolaryngological and audiological assessment (physical examination and audiometry), (2) neurological assessment (cognition, electroencephalogram and imaging examination) and (3) psychiatric assessment (structured interview). A total of 16 patients were included (87.5% women; mean age 61.43 ± 15.99 years). The otolaryngological examination was normal in all cases, but audiometry revealed that the degree of hearing loss was severe to profound in 68.75% of participants. Neurological assessment showed electroencephalogram changes in only 17.6% of cases, while 25% presented with mild attention deficit and 43.75% had small foci of gliosis or ischemia on the imaging examination. Psychiatric assessment showed that 68.75% of cases had depression, 6.25% had anxiety disorder and 25% had no psychiatric conditions. Musical hallucinations were strongly associated with female elderly adults and with mood disorders. Thus, in contrast to common auditory hallucinations, patients with musical hallucinations associated with tinnitus and hearing loss should be offered a more multidisciplinary assessment. © 2015 S. Karger AG, Basel.

Suppression of Tinnitus in a Patient with Unilateral Sudden Hearing Loss: A Case Report

PubMed Central

Fioretti, Alessandra; Peri, Giorgia; Eibenstein, Alberto

2012-01-01

We describe a case of a 67-year-old woman with severe disabling right-sided tinnitus, mild hyperacusis, and headache. The tinnitus was associated with sudden right hearing loss and vertigo, which occurred about 18 months before. Magnetic resonance imaging (MRI) resulted in normal anatomical structures of the cochlea and of the cranial nerves showing a partial empty sella syndrome with suprasellar cistern hernia. Angio-MR revealed a bilateral contact between the anterior-inferior cerebellar artery (AICA) and the acoustic-facial nerve with a potential neurovascular conflict. Surgery was considered unnecessary after further evaluations. The right ear was successfully treated with a combination device (hearing aid plus sound generator). Shortly after a standard fitting procedure, the patient reported a reduction of tinnitus, hyperacusis, and headache which completely disappeared at the follow-up evaluation after 3, 6, and 12 months. This paper demonstrates that the combination device resulted in a complete tinnitus and hyperacusis suppression in a patient with unilateral sensorineural sudden hearing loss. Our paper further supports the restoration of peripheral sensory input for the treatment of tinnitus associated with hearing loss in selected patients. PMID:23227400

White Matter Changes in Tinnitus: Is It All Age and Hearing Loss?

PubMed

Yoo, Hye Bin; De Ridder, Dirk; Vanneste, Sven

2016-02-01

Tinnitus is a condition characterized by the perception of auditory phantom sounds. It is known as the result of complex interactions between auditory and nonauditory regions. However, previous structural imaging studies on tinnitus patients showed evidence of significant white matter changes caused by hearing loss that are positively correlated with aging. Current study focused on which aspects of tinnitus pathologies affect the white matter integrity the most. We used the diffusion tensor imaging technique to acquire images that have higher contrast in brain white matter to analyze how white matter is influenced by tinnitus-related factors using voxel-based methods, region of interest analysis, and deterministic tractography. As a result, white matter integrity in chronic tinnitus patients was both directly affected by age and also mediated by the hearing loss. The most important changes in white matter regions were found bilaterally in the anterior corona radiata, anterior corpus callosum, and bilateral sagittal strata. In the tractography analysis, the white matter integrity values in tracts of right parahippocampus were correlated with the subjective tinnitus loudness.

Prevalence of hearing loss and tinnitus in Iraq and Afghanistan Veterans: A Chronic Effects of Neurotrauma Consortium study.

PubMed

Swan, A A; Nelson, J T; Swiger, B; Jaramillo, C A; Eapen, B C; Packer, M; Pugh, M J

2017-06-01

The purpose of this study was to describe the prevalence of hearing loss and tinnitus in a cohort of Iraq and Afghanistan Veterans (IAV) with common post-deployment conditions, including traumatic brain injury (TBI), post-traumatic stress disorder (PTSD), and other typical post-concussive conditions such as headaches and vertigo/dizziness. This retrospective observational study used data from the national Veterans Health Administration (VA) data repository from fiscal years 2001-2014. Veteran data was included if there were at least three years of VA care, with one or more years of care in 2007 or after. We identified comorbidities that may be associated with post-deployment hearing loss or tinnitus including TBI, PTSD, depression, and common post-concussive symptoms using International Classification of Diseases, 9th Revision, Clinical Modification codes. A multinomial logistic regression analysis was used to examine conditions associated with hearing loss or tinnitus. Among IAV, 570,332 were included in the final analysis. Of these, 7.78% of these were diagnosed with hearing loss alone, 6.54% with tinnitus alone, and 6.24% with both hearing loss and tinnitus. Comorbid TBI, PTSD, and depression were significantly associated with increased rates of hearing loss, tinnitus, or both conditions together. Older individuals, males, and those with TBI, PTSD, or vertigo/dizziness were significantly more likely to have hearing loss, tinnitus, or both. In order to provide more holistic post-deployment support, this myriad of conditions should be carefully considered in the planning of clinical care and beyond. Copyright © 2017 Elsevier B.V. All rights reserved.

Hearing loss

MedlinePlus

... eardrum) Ringing or buzzing sound in the ears ( tinnitus ) Causes Conductive hearing loss (CHL) occurs because of ... severe hearing loss or ringing in the ears (tinnitus). You have other symptoms, such as ear pain , ...

Tinnitus in normally hearing patients: clinical aspects and repercussions.

PubMed

Sanchez, Tanit Ganz; Medeiros, Italo Roberto Torres de; Levy, Cristiane Passos Dias; Ramalho, Jeanne da Rosa Oiticica; Bento, Ricardo Ferreira

2005-01-01

Patients with tinnitus and normal hearing constitute an important group, given that findings do not suffer influence of the hearing loss. However, this group is rarely studied, so we do not know whether its clinical characteristics and interference in daily life are the same of those of the patients with tinnitus and hearing loss. To compare tinnitus characteristics and interference in daily life among patients with and without hearing loss. Historic cohort. Among 744 tinnitus patients seen at a Tinnitus Clinic, 55 with normal audiometry were retrospectively evaluated. The control group consisted of 198 patients with tinnitus and hearing loss, following the same protocol. We analyzed the patients' data as well as the tinnitus characteristics and interference in daily life. The mean age of the studied group (43.1 +/- 13.4 years) was significantly lower than that of the control group (49.9 +/- 14.5 years). In both groups, tinnitus was predominant in women, bilateral, single tone and constant, but there were no differences between both groups. The interference in concentration and emotional status (25.5% and 36.4%) was significantly lower in the studied group than that of the control group (46% and 61.6%), but it did not happen in regard to interference over sleep and social life. Patients with tinnitus and normal hearing showed similar characteristics when compared to those with hearing loss. However, the age of the patients and the interference over concentration and emotional status were significantly lower in this group.

Prevalence of Tinnitus and Noise-induced Hearing Loss in Dentists

PubMed Central

Myers, Jamie; John, Andrew B.; Kimball, Suzanne; Fruits, Terry

2016-01-01

Introduction: The purpose of this study was to evaluate noise levels in dental offices and to estimate the risk and prevalence of tinnitus and noise-induced hearing loss (NIHL) in practicing dentists. Materials and Methods: First, measures were collected of sound pressure levels produced by dental handpieces and dental suction in the University of Oklahoma Health Sciences Center (OUHSC) College of Dentistry. Second, a survey was distributed to members of the Oklahoma Dental Association (ODA). Results: Measurements made in the dental operatory revealed dangerous levels when high-volume suction was in use alone and in conjunction with a dental handpiece. Questionnaire results suggested that practicing dentists report sensorineural hearing loss at a rate broadly in line with national averages. However, dentists reported a higher prevalence of tinnitus symptoms than would be expected based on sample demographics. Conclusion: Results from sound level measurements and questionnaire responses indicate that dentists are a population that could be placing their hearing health at risk in a typical daily work environment. PMID:27991466

Structure of perceived handicap in middle-aged males with noise-induced hearing loss, with and without tinnitus.

PubMed

Hallberg, L R; Johnsson, T; Axelsson, A

1993-01-01

By using a modified stepwise regression analysis technique, the structure of self-perceived handicap and tinnitus annoyance in 89 males with noise-induced hearing loss was described. Handicap was related to three clusters of variables, reflecting individual, environmental, and socioeconomic aspects, and 60% of the variance in self-perceived handicap was explained by the representatives of these clusters: i.e. 'acceptance of hearing problems', 'social support related to tinnitus' and 'years of education'. Tinnitus had no impact of its own on self-perceived handicap and only a modest portion (36%) of the variance in tinnitus annoyance was explained by 'sleep disturbance' and 'auditory perceptual difficulties'.

Hearing Loss in Adults.

ERIC Educational Resources Information Center

House, John W.

1997-01-01

This article discusses hearing loss in adults. It begins with an explanation of the anatomy of the ear and then explains the three types of hearing loss: conductive hearing loss, sensorineural hearing loss, and mixed conductive-sensorineural hearing loss. Tinnitus, hearing aids, and cochlear implants are also addressed. (CR)

[Tinnitus in noise-induced hearing impairment].

PubMed

Kowalska, S; Sułkowski, W

2001-01-01

The analysis of the epidemiological data indicates that exposure to noise is widespread and it is one of the most common causes of tinnitus, estimated at about 20.7% according to Hazell; 28% according to Axelsson; and 42% according to Palmer. Bearing in mind the scantiness of reliable data on the incidence and nature of tinnitus in persons exposed to industrial noise, and especially the need for the objectivity of this subjective symptom, the authors have decided to undertake the study aimed at assessing the interrelation between tinnitus, the magnitude and kind of hearing impairment, and otoacoustic emission. The study group included 191 persons aged 42.5 +/- 7.6 years (range, 25 to 65), occupationally exposed to noise at the levels of 88-92 dB(A) for 26.9 +/- 4.6 years (range, 9 to 30) who had reported hearing disorders and tinnitus. The control group, matched by similar age and duration of employment, consisted of 80 persons with perceptive hearing impairment induced by industrial noise who had not complained of tinnitus. The results of the study revealed that in 59.7% of the study subjects, noise proved to be one of the most probable factors responsible for the development of tinnitus. The presence of tinnitus was found in 22.5% and in 46% of the study subjects after 10 years and 11-20 years of noise exposure, respectively. In 95.8% of workers, tinnitus was associated with hearing loss, and only in 4.2% of cases it occurred in ears with normal hearing. In persons exposed to noise, tinnitus was most frequently (59.2%) bilateral and permanent. Following the audiologic examinations, verified by objective audiometry (tympanometry, ABR), cochlear hearing impairment was found in 68.6%; retrochochlear in 8.37%; mixed and other forms of impairment, e.g. presbyacousis, in 19.4% of subjects. The audiologic assessment of tinnitus demonstrated that in 62.3% of persons, tinnitus occurred at high frequencies and correlated with the magnitude of hearing impairment in the

Discrimination Task Reveals Differences in Neural Bases of Tinnitus and Hearing Impairment

PubMed Central

Husain, Fatima T.; Pajor, Nathan M.; Smith, Jason F.; Kim, H. Jeff; Rudy, Susan; Zalewski, Christopher; Brewer, Carmen; Horwitz, Barry

2011-01-01

We investigated auditory perception and cognitive processing in individuals with chronic tinnitus or hearing loss using functional magnetic resonance imaging (fMRI). Our participants belonged to one of three groups: bilateral hearing loss and tinnitus (TIN), bilateral hearing loss without tinnitus (HL), and normal hearing without tinnitus (NH). We employed pure tones and frequency-modulated sweeps as stimuli in two tasks: passive listening and active discrimination. All subjects had normal hearing through 2 kHz and all stimuli were low-pass filtered at 2 kHz so that all participants could hear them equally well. Performance was similar among all three groups for the discrimination task. In all participants, a distributed set of brain regions including the primary and non-primary auditory cortices showed greater response for both tasks compared to rest. Comparing the groups directly, we found decreased activation in the parietal and frontal lobes in the participants with tinnitus compared to the HL group and decreased response in the frontal lobes relative to the NH group. Additionally, the HL subjects exhibited increased response in the anterior cingulate relative to the NH group. Our results suggest that a differential engagement of a putative auditory attention and short-term memory network, comprising regions in the frontal, parietal and temporal cortices and the anterior cingulate, may represent a key difference in the neural bases of chronic tinnitus accompanied by hearing loss relative to hearing loss alone. PMID:22066003

The effect of tinnitus specific intracochlear stimulation on speech perception in patients with unilateral or asymmetric hearing loss accompanied with tinnitus and the effect of formal auditory training.

PubMed

Arts, Remo A G J; George, Erwin L J; Janssen, Miranda A M L; Griessner, Andreas; Zierhofer, Clemens; Stokroos, Robert J

2018-06-01

Previous studies show that intracochlear electrical stimulation independent of environmental sounds appears to suppress tinnitus, even long-term. In order to assess the viability of this potential treatment option it is essential to study the effects of this tinnitus specific electrical stimulation on speech perception. A randomised, prospective crossover design. Ten patients with unilateral or asymmetric hearing loss and severe tinnitus complaints. The audiological effects of standard clinical CI, formal auditory training and tinnitus specific electrical stimulation were investigated. Results show that standard clinical CI in unilateral or asymmetric hearing loss is shown to be beneficial for speech perception in quiet, speech perception in noise and subjective hearing ability. Formal auditory training does not appear to improve speech perception performance. However, CI-related discomfort reduces significantly more rapidly during CI rehabilitation in subjects receiving formal auditory training. Furthermore, tinnitus specific electrical stimulation has neither positive nor negative effects on speech perception. In combination with the findings from previous studies on tinnitus suppression using intracochlear electrical stimulation independent of environmental sounds, the results of this study contribute to the viability of cochlear implantation based on tinnitus complaints.

The impact of cochlear implantation on speech understanding, subjective hearing performance, and tinnitus perception in patients with unilateral severe to profound hearing loss.

PubMed

Távora-Vieira, Dayse; Marino, Roberta; Acharya, Aanand; Rajan, Gunesh P

2015-03-01

This study aimed to determine the impact of cochlear implantation on speech understanding in noise, subjective perception of hearing, and tinnitus perception of adult patients with unilateral severe to profound hearing loss and to investigate whether duration of deafness and age at implantation would influence the outcomes. In addition, this article describes the auditory training protocol used for unilaterally deaf patients. This is a prospective study of subjects undergoing cochlear implantation for unilateral deafness with or without associated tinnitus. Speech perception in noise was tested using the Bamford-Kowal-Bench speech-in-noise test presented at 65 dB SPL. The Speech, Spatial, and Qualities of Hearing Scale and the Abbreviated Profile of Hearing Aid Benefit were used to evaluate the subjective perception of hearing with a cochlear implant and quality of life. Tinnitus disturbance was measured using the Tinnitus Reaction Questionnaire. Data were collected before cochlear implantation and 3, 6, 12, and 24 months after implantation. Twenty-eight postlingual unilaterally deaf adults with or without tinnitus were implanted. There was a significant improvement in speech perception in noise across time in all spatial configurations. There was an overall significant improvement on the subjective perception of hearing and quality of life. Tinnitus disturbance reduced significantly across time. Age at implantation and duration of deafness did not influence the outcomes significantly. Cochlear implantation provided significant improvement in speech understanding in challenging situations, subjective perception of hearing performance, and quality of life. Cochlear implantation also resulted in reduced tinnitus disturbance. Age at implantation and duration of deafness did not seem to influence the outcomes.

Evidence that hidden hearing loss underlies amplitude modulation encoding deficits in individuals with and without tinnitus.

PubMed

Paul, Brandon T; Bruce, Ian C; Roberts, Larry E

2017-02-01

Damage to auditory nerve fibers that expresses with suprathreshold sounds but is hidden from the audiogram has been proposed to underlie deficits in temporal coding ability observed among individuals with otherwise normal hearing, and to be present in individuals experiencing chronic tinnitus with clinically normal audiograms. We tested whether these individuals may have hidden synaptic losses on auditory nerve fibers with low spontaneous rates of firing (low-SR fibers) that are important for coding suprathreshold sounds in noise while high-SR fibers determining threshold responses in quiet remain relatively unaffected. Tinnitus and control subjects were required to detect the presence of amplitude modulation (AM) in a 5 kHz, suprathreshold tone (a frequency in the tinnitus frequency region of the tinnitus subjects, whose audiometric thresholds were normal to 12 kHz). The AM tone was embedded within background noise intended to degrade the contribution of high-SR fibers, such that AM coding was preferentially reliant on low-SR fibers. We also recorded by electroencephalography the "envelope following response" (EFR, generated in the auditory midbrain) to a 5 kHz, 85 Hz AM tone presented in the same background noise, and also in quiet (both low-SR and high-SR fibers contributing to AM coding in the latter condition). Control subjects with EFRs that were comparatively resistant to the addition of background noise had better AM detection thresholds than controls whose EFRs were more affected by noise. Simulated auditory nerve responses to our stimulus conditions using a well-established peripheral model suggested that low-SR fibers were better preserved in the former cases. Tinnitus subjects had worse AM detection thresholds and reduced EFRs overall compared to controls. Simulated auditory nerve responses found that in addition to severe low-SR fiber loss, a degree of high-SR fiber loss that would not be expected to affect audiometric thresholds was needed to

Patterns of Tinnitus and Hearing Loss Secondary to Blast Injury

DTIC Science & Technology

2018-01-01

will be invited for on-site evaluations. The study groups will be: Group 1: Blast-exposed during deployment with post concussive symptoms (PCS), new...exposure, no tinnitus. The onsite evaluations will consist of a magnetoencephalography (MEG) scan, hearing tests , standard MRS interviews...neurocognitive tests and questionnaires, and tinnitus questionnaires. By comparing subjects with tinnitus and those without, we hope better characterize the

The effect of sensorineural hearing loss and tinnitus on speech recognition over air and bone conduction military communications headsets.

PubMed

Manning, Candice; Mermagen, Timothy; Scharine, Angelique

2017-06-01

Military personnel are at risk for hearing loss due to noise exposure during deployment (USACHPPM, 2008). Despite mandated use of hearing protection, hearing loss and tinnitus are prevalent due to reluctance to use hearing protection. Bone conduction headsets can offer good speech intelligibility for normal hearing (NH) listeners while allowing the ears to remain open in quiet environments and the use of hearing protection when needed. Those who suffer from tinnitus, the experience of perceiving a sound not produced by an external source, often show degraded speech recognition; however, it is unclear whether this is a result of decreased hearing sensitivity or increased distractibility (Moon et al., 2015). It has been suggested that the vibratory stimulation of a bone conduction headset might ameliorate the effects of tinnitus on speech perception; however, there is currently no research to support or refute this claim (Hoare et al., 2014). Speech recognition of words presented over air conduction and bone conduction headsets was measured for three groups of listeners: NH, sensorineural hearing impaired, and/or tinnitus sufferers. Three levels of speech-to-noise (SNR = 0, -6, -12 dB) were created by embedding speech items in pink noise. Better speech recognition performance was observed with the bone conduction headset regardless of hearing profile, and speech intelligibility was a function of SNR. Discussion will include study limitations and the implications of these findings for those serving in the military. Published by Elsevier B.V.

Tinnitus and Hearing Survey: A Screening Tool to Differentiate Bothersome Tinnitus From Hearing Difficulties

PubMed Central

Griest, Susan; Zaugg, Tara L.; Thielman, Emily; Kaelin, Christine; Galvez, Gino; Carlson, Kathleen F.

2015-01-01

Purpose Individuals complaining of tinnitus often attribute hearing problems to the tinnitus. In such cases some (or all) of their reported “tinnitus distress” may in fact be caused by trouble communicating due to hearing problems. We developed the Tinnitus and Hearing Survey (THS) as a tool to rapidly differentiate hearing problems from tinnitus problems. Method For 2 of our research studies, we administered the THS twice (mean of 16.5 days between tests) to 67 participants who did not receive intervention. These data allow for measures of statistical validation of the THS. Results Reliability of the THS was good to excellent regarding internal consistency (α = .86–.94), test–retest reliability (r = .76–.83), and convergent validity between the Tinnitus Handicap Inventory (Newman, Jacobson, & Spitzer, 1996; Newman, Sandridge, & Jacobson, 1998) and the A (Tinnitus) subscale of the THS (r = .78). Factor analysis confirmed that the 2 subscales, A (Tinnitus) and B (Hearing), have strong internal structure, explaining 71.7% of the total variance, and low correlation with each other (r = .46), resulting in a small amount of shared variance (21%). Conclusion These results provide evidence that the THS is statistically validated and reliable for use in assisting patients and clinicians in quickly (and collaboratively) determining whether intervention for tinnitus is appropriate. PMID:25551458

Tinnitus in patients with hearing loss due to mitochondrial DNA pathogenic variants.

PubMed

Lechowicz, Urszula; Pollak, Agnieszka; Raj-Koziak, Danuta; Dziendziel, Beata; Skarżyński, Piotr Henryk; Skarżyński, Henryk; Ołdak, Monika

2018-06-23

Tinnitus described as individual perception of phantom sound constitutes a significant medical problem and has become an essential subject of many studies conducted worldwide. In the study, we aimed to examine the prevalence of tinnitus among Polish hearing loss (HL) patients with identified mitochondrial DNA (mtDNA) variants. Among the selected group of unrelated HL patients with known mtDNA pathogenic variants, two questionnaires were conducted, i.e. Tinnitus Handicap Inventory translated into Polish (THI-POL) and Visual Analogue Scale (VAS) for measuring subjectively perceived tinnitus loudness, distress, annoyance and possibility of coping with this condition (VASs). Pathogenic mtDNA variants were detected with real-time PCR and sequencing of the whole mtDNA. This is the first extensive tinnitus characterization using THI-POL and VASs questionnaires in HL patients due to mtDNA variants. We have established the prevalence of tinnitus among the studied group at 23.5%. We found that there are no statistically significant differences in the prevalence of tinnitus and its characteristic features between HL patients with known HL mtDNA variants and the general Polish population. In Polish HL patients with tinnitus, m.7511T>C was significantly more frequent than in patients without tinnitus. We observed that the prevalence of tinnitus is lower in Polish patients with m.1555A>G as compared to other available data. Our data suggest that the mtDNA variants causative of HL may affect tinnitus development but this effect seems to be ethnic-specific.

Role of hearing AIDS in tinnitus intervention: a scoping review.

PubMed

Shekhawat, Giriraj Singh; Searchfield, Grant D; Stinear, Cathy M

2013-09-01

Tinnitus can have a devastating impact on the quality of life of the sufferer. Although the mechanisms underpinning tinnitus remain uncertain, hearing loss is often associated with its onset, and hearing aids are among the most commonly used tools for its management. To conduct a scoping review to explore the role of hearing aids in tinnitus management. Scoping review based on the six-stage framework of Arksey and O'Malley (2005). Relevant studies were identified using various databases (Scopus, Google Scholar, SpringerLink, and PubMed) and hand searching of journals and a reference list of articles. Out of 277 shortlisted articles, 29 studies (18 research studies and 11 reviews) were chosen for charting of data based on their abstracts. Tinnitus assessment measures used in studies were recorded along with changes in their scores. Measures used in studies included the Tinnitus Handicap Inventory (THI), Tinnitus Handicap Questionnaire (THQ), Tinnitus Severity Index (TSI), Tinnitus Reaction Questionnaire (TRQ), German version of Tinnitus Questionnaire (TQ), Beck Depression Inventory (BDI), and visual analogue scale (VAS) of tinnitus intensity. Where possible Cohen's d effect size statistic was calculated. Although the quality of evidence for hearing aids' effect on tinnitus is not strong, the weight of evidence (17 research studies for, 1 against) suggests merit in using hearing aids for tinnitus management. The majority of studies reviewed support the use of hearing aids for tinnitus management. Clinicians should feel reassured that some evidence shows support for the use of hearing aids for treating tinnitus, but there is still a need for stronger methodology and randomized control trials. American Academy of Audiology.

[Tinnitus and deafness].

PubMed

Dauman, R

2000-01-15

The relationships between tinnitus and hearing loss are studied from a clinical prospect. Five critical points are discussed. 1. Some degree of hearing loss is found in the vast majority of tinnitus patients; but an individual may well have a sensorineural hearing loss and no tinnitus at all. 2. A minor adjunction to the neurophysiological model of Jastreboff is proposed to take account of the association between tinnitus and hearing loss. 3. Tinnitus appears to cause more distress when hearing loss is marked. 4. Self-reported hearing loss should be considered when implementing habituation sound therapy. 5. According to McKinney, the rate of success on tinnitus that can be expected with habituation sound therapy is not significantly affected by hearing level.

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Permanent Hearing Loss and Tinnitus.

PubMed

Śliwińska-Kowalska, Mariola; Zaborowski, Kamil

2017-09-27

Background : Hearing loss is defined as worsening of hearing acuity and is usually expressed as an increase in the hearing threshold. Tinnitus, defined as "ringing in the ear", is a common and often disturbing accompaniment of hearing loss. Hearing loss and environmental exposures to noise are increasingly recognized health problems. Objectives : The objective was to assess whether the exposure-response relationship can be established between exposures to non-occupational noise and permanent hearing outcomes such as permanent hearing loss and tinnitus. Methods: Information sources : Computer searches of all accessible medical and other databases (PubMed, Web of Science, Scopus) were performed and complemented with manual searches. The search was not limited to a particular time span, except for the effects of personal listening devices (PLDs). The latter was limited to the years 2008-June 2015, since previous knowledge was summarized by SCENIHR descriptive systematic review published in 2008. Study eligibility criteria: The inclusion criteria were as follows: the exposure to noise was measured in sound pressure levels (SPLs) and expressed in individual equivalent decibel values (L EX,8h ), the studies included both exposed and reference groups, the outcome was a permanent health effect, i.e., permanent hearing loss assessed with pure-tone audiometry and/or permanent tinnitus assessed with a questionnaire. The eligibility criteria were evaluated by two independent reviewers. Study appraisal and synthesis methods: The risk of bias was assessed for all of the papers using a template for assessment of quality and the risk of bias. The GRADE (grading of recommendations assessment, development, and evaluation) approach was used to assess the overall quality of evidence. Meta-analysis was not possible due to methodological heterogeneity of included studies and the inadequacy of data. Results: Out of 220 references identified, five studies fulfilled the inclusion criteria

Irreversible atorvastatin-associated hearing loss.

PubMed

Liu, Michael; Alafris, Antonia; Longo, Anthony J; Cohen, Henry

2012-02-01

Drug-associated ototoxicity is a potentially irreversible adverse event. Among the several 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) available in the United States, only atorvastatin is associated with tinnitus, but none are associated with any forms of hearing loss. A search of the published literature (1950-August 2011) revealed no published case reports of ototoxicity associated with statins. To our knowledge, we describe the first case of progressive, irreversible hearing loss in a 32-year-old man 18 months after starting atorvastatin therapy. He began taking atorvastatin 20 mg every evening for treatment of hypercholesterolemia. Six months later, he complained of occasional episodes of tinnitus, which resolved spontaneously. An audiogram was obtained and was normal. By 18 months, the tinnitus became continuous. Another audiogram revealed bilateral "cookie-bite" middle-frequency hearing loss. Atorvastatin was immediately discontinued, and the patient was fitted with hearing aids. Four years after drug discontinuation, his hearing loss had neither progressed nor regressed. Use of the Naranjo adverse drug reaction probability scale indicated a possible (score of 2) temporal and causal relationship between the patient's hearing loss and atorvastatin. Causes of "cookie-bite" hearing loss include chronic exposure to loud noises, presbycusis, genetic predisposition, and drugs. The manufacturer of atorvastatin has received three unpublished cases of deafness, but claims that causal relationships were not established. Despite these claims by the manufacturer, based on this case report, we recommend that clinicians and patients be aware of the risk of atorvastatin-associated tinnitus and permanent hearing loss. Further research is needed to better understand the mechanism and frequency of this adverse event. © 2012 Pharmacotherapy Publications, Inc.

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Permanent Hearing Loss and Tinnitus

PubMed Central

Śliwińska-Kowalska, Mariola; Zaborowski, Kamil

2017-01-01

Background: Hearing loss is defined as worsening of hearing acuity and is usually expressed as an increase in the hearing threshold. Tinnitus, defined as “ringing in the ear”, is a common and often disturbing accompaniment of hearing loss. Hearing loss and environmental exposures to noise are increasingly recognized health problems. Objectives: The objective was to assess whether the exposure-response relationship can be established between exposures to non-occupational noise and permanent hearing outcomes such as permanent hearing loss and tinnitus. Methods: Information sources: Computer searches of all accessible medical and other databases (PubMed, Web of Science, Scopus) were performed and complemented with manual searches. The search was not limited to a particular time span, except for the effects of personal listening devices (PLDs). The latter was limited to the years 2008–June 2015, since previous knowledge was summarized by SCENIHR descriptive systematic review published in 2008. Study eligibility criteria: The inclusion criteria were as follows: the exposure to noise was measured in sound pressure levels (SPLs) and expressed in individual equivalent decibel values (LEX,8h), the studies included both exposed and reference groups, the outcome was a permanent health effect, i.e., permanent hearing loss assessed with pure-tone audiometry and/or permanent tinnitus assessed with a questionnaire. The eligibility criteria were evaluated by two independent reviewers. Study appraisal and synthesis methods: The risk of bias was assessed for all of the papers using a template for assessment of quality and the risk of bias. The GRADE (grading of recommendations assessment, development, and evaluation) approach was used to assess the overall quality of evidence. Meta-analysis was not possible due to methodological heterogeneity of included studies and the inadequacy of data. Results: Out of 220 references identified, five studies fulfilled the inclusion criteria

Tinnitus. I: Auditory mechanisms: a model for tinnitus and hearing impairment.

PubMed

Hazell, J W; Jastreboff, P J

1990-02-01

A model is proposed for tinnitus and sensorineural hearing loss involving cochlear pathology. As tinnitus is defined as a cortical perception of sound in the absence of an appropriate external stimulus it must result from a generator in the auditory system which undergoes extensive auditory processing before it is perceived. The concept of spatial nonlinearity in the cochlea is presented as a cause of tinnitus generation controlled by the efferents. Various clinical presentations of tinnitus and the way in which they respond to changes in the environment are discussed with respect to this control mechanism. The concept of auditory retraining as part of the habituation process, and interaction with the prefrontal cortex and limbic system is presented as a central model which emphasizes the importance of the emotional significance and meaning of tinnitus.

DPOAE in estimation of the function of the cochlea in tinnitus patients with normal hearing.

PubMed

Sztuka, Aleksandra; Pospiech, Lucyna; Gawron, Wojciech; Dudek, Krzysztof

2010-02-01

The most probable place generating tinnitus in the auditory pathway is the outer hair cells (OHCs) inside the cochlea. Otoacoustic emissions are used to assess their activity. The objective of the investigation was to measure the features of distortion product otoacoustic emissions (DPOAE) in a group of tinnitus patients without hearing loss, estimate the diagnostic value of the parameters for the analysis of cochlear function in the patients, emphasizing those most useful in localizing tinnitus generators, and determine the hypothetical influence of hyperacusis and misophony on DPOAE parameters in tinnitus patients. The material consisted of 44 patients with tinnitus and without hearing loss. In the control group were 33 patients without tinnitus with the same state of hearing. The tinnitus patients were divided into three subgroups: those with hyperacusis, those with misophonia, and those with neither. After collecting medical history and performing clinical examination of all the patients, tonal and impedance audiometry, ABR, and discomfort level were evaluated. Then DPOAE were measured using three procedures. First the amplitudes of two points per octave were assessed, second the "fine structure" method with 16-20 points per octave (f2/f1=1.22, L1=L2=70 dB), and the third procedure included recording the growth function in three series for input tones of f2=2002, 4004, and 6006Hz (f2/f1=1.22) and L1=L2 levels increasing by increments of 5 dB in each series. Hyperacusis was found in 63% and misophonia in 10% of the tinnitus patients with no hearing loss. DPOAE amplitudes in recordings with two points per octave and the fine structure method are very valuable parameters for estimating cochlear function in tinnitus patients with normal hearing. Function growth rate cannot be the only parameter in measuring DPOAE in tinnitus patients, including subjects with hyperacusis and misophonia. The markedly higher DPOAE amplitudes in the group of tinnitus patients without

Analysis of acutely exacerbated chronic tinnitus by the Tinnitus Handicap Inventory.

PubMed

Zeng, X; Li, P; Li, Z; Cen, J; Li, Y; Zhang, G

2016-01-01

To examine factors potentially contributing to acutely exacerbated chronic tinnitus initiation using the Tinnitus Handicap Inventory. Sixty acutely exacerbated chronic tinnitus out-patients were divided into two groups depending on whether hearing loss was aggravated or stable during tinnitus exacerbation. Total Tinnitus Handicap Inventory scores and scores for the three subscales (assessing functional limitations, emotional attitudes and catastrophic thoughts) were analysed. Total Tinnitus Handicap Inventory scores did not differ between groups. In patients with acutely exacerbated chronic tinnitus and aggravated hearing loss, functional subscale scores were significantly higher after acutely exacerbated chronic tinnitus than at baseline, but catastrophic and emotional subscale scores did not change. In patients with acutely exacerbated chronic tinnitus and stable hearing loss, emotional subscale scores were significantly higher after acutely exacerbated chronic tinnitus than at baseline, but catastrophic and functional subscale scores did not change. Elevated Tinnitus Handicap Inventory functional subscale scores might indicate further hearing loss, whereas elevated emotional subscale scores might be associated with negative life or work events.

Long-term tinnitus suppression with linear octave frequency transposition hearing AIDS.

PubMed

Peltier, Elisabeth; Peltier, Cedric; Tahar, Stephanie; Alliot-Lugaz, Evelyne; Cazals, Yves

2012-01-01

Over the last three years of hearing aid dispensing, it was observed that among 74 subjects fitted with a linear octave frequency transposition (LOFT) hearing aid, 60 reported partial or complete tinnitus suppression during day and night, an effect still lasting after several months or years of daily use. We report in more details on 38 subjects from whom we obtained quantified measures of tinnitus suppression through visual analog scaling and several additional psychoacoustic and audiometric measures. The long-term suppression seems independent of subject age, and of duration and subjective localization of tinnitus. A small but significant correlation was found with audiogram losses but not with high frequency loss slope. Long-term tinnitus suppression was observed for different etiologies, but with a low success rate for sudden deafness. It should be noted that a majority of subjects (23) had a history of noise exposure. Tinnitus suppression started after a few days of LOFT hearing aid use and reached a maximum after a few weeks of daily use. For nine subjects different amounts of frequency shifting were tried and found more or less successful for long-term tinnitus suppression, no correlation was found with tinnitus pitch. When the use of the LOFT hearing aid was stopped tinnitus reappeared within a day, and after re-using the LOFT aid it disappeared again within a day. For about one third of the 38 subjects a classical amplification or a non linear frequency compression aid was also tried, and no such tinnitus suppression was observed. Besides improvements in audiometric sensitivity to high frequencies and in speech discrimination scores, LOFT can be considered as a remarkable opportunity to suppress tinnitus over a long time scale. From a pathophysiological viewpoint these observations seem to fit with a possible re-attribution of activity to previously deprived cerebral areas corresponding to high frequency coding.

Relationship between Audiometric Slope and Tinnitus Pitch in Tinnitus Patients: Insights into the Mechanisms of Tinnitus Generation

PubMed Central

Schecklmann, Martin; Vielsmeier, Veronika; Steffens, Thomas; Landgrebe, Michael; Langguth, Berthold; Kleinjung, Tobias

2012-01-01

Background Different mechanisms have been proposed to be involved in tinnitus generation, among them reduced lateral inhibition and homeostatic plasticity. On a perceptual level these different mechanisms should be reflected by the relationship between the individual audiometric slope and the perceived tinnitus pitch. Whereas some studies found the tinnitus pitch corresponding to the maximum hearing loss, others stressed the relevance of the edge frequency. This study investigates the relationship between tinnitus pitch and audiometric slope in a large sample. Methodology This retrospective observational study analyzed 286 patients. The matched tinnitus pitch was compared to the frequency of maximum hearing loss and the edge of the audiogram (steepest hearing loss) by t-tests and correlation coefficients. These analyses were performed for the whole group and for sub-groups (uni- vs. bilateral (117 vs. 338 ears), pure-tone vs. narrow-band (340 vs. 115 ears), and low and high audiometric slope (114 vs. 113 ears)). Findings For the right ear, tinnitus pitch was in the same range and correlated significantly with the frequency of maximum hearing loss, but differed from and did not correlate with the edge frequency. For the left ear, similar results were found but the correlation between tinnitus pitch and maximum hearing loss did not reach significance. Sub-group analyses (bi- and unilateral, tinnitus character, slope steepness) revealed identical results except for the sub-group with high audiometric slope which revealed a higher frequency of maximum hearing loss as compared to the tinnitus pitch. Conclusion The study-results confirm a relationship between tinnitus pitch and maximum hearing loss but not to the edge frequency, suggesting that tinnitus is rather a fill-in-phenomenon resulting from homeostatic mechanisms, than the result of deficient lateral inhibition. Sub-group analyses suggest that audiometric steepness and the side of affected ear affect this

Role of worry in patients with chronic tinnitus and sensorineural hearing loss: a preliminary study.

PubMed

Caldirola, Daniela; Teggi, Roberto; Daccò, Silvia; Sangiorgio, Erika; Bussi, Mario; Perna, Giampaolo

2016-12-01

Tinnitus-related distress appears to be more strongly associated with multiple psychological factors than with any perceptual properties of tinnitus. Prior studies have not investigated the role of worry in tinnitus sufferers. Worry is a dispositional cognitive trait that involves a pervasive, non-specific, future-oriented proneness to fretting, which can foster negative affective states and catastrophic thinking about a specific trouble when the trouble is actual and present. We examined the relationship between worry and self-perceived anxiety and depressive symptoms and handicap in 54 outpatients with chronic tinnitus and sensorineural hearing loss who had been previously recruited for a randomized double-blind study on the efficacy of transmeatal low-level laser therapy for tinnitus. We measured the current anxiety and depressive symptoms with the State-Trait Anxiety Inventory Form Y-1/Self-evaluation Depression Scale, the handicap with the Tinnitus Handicap Inventory, and the proneness to worry with the Penn State Worry Questionnaire. For the psychoacoustic tinnitus measures, we considered the loudness match and the minimum masking level. We found that tinnitus-related anxiety and depressive symptoms and handicap were significantly associated with proneness to worry (linear regression models, p < 0.01), whereas no associations were found with the psychoacoustic measures. This suggests the usefulness of worry assessment when managing chronic tinnitus in clinical practice. Early therapeutic interventions for reducing proneness to worry may facilitate better adaptation to tinnitus.

Subjective tinnitus and hearing problems in adolescents.

PubMed

Bulbul, Selda Fatma; Muluk, Nuray Bayar; Cakir, Elif Pinar; Tufan, Erennur

2009-08-01

We investigated the hearing problems and tinnitus frequencies in adolescents at three public primary and two high schools. This study was carried out at three public primary and two high schools. 428 Turkish school children (244 girls, 184 boys) were asked to voluntarily answer a set of questionnaires in their classrooms at the beginning of the training program. There were 250 students (105 male, 145 female) in Primary School and 178 (79 male, 99 female) students in High School. We used questionnaire to evaluate subjective tinnitus and hearing problems. Walkman usage, listening loud and noisy music, intra-familial physical trauma, concentration difficulty in class and school success were also evaluated. In age-related groups (Group 1=11-13 years; Group 2=13-15 years; Group 3=16-18 years), hearing loss was present in 32.1% of Group 1, 19% of Group 2 and 28.3% of Group 3. Listening loud and noisy music was reported in 81.8% of Group 1, 95.4% of Group 2 and 87% of Group 3. Tinnitus was present 36.8% in Group 2, 33.5% in Group 1 and 31.5% in Group 3. Tinnitus after listening loud music was present in 42.7% of Group 2, 36.1% of Group 3 and 25.6% of Group 1. Among all students with tinnitus, 19.5% considered their school success as very good, 41.1% as good and 39.4% as bad. In students, using Walkman, tinnitus was seen both in the right and left ears. Tinnitus may be seen in adolescents at primary and high schools. Listening loud and noisy music and Walkman usage may cause an increase in the frequency of tinnitus manifestation. Adolescents should be educated about the hazardous effects of loud music. Education should include families, teachers, students, and whole community. These issues should be taken into public health policy of the countries.

A crossover trial comparing wide dynamic range compression and frequency compression in hearing aids for tinnitus therapy.

PubMed

Hodgson, Shirley-Anne; Herdering, Regina; Singh Shekhawat, Giriraj; Searchfield, Grant D

2017-01-01

It has been suggested that frequency lowering may be a superior tinnitus reducing digital signal processing (DSP) strategy in hearing aids than conventional amplification. A crossover trial was undertaken to determine if frequency compression (FC) was superior to wide dynamic range compression (WDRC) in reducing tinnitus. A 6-8-week crossover trial of two digital signal-processing techniques (WDRC and 2 WDRC with FC) was undertaken in 16 persons with high-frequency sensorineural hearing loss and chronic tinnitus. WDRC resulted in larger improvements in Tinnitus Functional Index and rating scale scores than WDRC with FC. The tinnitus improvements obtained with both processing types appear to be due to reduced hearing handicap and possibly decreased tinnitus audibility. Hearing aids are useful assistive devices in the rehabilitation of tinnitus. FC was very successful in a few individuals but was not superior to WDRC across the sample. It is recommended that WDRC remain as the default first choice tinnitus hearing aid processing strategy for tinnitus. FC should be considered as one of the many other options for selection based on individual hearing needs. Implications of Rehabilitation Hearing aids can significantly reduce the effects of tinnitus after 6-8 weeks of use. Addition of frequency compression digital signal processing does not appear superior to standard amplitude compression alone. Improvements in tinnitus were correlated with reductions in hearing handicap.

Unilateral Cochlear Implantation Reduces Tinnitus Loudness in Bimodal Hearing: A Prospective Study

PubMed Central

Servais, Jérôme J.; Hörmann, Karl; Wallhäusser-Franke, Elisabeth

2017-01-01

Perceptive and receptive aspects of subjective tinnitus like loudness and tinnitus-related distress are partly independent. The high percentage of hearing loss in individuals with tinnitus suggests causality of hearing impairment particularly for the tinnitus percept, leading to the hypothesis that restoration of auditory input has a larger effect on tinnitus loudness than on tinnitus-related distress. Furthermore, it is assumed that high levels of depression or anxiety prevent reductions of tinnitus loudness and distress following restoration of activity in the cochlea. This prospective study investigated the influence of unilateral cochlear implant (CI) on tinnitus in 19 postlingually deafened adults during 6 months following implantation. All had bimodal provision with the other ear being continuously supported by a hearing aid. On the day before CI implantation (T1, T2), and at about 3 and 6 months postsurgery (T3, T4), participants were questioned about their current tinnitus. Loudness was rated on a Numeric Rating Scale, distress was assessed by the TQ12 Tinnitus Questionnaire, and depression and anxiety were recorded with the Hospital Anxiety and Depression Scale. At T2, 79% experienced tinnitus, one participant developed tinnitus after implantation. Following implantation, tinnitus loudness was reduced significantly by 42%, while reductions in tinnitus-related distress (−24%), depression (−20%), and anxiety (−20%) did not attain statistical significance. Significant correlations existed between tinnitus measures, and between postimplantation tinnitus-related distress and anxiety and depression scores. Moreover, improvement of hearing in the CI ear was significantly correlated with reduction in tinnitus loudness. A new aspect of this study is the particular influence of CI provision on perceptive aspects of preexisting tinnitus (hypothesis 1), with the effect size regarding postimplant reduction of perceived tinnitus loudness (1.40) being much

Hearing Loss Prevention: Improvements to DOD Hearing Conservation Programs Could Lead to Better Outcomes

DTIC Science & Technology

2011-01-01

Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden...Figure 1: Growth in Numbers of New VA Disability Compensation Awards to Veterans for Hearing Loss and Tinnitus for Fiscal Years 2005 through 2009...Department of Veterans Affairs (VA) has reported that tinnitus (ringing in the ears) and hearing loss remain some of the most common service-connected

One-Year Results for Patients with Unilateral Hearing Loss and Accompanying Severe Tinnitus and Hyperacusis Treated with a Cochlear Implant.

PubMed

Ramos Macías, Angel; Falcón-González, Juan Carlos; Manrique Rodríguez, Manuel; Morera Pérez, Constantino; García-Ibáñez, Luis; Cenjor Español, Carlos; Coudert-Koall, Chrystelle; Killian, Matthijs

2018-06-21

To show that patients with unilateral hearing loss (UHL), with one ear fulfilling cochlear implant (CI) indication criteria, and an additional severe tinnitus handicap can be treated effectively with a CI. A prospective multi-centre study was conducted in five Spanish centres. Sixteen adult patients with UHL and a mean Tinnitus Handicap Inventory (THI) score of at least 58 were implanted. The study design included repeated within-subject measures of quality of life (Health Utility Index Mark 3 [HUI3]), tinnitus (THI, Visual Analogue Scale [VAS] on tinnitus loudness), hearing (Speech, Spatial, and Qualities of Hearing Scale- [SSQ]), and hyperacusis (Test de Hipersensibilidad al Sonido [THS]) up to 12 months after the initial CI fitting. Group data showed significant subjective benefit from CI treatment: the preoperative HUI3 total utility score of 0.45 went up to 0.57 at 6 months and 0.63 at 12 months; the preoperative THI total score of 75 decreased to 40 at 6 months and 35 at 12 months. The preoperative tinnitus loudness VAS score of 8.2 decreased to 2.4 at 6 months and 2.2 at 12 months with the implant "On" and to 6.7 at 6 months and 6.5 at 12 months with the implant "Off." The preoperative THS total score of 26 decreased to 17 at 12 months. The preoperative SSQ total score of 4.2 increased to 5.1 at 6 months and 6.3 at 12 months. No unanticipated adverse events were reported during the study period. At 12 months after CI activation all subjects (except 1 subject who used the device 6 days a week) wore their devices all day and every day. The primary reason for CI use was split evenly between tinnitus suppression (n = 6) and both hearing and tinnitus (n = 6). A CI should be considered as a treatment option in patients with UHL and a concomitant severe tinnitus handicap. However, appropriate counselling of candidates on the anticipated risks, benefits, and limitations that are inherent to cochlear implantation is imperative. © 2018 The Author(s) Published by S

Patient-Reported Measures of Hearing Loss and Tinnitus in Pediatric Cancer and Hematopoietic Stem Cell Transplantation: A Systematic Review

ERIC Educational Resources Information Center

Stark, Daniel; Rosenberg, Abby R.; Johnston, Donna; Knight, Kristin; Caperon, Lizzie; Uleryk, Elizabeth; Frazier, A. Lindsay; Sung, Lillian

2016-01-01

Purpose: We identified studies that described use of any patient-reported outcome scale for hearing loss or tinnitus among children and adolescents and young adults (AYAs) with cancer or hematopoietic stem cell transplantation (HSCT) recipients. Method: In this systematic review, we performed electronic searches of OvidSP MEDLINE, EMBASE, and…

Clinical Trials: D-Methionine to Reduce Noise-Induced Hearing Loss. Phase 3

DTIC Science & Technology

2014-03-01

placebo-controlled Phase 3 clinical trial of oral D-met to reduce noise-induced hearing loss (NIHL) and tinnitus . The goal of the study is to...primary objective of this study is to determine the efficacy of D-Met in preventing NIHL or reducing tinnitus secondary to a minimum of 500 rounds...an oral, orange flavored suspension of D-methionine can prevent noise-induced hearing loss (NIHL) and tinnitus in our troops. Hypotheses

Reiter's syndrome and hearing loss: a possible association?

PubMed

Monsanto, Rafael C; Neto, Arlindo C L; Lorenzetti, Fábio T M

2014-12-01

Patient complained of hearing loss and tinnitus after the onset of Reiter's syndrome. Audiometry confirmed the hearing loss on the left ear; blood work showed increased erythrocyte sedimentation rate and C3 fraction of the complement. Genotyping for HLA-B27 was positive. Treatment with prednisolone did not improve the hearing levels.

Audiometric Testing With Pulsed, Steady, and Warble Tones in Listeners With Tinnitus and Hearing Loss

PubMed Central

Walker, Matthew A.; Short, Ciara E.; Skinner, Kimberly G.

2017-01-01

Purpose This study evaluated the American Speech-Language-Hearing Association's recommendation that audiometric testing for patients with tinnitus should use pulsed or warble tones. Using listeners with varied audiometric configurations and tinnitus statuses, we asked whether steady, pulsed, and warble tones yielded similar audiometric thresholds, and which tone type was preferred. Method Audiometric thresholds (octave frequencies from 0.25–16 kHz) were measured using steady, pulsed, and warble tones in 61 listeners, who were divided into 4 groups on the basis of hearing and tinnitus status. Participants rated the appeal and difficulty of each tone type on a 1–5 scale and selected a preferred type. Results For all groups, thresholds were lower for warble than for pulsed and steady tones, with the largest effects above 4 kHz. Appeal ratings did not differ across tone type, but the steady tone was rated as more difficult than the warble and pulsed tones. Participants generally preferred pulsed and warble tones. Conclusions Pulsed tones provide advantages over steady and warble tones for patients regardless of hearing or tinnitus status. Although listeners preferred pulsed and warble tones to steady tones, pulsed tones are not susceptible to the effects of off-frequency listening, a consideration when testing listeners with sloping audiograms. PMID:28892822

Audiometric Testing With Pulsed, Steady, and Warble Tones in Listeners With Tinnitus and Hearing Loss.

PubMed

Lentz, Jennifer J; Walker, Matthew A; Short, Ciara E; Skinner, Kimberly G

2017-09-18

This study evaluated the American Speech-Language-Hearing Association's recommendation that audiometric testing for patients with tinnitus should use pulsed or warble tones. Using listeners with varied audiometric configurations and tinnitus statuses, we asked whether steady, pulsed, and warble tones yielded similar audiometric thresholds, and which tone type was preferred. Audiometric thresholds (octave frequencies from 0.25-16 kHz) were measured using steady, pulsed, and warble tones in 61 listeners, who were divided into 4 groups on the basis of hearing and tinnitus status. Participants rated the appeal and difficulty of each tone type on a 1-5 scale and selected a preferred type. For all groups, thresholds were lower for warble than for pulsed and steady tones, with the largest effects above 4 kHz. Appeal ratings did not differ across tone type, but the steady tone was rated as more difficult than the warble and pulsed tones. Participants generally preferred pulsed and warble tones. Pulsed tones provide advantages over steady and warble tones for patients regardless of hearing or tinnitus status. Although listeners preferred pulsed and warble tones to steady tones, pulsed tones are not susceptible to the effects of off-frequency listening, a consideration when testing listeners with sloping audiograms.

Reduced volume of Heschl's gyrus in tinnitus.

PubMed

Schneider, Peter; Andermann, Martin; Wengenroth, Martina; Goebel, Rainer; Flor, Herta; Rupp, André; Diesch, Eugen

2009-04-15

The neural basis of tinnitus is unknown. Recent neuroimaging studies point towards involvement of several cortical and subcortical regions. Here we demonstrate that tinnitus may be associated with structural changes in the auditory cortex. Using individual morphological segmentation, the medial partition of Heschl's gyrus (mHG) was studied in individuals with and without chronic tinnitus using magnetic resonance imaging. Both the tinnitus and the non-tinnitus group included musicians and non-musicians. Patients exhibited significantly smaller mHG gray matter volumes than controls. In unilateral tinnitus, this effect was almost exclusively seen in the hemisphere ipsilateral to the affected ear. In bilateral tinnitus, mHG volume was substantially reduced in both hemispheres. The tinnitus-related volume reduction was found across the full extent of mHG, not only in the high-frequency part usually most affected by hearing loss-induced deafferentation. However, there was also evidence for a relationship between volume reduction and hearing loss. Correlations between volume and hearing level depended on the subject group as well as the asymmetry of the hearing loss. The volume changes observed may represent antecedents or consequences of tinnitus and tinnitus-associated hearing loss and also raise the possibility that small cortical volume constitutes a vulnerability factor.

Tinnitus

MedlinePlus

... tinnitus in a significant number of study volunteers. Cochlear implants are sometimes used in people who have tinnitus along with severe hearing loss. A cochlear implant bypasses the damaged portion of the inner ...

Reiter's syndrome and hearing loss: a possible association?

PubMed Central

Monsanto, Rafael C; Neto, Arlindo C L; Lorenzetti, Fábio T M

2014-01-01

Key Clinical Message Patient complained of hearing loss and tinnitus after the onset of Reiter's syndrome. Audiometry confirmed the hearing loss on the left ear; blood work showed increased erythrocyte sedimentation rate and C3 fraction of the complement. Genotyping for HLA-B27 was positive. Treatment with prednisolone did not improve the hearing levels. PMID:25548635

The Role of Audiologic Evaluation in Progressive Audiologic Tinnitus Management

PubMed Central

Henry, James A.; Zaugg, Tara L.; Myers, Paula J.; Schechter, Martin A.

2008-01-01

Progressive Audiologic Tinnitus Management (PATM) is based on the premise that tinnitus is managed most efficiently using a hierarchy of clinical services that address different levels of need. PATM includes five levels of management: (a) triage; (b) audiologic evaluation; (c) group education; (d) tinnitus evaluation; and (e) individualized management. This article provides an overview of PATM and focuses on the procedures that make up the Level 2 Audiologic Evaluation. The evaluation is conducted to assess the potential need for medical, audiologic (hearing loss, tinnitus, hyperacusis), and/or mental health services. The Tinnitus Handicap Inventory, Hearing Handicap Inventory, and Tinnitus and Hearing Survey are used to differentiate effects of tinnitus and hearing loss. If indicated, patients are interviewed with the Tinnitus-Impact Screening Interview. Patients requiring amplification receive hearing aids. Often, management of hearing loss at Level 2 addresses any problems that were attributed to the tinnitus, which obviates further tinnitus-specific intervention. PMID:18628281

[The comparison of clinical features and laboratory indexes between flat descending hearing loss and total hearing loss].

PubMed

Wang, R L; Zhang, D M

2017-12-20

Objective: To discuss similarities and differences in clinical features and laboratory indexes between patients with flat descending type sudden hearing loss and those with total hearing loss. Method: The clinical data of 123 patients with full frequencies hearing loss were retrospectively analyzed. The differences in clinical features and laboratory tests(platelet, coagulation series, D-dimer, blood lipids, hemorheology) between patients with flat descending hearing loss and those with total hearing loss were analyzed by gender, age and ear side, treatment time, concomitant symptom (tinnitus, dizziness), original underlying diseases (hypertension, diabetes), etc. Result: In the clinical features,among 51 flat descending cases, the ratio of male and female was 2.401:1; among 72 total hearing loss cases, the ratio of men and women ratio was 1.058:1 ( P <0.05). Among two groups of patients,the majority received treatment within 7 days, among whom 66.7% were flat descending population, and 83.3% were total hearing loss population ( P <0.05). Flat descending population with dizziness only accounted for 35.3% while this figure was up to 70.8% when it came to total hearing loss patients ( P <0.01). Two groups showed no differences in age, ear side, tinnitus, the original underlying diseases (hypertension, diabetes). In the laboratory tests, the total hearing loss population overtopped the plat descending population in PLT and PCT ( P <0.05), while falling below the plat descending population in APTT ( P <0.01). Two groups showed no differences in other indicators of platelet and coagulation series and laboratory data of D-dimer, blood lipids, hemorheology. Conclusion: Compared with flat descending sudden hearing loss, sudden total hearing loss more frequently happened to females who also were accompanied by dizziness. The treatment rate within 7 days was high and the patients with hypercoagulable state accounted for a higher proportion. Copyright© by the Editorial

Right-Ear Advantage for Speech-in-Noise Recognition in Patients with Nonlateralized Tinnitus and Normal Hearing Sensitivity.

PubMed

Tai, Yihsin; Husain, Fatima T

2018-04-01

Despite having normal hearing sensitivity, patients with chronic tinnitus may experience more difficulty recognizing speech in adverse listening conditions as compared to controls. However, the association between the characteristics of tinnitus (severity and loudness) and speech recognition remains unclear. In this study, the Quick Speech-in-Noise test (QuickSIN) was conducted monaurally on 14 patients with bilateral tinnitus and 14 age- and hearing-matched adults to determine the relation between tinnitus characteristics and speech understanding. Further, Tinnitus Handicap Inventory (THI), tinnitus loudness magnitude estimation, and loudness matching were obtained to better characterize the perceptual and psychological aspects of tinnitus. The patients reported low THI scores, with most participants in the slight handicap category. Significant between-group differences in speech-in-noise performance were only found at the 5-dB signal-to-noise ratio (SNR) condition. The tinnitus group performed significantly worse in the left ear than in the right ear, even though bilateral tinnitus percept and symmetrical thresholds were reported in all patients. This between-ear difference is likely influenced by a right-ear advantage for speech sounds, as factors related to testing order and fatigue were ruled out. Additionally, significant correlations found between SNR loss in the left ear and tinnitus loudness matching suggest that perceptual factors related to tinnitus had an effect on speech-in-noise performance, pointing to a possible interaction between peripheral and cognitive factors in chronic tinnitus. Further studies, that take into account both hearing and cognitive abilities of patients, are needed to better parse out the effect of tinnitus in the absence of hearing impairment.

The effect of tinnitus retraining therapy on chronic tinnitus: A controlled trial

PubMed Central

Berry, Jennifer L.; Brozoski, Thomas J.

2017-01-01

Objectives The goal of this study was to compare treatment outcomes for chronic bothersome tinnitus after Tinnitus Retraining Therapy (TRT) versus standard of care treatment (SC) and to determine the longevity of the effect over an 18‐month period. Study Design A randomized controlled trial comparing TRT to SC for chronic tinnitus. Methods Adults with subjective, stable, bothersome chronic tinnitus associated with hearing loss amenable to aural rehabilitation with hearing aids were recruited. The Tinnitus Handicap Inventory (THI) was the primary outcome measure and the Tinnitus Functional Index (TFI) the secondary outcome measure of tinnitus severity and impact. Data were collected at screening, entry (0 months), and 6, 12, and 18 months after the beginning of treatment, using an integrated digitized suite of evaluation modules. TRT consisted of directive counseling and acoustic enrichment using combination hearing aids and sound generators; SC consisted of general aural rehabilitation counseling and hearing aids. Results Significant improvement in tinnitus impact occurred after both TRT and SC therapy, with a larger treatment effect obtained in the TRT group. Lasting therapeutic benefit was evident at 18 months in both groups. THI initial scores were unstable in 10% of enrolled participants, showing moderate bidirectional fluctuation between screening and baseline (0 month) assessment. Conclusion Adults with moderate to severe tinnitus and hearing loss amenable to amplification, benefit from either TRT or SC treatment when combined with hearing aid use. TRT benefit may exceed that of SC. The global improvement in tinnitus severity that accrued over an 18‐month period appeared to be robust and clinically significant. Level of Evidence I PMID:28894836

Investigation of Tinnitus Patients in Italy: Clinical and Audiological Characteristics

PubMed Central

Martines, Francesco; Bentivegna, Daniela; Di Piazza, Fabiola; Martines, Enrico; Sciacca, Vincenzo; Martinciglio, Gioacchino

2010-01-01

Objective. 312 tinnitus sufferers were studied in order to analyze: the clinical characteristics of tinnitus; the presence of tinnitus-age correlation and tinnitus-hearing loss correlation; the impact of tinnitus on subjects' life and where possible the etiological/predisposing factors of tinnitus. Results. There is a slight predominance of males. The highest percentage of tinnitus results in the decades 61–70. Of the tinnitus sufferers, 197 (63.14%) have a hearing deficit (light hearing loss in 37.18% of cases). The hearing impairment results of sensorineural type in 74.62% and limited to the high frequencies in 58.50%. The tinnitus is referred as unilateral in 59.93%, a pure tone in 66.99% and 10 dB above the hearing threshold in 37.7%. It is limited to high frequencies in 72.10% of the patients with sensorineural hearing loss (SNHL) while the 88.37% of the patients with high-frequency SNHL have a high-pitched tinnitus (χ 2 = 66.26;P < .005). Conclusion. Hearing status and age represent the principal tinnitus related factors; there is a statistically significant association between high-pitched tinnitus and high-frequency SNHL. There is no significant correlation between tinnitus severity and tinnitus loudness confirming the possibility that neural connection involved in evoking tinnitus-related negative reactions are governed by conditioned reflexes. PMID:20652075

Hearing thresholds, tinnitus, and headphone listening habits in nine-year-old children.

PubMed

Båsjö, Sara; Möller, Claes; Widén, Stephen; Jutengren, Göran; Kähäri, Kim

2016-10-01

Investigate hearing function and headphone listening habits in nine-year-old Swedish children. A cross-sectional study was conducted and included otoscopy, tympanometry, pure-tone audiometry, and spontaneous otoacoustic emissions (SOAE). A questionnaire was used to evaluate headphone listening habits, tinnitus, and hyperacusis. A total of 415 children aged nine years. The prevalence of a hearing threshold ≥20 dB HL at one or several frequencies was 53%, and the hearing thresholds at 6 and 8 kHz were higher than those at the low and mid frequencies. SOAEs were observed in 35% of the children, and the prevalence of tinnitus was 5.3%. No significant relationship between SOAE and tinnitus was found. Pure-tone audiometry showed poorer hearing thresholds in children with tinnitus and in children who regularly listened with headphones. The present study of hearing, listening habits, and tinnitus in nine-year old children is, to our knowledge, the largest study so far. The main findings were that hearing thresholds in the right ear were poorer in children who used headphones than in children not using them, which could be interpreted as headphone listening may have negative consequences to children's hearing. Children with tinnitus showed poorer hearing thresholds compared to children without tinnitus.

Comparison of tinnitus and psychological aspects between the younger and older adult patients with tinnitus.

PubMed

Park, So Young; Han, Jung Ju; Hwang, Jae Hyung; Whang, Eul Sung; Yeo, Sang Won; Park, Shi Nae

2017-04-01

To explore the differences in various tinnitus-related features and psychological aspects between the younger and older adult patients with tinnitus. We retrospectively reviewed the clinical data of the adult patients who visited our tinnitus clinic in 2013 and completed full tinnitus assessment including audiometry, tinnitus matching, standardized tinnitus questionnaires, and psychometric questionnaires. The younger group included patients aged 20-45 years (n=64), and the older group, those older than 65 years (n=76). Clinical features, hearing levels, matched tinnitus pitches and loudness, self-report tinnitus severity scores, Beck depression inventory scores, and stress scores were compared between the groups. Tinnitus duration was longer in the older group (p=0.002). Mean PTAs were 16dB HL in the younger, and 38dB HL in the older groups (p<0.001). Eighty-nine percent of the younger patients had normal hearing, while 82% of the older patients had hearing loss (p<0.001). Matched tinnitus loudness was greater in the older group (64dB HL vs. 36dB HL, p<0.001). All of the self-report tinnitus, depression, and stress scores did not differ between the groups. The older patients seemed to be more receptive to tinnitus. The majority of older tinnitus patients had concomitant hearing loss, and thus hearing rehabilitation should be considered preferentially for tinnitus management in this age group. Subjective tinnitus severity, depressive symptoms, and the stress levels were similar between the younger and older tinnitus patients. Therefore, treatment could be planned based upon the comprehensive understanding of the tinnitus characteristics and psychological aspects in each patient irrespective of age. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Protective Effects of Ginkgo biloba Extract EGb 761 against Noise Trauma-Induced Hearing Loss and Tinnitus Development

PubMed Central

Korn, Sabine

2014-01-01

Noise-induced hearing loss (NIHL) and resulting comorbidities like subjective tinnitus are common diseases in modern societies. A substance shown to be effective against NIHL in an animal model is the Ginkgo biloba extract EGb 761. Further effects of the extract on the cellular and systemic levels of the nervous system make it a promising candidate not only for protection against NIHL but also for its secondary comorbidities like tinnitus. Following an earlier study we here tested the potential effectiveness of prophylactic EGb 761 treatment against NIHL and tinnitus development in the Mongolian gerbil. We monitored the effects of EGb 761 and noise trauma-induced changes on signal processing within the auditory system by means of behavioral and electrophysiological approaches. We found significantly reduced NIHL and tinnitus development upon EGb 761 application, compared to vehicle treated animals. These protective effects of EGb 761 were correlated with changes in auditory processing, both at peripheral and central levels. We propose a model with two main effects of EGb 761 on auditory processing, first, an increase of auditory brainstem activity leading to an increased thalamic input to the primary auditory cortex (AI) and second, an asymmetric effect on lateral inhibition in AI. PMID:25028612

Assessment of hearing and hearing disorders in rock/jazz musicians.

PubMed

Kähärit, Kim; Zachau, Gunilla; Eklöf, Mats; Sandsjö, Leif; Möller, Claes

2003-07-01

The aim of this study was to assess hearing and hearing disorders among rock/jazz musicians. One hundred and thirty-nine (43 women and 96 men) musicians participated. The results are based on pure-tone audiometry and questionnaire responses. According to our definition of hearing loss, tinnitus, hyperacusis, distortion and/or diplacusis as hearing disorders, we found disorders in 74%, of the rock/jazz musicians studied. Hearing loss, tinnitus and hyperacusis were most common, and the latter two were found significantly more frequently than in different reference populations. The women showed bilateral, significantly better hearing thresholds at 3-6 kHz than the men. Hyperacusis, and the combination of both hyperacusis and tinnitus, were found to be significantly more frequent among women than among men. Hearing loss and tinnitus were significantly more common among men than among women. It is important to evaluate all kinds of hearing problems (other than hearing loss) in musicians, since they represent an occupational group especially dependent on optimal, functional hearing. On the basis of our results, we suggest that hearing problems such as tinnitus, hyperacusis, distortion and/or diplacusis should, in addition to hearing loss, be defined as hearing disorders.

Learning tinnitus

NASA Astrophysics Data System (ADS)

van Hemmen, J. Leo

Tinnitus, implying the perception of sound without the presence of any acoustical stimulus, is a chronic and serious problem for about 2% of the human population. In many cases, tinnitus is a pitch-like sensation associated with a hearing loss that confines the tinnitus frequency to an interval of the tonotopic axis. Even in patients with a normal audiogram the presence of tinnitus may be associated with damage of hair-cell function in this interval. It has been suggested that homeostatic regulation and, hence, increase of activity leads to the emergence of tinnitus. For patients with hearing loss, we present spike-timing-dependent Hebbian plasticity (STDP) in conjunction with homeostasis as a mechanism for ``learning'' tinnitus in a realistic neuronal network with tonotopically arranged synaptic excitation and inhibition. In so doing we use both dynamical scaling of the synaptic strengths and altering the resting potential of the cells. The corresponding simulations are robust to parameter changes. Understanding the mechanisms of tinnitus induction, such as here, may help improving therapy. Work done in collaboration with Julie Goulet and Michael Schneider. JLvH has been supported partially by BCCN - Munich.

The Prevalence and Characteristics of Tinnitus with Profound Sensori-Neural Hearing Impairment.

ERIC Educational Resources Information Center

Drukier, Gale S.

1989-01-01

Of 331 children (aged 6-18) with profound hearing impairment, 96 were found to have tinnitus. More females than males reported tinnitus. Most of the children with tinnitus were bothered to some degree by it and indicated that the noises adversely affected their ability to hear voices. (JDD)

Effect of stapedotomy on pre-operative tinnitus and its psychosomatic burden.

PubMed

Bast, Florian; Mazurek, Birgit; Schrom, Thomas

2013-12-01

According to the literature, between 40 and 90% of otosclerosis patients suffering from hearing loss also suffer from tinnitus on the affected side. For a lot of these patients tinnitus represents a handicap that is just as debilitating as the hearing loss itself. The main goal of the surgical treatment of otosclerosis is a significant improvement in hearing loss, but frequent reports of reduced tinnitus after surgery suggest that this can be a positive side effect. All patients who underwent stapedotomy were initially included in the study. Retrospectively, the tinnitus questionnaire as compiled by Goebel and Hiller was sent to the patients, and 34 patients (37 ears) replied. The pre- and postoperative cases of tinnitus were divided into compensated and non-compensated tinnitus. In addition the following tinnitus-related factors were evaluated: emotional, cognitive and mental burden; intrusiveness of the tinnitus; hearing problems; somatic ailments; and sleep disturbances. Over 80% of the patients surveyed suffered from tinnitus pre-operation. The tinnitus disappeared or improved in over 60% of the cases after stapedotomy. In addition, the related factors surveyed also improved appreciably post surgery and reached a significant level in patients with compensated tinnitus. Besides a significant improvement in hearing loss the intensity and the psychosomatic burden of a pre-operative tinnitus can be reduced by stapedotomy. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Cortico-limbic morphology separates tinnitus from tinnitus distress

PubMed Central

Leaver, Amber M.; Seydell-Greenwald, Anna; Turesky, Ted K.; Morgan, Susan; Kim, Hung J.; Rauschecker, Josef P.

2012-01-01

Tinnitus is a common auditory disorder characterized by a chronic ringing or buzzing “in the ear.”Despite the auditory-perceptual nature of this disorder, a growing number of studies have reported neuroanatomical differences in tinnitus patients outside the auditory-perceptual system. Some have used this evidence to characterize chronic tinnitus as dysregulation of the auditory system, either resulting from inefficient inhibitory control or through the formation of aversive associations with tinnitus. It remains unclear, however, whether these “non-auditory” anatomical markers of tinnitus are related to the tinnitus signal itself, or merely to negative emotional reactions to tinnitus (i.e., tinnitus distress). In the current study, we used anatomical MRI to identify neural markers of tinnitus, and measured their relationship to a variety of tinnitus characteristics and other factors often linked to tinnitus, such as hearing loss, depression, anxiety, and noise sensitivity. In a new cohort of participants, we confirmed that people with chronic tinnitus exhibit reduced gray matter in ventromedial prefrontal cortex (vmPFC) compared to controls matched for age and hearing loss. This effect was driven by reduced cortical surface area, and was not related to tinnitus distress, symptoms of depression or anxiety, noise sensitivity, or other factors. Instead, tinnitus distress was positively correlated with cortical thickness in the anterior insula in tinnitus patients, while symptoms of anxiety and depression were negatively correlated with cortical thickness in subcallosal anterior cingulate cortex (scACC) across all groups. Tinnitus patients also exhibited increased gyrification of dorsomedial prefrontal cortex (dmPFC), which was more severe in those patients with constant (vs. intermittent) tinnitus awareness. Our data suggest that the neural systems associated with chronic tinnitus are different from those involved in aversive or distressed reactions to

[Tinnitus: algorithm of diagnostics and clinical management].

PubMed

Boiko, N V

Hearing of sound, or tinnitus, can be a symptom of different diseases. The differential diagnosis should be based on the identification of subgroups with confirmed causes of the disease. Subjective and objective tinnitus groups should be isolated. Objective tinnitus can be vascular or muscular. In making a diagnosis of tinnitus, it is important to know its characteristics, laterality, circumstances of onset, duration, comorbidity with other symptoms: headache, hearing decline, dizziness, depression, etc. Urgent diagnostic and treatment measures are needed after the identification of 'red flags': acute pulsatile tinnitus, in particular after the brain injury, combination of tinnitus with acute hearing loss and depression.

[Analysis of characteristics of tinnitus in patients with auditory neuropathy spectrum disorder].

PubMed

Wang, Hongyang; Qi, Yue; Guan, Jing; Lan, Lan; Xie, Linyi; Yu, Lan; Yin, Zifang; Zong, Liang; Wang, Dayong; Wang, Qiuju

2014-04-01

To investigate the characteristics of tinnitus in patients with auditory neuropathy spec- trum disorder (ANSD). This study recruited 14 ANSD patients with tinnitus. All the ANSD patients un- derwent detailed history taking, audiological examinations and assessments of tinnitus. This study analyzed the correlation of tinnitus status and hearing loss, and discussed the effects of sex, age, and the course of disease on tinnitus in ANSD patients. (1) In the ANSD patients, tinnitus often occurred in 3 years after the onset of hearing loss; (2) Tinnitus was highly prevalent in ANSD patients, and the severity of tinnitus was mostly from mild to moderate; (3) There was no obvious correlation between the subjective grading of tinnitus and hearing loss de- gree, and the impact of curve patterns of hearing loss on the level of tinnitus need much more evidence-based proof; (4) Along with the course extension, the impact of tinnitus on the quality of life was much more obvious; (5) Some risk factors such as noise exposure could be the reasons of aggravating the degree of tinnitus. Tinnitus in ANSD patients has its unique clinical features. The study of Tinnitus in ANSD patients can provide clinical basis for further research in ANSD.

Progressive sensorineural hearing loss, subjective tinnitus and vertigo caused by elevated blood lipids.

PubMed

Pulec, J L; Pulec, M B; Mendoza, I

1997-10-01

The otologist frequently sees patients with progressive sensorineural hearing loss, subjective aural tinnitus and vertigo with no apparent cause. Elevated blood lipids may be a cause of inner ear malfunction on a biochemical basis. To establish the true incidence of this condition, all new patients (4,251) seen during an eight-year period were evaluated; of these, 2,332 patients had complaints of inner ear disease. All had a complete neurotologic examination, appropriate audiometric and vestibular studies and imaging, and blood tests including lipid phenotype studies. Hyperlipoproteinemia was found in 120 patients (5.1%). Most patients were found to be overweight and had additional coexisting conditions such as diabetes mellitus. Treatment with vasodilators and a 500-calorie, high-protein, low-carbohydrate diet yielded improvement of symptoms in 83% of patients within five months of initiation of treatment.

Quality of Life and Hearing Eight Years After Sudden Sensorineural Hearing Loss.

PubMed

Härkönen, Kati; Kivekäs, Ilkka; Rautiainen, Markus; Kotti, Voitto; Vasama, Juha-Pekka

2017-04-01

To explore long-term hearing results, quality of life (QoL), quality of hearing (QoH), work-related stress, tinnitus, and balance problems after idiopathic sudden sensorineural hearing loss (ISSNHL). Cross-sectional study. We reviewed the audiograms of 680 patients with unilateral ISSNHL on average 8 years after the hearing impairment, and then divided the patients into two study groups based on whether their ISSNHL had recovered to normal (pure tone average [PTA] ≤ 30 dB) or not (PTA > 30 dB). The inclusion criteria were a hearing threshold decrease of 30 dB or more in at least three contiguous frequencies occurring within 72 hours in the affected ear and normal hearing in the contralateral ear. Audiograms of 217 patients fulfilled the criteria. We reviewed their medical records; measured present QoL, QoH, and work-related stress with specific questionnaires; and updated the hearing status. Poor hearing outcome after ISSNHL was correlated with age, severity of hearing loss, and vertigo together with ISSNHL. Quality of life and QoH were statistically significantly better in patients with recovered hearing, and the patients had statistically significantly less tinnitus and balance problems. During the 8-year follow-up, the PTA of the affected ear deteriorated on average 7 dB, and healthy ear deteriorated 6 dB. Idiopathic sudden sensorineural hearing loss that failed to recover had a negative impact on long-term QoL and QoH. The hearing deteriorated as a function of age similarly both in the affected and the healthy ear, and there were no differences between the groups. The cumulative recurrence rate for ISSNHL was 3.5%. 4 Laryngoscope, 127:927-931, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Survey of commercial airline pilots' hearing loss

NASA Technical Reports Server (NTRS)

Begault, D. R.; Wenzel, E. M.; Tran, L. L.; Anderson, M. R.

1998-01-01

64 commercial airline pilots (ages 35-64 yr, Mdn: 53) were surveyed regarding hearing loss and tinnitus. Within specific age groups, the proportions responding positively exceed the corresponding proportions in the general population reported by the National Center for Health Statistics.

The relationship between tinnitus pitch and parameters of audiometry and distortion product otoacoustic emissions.

PubMed

Keppler, H; Degeest, S; Dhooge, I

2017-11-01

Chronic tinnitus is associated with reduced auditory input, which results in changes in the central auditory system. This study aimed to examine the relationship between tinnitus pitch and parameters of audiometry and distortion product otoacoustic emissions. For audiometry, the parameters represented the edge frequency of hearing loss, the frequency of maximum hearing loss and the frequency range of hearing loss. For distortion product otoacoustic emissions, the parameters were the frequency of lowest distortion product otoacoustic emission amplitudes and the frequency range of reduced distortion product otoacoustic emissions. Sixty-seven patients (45 males, 22 females) with subjective chronic tinnitus, aged 18 to 73 years, were included. No correlation was found between tinnitus pitch and parameters of audiometry and distortion product otoacoustic emissions. However, tinnitus pitch fell mostly within the frequency range of hearing loss. The current study seems to confirm the relationship between tinnitus pitch and the frequency range of hearing loss, thus supporting the homeostatic plasticity model.

Psychoacoustic Tinnitus Loudness and Tinnitus-Related Distress Show Different Associations with Oscillatory Brain Activity

PubMed Central

Balkenhol, Tobias; Wallhäusser-Franke, Elisabeth; Delb, Wolfgang

2013-01-01

Background The phantom auditory perception of subjective tinnitus is associated with aberrant brain activity as evidenced by magneto- and electroencephalographic studies. We tested the hypotheses (1) that psychoacoustically measured tinnitus loudness is related to gamma oscillatory band power, and (2) that tinnitus loudness and tinnitus-related distress are related to distinct brain activity patterns as suggested by the distinction between loudness and distress experienced by tinnitus patients. Furthermore, we explored (3) how hearing impairment, minimum masking level, and (4) psychological comorbidities are related to spontaneous oscillatory brain activity in tinnitus patients. Methods and Findings Resting state oscillatory brain activity recorded electroencephalographically from 46 male tinnitus patients showed a positive correlation between gamma band oscillations and psychoacoustic tinnitus loudness determined with the reconstructed tinnitus sound, but not with the other psychoacoustic loudness measures that were used. Tinnitus-related distress did also correlate with delta band activity, but at electrode positions different from those associated with tinnitus loudness. Furthermore, highly distressed tinnitus patients exhibited a higher level of theta band activity. Moreover, mean hearing loss between 0.125 kHz and 16 kHz was associated with a decrease in gamma activity, whereas minimum masking levels correlated positively with delta band power. In contrast, psychological comorbidities did not express significant correlations with oscillatory brain activity. Conclusion Different clinically relevant tinnitus characteristics show distinctive associations with spontaneous brain oscillatory power. Results support hypothesis (1), but exclusively for the tinnitus loudness derived from matching to the reconstructed tinnitus sound. This suggests to preferably use the reconstructed tinnitus spectrum to determine psychoacoustic tinnitus loudness. Results also support

Residual Inhibition Functions Overlap Tinnitus Spectra and the Region of Auditory Threshold Shift

PubMed Central

Moffat, Graeme; Baumann, Michael; Ward, Lawrence M.

2008-01-01

Animals exposed to noise trauma show augmented synchronous neural activity in tonotopically reorganized primary auditory cortex consequent on hearing loss. Diminished intracortical inhibition in the reorganized region appears to enable synchronous network activity that develops when deafferented neurons begin to respond to input via their lateral connections. In humans with tinnitus accompanied by hearing loss, this process may generate a phantom sound that is perceived in accordance with the location of the affected neurons in the cortical place map. The neural synchrony hypothesis predicts that tinnitus spectra, and heretofore unmeasured “residual inhibition functions” that relate residual tinnitus suppression to the center frequency of masking sounds, should cover the region of hearing loss in the audiogram. We confirmed these predictions in two independent cohorts totaling 90 tinnitus subjects, using computer-based tools designed to assess the psychoacoustic properties of tinnitus. Tinnitus spectra and residual inhibition functions for depth and duration increased with the amount of threshold shift over the region of hearing impairment. Residual inhibition depth was shallower when the masking sounds that were used to induce residual inhibition showed decreased correspondence with the frequency spectrum and bandwidth of the tinnitus. These findings suggest that tinnitus and its suppression in residual inhibition depend on processes that span the region of hearing impairment and not on mechanisms that enhance cortical representations for sound frequencies at the audiometric edge. Hearing thresholds measured in age-matched control subjects without tinnitus implicated hearing loss as a factor in tinnitus, although elevated thresholds alone were not sufficient to cause tinnitus. PMID:18712566

Tinnitus with temporomandibular joint disorders: a specific entity of tinnitus patients?

PubMed

Vielsmeier, Veronika; Kleinjung, Tobias; Strutz, Jürgen; Bürgers, Ralf; Kreuzer, Peter Michael; Langguth, Berthold

2011-11-01

Tinnitus is frequently associated with temporomandibular joint (TMJ) dysfunction. However, the nature of the relationship is not fully understood. Here the authors compared 30 patients with a confirmed diagnosis of temporomandibular joint dysfunction and tinnitus to a group of 61 patients with tinnitus but without any subjective complaints of TMJ dysfunction with respect to clinical and demographic characteristics. Case-control study. Tertiary referral center. Tinnitus patients with and without TMJ dysfunction presenting at the Department of Prosthetic Dentistry and th: Tinnitus Clinic at the University of Regensburg. Tinnitus patients with TMJ disorder had better hearing function (P < .0005), lower age (P = .001), and lower age at tinnitus onset (P = .002) and were more frequently female (P = .003). Their subjectively perceived tinnitus loudness was lower (P = .01), and more of them could modulate their tinnitus by jaw or neck movements (P = .001). Classical risk factors for tinnitus (age, male gender, hearing loss) are less relevant in tinnitus patients with TMJ disorder, suggesting a causal role of TMJ pathology in the generation and maintenance of tinnitus. Based on this finding, treatment of TMJ disorder may represent a causally oriented treatment strategy for tinnitus.

Analysis of the prevalence and associated risk factors of tinnitus in adults.

PubMed

Kim, Hyung-Jong; Lee, Hyo-Jeong; An, Soo-Youn; Sim, Songyong; Park, Bumjung; Kim, Si Whan; Lee, Joong Seob; Hong, Sung Kwang; Choi, Hyo Geun

2015-01-01

Tinnitus is a common condition in adults; however, the pathophysiology of tinnitus remains unclear, and no large population-based study has assessed the associated risk factors. The aim of this study was to analyze the prevalence and associated risk factors of tinnitus. We conducted a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey, with 19,290 participants ranging in age from 20 to 98 years old, between 2009 and 2012. We investigated the prevalence of tinnitus using a questionnaire and analyzed various possible factors associated with tinnitus using simple and multiple logistic regression analysis with complex sampling. The prevalence of tinnitus was 20.7%, and the rates of tinnitus associated with no discomfort, moderate annoyance, and severe annoyance were 69.2%, 27.9%, and 3.0%, respectively. The prevalence of tinnitus and the rates of annoying tinnitus increased with age. The adjusted odds ratio (AOR) of tinnitus was higher for females, those with a smoking history, those reporting less sleep (≤ 6 h), those with more stress, those in smaller households, those with a history of hyperlipidemia osteoarthritis, rheumatoid arthritis, asthma, depression, thyroid disease, an abnormal tympanic membrane, unilateral hearing loss, bilateral hearing loss, noise exposure from earphones, noise exposure at the workplace, noise exposure outside the workplace, and brief noise exposure. Additionally, unemployed individuals and soldiers had higher AORs for tinnitus. The AOR of annoying tinnitus increased with age, stress, history of hyperlipidemia, unilateral hearing loss, and bilateral hearing loss. Tinnitus is very common in the general population and is associated with gender, smoking, stress, sleep, hearing loss, hyperlipidemia, osteoarthritis, rheumatoid arthritis, asthma, depression, and thyroid disease history.

Assessing tinnitus and prospective tinnitus therapeutics using a psychophysical animal model.

PubMed

Bauer, C A; Brozoski, T J

2001-03-01

Subjective tinnitus is a common and often debilitating disorder that is difficult to study because it is a perceptual state without an objective stimulus correlate. Studying tinnitus in humans is further complicated by the heterogeneity of tinnitus quality, severity, and associated hearing loss. As a consequence, the pathophysiology of tinnitus is poorly understood and treatments are often unsuccessful. In the present study, an animal psychophysical model was developed to reflect several features of tinnitus observed in humans. Chronic tinnitus was induced in rats by a single intense unilateral exposure to noise. The tinnitus was measured using a psychophysical procedure, which required the animals to discriminate between auditory test stimuli consisting of tones, noise, and 0 dB. Tinnitus was indicated by a frequency-specific shift in discrimination functions with respect to control subjects not exposed to noise. The psychophysical consequences of the noise exposure were best explained by a tinnitus hypothesis and could not be explained easily by other consequences of noise exposure such as hearing loss. The qualitative features of the tinnitus were determined and related to the duration of noise exposure and the associated cochlear trauma. The tinnitus was found to persist and intensify over 17 months of testing. Finally, the tinnitus was reversibly attenuated by treatment with gabapentin, a GABA agonist. It was concluded that this model reflected several features of human tinnitus, such as its tonality and persistence, and could be useful as a screen for potential therapeutics as well as a tool to help unravel the pathophysiology of the disorder of phantom auditory perception.

Drugs in the treatment of tinnitus.

PubMed

Goodey, R J

1981-01-01

Many drugs and some foods can cause or aggravate tinnitus in some patients. These substances should be identified and withdrawn. Tinnitus may be improved by the treatment of associated conditions, infections, or hearing loss with appropriate drugs--hypotensives, antibiotics, vasodilators, fluoride or thyroxine. Intravenous lignocaine can temporarily reduce or abolish tinnitus in many patients but can aggravate existing tinnitus in some and may have no effect on others. Analogy with pain of central origin suggests that the beneficial effects of lignocaine (lidocaine) may be due to its anticonvulsant action. Lignocaine is used as a test to distinguish between different mechanisms of tinnitus and to predict responses to oral anticonvulsants. Dramatic responses with lignocaine are usually associated with cochlear hearing loss and often with comparable though less marked responses to oral anticonvulsants. Patients who do not benefit from lignocaine do not respond to oral anticonvulsants. The action of anticonvulsants is often potentiated by tricyclic antidepressants. The majority of patients who respond to lignocaine can also have their tinnitus effectively masked, as predicted, on a tinnitus synthesizer. A small proportion respond to masking and not to lignocaine and a small proportion to lignocaine and not to masking. Beneficial effects of masking and anticonvulsants are cumulative. Anticonvulsants may also produce subjective improvement in clarity, improved tolerance of hearing aids and increased masking benefit when a hearing aid is worn.

Hearing loss and the central auditory system: Implications for hearing aids

NASA Astrophysics Data System (ADS)

Frisina, Robert D.

2003-04-01

Hearing loss can result from disorders or damage to the ear (peripheral auditory system) or the brain (central auditory system). Here, the basic structure and function of the central auditory system will be highlighted as relevant to cases of permanent hearing loss where assistive devices (hearing aids) are called for. The parts of the brain used for hearing are altered in two basic ways in instances of hearing loss: (1) Damage to the ear can reduce the number and nature of input channels that the brainstem receives from the ear, causing plasticity of the central auditory system. This plasticity may partially compensate for the peripheral loss, or add new abnormalities such as distorted speech processing or tinnitus. (2) In some situations, damage to the brain can occur independently of the ear, as may occur in cases of head trauma, tumors or aging. Implications of deficits to the central auditory system for speech perception in noise, hearing aid use and future innovative circuit designs will be provided to set the stage for subsequent presentations in this special educational session. [Work supported by NIA-NIH Grant P01 AG09524 and the International Center for Hearing & Speech Research, Rochester, NY.

Analysis of the Prevalence and Associated Risk Factors of Tinnitus in Adults

PubMed Central

Kim, Hyung-Jong; Lee, Hyo-Jeong; An, Soo-Youn; Sim, Songyong; Park, Bumjung; Kim, Si Whan; Lee, Joong Seob; Hong, Sung Kwang; Choi, Hyo Geun

2015-01-01

Background Tinnitus is a common condition in adults; however, the pathophysiology of tinnitus remains unclear, and no large population-based study has assessed the associated risk factors. The aim of this study was to analyze the prevalence and associated risk factors of tinnitus. Methods We conducted a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey, with 19,290 participants ranging in age from 20 to 98 years old, between 2009 and 2012. We investigated the prevalence of tinnitus using a questionnaire and analyzed various possible factors associated with tinnitus using simple and multiple logistic regression analysis with complex sampling. Results The prevalence of tinnitus was 20.7%, and the rates of tinnitus associated with no discomfort, moderate annoyance, and severe annoyance were 69.2%, 27.9%, and 3.0%, respectively. The prevalence of tinnitus and the rates of annoying tinnitus increased with age. The adjusted odds ratio (AOR) of tinnitus was higher for females, those with a smoking history, those reporting less sleep (≤ 6 h), those with more stress, those in smaller households, those with a history of hyperlipidemia osteoarthritis, rheumatoid arthritis, asthma, depression, thyroid disease, an abnormal tympanic membrane, unilateral hearing loss, bilateral hearing loss, noise exposure from earphones, noise exposure at the workplace, noise exposure outside the workplace, and brief noise exposure. Additionally, unemployed individuals and soldiers had higher AORs for tinnitus. The AOR of annoying tinnitus increased with age, stress, history of hyperlipidemia, unilateral hearing loss, and bilateral hearing loss. Conclusions Tinnitus is very common in the general population and is associated with gender, smoking, stress, sleep, hearing loss, hyperlipidemia, osteoarthritis, rheumatoid arthritis, asthma, depression, and thyroid disease history. PMID:26020239

The relationship between distortion product otoacoustic emissions and extended high-frequency audiometry in tinnitus patients. Part 1: normally hearing patients with unilateral tinnitus.

PubMed

Fabijańska, Anna; Smurzyński, Jacek; Hatzopoulos, Stavros; Kochanek, Krzysztof; Bartnik, Grażyna; Raj-Koziak, Danuta; Mazzoli, Manuela; Skarżyński, Piotr H; Jędrzejczak, Wieslaw W; Szkiełkowska, Agata; Skarżyński, Henryk

2012-12-01

The aim of this study was to evaluate distortion product otoacoustic emissions (DPOAEs) and extended high-frequency (EHF) thresholds in a control group and in patients with normal hearing sensitivity in the conventional frequency range and reporting unilateral tinnitus. Seventy patients were enrolled in the study: 47 patients with tinnitus in the left ear (Group 1) and 23 patients with tinnitus in the right ear (Group 2). The control group included 60 otologically normal subjects with no history of pathological tinnitus. Pure-tone thresholds were measured at all standard frequencies from 0.25 to 8 kHz, and at 10, 12.5, 14, and 16 kHz. The DPOAEs were measured in the frequency range from approximately 0.5 to 9 kHz using the primary tones presented at 65/55 dB SPL. The left ears of patients in Group 1 had higher median hearing thresholds than those in the control subjects at all 4 EHFs, and lower mean DPOAE levels than those in the controls for almost all primary frequencies, but significantly lower only in the 2-kHz region. Median hearing thresholds in the right ears of patients in Group 2 were higher than those in the right ears of the control subjects in the EHF range at 12.5, 14, and 16 kHz. The mean DPOAE levels in the right ears were lower in patients from Group 2 than those in the controls for the majority of primary frequencies, but only reached statistical significance in the 8-kHz region. Hearing thresholds in tinnitus ears with normal hearing sensitivity in the conventional range were higher in the EHF region than those in non-tinnitus control subjects, implying that cochlear damage in the basal region may result in the perception of tinnitus. In general, DPOAE levels in tinnitus ears were lower than those in ears of non-tinnitus subjects, suggesting that subclinical cochlear impairment in limited areas, which can be revealed by DPOAEs but not by conventional audiometry, may exist in tinnitus ears. For patients with tinnitus, DPOAE measures combined with

Program Sustainability: Hearing Loss and Tinnitus Prevention in American Indian Communities.

PubMed

Martin, William Hal; Sobel, Judith L; Griest, Susan E; Howarth, Linda C; Becker, Thomas M

2017-03-01

An important goal of any health promotion effort is to have it maintained in delivery and effectiveness over time. The purpose of this study was to establish a community-based noise-induced hearing loss and tinnitus prevention program in three different types of American Indian communities and evaluate them for evidence of long-term sustainability. The target population was fourth- and fifth-grade students from three different models of American Indian communities. The evidenced-based Dangerous Decibels ® program was adapted to include local media, classroom education, family and community outreach, and web-based activities. Sustainability was attempted by promoting funding stability, political support, partnerships, organizational capacity, program adaptation, program evaluation, communications, public health impacts, and strategic planning. Currently, there is evidence suggesting that the hearing health promotion program is self-sustaining in all three American Indian communities. The intervention was effective at changing knowledge, attitudes, beliefs, and behaviors in the target population, but program adoption and self-sustenance faced challenges that required patience, persistence, and creativity by the program team. Components of the intervention continue to be delivered by local members of each community. Critical factors that led to self-sustaining programs included approval of community leaders and engagement of community members in the design, administration, and evaluation of the effort; use of a well-developed, evidence-based intervention; and high-level training of local participants who could confidently and effectively continue delivering the program following a gradual transition to independence. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Changes in the Tinnitus Handicap Questionnaire After Cochlear Implantation

PubMed Central

Pan, Tao; Tyler, Richard S.; Ji, Haihong; Coelho, Claudia; Gehringer, Anne K.; Gogel, Stephanie A.

2010-01-01

Purpose To determine (a) changes in the Tinnitus Handicap Questionnaire (THQ) for patients using cochlear implants, (b) differences between patients who receive total or partial relief, and (c) identifiable characteristics of those who report tinnitus after implantation. Method Pre- and postoperatively, 244 adults were administered the THQ when they reported tinnitus. Results Of the 153 patients who had tinnitus preoperatively, 94 (61%) patients reported total suppression and 59 (39%) reported a partial reduction. In 91 patients who did not have tinnitus before implantation, 11 (12%) reported tinnitus postimplantation. The THQ score decreased from 41% preimplant to 30% postimplant. The largest reductions involved social handicap and hearing. Patients with a more severe hearing loss might be more likely to experience an exacerbation of their tinnitus. We were not able to clearly identify differences between patients who received total or partial relief and the characteristics of patients who reported tinnitus after implantation. Those who acquired tinnitus had the shortest duration hearing loss (5.6 years) and were the oldest (63 years). The average THQ score of patients getting tinnitus was 29%. Conclusions Most tinnitus patients benefit from receiving a cochlear implant. PMID:19949236

The effect of tinnitus on some psychoacoustical abilities in individuals with normal hearing sensitivity.

PubMed

Jain, Chandni; Sahoo, Jitesh Prasad

Tinnitus is the perception of a sound without an external source. It can affect auditory perception abilities in individuals with normal hearing sensitivity. The aim of the study was to determine the effect of tinnitus on psychoacoustic abilities in individuals with normal hearing sensitivity. The study was conducted on twenty subjects with tinnitus and twenty subjects without tinnitus. Tinnitus group was again divided into mild and moderate tinnitus based on the tinnitus handicap inventory. Differential limen of intensity, differential limen of frequency, gap detection test, modulation detection thresholds were done through the mlp toolbox in Matlab and speech in noise test was done with the help of Quick SIN in Kannada. RESULTS of the study showed that the clinical group performed poorly in all the tests except for differential limen of intensity. Tinnitus affects aspects of auditory perception like temporal resolution, speech perception in noise and frequency discrimination in individuals with normal hearing. This could be due to subtle changes in the central auditory system which is not reflected in the pure tone audiogram.

Increased Atherosclerosis Correlates with Subjective Tinnitus Severity.

PubMed

Yüksel, Fatih; Karataş, Duran; Türkdoğan, Figen Tunalı; Yüksel, Özlem

2018-03-01

The aim of the present study was to investigate whether increased intima media thickness was associated with the severity of subjective non-pulsatile tinnitus and hearing loss. Data of the patients who came to Otorhinolaryngology Department of Isparta Government Hospital with subjective non-pulsatile tinnitus complaint, between January 2012 and June 2013, were evaluated retrospectively. A total of 215 patients were included in the present study. Hearing tests, biochemical analysis, tinnitus handicap inventory (THI), visual analogue scale (VAS) and doppler ultrasonography results of the patients were reviewed and recorded. The patients were classified into two groups as those having an increased intima media thickness and those having a normal intima media thickness. The said groups were compared with respect to age, gender, THI, VAS, hearing test findings and lipid values. Moreover, THI and VAS groups were compared with respect to intima-media thickness. In the group having increased intima-media thickness, THI and VAS average, frequency of hypertension, total cholesterol, low density lipoprotein and triglyceride averages and mean frequencies obtained by hearing test were significantly higher. Comparison of THI and VAS groups showed that intima-media thickness was significantly different between those having a mild tinnitus and those having a severe tinnitus. Increased intima-media thickness was associated with the severity of subjective non-pulsatile tinnitus and hearing loss. For this reason, the carotid system should be examined in subjective non-pulsatile tinnitus patients.

Transitory endolymph leakage induced hearing loss and tinnitus: depolarization, biphasic shortening and loss of electromotility of outer hair cells

NASA Technical Reports Server (NTRS)

Zenner, H. P.; Reuter, G.; Zimmermann, U.; Gitter, A. H.; Fermin, C.; LePage, E. L.

1994-01-01

There are types of deafness and tinnitus in which ruptures or massive changes in the ionic permeability of the membranes lining the endolymphatic space [e.g., of the reticular lamina (RL)] are believed to allow potassium-rich endolymph to deluge the low [K+] perilymphatic fluid (e.g., in the small spaces of Nuel). This would result in a K+ intoxication of sensory and neural structures. Acute attacks of Meniere's disease have been suggested to be an important example for this event. The present study investigated the effects of transiently elevated [K+] due to the addition of artificial endolymph to the basolateral cell surface of outer hair cells (OHC) in replicating endolymph-induced K+ intoxication of the perilymph in the small spaces of Nuel. The influence of K+ intoxication of the basolateral OHC cell surface on the transduction was then examined. Intoxication resulted in an inhibition of the physiological repolarizing K+ efflux from hair cells. This induced unwanted depolarizations of the hair cells, interfering with mechanoelectrical transduction. A pathological longitudinal OHC shortening was also found, with subsequent compression of the organ of Corti possibly influencing the micromechanics of the mechanically active OHC. Both micromechanical and electrophysiological alterations are proposed to contribute to endolymph leakage induced attacks of deafness and possibly also to tinnitus. Moreover, repeated or long-lasting K+ intoxications of OHC resulted in a chronic and complete loss of OHC motility. This is suggested to be a pathophysiological basis in some patients with chronic hearing loss resulting from Meniere's syndrome.

Effects of frequency discrimination training on tinnitus: results from two randomised controlled trials.

PubMed

Hoare, Derek J; Kowalkowski, Victoria L; Hall, Deborah A

2012-08-01

That auditory perceptual training may alleviate tinnitus draws on two observations: (1) tinnitus probably arises from altered activity within the central auditory system following hearing loss and (2) sound-based training can change central auditory activity. Training that provides sound enrichment across hearing loss frequencies has therefore been hypothesised to alleviate tinnitus. We tested this prediction with two randomised trials of frequency discrimination training involving a total of 70 participants with chronic subjective tinnitus. Participants trained on either (1) a pure-tone standard at a frequency within their region of normal hearing, (2) a pure-tone standard within the region of hearing loss or (3) a high-pass harmonic complex tone spanning a region of hearing loss. Analysis of the primary outcome measure revealed an overall reduction in self-reported tinnitus handicap after training that was maintained at a 1-month follow-up assessment, but there were no significant differences between groups. Secondary analyses also report the effects of different domains of tinnitus handicap on the psychoacoustical characteristics of the tinnitus percept (sensation level, bandwidth and pitch) and on duration of training. Our overall findings and conclusions cast doubt on the superiority of a purely acoustic mechanism to underpin tinnitus remediation. Rather, the nonspecific patterns of improvement are more suggestive that auditory perceptual training affects impact on a contributory mechanism such as selective attention or emotional state.

[Application of objective audiological tests in bilateral tinnitus patients with normal hearing capability].

PubMed

Wang, Z; Tian, Y; Jiang, X J

2016-12-01

Objective: To analyze the relationship of tinnitus and early stage damage of cochlear, to explore the clinical applied value of distortion product otoacoustic emission(DPOAE) and auditory brainstem response(ABR) in the bilateral tinnitus patients with normal hearing capability. Method: There are 30 cases(60 ears) in the tinnitus group with bilateral tinnitus patients with normal hearing capability, and there are 30 cases(60 ears) in the control group without tinnitus of normal hearing capability. The two groups both test the DPOAE and ABR,and compare the results of the DPOAE and ABR. Result: The passing rate of DPOAE in all frequencies was 100% in the control group,42.67% in the tinnitus group. Significant differences existed between the two groups( P <0.05).The DPOAE could be checked out at all frequencies under 2 kHz except 0.75 kHz in the tinnitus group, and the passing rates of DPOAE were significantly lower than those in control group( P <0.05).There were 3 cases could not be checked out at 0.75 kHz frequency, but there were no significant difference( P >0.05).The DPOAE amplitudes at frequencies of 3 to 8 kHz in tinnitus ears were significantly lower than those in nontinnitus ears(the P value were 0.011,0.013,0.008,0.027 ).Wave Ⅰ,Ⅲ and Ⅴcould be detected in all ears tested at 80 dB nHL. The latencies of WaveⅠin tinnitus group were obviously prolonged.The latencies of Wave Ⅲ and Ⅴ in tinnitus group were also prolonged, but there was no significant difference( P >0.05).The interval between waves Ⅰand Ⅲ,waves Ⅲ and Ⅴand wavesⅠand Ⅴ showed no difference. Conclusion: The maybe cochlear early injury in fractional bilateral tinnitus patients with normal hearing capability, DPOAE and ABR can act as an objective method for diagnosing peripheral tinnitus. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

Clinical practice guideline: tinnitus.

PubMed

Tunkel, David E; Bauer, Carol A; Sun, Gordon H; Rosenfeld, Richard M; Chandrasekhar, Sujana S; Cunningham, Eugene R; Archer, Sanford M; Blakley, Brian W; Carter, John M; Granieri, Evelyn C; Henry, James A; Hollingsworth, Deena; Khan, Fawad A; Mitchell, Scott; Monfared, Ashkan; Newman, Craig W; Omole, Folashade S; Phillips, C Douglas; Robinson, Shannon K; Taw, Malcolm B; Tyler, Richard S; Waguespack, Richard; Whamond, Elizabeth J

2014-10-01

, and is not associated with focal neurologic abnormalities or an asymmetric hearing loss. The panel made the following recommendations: Clinicians should (a) perform a targeted history and physical examination at the initial evaluation of a patient with presumed primary tinnitus to identify conditions that if promptly identified and managed may relieve tinnitus; (b) obtain a prompt, comprehensive audiologic examination in patients with tinnitus that is unilateral, persistent (≥ 6 months), or associated with hearing difficulties; (c) distinguish patients with bothersome tinnitus of recent onset from those with persistent symptoms (≥ 6 months) to prioritize intervention and facilitate discussions about natural history and follow-up care; (d) educate patients with persistent, bothersome tinnitus about management strategies; (e) recommend a hearing aid evaluation for patients who have persistent, bothersome tinnitus associated with documented hearing loss; and (f) recommend cognitive behavioral therapy to patients with persistent, bothersome tinnitus. The panel recommended against (a) antidepressants, anticonvulsants, anxiolytics, or intratympanic medications for the routine treatment of patients with persistent, bothersome tinnitus; (b) Ginkgo biloba, melatonin, zinc, or other dietary supplements for treating patients with persistent, bothersome tinnitus; and (c) transcranial magnetic stimulation for the routine treatment of patients with persistent, bothersome tinnitus. The development group provided the following options: Clinicians may (a) obtain an initial comprehensive audiologic examination in patients who present with tinnitus (regardless of laterality, duration, or perceived hearing status); and (b) recommend sound therapy to patients with persistent, bothersome tinnitus. The development group provided no recommendation regarding the effect of acupuncture in patients with persistent, bothersome tinnitus. © American Academy of Otolaryngology—Head and Neck

[Rock music and hearing disorders].

PubMed

Størmer, Carl Christian Lein; Stenklev, Niels Christian

2007-03-29

Continued exposition to loud noise is a well-known risk factor for development of various hearing disorders; rock musicians are especially vulnerable. The aim of this paper was to get an overview of hearing loss, tinnitus and hyperacusis among rock musicians. Medline was systematically searched, using combinations of the terms "hearing", "rock music", "tinnitus" and "hyperacusis". Seven publications concerning hearing of rock musicians were identified. Permanent hearing loss occurred in 20% (mean) of the rock musicians; the prevalence varied from 5 to 41%. Tinnitus and hyperacusis appear significantly more often in rock musicians than in non-musicians. Rock musicians have increased resistance against loud music and exposure over time is protective towards hearing loss. Further research is needed to assess rock music's impact on musicians' hearing.

Cortical Reorganisation during a 30-Week Tinnitus Treatment Program

PubMed Central

McMahon, Catherine M.; Ibrahim, Ronny K.; Mathur, Ankit

2016-01-01

tinnitus treatment, and may result from the hearing loss per se. On the other hand, the shifts in the tonotopic map towards the non-tinnitus participants’ source location suggests that the tinnitus treatment might reduce the disruptions in the map, presumably produced by the tinnitus percept directly or indirectly. Further, the similarity in the trajectory of change across the objective and subjective parameters after time-shifting the perceptual changes by 5 weeks suggests that during or following treatment, perceptual changes in the tinnitus percept may precede neurophysiological changes. Subgroup analyses conducted by magnitude of hearing loss suggest that there were no differences in the 500 Hz and 1000 Hz source strength amplitudes for the mild-moderate compared with the mild-severe hearing loss subgroup, although the mean source strength was consistently higher for the mild-severe subgroup. Further, the mild-severe subgroup had 500 Hz and 1000 Hz source locations located more anteriorly (i.e., more disrupted compared to the control group) compared to the mild-moderate group, although this was trending towards significance only for the 500Hz left hemisphere source. While the small numbers of participants within the subgroup analyses reduce the statistical power, this study suggests that those with greater magnitudes of hearing loss show greater cortical disruptions with tinnitus and that tinnitus treatment appears to reduce the tonotopic map disruptions but not the source strength (or central gain). PMID:26901425

Electric-acoustic stimulation suppresses tinnitus in a subject with high-frequency single-sided deafness.

PubMed

Mertens, Griet; Van Rompaey, Vincent; Van de Heyning, Paul

2018-05-17

A suggested solution to suppress tinnitus is to restore the normal sensory input. This is based on the auditory deprivation hypothesis. It is known that hearing aids can provide sufficient activation of the auditory nervous system and reduce tinnitus in subjects with mild to moderate hearing loss and that cochlear implantation can reduce tinnitus in subjects with severe to profound hearing loss. This applies to subjects with single-sided deafness (SSD) or bilateral hearing loss. To investigate if electric-acoustic stimulation (EAS) can reduce severe tinnitus in a subject with residual hearing in the ipsilateral ear and contralateral normal hearing (high-frequency SSD) by restoring the auditory input. Tinnitus reduction was investigated for 1 year after implantation in a subject with high-frequency SSD, who uses EAS, and was compared to 11 subjects with a cochlear implant (CI) with SSD. The Visual Analogue Scale (VAS) and the Tinnitus Questionnaire (TQ) were administered pre-operatively and at 1, 3, 6, and 12 months after implantation. Significant tinnitus reduction was observed 1 month after implantation on the VAS in the subjects with SSD using a CI. Tinnitus reduction was also observed in the subject with high-frequency SSD using EAS. A further decrease was observed 3 months after implantation. The TQ and VAS scores remained stable up to 1 year after implantation. A CI can significantly reduce ipsilateral severe tinnitus in a subject with SSD. Ipsilateral severe tinnitus can also be reduced using EAS in subjects with high-frequency SSD.

Work-Related Noise Exposure in a Cohort of Patients with Chronic Tinnitus: Analysis of Demographic and Audiological Characteristics.

PubMed

Ralli, Massimo; Balla, Maria Paola; Greco, Antonio; Altissimi, Giancarlo; Ricci, Pasquale; Turchetta, Rosaria; de Virgilio, Armando; de Vincentiis, Marco; Ricci, Serafino; Cianfrone, Giancarlo

2017-09-08

Work-related noise exposure is one of the major factors contributing to the development of adult-onset hearing loss and tinnitus. The aim of this study was to analyze, in patients with chronic tinnitus and long-term occupational noise exposure, (A) characteristics of hearing loss, tinnitus, comorbidities, demographic characteristics and a history of work-related noise exposure and (B) differences among individuals employed in occupations with high and low risk of developing work-related noise-induced hearing loss (NIHL). One hundred thirty six patients with chronic tinnitus and at least a 10 year-long working history were divided into two groups based on the risk of their profession to induce NIHL. Individuals employed in jobs at high risk for NIHL were mostly males and exhibited a poorer hearing threshold, more evident in the left ear. Tinnitus was mostly bilateral; the next largest presentation was left-sided; patients described their tinnitus as buzzing or high-pitched. Correlation between age, length of tinnitus and worse hearing was found. Patients with a higher degree of hearing impairment were mostly males and were more likely to have a family history of hearing loss and at least one cardiovascular comorbidity. Our study shows some differences in individuals with tinnitus and a history of a profession associated with increased exposure to NIHL compared to those without such a history.

Work-Related Noise Exposure in a Cohort of Patients with Chronic Tinnitus: Analysis of Demographic and Audiological Characteristics

PubMed Central

Balla, Maria Paola; Greco, Antonio; Altissimi, Giancarlo; Ricci, Pasquale; Turchetta, Rosaria; de Virgilio, Armando; de Vincentiis, Marco; Ricci, Serafino; Cianfrone, Giancarlo

2017-01-01

Work-related noise exposure is one of the major factors contributing to the development of adult-onset hearing loss and tinnitus. The aim of this study was to analyze, in patients with chronic tinnitus and long-term occupational noise exposure, (A) characteristics of hearing loss, tinnitus, comorbidities, demographic characteristics and a history of work-related noise exposure and (B) differences among individuals employed in occupations with high and low risk of developing work-related noise-induced hearing loss (NIHL). One hundred thirty six patients with chronic tinnitus and at least a 10 year-long working history were divided into two groups based on the risk of their profession to induce NIHL. Individuals employed in jobs at high risk for NIHL were mostly males and exhibited a poorer hearing threshold, more evident in the left ear. Tinnitus was mostly bilateral; the next largest presentation was left-sided; patients described their tinnitus as buzzing or high-pitched. Correlation between age, length of tinnitus and worse hearing was found. Patients with a higher degree of hearing impairment were mostly males and were more likely to have a family history of hearing loss and at least one cardiovascular comorbidity. Our study shows some differences in individuals with tinnitus and a history of a profession associated with increased exposure to NIHL compared to those without such a history. PMID:28885581

Active Duty-U.S. Army Noise Induced Hearing Injury Quarterly Surveillance Q3 2011 thru Q4 2013

DTIC Science & Technology

2014-06-30

incident case rates for sensorineural hearing loss significant threshold shift, tinnitus , and Noise-Induced Hearing Loss. RECOMMENDATIONS: Commanders...2013 A-1 APPENDIX A REFERENCES Humes LE, Jollenbeck LM, Durch JS: Noise and military service: Implications for hearing loss and tinnitus . Washington...FUNCTION STUDIES TINN Tinnitus 38830 TINNITUS UNSPECIFIED TINN Tinnitus 38831 SUBJECTIVE TINNITUS TINN Tinnitus 38832 OBJECTIVE TINNITUS CPT Codes

The Role of Central Nervous System Plasticity in Tinnitus

ERIC Educational Resources Information Center

Saunders, James C.

2007-01-01

Tinnitus is a vexing disorder of hearing characterized by sound sensations originating in the head without any external stimulation. The specific etiology of these sensations is uncertain but frequently associated with hearing loss. The "neurophysiogical" model of tinnitus has enhanced appreciation of central nervous system (CNS) contributions.…

Clinical Evaluation of Tinnitus.

PubMed

Hertzano, Ronna; Teplitzky, Taylor B; Eisenman, David J

2016-05-01

The clinical evaluation of patients with tinnitus differs based on whether the tinnitus is subjective or objective. Subjective tinnitus is usually associated with a hearing loss, and therefore, the clinical evaluation is focused on an otologic and audiologic evaluation with adjunct imaging/tests as necessary. Objective tinnitus is divided into perception of an abnormal somatosound or abnormal perception of a normal somatosound. The distinction between these categories is usually possible based on a history, physical examination, and audiogram, leading to directed imaging to identify the underlying abnormality. Copyright © 2016 Elsevier Inc. All rights reserved.

Lifetime leisure music exposure associated with increased frequency of tinnitus.

PubMed

Moore, David R; Zobay, Oliver; Mackinnon, Robert C; Whitmer, William M; Akeroyd, Michael A

2017-04-01

Tinnitus has been linked to noise exposure, a common form of which is listening to music as a leisure activity. The relationship between tinnitus and type and duration of music exposure is not well understood. We conducted an internet-based population study that asked participants questions about lifetime music exposure and hearing, and included a hearing test involving speech intelligibility in noise, the High Frequency Digit Triplets Test. 4950 people aged 17-75 years completed all questions and the hearing test. Results were analyzed using multinomial regression models. High exposure to leisure music, hearing difficulty, increasing age and workplace noise exposure were independently associated with increased tinnitus. Three forms of music exposure (pubs/clubs, concerts, personal music players) did not differ in their relationship to tinnitus. More males than females reported tinnitus. The objective measure of speech reception threshold had only a minimal relationship with tinnitus. Self-reported hearing difficulty was more strongly associated with tinnitus, but 76% of people reporting usual or constant tinnitus also reported little or no hearing difficulty. Overall, around 40% of participants of all ages reported never experiencing tinnitus, while 29% reported sometimes, usually or constantly experiencing tinnitus that lasted more than 5 min. Together, the results suggest that tinnitus is much more common than hearing loss, but that there is little association between the two, especially among the younger adults disproportionately sampled in this study. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Does Tinnitus Distress Depend on Age of Onset?

PubMed Central

Schlee, Winfried; Kleinjung, Tobias; Hiller, Wolfgang; Goebel, Gerhard; Kolassa, Iris-Tatjana; Langguth, Berthold

2011-01-01

Objectives Tinnitus is the perception of a sound in the absence of any physical source of it. About 5–15% of the population report hearing such a tinnitus and about 1–2% suffer from their tinnitus leading to anxiety, sleep disorders or depression. It is currently not completely understood why some people feel distressed by their tinnitus, while others don't. Several studies indicate that the amount of tinnitus distress is associated with many factors including comorbid anxiety, comorbid depression, personality, the psychosocial situation, the amount of the related hearing loss and the loudness of the tinnitus. Furthermore, theoretical considerations suggest an impact of the age at tinnitus onset influencing tinnitus distress. Methods Based on a sample of 755 normal hearing tinnitus patients we tested this assumption. All participants answered a questionnaire on the amount of tinnitus distress together with a large variety of clinical and demographic data. Results Patients with an earlier onset of tinnitus suffer significantly less than patients with an onset later in life. Furthermore, patients with a later onset of tinnitus describe their course of tinnitus distress as more abrupt and distressing right from the beginning. Conclusion We argue that a decline of compensatory brain plasticity in older age accounts for this age-dependent tinnitus decompensation. PMID:22125612

Does tinnitus distress depend on age of onset?

PubMed

Schlee, Winfried; Kleinjung, Tobias; Hiller, Wolfgang; Goebel, Gerhard; Kolassa, Iris-Tatjana; Langguth, Berthold

2011-01-01

Tinnitus is the perception of a sound in the absence of any physical source of it. About 5-15% of the population report hearing such a tinnitus and about 1-2% suffer from their tinnitus leading to anxiety, sleep disorders or depression. It is currently not completely understood why some people feel distressed by their tinnitus, while others don't. Several studies indicate that the amount of tinnitus distress is associated with many factors including comorbid anxiety, comorbid depression, personality, the psychosocial situation, the amount of the related hearing loss and the loudness of the tinnitus. Furthermore, theoretical considerations suggest an impact of the age at tinnitus onset influencing tinnitus distress. Based on a sample of 755 normal hearing tinnitus patients we tested this assumption. All participants answered a questionnaire on the amount of tinnitus distress together with a large variety of clinical and demographic data. Patients with an earlier onset of tinnitus suffer significantly less than patients with an onset later in life. Furthermore, patients with a later onset of tinnitus describe their course of tinnitus distress as more abrupt and distressing right from the beginning. We argue that a decline of compensatory brain plasticity in older age accounts for this age-dependent tinnitus decompensation.

Comparisons of auditory brainstem response and sound level tolerance in tinnitus ears and non-tinnitus ears in unilateral tinnitus patients with normal audiograms.

PubMed

Shim, Hyun Joon; An, Yong-Hwi; Kim, Dong Hyun; Yoon, Ji Eun; Yoon, Ji Hyang

2017-01-01

Recently, "hidden hearing loss" with cochlear synaptopathy has been suggested as a potential pathophysiology of tinnitus in individuals with a normal hearing threshold. Several studies have demonstrated that subjects with tinnitus and normal audiograms show significantly reduced auditory brainstem response (ABR) wave I amplitudes compared with control subjects, but normal wave V amplitudes, suggesting increased central auditory gain. We aimed to reconfirm the "hidden hearing loss" theory through a within-subject comparison of wave I and wave V amplitudes and uncomfortable loudness level (UCL), which might be decreased with increased central gain, in tinnitus ears (TEs) and non-tinnitus ears (NTEs). Human subjects included 43 unilateral tinnitus patients (19 males, 24 females) with normal and symmetric hearing thresholds and 18 control subjects with normal audiograms. The amplitudes of wave I and V from the peak to the following trough were measured twice at 90 dB nHL and we separately assessed UCLs at 500 Hz and 3000 Hz pure tones in each TE and NTE. The within-subject comparison between TEs and NTEs showed no significant differences in wave I and wave V amplitude, or wave V/I ratio in both the male and female groups. Individual data revealed increased V/I amplitude ratios > mean + 2 SD in 3 TEs, but not in any control ears. We found no significant differences in UCL at 500 Hz or 3000 Hz between the TEs and NTEs, but the UCLs of both TEs and NTEs were lower than those of the control ears. Our ABR data do not represent meaningful evidence supporting the hypothesis of cochlear synaptopathy with increased central gain in tinnitus subjects with normal audiograms. However, reduced sound level tolerance in both TEs and NTEs might reflect increased central gain consequent on hidden synaptopathy that was subsequently balanced between the ears by lateral olivocochlear efferents.

Effect of atorvastatin on progression of sensorineural hearing loss and tinnitus in the elderly: results of a prospective, randomized, double-blind clinical trial.

PubMed

Olzowy, Bernhard; Canis, Martin; Hempel, John-Martin; Mazurek, Birgit; Suckfüll, Markus

2007-06-01

To test whether the 3-hydroxy-3-methylglutaryl- coenzyme A reductase inhibitor atorvastatin can slow down the progression of presbycusis. Fifty patients 60- to 75-years-old with presbycusis and moderately elevated serum cholesterol. In a double-blind design, patients were randomly assigned to treatment with either atorvastatin (40 mg/d orally) or placebo. Pure-tone audiometry and tinnitus evaluation at enrolment and after 7 and 13 months. Development of hearing thresholds after 7 and 13 months showed no significant differences between the groups. Tinnitus score continuously improved in the atorvastatin group (34.8 at 7 and 27.6 at 13 mo), whereas it slightly deteriorated in the placebo group (24.8 at 7 and 26.8 at 13 mo). The effect on tinnitus was a tendency without statistic significance (p = 0.0833). Atorvastatin had no effect on the development of hearing thresholds, but resulted in a trend toward a relief of tinnitus.

Evaluation of Sound Therapy Tinnitus Treatments with Concurrent Counseling in Active Duty Military Personnel

DTIC Science & Technology

2014-07-04

14 List of figures 1. Prevalence of service-connected tinnitus and hearing loss by FY...3 3. Tinnitus apps provided for use with the Apple iPod TouchTM ...................................................... 4 4. Chronology of...experience tinnitus will seek medical attention for treatment (Formby and Scherer, 2013; Hearing Center of Excellence, 2013). The prevalence of tinnitus in

The Effect of Tinnitus on Listening Effort in Normal-Hearing Young Adults: A Preliminary Study.

PubMed

Degeest, Sofie; Keppler, Hannah; Corthals, Paul

2017-04-14

The objective of this study was to investigate the effect of chronic tinnitus on listening effort. Thirteen normal-hearing young adults with chronic tinnitus were matched with a control group for age, gender, hearing thresholds, and educational level. A dual-task paradigm was used to evaluate listening effort in different listening conditions. A primary speech-recognition task and a secondary memory task were performed both separately and simultaneously. Furthermore, subjective listening effort was questioned for various listening situations. The Tinnitus Handicap Inventory was used to control for tinnitus handicap. Listening effort significantly increased in the tinnitus group across listening conditions. There was no significant difference in listening effort between listening conditions, nor was there an interaction between groups and listening conditions. Subjective listening effort did not significantly differ between both groups. This study is a first exploration of listening effort in normal-hearing participants with chronic tinnitus showing that listening effort is increased as compared with a control group. There is a need to further investigate the cognitive functions important for speech understanding and their possible relation with the presence of tinnitus and listening effort.

Clinical and audiologic characteristics of patients with sensorineural tinnitus and its association with psychological aspects: an analytic retrospective study.

PubMed

Al-Swiahb, Jamil Nasser; Hwang, Eul Seung; Kong, Ji Sun; Kim, Woo Jin; Yeo, Sang Won; Park, Shi Nae

2016-12-01

This study was performed to analyze clinical and audiologic characteristics of sensorineural tinnitus and to investigate the associating factors reflecting psychological aspects of stress and depression of the patients. This is a retrospective analytical study conducted in a tinnitus clinic of a tertiary referral center of a university hospital. The medical records of 216 patients suffering from sensorineural tinnitus were thoroughly evaluated to determine correlations between clinical and audiological characteristics, including age, sex, predisposing or etiologic factors, hearing levels up to extended high frequencies, and tinnitus severity. Psychological aspects of stress and depression were also evaluated and analyzed to seek the associations with tinnitus severity. All data were stored in our database bank and were statistically analyzed. Our study subjects showed a slight male predominance. The highest percentage of tinnitus was found in patients of 60-80 years old. Only 32.5 % of tinnitus patients were subjectively aware of their hearing loss, whereas 73 % of subjects had hearing deficits in some frequencies in their audiogram. Hearing impairments were of the low-frequency sensorineural type in 18.2 % of patients and were limited to the high frequencies in 77.9 % of patients. Tinnitus was unilateral in 51 % of patients and had a tonal nature in 45 % of patients. In total, 45.8 % of patients with high-frequency sensorineural hearing loss had high-pitched tinnitus. There were significant correlations between tinnitus severity, loudness and annoyance. Correlations with THI (Tinnitus Handicap Inventory) and Beck depression index scores were also found. Sensorineural tinnitus was related with hearing loss in some frequencies nevertheless of patients' own awareness of hearing loss. Loudness and annoyance of tinnitus seems to be two important factors reflecting psychological problems of patients' stress and depression.

Characterization of tinnitus in Nigeria.

PubMed

Sogebi, Olusola Ayodele

2013-08-01

This study aimed to characterize tinnitus in middle aged and elderly out-patients attending a specialized clinic in a developing country. A cross sectional study of patients attending the ear, nose and throat (ENT) clinic of Olabisi Onabanjo University Teaching Hospital, OOUTH Sagamu, Nigeria. Data was collected with the use of a structured questionnaire. Data collected included socio demographics, medical history including experience of tinnitus, PTAs, BMI and BP. Data was analyzed using SPSS version 17.0. 79 patients had complaints of tinnitus thus making a crude prevalence of 14.5%, the prevalence increased steadily along the age groups. 51.9% of patients experienced tinnitus for a short period. 53.2% of the patients had symptoms referable to only one ear, while 54.4% had discrete as opposed to multiple types of tinnitus. Occurrence of intermittent symptoms was experienced by 75.9% of the patients and 70.9% were non-pulsatile in nature. Tinnitus was significantly associated with abnormal audiographic pattern, global increased hearing thresholds, high tone hearing loss, vertigo, hypertension and obesity. Tinnitus character was majorly short term, unilateral, discrete, intermittent, and non-pulsatile in nature, and it is associated with otological, audiological, anthropometric and cardiovascular anomalies. The characteristics of tinnitus in Nigerian patients were similar to those described in developed countries, but the major risk factors for tinnitus except hearing impairment, may be different from the latter. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Sudden Sensorineural Hearing Loss: The Question of Perilymph Fistula.

ERIC Educational Resources Information Center

Backous, Douglas D.; Niparko, John K.

1997-01-01

Perilymph fistula (PLF) is an abnormal communication between the fluid-containing spaces of the inner ear and the air-containing spaces of the temporal bone that can cause hearing loss, tinnitus, aural fullness, vertigo, and postural instability. Diagnosis of PLF and management of those with presumed PLF are discussed. (Contains extensive…

The cochlear implant as a tinnitus treatment.

PubMed

Vallés-Varela, Héctor; Royo-López, Juan; Carmen-Sampériz, Luis; Sebastián-Cortés, José M; Alfonso-Collado, Ignacio

2013-01-01

Tinnitus is a symptom of high prevalence in patients with cochlear pathology. We studied the evolution of tinnitus in patients undergoing unilateral cochlear implantation for treatment of profound hearing loss. This was a longitudinal, retrospective study of patients that underwent unilateral cochlear implantation and who had bilateral tinnitus. Tinnitus was assessed quantitatively and qualitatively before surgery and at 6 and 12 months after surgery. We evaluated 20 patients that underwent unilateral cochlear implantation with a Nucleus(®) CI24RE Contour Advance™ electrode device. During the periods in which the device was in operation, improvement or disappearance of tinnitus was evidenced in the ipsilateral ear in 65% of patients, and in the contralateral ear, in 50%. In periods in which the device was disconnected, improvement or disappearance of tinnitus was found in the ipsilateral ear in 50% of patients, and in the ear contralateral to the implant in 45% of the patients. In 10% of the patients, a new tinnitus appeared in the ipsilateral ear. The patients with profound hearing loss and bilateral tinnitus treated with unilateral cochlear implantation improved in a high percentage of cases, in the ipsilateral ear and in the contralateral ear. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Tinnitus and hyperacusis: Contributions of paraflocculus, reticular formation and stress.

PubMed

Chen, Yu-Chen; Chen, Guang-Di; Auerbach, Benjamin D; Manohar, Senthilvelan; Radziwon, Kelly; Salvi, Richard

2017-06-01

Tinnitus and hyperacusis are common and potentially serious hearing disorders associated with noise-, age- or drug-induced hearing loss. Accumulating evidence suggests that tinnitus and hyperacusis are linked to excessive neural activity in a distributed brain network that not only includes the central auditory pathway, but also brain regions involved in arousal, emotion, stress and motor control. Here we examine electrophysiological changes in two novel non-auditory areas implicated in tinnitus and hyperacusis: the caudal pontine reticular nucleus (PnC), involved in arousal, and the paraflocculus lobe of the cerebellum (PFL), implicated in head-eye coordination and gating tinnitus and we measure the changes in corticosterone stress hormone levels. Using the salicylate-induced model of tinnitus and hyperacusis, we found that long-latency (>10 ms) sound-evoked response components in both the brain regions were significantly enhanced after salicylate administration, while the short-latency responses were reduced, likely reflecting cochlear hearing loss. These results are consistent with the central gain model of tinnitus and hyperacusis, which proposes that these disorders arise from the amplification of neural activity in central auditory pathway plus other regions linked to arousal, emotion, tinnitus gating and motor control. Finally, we demonstrate that salicylate results in an increase in corticosterone level in a dose-dependent manner consistent with the notion that stress may interact with hearing loss in tinnitus and hyperacusis development. This increased stress response has the potential to have wide-ranging effects on the central nervous system and may therefore contribute to brain-wide changes in neural activity. Copyright © 2017 Elsevier B.V. All rights reserved.

Active Duty - U.S. Army Noise Induced Hearing Injury Surveillance Calendar Years 2009-2013

DTIC Science & Technology

2014-06-01

rates for sensorineural hearing loss, significant threshold shift, tinnitus , and Noise-Induced Hearing Loss. The intention is to monitor the morbidity...surveillance. These code groups include sensorineural hearing loss (SNHL), significant threshold shift (STS), noise-induced hearing loss (NIHL) and tinnitus ... Tinnitus ) was analyzed using a regression model to determine the trend of incidence rates from 2007 to the current year. Statistical significance of a

Assessing Auditory Processing Deficits in Tinnitus and Hearing Impaired Patients with the Auditory Behavior Questionnaire

PubMed Central

Diges, Isabel; Simón, Francisco; Cobo, Pedro

2017-01-01

Background and Purpose: Auditory processing disorders (APD), tinnitus and hearing loss (HL) are typical issues reported by patients in audiologic clinics. These auditory impairments can be concomitant or mutually excluding. APD are not necessarily accompanied by significant HL, whereas many adults exhibit peripheral HL and typical cognitive deficits often associated with APD. Since HL, tinnitus and APD affects to several parts of the ascending auditory pathway from the periphery to the auditory cortex, there could be some interrelationship between them. For instance, tinnitus has been reported to degrade the auditory localization capacity. Tinnitus is believed to be triggered by deafferentation of normal peripheral input to the central auditory system. This peripheral deficit can be accompanied by HL or not, since a type of permanent cochlear damage (thus deafferentation) without an elevation of hearing thresholds might persist. Therefore, a combined study of APD, tinnitus and HL on the same cohort of patients can be audiologically relevant and worthy. Methods: Statistical analysis is applied to a cohort of 305 patients attending an audiology clinic in Madrid (Spain). This group of patients is first categorized in four subgroups, namely, HLTG (with tinnitus and HL), NHLTG (with tinnitus and without HL), HLNTG (with HL but no tinnitus), and NHLNTG (neither tinnitus nor HL). The statistical variables include Age, Average Auditory Threshold (ATT), for assessing HL, Tinnitus Handicap Inventory (THI), for measuring tinnitus, and a new 25-item Auditory Behavior Questionnaire (ABQ), for scoring APD. Factor analysis is applied to arrange these items into 4 subscales. The internal consistency reliability of this ABQ is confirmed by calculating Cronbach's coefficients α. The test-retest reliability is assessed by the intraclass correlation coefficients, ICC. Statistical techniques applied to the data set include descriptive analysis of variables and Spearman rank

Audiometric asymmetry and tinnitus laterality.

PubMed

Tsai, Betty S; Sweetow, Robert W; Cheung, Steven W

2012-05-01

To identify an optimal audiometric asymmetry index for predicting tinnitus laterality. Retrospective medical record review. Data from adult tinnitus patients (80 men and 44 women) were extracted for demographic, audiometric, tinnitus laterality, and related information. The main measures were sensitivity, specificity, positive predictive value (PPV), and receiver operating characteristic (ROC) curves. Three audiometric asymmetry indices were constructed using one, two, or three frequency elements to compute the average interaural threshold difference (aITD). Tinnitus laterality predictive performance of a particular index was assessed by increasing the cutoff or minimum magnitude of the aITD from 10 to 35 dB in 5-dB steps to determine its ROC curve. Single frequency index performance was inferior to the other two (P < .05). Double and triple frequency indices were indistinguishable (P > .05). Two adjoining frequency elements with aITD ≥ 15 dB performed optimally for predicting tinnitus laterality (sensitivity = 0.59, specificity = 0.71, and PPV = 0.76). Absolute and relative magnitudes of hearing loss in the poorer ear were uncorrelated with tinnitus distress. An optimal audiometric asymmetry index to predict tinnitus laterality is one whereby 15 dB is the minimum aITD of two adjoining frequencies, inclusive of the maximal ITD. Tinnitus laterality dependency on magnitude of interaural asymmetry may inform design and interpretation of neuroimaging studies. Monaural acoustic tinnitus therapy may be an initial consideration for asymmetric hearing loss meeting the criterion of aITD ≥ 15 dB. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Tinnitus pitch and minimum masking levels in different etiologies.

PubMed

Zagólski, Olaf; Stręk, Paweł

2014-07-01

We sought to determine whether the results of audiological tests and tinnitus characteristics, particularly tinnitus pitch and minimum masking level (MML), depend on tinnitus etiology, and what other etiology-specific tinnitus characteristics there are. The patients answered questions concerning tinnitus laterality, duration, character, aggravation, alleviation, previous treatment, and circumstances of onset. The results of tympanometry, pure-tone audiometry, distortion-product otoacoustic emissions, tinnitus likeness spectrum, MML, and uncomfortable loudness level were evaluated. Patients with several tinnitus etiological factors were excluded. The remaining participants were divided into groups according to medical history: acute acoustic trauma: 67 ears; chronic acoustic trauma: 82; prolonged use of oral estrogen and progesterone contraceptives: 46; Ménière's disease: 25; congenital hearing loss: 19; sensorineural sudden deafness: 40; dull head trauma: 19; viral labyrinthitis: 53; stroke: 6; presbycusis: 152. Data of 509 ears were analysed. Tinnitus pitch was highest in patients with acute acoustic trauma and lowest in patients receiving estrogen and progesterone. MML was lowest after acute acoustic trauma and in congenital hearing loss, and highest after a stroke and in the case of presbytinnitus. Tinnitus pitch and MML are etiology dependent.

Sudden onset unilateral sensorineural hearing loss after rabies vaccination.

PubMed

Okhovat, Saleh; Fox, Richard; Magill, Jennifer; Narula, Antony

2015-12-15

A 33-year-old man developed profound sudden onset right-sided hearing loss with tinnitus and vertigo, within 24 h of pretravel rabies vaccination. There was no history of upper respiratory tract infection, systemic illness, ototoxic medication or trauma, and normal otoscopic examination. Pure tone audiograms (PTA) demonstrated right-sided sensorineural hearing loss (thresholds 90-100 dB) and normal left-sided hearing. MRI internal acoustic meatus, viral serology (hepatitis B, C, HIV and cytomegalovirus) and syphilis screen were normal. Positive Epstein-Barr virus IgG, viral capsid IgG and anticochlear antibodies (anti-HSP-70) were noted. Initial treatment involved a course of high-dose oral prednisolone and acyclovir. Repeat PTAs after 12 days of treatment showed a small improvement in hearing thresholds. Salvage intratympanic steroid injections were attempted but failed to improve hearing further. Sudden onset sensorineural hearing loss (SSNHL) is an uncommon but frightening experience for patients. This is the first report of SSNHL following rabies immunisation in an adult. 2015 BMJ Publishing Group Ltd.

The Effect of Tinnitus on Listening Effort in Normal-Hearing Young Adults: A Preliminary Study

ERIC Educational Resources Information Center

Degeest, Sofie; Keppler, Hannah; Corthals, Paul

2017-01-01

Purpose: The objective of this study was to investigate the effect of chronic tinnitus on listening effort. Method: Thirteen normal-hearing young adults with chronic tinnitus were matched with a control group for age, gender, hearing thresholds, and educational level. A dual-task paradigm was used to evaluate listening effort in different…

Tinnitus retraining therapy: a different view on tinnitus.

PubMed

Jastreboff, Pawel J; Jastreboff, Margaret M

2006-01-01

Tinnitus retraining therapy (TRT) is a method for treating tinnitus and decreased sound tolerance, based on the neurophysiological model of tinnitus. This model postulates involvement of the limbic and autonomic nervous systems in all cases of clinically significant tinnitus and points out the importance of both conscious and subconscious connections, which are governed by principles of conditioned reflexes. The treatments for tinnitus and misophonia are based on the concept of extinction of these reflexes, labeled as habituation. TRT aims at inducing changes in the mechanisms responsible for transferring signal (i.e., tinnitus, or external sound in the case of misophonia) from the auditory system to the limbic and autonomic nervous systems, and through this, remove signal-induced reactions without attempting to directly attenuate the tinnitus source or tinnitus/misophonia-evoked reactions. As such, TRT is effective for any type of tinnitus regardless of its etiology. TRT consists of: (1) counseling based on the neurophysiological model of tinnitus, and (2) sound therapy (with or without instrumentation). The main role of counseling is to reclassify tinnitus into the category of neutral stimuli. The role of sound therapy is to decrease the strength of the tinnitus signal. It is crucial to assess and treat tinnitus, decreased sound tolerance, and hearing loss simultaneously. Results from various groups have shown that TRT can be an effective method of treatment. Copyright (c) 2006 S. Karger AG, Basel.

[The investigation rate and influence factors of tinnitus with chronic suppurative otitis media].

PubMed

Lin, Y J; Wu, X Q; Ma, X; Lai, R Z

2018-04-01

Objective: To investigate the incidence of tinnitus and its influencing factors in patients with chronic suppurative otitis media, and to provide clinical data for the study of the pathogenesis of tinnitus. Method: The clinical data of 77 patients with chronic suppurative otitis media who underwent modified radical mastoidectomy and tympanoplasty were investigated. When tinnitus and otitis media happened in the same side,then the tinnitus is judged to be otitis media related. Patients were further divided into otitis media related tinnitus and the no tinnitus groups. The differences of tinnitus severity, sleep disturbance, migraine (migraine features), snoring and gastroesophageal reflux were compared between the two groups in tinnitus occurrence and classification. Result: The incidence of otitis media related tinnitus was 55.8%(43/77). Most of the tinnitus happened(33/43) later than the occurrence of otitis media for several years or even decades. There were 43 cases of tinnitus associated with otitis media, and 31 cases without tinnitus. Between the groups, significant differences were observed in migraine features, and the P value is 0.011, while no significant differences were noticed in the severity of hearing loss and sleep disorders, snoring, gastroesophageal reflux. Ranking of otitis media related tinnitus was positively related to the degree of hearing loss, especially the bone conduction threshold. With Spearman rank correlation test,P values of mean value(250Hz,500Hz,1kHz,2kHz,4kHz), middle frequency (1kHz, 2kHz)and high frequency (4kHz) of bone conduction threshold were 0.010,0.019 and 0.003, and the correlation coefficients were 0.391,0.356 and 0.443, respectively. Conclusion: The occurrence of tinnitus in patients with otitis media may not be consistent with the time of otitis media, and theoretically later than the occurrence of otitis media is more reasonable. Whether tinnitus occurs in patients with otitis media is not related to sleep disorders

Tinnitus in adolescents and its relation to the use of personal sound systems.

PubMed

Silvestre, Renata Almeida Araujo; Ribas, Angela; Marques, Jair Mendes; Lacerda, Adriana Bender Moreira de

References to recreational exposure to high sound pressure levels (SPL) and the risk of hearing loss and sensation of tinnitus has increased in the adolescent population. To identify the occurrence of tinnitus in adolescents who use personal sound systems (PSS). This was a descriptive cross-sectional study, using a sample of 153 normal-hearing adolescent students. Participants answered a self-adaministered questionnaire containing open and closed questions, addressing information regarding sound habits with the use of PSS and symptoms associated with this practice. The occurrence of a habit of using PSS was 93%. Comparing the exposed and unexposed groups, the incidence of tinnitus was 40% and 33% respectively, and 22% reported the occurrence of tinnitus induced by the use of PSS. There was no significant difference for the presence of tinnitus depending on the degree of exposure. Although no relation between the use of PSS with tinnitus has been observed, the prevalence of symptoms of up to 40%, including noise-induced episodes, reinforces the possibility of subclinical hearing loss induced by high NPS and, because of the irreversible nature of these losses, the urgency of educational and regulatory measures to reverse these habits and attitudes.

[Management of sudden neurosensory hearing loss in a Primary Care Centre].

PubMed

Muñoz-Proto, F; Carnevale, C; Bejarano-Panadés, N; Ferrán-de la Cierva, L; Mas-Mercant, S; Sarría-Echegaray, P

2014-04-01

Sudden hearing loss is a rapid loss of neurosensory hearing that may occur within hours or days in an apparently healthy patient. Its origins are variable and multifactorial. Most patients do not recover hearing if not treated, and some even develop cophosis (deafness) in the affected ear. It is an otological emergency, as early therapeutic management offers a better hearing prognosis. As there is limited knowledge on this condition, it may be underdiagnosed in Primary Health Care Centers. It should be suspected in patients with abrupt hearing loss or tinnitus. Sophisticated instruments are not required for its diagnosis, just a detailed history, basic otoscopy, and proper interpretation of the hearing test. In this way, an accurate diagnosis is achieved in most cases, which is confirmed by audiometry. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

Tinnitus

MedlinePlus

Tinnitus is often described as a ringing in the ears. It also can sound like roaring, clicking, ... one or both ears. Millions of Americans have tinnitus. People with severe tinnitus may have trouble hearing, ...

Noise-induced inner hair cell ribbon loss disturbs central arc mobilization: a novel molecular paradigm for understanding tinnitus.

PubMed

Singer, Wibke; Zuccotti, Annalisa; Jaumann, Mirko; Lee, Sze Chim; Panford-Walsh, Rama; Xiong, Hao; Zimmermann, Ulrike; Franz, Christoph; Geisler, Hyun-Soon; Köpschall, Iris; Rohbock, Karin; Varakina, Ksenya; Verpoorten, Sandrine; Reinbothe, Thomas; Schimmang, Thomas; Rüttiger, Lukas; Knipper, Marlies

2013-02-01

Increasing evidence shows that hearing loss is a risk factor for tinnitus and hyperacusis. Although both often coincide, a causal relationship between tinnitus and hyperacusis has not been shown. Currently, tinnitus and hyperacusis are assumed to be caused by elevated responsiveness in subcortical circuits. We examined both the impact of different degrees of cochlear damage and the influence of stress priming on tinnitus induction. We used (1) a behavioral animal model for tinnitus designed to minimize stress, (2) ribbon synapses in inner hair cells (IHCs) as a measure for deafferentation, (3) the integrity of auditory brainstem responses (ABR) to detect differences in stimulus-evoked neuronal activity, (4) the expression of the activity-regulated cytoskeletal protein, Arc, to identify long-lasting changes in network activity within the basolateral amygdala (BLA), hippocampal CA1, and auditory cortex (AC), and (5) stress priming to investigate the influence of corticosteroid on trauma-induced brain responses. We observed that IHC ribbon loss (deafferentation) leads to tinnitus when ABR functions remain reduced and Arc is not mobilized in the hippocampal CA1 and AC. If, however, ABR waves are functionally restored and Arc is mobilized, tinnitus does not occur. Both central response patterns were found to be independent of a profound threshold loss and could be shifted by the corticosterone level at the time of trauma. We, therefore, discuss the findings in the context of a history of stress that can trigger either an adaptive or nonadaptive brain response following injury.

Tinnitus in children: an uncommon symptom?

PubMed

Shetye, A; Kennedy, V

2010-08-01

Tinnitus in children is regarded as an uncommon problem rarely noted by general paediatricians. Its reported prevalence varies from 12% to 36% in children with normal hearing thresholds and up to 66% in children with hearing loss and approximately 3-10% of children have been reported troubled by tinnitus. Some children do not spontaneously complain of it, but may demonstrate behavioural problems at school and home. A careful history, in conjunction with clinical findings, should guide the appropriate management approach. Even very young children are able to provide insights into what troubles them allowing children's thoughts and fears regarding this symptom to be addressed. We review the available literature on the nature and impact of tinnitus and as guidelines for this do not exist, suggest a pragmatic approach to the management of tinnitus in children. Children with troublesome tinnitus, however, should be referred on to a paediatric audiology department for further investigation and management.

Effects of serum zinc level on tinnitus.

PubMed

Berkiten, Güler; Kumral, Tolgar Lütfi; Yıldırım, Güven; Salturk, Ziya; Uyar, Yavuz; Atar, Yavuz

2015-01-01

The aim of this study was to assess zinc levels in tinnitus patients, and to evaluate the effects of zinc deficiency on tinnitus and hearing loss. One-hundred patients, who presented to an outpatient clinic with tinnitus between June 2009 and 2014, were included in the study. Patients were divided into three groups according to age: Group I (patients between 18 and 30years of age); Group II (patients between 31 and 60years of age); and Group III (patients between 61 and 78years of age). Following a complete ear, nose and throat examination, serum zinc levels were measured and the severity of tinnitus was quantified using the Tinnitus Severity Index Questionnaire (TSIQ). Patients were subsequently asked to provide a subjective judgment regarding the loudness of their tinnitus. The hearing status of patients was evaluated by audiometry and high-frequency audiometry. An average hearing sensitivity was calculated as the mean value of hearing thresholds between 250 and 20,000Hz. Serum zinc levels between 70 and 120μg/dl were considered normal. The severity and loudness of tinnitus, and the hearing thresholds of the normal zinc level and zinc-deficient groups, were compared. Twelve of 100 (12%) patients exhibited low zinc levels. The mean age of the zinc-deficient group was 65.41±12.77years. Serum zinc levels were significantly lower in group III (p<0.01). The severity and loudness of tinnitus were greater in zinc-deficient patients (p=0.011 and p=0.015, respectively). Moreover, the mean thresholds of air conduction were significantly higher in zinc-deficient patients (p=0.000). We observed that zinc levels decrease as age increases. In addition, there was a significant correlation between zinc level and the severity and loudness of tinnitus. Zinc deficiency was also associated with impairments in hearing thresholds. Copyright © 2015 Elsevier Inc. All rights reserved.

Acute otitis media associated bilateral sudden hearing loss: case report and literature review.

PubMed

Smith, A; Gutteridge, I; Elliott, D; Cronin, M

2017-07-01

Sudden sensorineural hearing loss is a rare otological condition with potential for dire outcomes including permanent hearing loss. Although the majority of cases are deemed idiopathic, bilateral sudden sensorineural hearing loss represents a rare subset typically related to systemic conditions, with higher morbidity and mortality. A controversial association with acute otitis media has been reported, with few bilateral cases published in the literature. A very rare case of bilateral sudden sensorineural hearing loss associated with acute otitis media is described, with a review of the literature. The limited evidence available suggests that acute otitis media with tinnitus and/or bacterial pathology may have an increased risk of sudden sensorineural hearing loss, which is consistent with the case described. Although there is no sufficiently powered published evidence to provide definitive treatment guidelines, the literature reviewed suggests that early myringotomy and antibiotics may greatly improve treatment outcomes.

Exposure to music and noise-induced hearing loss (NIHL) among professional pop/rock/jazz musicians.

PubMed

Halevi-Katz, Dana N; Yaakobi, Erez; Putter-Katz, Hanna

2015-01-01

Noise-induced hearing loss (NIHL) has been extensively studied in industrial work environments. With the advent of new technologies, loud music has been increasingly affecting listeners outside of the industrial setting. Most research on the effects of music and hearing loss has focused on classical musicians. The purpose of the current study was to examine the relationship between the amount of experience a professional pop/rock/jazz musician has and objective and subjective variables of the musician's hearing loss. This study also examined professional pop/rock/jazz musicians' use of hearing protection devices in relation to the extent of their exposure to amplified music. Forty-four pop/rock/jazz musicians were interviewed using the Pop/Rock/Jazz Musician's Questionnaire (PRJMQ) in order to obtain self-reported symptoms of tinnitus and hyperacusis. Forty-two of the subjects were also tested for air-conduction hearing thresholds in the frequency range of 1-8 kHz. Results show that the extent of professional pop/rock/jazz musicians' exposure to amplified music was related to both objective and subjective variables of hearing loss: Greater musical experience was positively linked to higher hearing thresholds in the frequency range of 3-6 kHz and to the subjective symptom of tinnitus. Weekly hours playing were found to have a greater effect on hearing loss in comparison to years playing. Use of hearing protection was not linked to the extent of exposure to amplified music. It is recommended that further research be conducted with a larger sample, in order to gain a greater understanding of the detrimental effects of hours playing versus years playing.

Exposure to music and noise-induced hearing loss (NIHL) among professional pop/rock/jazz musicians

PubMed Central

Halevi-Katz, Dana N.; Yaakobi, Erez; Putter-Katz, Hanna

2015-01-01

Noise-induced hearing loss (NIHL) has been extensively studied in industrial work environments. With the advent of new technologies, loud music has been increasingly affecting listeners outside of the industrial setting. Most research on the effects of music and hearing loss has focused on classical musicians. The purpose of the current study was to examine the relationship between the amount of experience a professional pop/rock/jazz musician has and objective and subjective variables of the musician's hearing loss. This study also examined professional pop/rock/jazz musicians’ use of hearing protection devices in relation to the extent of their exposure to amplified music. Forty-four pop/rock/jazz musicians were interviewed using the Pop/Rock/Jazz Musician's Questionnaire (PRJMQ) in order to obtain self-reported symptoms of tinnitus and hyperacusis. Forty-two of the subjects were also tested for air-conduction hearing thresholds in the frequency range of 1-8 kHz. Results show that the extent of professional pop/rock/jazz musicians’ exposure to amplified music was related to both objective and subjective variables of hearing loss: Greater musical experience was positively linked to higher hearing thresholds in the frequency range of 3-6 kHz and to the subjective symptom of tinnitus. Weekly hours playing were found to have a greater effect on hearing loss in comparison to years playing. Use of hearing protection was not linked to the extent of exposure to amplified music. It is recommended that further research be conducted with a larger sample, in order to gain a greater understanding of the detrimental effects of hours playing versus years playing. PMID:25913555

Assessment of Four Passive Hearing Protection Devices for Continuous Noise Attenuation, Impulsive Noise Insertion Loss, and Auditory Localization Performance

DTIC Science & Technology

2014-11-17

their duties, and may decrease the future standard of living and career opportunities for the Soldier. Tinnitus and noise-induced hearing loss are the...tested. Volunteers were given a questionnaire to report if they were sick, suffering from allergies, experiencing tinnitus , or otherwise in poor health

[Neurofeedback therapy in the treatment of tinnitus].

PubMed

Zhao, Z Q; Lei, G X; Li, Y L; Zhang, D; Shen, W D; Yang, S M; Qiao, Y H

2018-02-01

Neurofeedback therapy is a fast-growing field of tinnitus treatment, which is a new type of biofeedback therapy. In the past, the "muscle tone" and "blood flow" were used as feedback signals in biofeedback therapy to treat tinnitus, however there was no long-term follow-up report. Instead, neurofeedback therapy utilizes EEG (electroencephalogram) as the feedback signal, which is also called EEG biofeedback therapy. At present, most treatments of tinnitus only record subjective measures of patients as evaluation indicators, whereas neurofeedback therapy is more convincing for using comprehensive evaluation including changes of brain wave as objective indicators and subjective measures of patients. A significant number of tinnitus patients have varying degree of hearing loss. As neurofeedback therapy takes advantage of EEG as feedback signal that is delivered to the patients through visual information, it has unique advantages of being not affected by the degree of hearing loss compared to the sound masking or other sound treatment. Long-term follow-up results showed that the efficacy of neurofeedback therapy was stable after half a year of short-term treatment. This paper summarizes the progress of the various types of biofeedback therapy in the treatment of tinnitus, and focuses on the neurofeedback therapy for the mechanism, indication, process, efficacy evaluation, defect and prospect of neurofeedback therapy in tinnitus treatment in order to help promote the development of domestic clinical neurofeedback therapy in tinnitus.

Open ear hearing aids in tinnitus therapy: An efficacy comparison with sound generators.

PubMed

Parazzini, Marta; Del Bo, Luca; Jastreboff, Margaret; Tognola, Gabriella; Ravazzani, Paolo

2011-08-01

This study aimed to compare the effectiveness of tinnitus retraining therapy (TRT) with sound generators or with open ear hearing aids in the rehabilitation of tinnitus for a group of subjects who, according to Jastreboff categories, can be treated with both approaches to sound therapy (borderline of Category 1 and 2). This study was a prospective data collection with a parallel-group design which entailed that each subject was randomly assigned to one of the two treatments group: half of the subjects were fitted binaurally with sound generators, and the other half with open ear hearing aids. Both groups received the same educational counselling sessions. Ninety-one subjects passed the screening criteria and were enrolled into the study. Structured interviews, with a variety of measures evaluated through the use of visual-analog scales and the tinnitus handicap inventory self-administered questionnaire, were performed before the therapy and at 3, 6, and 12 months during the therapy. Data showed a highly significant improvement in both tinnitus treatments starting from the first three months and up to one year of therapy, with a progressive and statistically significant decrease in the disability every three months. TRT was equally effective with sound generator or open ear hearing aids: they gave basically identical, statistically indistinguishable results.

Active Duty- U.S. Army Noise-Induced Hearing Injury Quarterly Surveillance: Q1 2010 Thru Q2 2012

DTIC Science & Technology

2014-06-10

threshold shift, tinnitus , and Noise-Induced Hearing Loss. RECOMMENDATIONS: Commanders and Preventive Medicine assets at multiple levels should use...Humes LE, Jollenbeck LM, Durch JS: Noise and military service: Implications for hearing loss and tinnitus . Washington, DC: National Academy Press...NONSPECIFIC ABNORMAL AUDITORY FUNCTION STUDIES TINN Tinnitus 38830 TINNITUS UNSPECIFIED TINN Tinnitus 38831 SUBJECTIVE TINNITUS TINN Tinnitus 38832 OBJECTIVE

Self-reports about tinnitus and about cochlear implants.

PubMed

Noble, W

2000-08-01

Analyze literature on self-report outcomes in two areas of audiological rehabilitation: 1) tinnitus and 2) cochlear implant hearing aids. 1) Tinnitus: survey of features in the development of self-report approaches and of formal scales used in assessment of tinnitus disability and handicaps. 2) Cochlear implants: summary of the literature using self-report approaches to cochlear implant experience that indicates points of theoretical significance. 1) Major features of tinnitus are: a) disabilities such as interference with and distortion of normal auditory perception; b) handicaps such as emotional distress, interference with sleep, and with personal and social life. Nonauditory factors-chronic depression, high self-focused attention-mediate the degree of experienced tinnitus handicap. 2) People with prelingual loss of hearing report that a cochlear implant primarily enables improved detection and discrimination of environmental sound; those with postlingual loss find that an implant in addition provides improved speech recognition. 1) Coping with tinnitus is influenced by the personal resources that can be brought to bear on the experience, highlighting a general point that any rehabilitation outcome is not only a matter of acoustical solutions. By the same token, tinnitus can be easier to cope with if its "psychoacoustic presence" can be diminished by some form of masking. 2) Cochlear implants fitted in childhood that do not provide meaningful input signals in real-world settings may be rejected in adolescence. 3) "Hearing," as a capacity, does not have a fixed worth. Different circumstances mean it will be taken as desirable or as delivering torment (extreme tinnitus, e.g.). Its value will also vary depending on the extent of a person's access to spoken language (aiding in very early childhood, e.g.).

Tinnitus and leisure noise.

PubMed

Williams, Warwick; Carter, Lyndal

2017-04-01

To study the relationship of life-time noise exposure and experience of tinnitus. Audiometric measures included otoscopy, pure tone air- and bone-conduction hearing threshold levels (HTL) and otoacoustic emissions (OAEs). Participants completed questionnaires including demographic information, past hearing health, history of participation in loud leisure activities, and attitudes to noise. A representative sample (1435) of the young (11-35 years old) Australian population. Of the sample, 63% indicated they experienced tinnitus in some form. There was no correlation of tinnitus experience with HTL or OAE amplitudes. Although median octave band HTLs for those who experienced tinnitus "all the time" were slightly higher for those who did not, neither group exhibited HTLs outside clinically-normal values. Of those who experienced tinnitus a direct correlation was found between frequency of experience of tinnitus and increasing cumulative, life-time noise exposure. Those who experienced tinnitus were more likely to report noticing deterioration in their hearing ability over time and to report difficulty hearing in quiet and/or noisy situations. Experience of tinnitus was found throughout this young population but not associated with HTLs or variation in OAE amplitudes. Males experienced 'permanent' tinnitus at significantly greater rate than females.

[Hearing loss and idoneity--the segnalation of noise-induced hearing loss hearing Loss].

PubMed

Albera, Roberto; Dagna, Federico; Cassandro, Claudia; Canale, Andrea

2011-01-01

Work idoneity in hearing loss must be related to working ability and evolution risks. Working ability is referred to the difficulties found in speech comprehension and in signals perception. As regards hearing loss evolution it is necessary to define if the subject is affected by conductive or neurosensorial hearing loss. In conductive hearing loss it is necessary to evaluate entity and frequential distribution of the deficit. In neurosensorial hearing loss it is necessary to distinguish between noise-induced hearing loss and extraprofessional hearing loss. In noise-induced hearing loss the evolution risk is high if the noise exposure is less than 10-15 years or the actual noise exposure is louder than the former. In case of extraprofessional hearing loss the evolution risk is higher in presbycusis, endolymphatic hydrops and toxic hearing loss. The necessity to report the presence on professionale noise-induced hearing loss arises if audiometric threshold is more than 25 dB at 0.5-1-2-3-4 kHz and if it is verified the professional origine of hearing loss.

[Chronic tinnitus in children and adolescents].

PubMed

Rosanowski, F; Hoppe, U; Pröschel, U; Eysholdt, U

1997-11-01

The problem of tinnitus in adults is reviewed systematically in nearly all standard otolaryngology reference works, whereas textbooks and monographs that focus on pediatric otorhinolaryngology or audiology and hearing in children and adolescents provide only little information concerning the epidemiology, etiology and therapy of tinnitus. The purpose of this study was to evaluate the psychosomatic aspects of chronic tinnitus in this younger age group. A rational diagnostic approach is discussed as to which diagnostic measures are necessary in the pediatric group for deciding which therapeutic option to chose. The therapeutic outcome of tinnitus counselling in non-severe cases and of parenteral lidocaine infusions in cases of a troublesome tinnitus is presented. From January 1992 to December 1995, 31 children and adolescents in the age range from 6 to 17 years were treated for a chronic tinnitus without a measurable hearing loss. In 20 cases the tinnitus was bilateral; in 11 cases it was unilateral, without side preference. In 24 patients the case history gave no hint of a major annoyance by the tinnitus or significant psychological components. In these cases tinnitus counselling was carried out. In 7 cases-3 girls and 4 boys in the age range from 10 to 17 years-the kind and grade of symptom satisfied the ICD-10 criteria of a depressive episode. These patients were hospitalized for 10 days and a lidocaine infusion therapy (2 mg/kg Xylocain Cor in 500 ml HAES 6%) was performed as treatment for the somatic component of the disorder. Data were analyzed catamnestically using the patients' files. In all cases normal hearing threshold and speech intelligibility were ascertained by pure-tone and speech audiometry. Auditory evoked brainstem potentials gave no further information. The measurement of transient evoked otoacoustic emissions gave no consistent results in either of the two groups. Tinnitus measurement and audiometric masking could only be carried out in patients

Sound generator associated with the counseling in the treatment of tinnitus: evaluation of the effectiveness.

PubMed

Rocha, Andressa Vital; Mondelli, Maria Fernanda Capoani Garcia

The relations between the tinnitus and the hearing loss are due to the sensory deprivation caused by hearing loss, since this is followed by the functional and structural alteration of the auditory system as a whole. The cochlear lesions are accompanied by a reduction in the activity of the cochlear nerve, and the neural activity keeps increased in mainly all the central auditory nervous system to compensate this deficit. This study aimed to verify the effectiveness of the sound generator (SG) associated with the counseling in the treatment of the tinnitus in individuals with and without hearing loss regarding the improvement of the nuisance through Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS). The sample consisted of 30 individuals of both genders divided into two groups: Group 1 (G1) was comprised of 15 individuals with tinnitus and normal hearing, adapted to SG; Group 2 (G2) was comprised of 15 individuals with complaints of hearing acuity and tinnitus, adapted with SG and an individual hearing aid device (HA). Both groups underwent the following procedures: anamnesis and history of complaint, high frequency audiometry (HFA), imitanciometry, acuphenometry with the survey of psychoacoustic pitch and loudness thresholds and application of the tools THI and VAS. All of them were adapted with HA and Siemens SG and participated in a session of counseling. The individuals were assessed in three situations: initial assessment (before the adaptation of the HA and SG), monitoring and final assessment (6 months after adaptation). The comparison of the tinnitus nuisance and handicap in the three stages of assessment showed a significant improvement for both groups. The use of the SG was similarly effective in the treatment of the tinnitus in individuals with and without hearing loss, causing an improvement of the nuisance and handicap. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier

Characteristics of tinnitus in adolescents and association with psychoemotional factors.

PubMed

Kim, So Young; Jeon, Yung Jin; Lee, Jun-Young; Kim, Young Ho

2017-09-01

The characteristics and underlying mechanisms of tinnitus remain more elusive in the pediatric population than in adults. We investigated the prevalence of tinnitus, its characteristics, and associated factors, with a focus on psychoemotional problems in adolescents. Cross-sectional study METHODS: In total, 962 adolescents were surveyed for tinnitus and possibly related otologic and socioeconomic factors. The participants completed a visual analog scale (VAS) pertaining to various aspects of tinnitus, as well as the Tinnitus Handicap Inventory, Children's Depression Inventory (CDI), State Anxiety Inventory for Children, Trait Anxiety Inventory for Children (TAIC), Internet Addiction Test, Conners' Abbreviated Parent Rating Scale, and a learning disability score. Characteristics of tinnitus were analyzed, and psychoemotional and other factors were compared between tinnitus and nontinnitus groups. Approximately one-third of subjects reported experiencing tinnitus. A family history of tinnitus, subjective hearing loss, dizziness, and CDI and TAIC abnormalities were significantly associated with tinnitus. In the tinnitus-always group, tinnitus showed significant relationships with subjective hearing loss, bilateral tinnitus, and VAS, CDI, and TAIC scores. The results suggest that about one-third of adolescents experience tinnitus, which may be related to psychoemotional factors. In particular, anxiety and depression may be important factors to consider in managing tinnitus in adolescents. Further study of tinnitus in adolescents, including efforts toward diagnosis and management, is needed to determine whether there is a causal relationship with anxiety and depression, and the extent to which adverse outcomes may be associated with these psychoemotional factors. 4 Laryngoscope, 127:2113-2119, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Comparison of characteristics observed in tinnitus patients with unilateral vs bilateral symptoms, with both normal hearing threshold and distortion-product otoacoustic emissions.

PubMed

Zagólski, Olaf; Stręk, Paweł

2017-02-01

Tinnitus characteristics in normal-hearing patients differ between the groups with unilateral and bilateral complaints. The study was to determine the differences between tinnitus characteristics observed in patients with unilateral vs bilateral symptoms and normal hearing threshold, as well as normal results of distortion-product otoacoustic emissions (DPOAEs). The patients answered questions concerning tinnitus duration, laterality, character, accompanying symptoms, and circumstances of onset. The results of tympanometry, auditory brainstem responses, tinnitus likeness spectrum, minimum masking level (MML), and uncomfortable loudness level were evaluated. Records of 380 tinnitus sufferers were examined. Patients with abnormal audiograms and/or DPOAEs were excluded. The remaining 66 participants were divided into groups with unilateral and bilateral tinnitus. Unilateral tinnitus in normal-hearing patients was diagnosed twice more frequently than bilateral. Tinnitus pitch was higher in the group with bilateral tinnitus (p < .001). MML was lower in unilateral tinnitus (p < .05). Mean age of patients was higher in the unilateral tinnitus group (p < .05). Mean tinnitus duration was longer (p < .05) and hypersensitivity to sound was more frequent (p < .05) in the bilateral tinnitus group. Repeated exposure to excessive noise was the most frequent cause in the bilateral tinnitus group.

Top-down and bottom-up neurodynamic evidence in patients with tinnitus.

PubMed

Hong, Sung Kwang; Park, Sejik; Ahn, Min-Hee; Min, Byoung-Kyong

2016-12-01

Although a peripheral auditory (bottom-up) deficit is an essential prerequisite for the generation of tinnitus, central cognitive (top-down) impairment has also been shown to be an inherent neuropathological mechanism. Using an auditory oddball paradigm (for top-down analyses) and a passive listening paradigm (for bottom-up analyses) while recording electroencephalograms (EEGs), we investigated whether top-down or bottom-up components were more critical in the neuropathology of tinnitus, independent of peripheral hearing loss. We observed significantly reduced P300 amplitudes (reflecting fundamental cognitive processes such as attention) and evoked theta power (reflecting top-down regulation in memory systems) for target stimuli at the tinnitus frequency of patients with tinnitus but without hearing loss. The contingent negative variation (reflecting top-down expectation of a subsequent event prior to stimulation) and N100 (reflecting auditory bottom-up selective attention) were different between the healthy and patient groups. Interestingly, when tinnitus patients were divided into two subgroups based on their P300 amplitudes, their P170 and N200 components, and annoyance and distress indices to their tinnitus sound were different. EEG theta-band power and its Granger causal neurodynamic results consistently support a double dissociation of these two groups in both top-down and bottom-up tasks. Directed cortical connectivity corroborates that the tinnitus network involves the anterior cingulate and the parahippocampal areas, where higher-order top-down control is generated. Together, our observations provide neurophysiological and neurodynamic evidence revealing a differential engagement of top-down impairment along with deficits in bottom-up processing in patients with tinnitus but without hearing loss. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Maladaptive plasticity in tinnitus-triggers, mechanisms and treatment

PubMed Central

Shore, Susan E; Roberts, Larry E.; Langguth, Berthold

2016-01-01

Tinnitus is a phantom auditory sensation that reduces quality of life for millions worldwide and for which there is no medical cure. Most cases are associated with hearing loss caused by the aging process or noise exposure. Because exposure to loud recreational sound is common among youthful populations, young persons are at increasing risk. Head or neck injuries can also trigger the development of tinnitus, as altered somatosensory input can affect auditory pathways and lead to tinnitus or modulate its intensity. Emotional and attentional state may play a role in tinnitus development and maintenance via top-down mechanisms. Thus, military in combat are particularly at risk due to combined hearing loss, somatosensory system disturbances and emotional stress. Neuroscience research has identified neural changes related to tinnitus that commence at the cochlear nucleus and extend to the auditory cortex and brain regions beyond. Maladaptive neural plasticity appears to underlie these neural changes, as it results in increased spontaneous firing rates and synchrony among neurons in central auditory structures that may generate the phantom percept. This review highlights the links between animal and human studies, including several therapeutic approaches that have been developed, which aim to target the neuroplastic changes underlying tinnitus. PMID:26868680

Chronic tinnitus resulting from cerumen removal procedures.

PubMed

Folmer, Robert L; Shi, Baker Yongbing

2004-01-01

This study was undertaken to determine how many cases of chronic tinnitus in a clinic population resulted from cerumen removal procedures and to summarize cerumen management methodologies and recommendations that will reduce the likelihood of such serious complications. Detailed questionnaires were mailed to 2400 consecutive patients (1704 male, 696 female; mean age, 53.3 +/- 11.8 years; age range, 7-87 years) prior to their initial appointment at the Oregon Health & Science University Tinnitus Clinic between 1986 and 2000. These questionnaires requested information about patients' medical, hearing, and tinnitus histories. Records were analyzed to determine how many patients reported that their chronic tinnitus began as a result of cerumen removal procedures. Of 2400 patients, 11 (0.46%) reported that their tinnitus began as a result of cerumen removal procedures performed by clinicians. Three additional patients reported that chronic tinnitus began as a result of their own attempts to clean their ear canals. Chronic and debilitating conditions, such as hearing loss and tinnitus, can occur as results of attempts to remove cerumen. By following the recommendations of experts in cerumen management techniques, clinicians can reduce the likelihood of catastrophic complications and subsequent litigation.

Effects of long-term non-traumatic noise exposure on the adult central auditory system. Hearing problems without hearing loss.

PubMed

Eggermont, Jos J

2017-09-01

It is known that hearing loss induces plastic changes in the brain, causing loudness recruitment and hyperacusis, increased spontaneous firing rates and neural synchrony, reorganizations of the cortical tonotopic maps, and tinnitus. Much less in known about the central effects of exposure to sounds that cause a temporary hearing loss, affect the ribbon synapses in the inner hair cells, and cause a loss of high-threshold auditory nerve fibers. In contrast there is a wealth of information about central effects of long-duration sound exposures at levels ≤80 dB SPL that do not even cause a temporary hearing loss. The central effects for these moderate level exposures described in this review include changes in central gain, increased spontaneous firing rates and neural synchrony, and reorganization of the cortical tonotopic map. A putative mechanism is outlined, and the effect of the acoustic environment during the recovery process is illustrated. Parallels are drawn with hearing problems in humans with long-duration exposures to occupational noise but with clinical normal hearing. Copyright © 2016 Elsevier B.V. All rights reserved.

[Tinnitus Center at the Nofer Institute of Occupational Medicine--earliest experience].

PubMed

Guzek, Wojciech J; Sułkowski, Wiesław J; Kowalska, Sylwia; Makowska, Zofia

2002-01-01

Of the 150 patients admitted in 2001 to the Tinnitus Center located at the Nofer Institute of Occupational Medicine, Łódź, Poland, 80 were subjected to complex examinations consisted of standardized questionnaire on medical history, psychological tests and audiological assessment. The diagnostic procedure was completed for 52 patients (23 females and 29 males; mean age: 53 years). In this group, five patients were found to have conductive hearing loss due to chronic eustachtis or otosclerosis. They were excluded from further studies. Among the other 47 patients, 26 showed normal hearing threshold and 21 suffered from uni- or bilateral sensorineural hearing loss. Hyperacusis was diagnosed in 16 cases. The measurements of brainstem evoked potentials revealed V wave latency asymmetry in 7 cases, which implied the necessity to perform CT or MNR. In neither of cases did this diagnosis confirm the suspected tumor development (n. VIII neurinoma or pontocerebral angle tumor. The preliminary assessment of treatment efficacy for subjective tinnitus with use of retraining therapy yielded the following conclusions: 1. The application of hearing aid brings about an immediate improvement in the patient's self-assessment of hearing and a better tolerance towards tinnitus. 2. A systematic all-day wear of noise generators contributes to the patient's increased tolerance towards tinnitus, improved mental condition and alleviated hyperacusis. 3. The efficacy of the tinnitus retraining therapy, following Jastreboff, depends on providing the patient with detailed information on the causes and mechanisms of tinnitus development. 4. The negative diagnostics for tumor within the cranial cavity has not only a soothing effect on the patient as it relieves his/her stress, but it can also be a good starting point for the tinnitus retraining therapy.

ACR Appropriateness Criteria® Tinnitus.

PubMed

Kessler, Marcus M; Moussa, Marwan; Bykowski, Julie; Kirsch, Claudia F E; Aulino, Joseph M; Berger, Kevin L; Choudhri, Asim F; Fife, Terry D; Germano, Isabelle M; Kendi, A Tuba; Kim, Jeffrey H; Luttrull, Michael D; Nunez, Diego; Shah, Lubdha M; Sharma, Aseem; Shetty, Vilaas S; Symko, Sophia C; Cornelius, Rebecca S

2017-11-01

Tinnitus is the perception of sound in the absence of an external source. It is a common symptom that can be related to hearing loss and other benign causes. However, tinnitus may be disabling and can be the only symptom in a patient with a central nervous system process disorder. History and physical examination are crucial first steps to determine the need for imaging. CT and MRI are useful in the setting of pulsatile tinnitus to evaluate for an underlying vascular anomaly or abnormality. If there is concomitant asymmetric hearing loss, neurologic deficit, or head trauma, imaging should be guided by those respective ACR Appropriateness Criteria ® documents, rather than the presence of tinnitus. Imaging is not usually appropriate in the evaluation of subjective, nonpulsatile tinnitus that does not localize to one ear. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The Effect of Integrated Hearing Protection Surround Levels on Sound Localization

DTIC Science & Technology

2015-02-01

perceived hearing loss, and tinnitus . 4 DRDC-RDDC-2015-R012 Individuals who met the telephone screening criteria were examined by...and military service: Implications for hearing loss and tinnitus . Institute of Medicine of the National Academy of Science. National Academies Press

Prevalence of and Risk Factors for Tinnitus and Tinnitus-Related Handicap in a College-Aged Population.

PubMed

Bhatt, Ishan Sunilkumar

Tinnitus is a common otological condition that affects almost 10% of US adults. Research suggests that college students are vulnerable to tinnitus and hearing loss as they are exposed to traumatic levels of noise on a regular basis. Tinnitus and its influence in daily living continue to be underappreciated in the college-aged population. Therefore, the objective for the present study was to analyze prevalence and associated risk factors of tinnitus and tinnitus-related handicap in a sample of college-aged students. A survey was administered to 678 students aged 18-30 years in a cross-section of randomly selected university classes. The survey was adopted from the National Health and Nutrition Examination Survey (2010). It inquired about demographic details, medical and audiological history, routine noise exposure, smoking, sound level tolerance, tinnitus, and tinnitus-related handicap in daily living. Tinnitus-related handicap was assessed by the Tinnitus Handicap Inventory (THI). Participants were divided into four groups: chronic tinnitus (bothersome tinnitus for >1 year), acute tinnitus (bothersome tinnitus for ≤1 year), subacute tinnitus (at least one experience of tinnitus in a lifetime), and no tinnitus (no experience of tinnitus in a lifetime). The prevalence of chronic, acute, subacute, and no tinnitus was 8.4%, 13.0%, 37.9%, and 40.7% respectively. Almost 9% of subjects with any form of tinnitus reported more than a slight tinnitus-related handicap (i.e., THI score ≥18). A multinomial regression analysis revealed that individuals with high noise exposure, high sound level tolerance score, recurring ear infections, and self-reported hearing loss had high odds of chronic tinnitus. Females showed higher prevalence of acute tinnitus than males. Individuals with European American ethnicity and smoking history showed high odds of reporting subacute tinnitus. Almost 10% of the subjects reported that they were music students. The prevalence of chronic, acute

Cochlear synaptopathy in acquired sensorineural hearing loss: Manifestations and mechanisms.

PubMed

Liberman, M Charles; Kujawa, Sharon G

2017-06-01

Common causes of hearing loss in humans - exposure to loud noise or ototoxic drugs and aging - often damage sensory hair cells, reflected as elevated thresholds on the clinical audiogram. Recent studies in animal models suggest, however, that well before this overt hearing loss can be seen, a more insidious, but likely more common, process is taking place that permanently interrupts synaptic communication between sensory inner hair cells and subsets of cochlear nerve fibers. The silencing of affected neurons alters auditory information processing, whether accompanied by threshold elevations or not, and is a likely contributor to a variety of perceptual abnormalities, including speech-in-noise difficulties, tinnitus and hyperacusis. Work described here will review structural and functional manifestations of this cochlear synaptopathy and will consider possible mechanisms underlying its appearance and progression in ears with and without traditional 'hearing loss' arising from several common causes in humans. Copyright © 2017 Elsevier B.V. All rights reserved.

Prevalence of Hearing Loss in Teachers of Singing and Voice Students.

PubMed

Isaac, Mitchell J; McBroom, Deanna H; Nguyen, Shaun A; Halstead, Lucinda A

2017-05-01

Singers and voice teachers are exposed to a range of noise levels during a normal working day. This study aimed to assess the hearing thresholds in a large sample of generally healthy professional voice teachers and voice students to determine the prevalence of hearing loss in this population. A cross-sectional study was carried out. Voice teachers and vocal students had the option to volunteer for a hearing screening of six standard frequencies in a quiet room with the Shoebox audiometer (Clearwater Clinical Limited) and to fill out a brief survey. Data were analyzed for the prevalence and severity of hearing loss in teachers and students based on several parameters assessed in the surveys. All data were analyzed using Microsoft Excel (Microsoft Corp.) and SPSS Statistics Software (IBM Corp.). A total of 158 participants were included: 58 self-identified as voice teachers, 106 as voice students, and 6 as both. The 6 participants who identified as both, were included in both categories for statistical purposes. Of the 158 participants, 36 had some level of hearing loss: 51.7% of voice teachers had hearing loss, and 7.5% of voice students had hearing loss. Several parameters of noise exposure were found to positively correlate with hearing loss and tinnitus (P < 0.05). Years as a voice teacher and age were both predictors of hearing loss (P < 0.05). Hearing loss in a cohort of voice teachers appears to be more prevalent and severe than previously thought. There is a significant association between years teaching and hearing loss. Raising awareness in this population may prompt teachers and students to adopt strategies to protect their hearing. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Assessing audiological, pathophysiological, and psychological variables in chronic tinnitus: a study of reliability and search for prognostic factors.

PubMed

Hiller, W; Goebel, G

1999-01-01

The development and course of chronic tinnitus are determined by both biological and psychological factors. To combine these different sources of data, we developed a standardized interview to assess tinnitus history, summarize audiological findings, screen for etiological conditions, and explore tinnitus-related psychological complaints (Structured Tinnitus Interview). The results of a test-retest study with 65 tinnitus inpatients show that most of these components can be assessed with acceptable or high reliability. Further data based on 166 patients demonstrate that tinnitus annoyance was to some extent different from patterns of general psychological complaints, although there were medium intercorrelations with depression. Significant predictors of tinnitus annoyance were (a) continuous tinnitus without intervals, (b) hearing loss, (c) increasing tinnitus loudness over time, (d) poor maskability, (e) history of sudden hearing loss, and (f) associated craniomandibular disorder. Psychological distress was not significantly increased in patients whose tinnitus was associated to vascular disorder, cervical spine dysfunction, acoustic trauma, Menihre's disease, or neurological disorder.

Relationships among psychoacoustic judgments, speech understanding ability and self-perceived handicap in tinnitus subjects.

PubMed

Newman, C W; Wharton, J A; Shivapuja, B G; Jacobson, G P

1994-01-01

Tinnitus is often a disturbing symptom which affects 6-20% of the population. Relationships among tinnitus pitch and loudness judgments, audiometric speech understanding measures and self-perceived handicap were evaluated in a sample of subjects with tinnitus and hearing loss (THL). Data obtained from the THL sample on the audiometric speech measures were compared to the performance of an age-matched hearing loss only (HL) group. Both groups had normal hearing through 1 kHz with a sloping configuration of < or = 20 dB/octave between 2-12 kHz. The THL subjects performed more poorly on the low predictability items of the Speech Perception in Noise Test, suggesting that tinnitus may interfere with the perception of speech signals having reduced linguistic redundancy. The THL subjects rated their tinnitus as annoying at relatively low sensation levels using the pitch-match frequency as the reference tone. Further, significant relationships were found between loudness judgment measures and self-rated annoyance. No predictable relationships were observed between the audiometric speech measures and perceived handicap using the Tinnitus Handicap Questionnaire. These findings support the use of self-report measures in tinnitus patients in that audiometric speech tests alone may be insufficient in describing an individual's reaction to his/her communication breakdowns.

Active Duty-U.S. Army Noise Induced Hearing Injury Quarterly Surveillance Q3 2007 thru Q4 2009

DTIC Science & Technology

2014-05-11

years (CY) Q3 2007-Q4 2009 shows incident case rates for sensorineural hearing loss (SNHL), significant threshold shift (STS), tinnitus , and Noise-Induced...Prev Med. 2010;38(1S):S71-S77. Humes LE, Jollenbeck LM, Durch JS. Noise and military service: Implications for hearing loss and tinnitus . Washington...threshold shift 79415 NONSPECIFIC ABNORMAL AUDITORY FUNCTION STUDIES TINN Tinnitus 38830 TINNITUS UNSPECIFIED TINN Tinnitus 38831 SUBJECTIVE TINNITUS

[Tinnitus and temporomandibular joint: State of the art].

PubMed

Lina-Granade, G; Truy, E; Ionescu, E; Garnier, P; Thai Van, H

2016-12-01

Tinnitus has been described in temporomandibular joint dysfunction for a long time. Yet, other disorders, such as hearing loss, stress, anxiety and depression, play a major role in the pathophysiology of tinnitus. Temporomandibular joint dysfunctions seem to increase the risk of tinnitus in patients with other predisposing factors. Especially somatosensory tinnitus, which is characterized by sound modulations with neck or mandible movements, is frequently associated with temporomandibular joint dysfunction, but it is not pathognomonic of such a disorder. In such cases, functional therapy of the temporomandibular joint should be part of the multidisciplinary rehabilitation of patients with tinnitus. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Vision loss and hearing loss in painting and musical composition.

PubMed

Marmor, Michael F

2014-07-01

This article considers the impact of vision and hearing loss on great painters and musical composers. The visual work of Mary Cassatt, Georgia O'Keeffe, Edgar Degas, and Claude Monet all showed alterations as their vision failed. In contrast, Gabriel Fauré, Bedřich Smetana, and Ludwig von Beethoven wrote many of their best compositions while totally deaf, and Georg Friedrich Handel and Frederick Delius struggled to compose late in life when they lost their vision (although their hearing remained excellent). There are 2 major distinctions between the role of vision and hearing for these artistic disciplines. First, there is a surrogate means of "hearing" music, through the musical score, which allows composers to write and edit music while totally deaf. The greatest problem with deafness for a skilled composer is interference from internal noise (tinnitus). There is no surrogate for vision to allow a painter to work when the subject is a blur or the colors on the canvas cannot be distinguished. Second, although the appreciation of art is visual and that of music is auditory, the transcription of both art and musical composition is visual. Thus, visual loss does pose a problem for a composer accustomed to working with good sight, because it disrupts habitual methods of writing and editing music. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Tinnitus in Temporomandibular Joint Disorders: Is it a Specific Somatosensory Tinnitus Subtype?

PubMed

Algieri, Giuseppe Maria Antonio; Leonardi, Alessandra; Arangio, Paolo; Vellone, Valentino; Paolo, Carlo Di; Cascone, Piero

2017-04-19

The most significant otologic symptoms, consisting of ear pain, tinnitus, dizziness, hearing loss and auricolar "fullness", generally arise within the auditory system, often are associated with extra auricolar disorders, particularly disorder of the temporo-mandibular joint. In our study we examined a sample of 200 consecutive patients who had experienced severe disabling symptom. The patiens came to maxillofacial specialist assessment for temporomandibular disorder. Each patient was assessed by a detailed anamnestic and clinical temporomandibular joint examination and they are divided into five main groups according classification criteria established by Wilkes; tinnitus and subjective indicators of pain are evaluated. The results of this study provide a close correlation between the joint pathology and otologic symptoms, particularly regarding tinnitus and balance disorders, and that this relationship is greater the more advanced is the stage of joint pathology. Moreover, this study shows that TMD-related tinnitus principally affects a younger population (average fifth decade of life) and mainly women (more than 2/3 of the cases). Such evidence suggests the existence of a specific tinnitus subtype that may be defined as "TMD-related somatosensory tinnitus".

[Hearing loss in urban transportation workers in Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil].

PubMed

Medeiros, Adriane Mesquita de; Assunção, Ada Ávila; Santos, Juliana Nunes

2015-09-01

This study analyzed the association between self-reported diagnosis of hearing loss and individual and occupational factors among urban transportation workers in Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil. The sample size was calculated by quotas and stratified by occupation (drivers and fare collectors) in the urban transportation companies in Belo Horizonte, Betim, and Contagem. Data were collected with face-to-face interviews and recorded by the interviewers on netbooks. The dependent variable was defined as an affirmative response to the question on prevailing medical diagnosis of hearing loss. The independent variables were organized in three blocks: social and demographic characteristics, lifestyle, and work aspects. Diagnosis of hearing loss was reported by 213 of the 1,527 workers and was associated with age and diagnosis of tinnitus. At the occupational level, hearing loss was associated with history of sick leave, time-on-the-job, and two environmental risks, unbearable noise and whole-body vibration. Measures to prevent hearing loss are needed for urban transportation workers.

Reading Comprehension in Quiet and in Noise: Effects on Immediate and Delayed Recall in Relation to Tinnitus and High-Frequency Hearing Thresholds.

PubMed

Brännström, K Jonas; Waechter, Sebastian

2018-06-01

A common complaint by people with tinnitus is that they experience that the tinnitus causes attention and concentration problems. Previous studies have examined how tinnitus influences cognitive performance on short and intensive cognitive tasks but without proper control of hearing status. To examine the impact tinnitus and high-frequency hearing thresholds have on reading comprehension in quiet and in background noise. A between-group design with matched control participants. One group of participants with tinnitus (n = 20) and an age and gender matched control group without tinnitus (n = 20) participated. Both groups had normal hearing thresholds (20 dB HL at frequencies 0.125 to 8 kHz). Measurements were made assessing hearing thresholds and immediate and delayed recall using a reading comprehension test in quiet and in noise. All participants completed the Swedish version of the Hospital Anxiety and Depression Scale, and participants with tinnitus also completed the Tinnitus Questionnaire. The groups did not differ in immediate nor delayed recall. Accounting for the effect of age, a significant positive correlation was found between best ear high-frequency pure tone average (HF-PTA; 10000, 12500, and 14000 Hz) and the difference score between immediate and delayed recall in noise. Tinnitus seems to have no effect on immediate and delayed recall in quiet or in background noise when hearing status is controlled for. The detrimental effect of background noise on the processes utilized for efficient encoding into long-term memory is larger in participants with better HF-PTA. More specifically, when reading in noise, participants with better HF-PTA seem to recall less information than participants with poorer HF-PTA. American Academy of Audiology.

Application of distortion product otoacoustic emissions to inflation of the eustachian tube in low frequency tinnitus with normal hearing.

PubMed

Wang, Hui; Song, Ningying; Li, Xujing; Lv, Hongguang

2013-06-01

This study was designed to investigate the applications of distortion product otoacoustic emissions to assess the efficacy of eustachian tube inflation on low frequency tinnitus with normal hearing. Ninety-four patients (155 ears) suffering from subjective tinnitus with normal hearing sensitivity participated in this study. Control group consists of fifty volunteers (100 ears) without tinnitus. They were subjected to full history taking, otoscopy, basic audiologic evaluation and distortion product otoacoustic emissions (DPOAE). As for the patients with decreased DPOAE amplitude over a limited frequency range from 0.5 to 1kHz, we offered nose dropping and tubal inflation for a week and DPOAE was preformed again. The patients were followed up for a month. 34.8% DPOAE-gram showed decreased amplitude at the frequencies from 0.5 to 1kHz in tinnitus group and "the ring" is mostly lower in pitch. Among the patients accepted the treatment of eustachian tube inflation, 16.7% the tinnitus disappeared, no recurrence within one month; 66.67% the tinnitus reduced within one month. 95.5% the amplitude of DPOAE showed improved over the limited frequency. 16.7% the tinnitus still existed. The changes of the mechanical properties of ossicular chain or the tympanic membrane influenced by tympanum pressure may cause tinnitus, which is sub-clinical prior to the changes of audiometry and tympanometry. The low frequency tinnitus may gain transitory relief from ringing with the tubal inflation. DPOAE was proved to be a useful tool in the evaluation of the efficacy of tubal inflation on low frequency tinnitus with normal hearing. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Animal models of tinnitus.

PubMed

Brozoski, Thomas J; Bauer, Carol A

2016-08-01

Presented is a thematic review of animal tinnitus models from a functional perspective. Chronic tinnitus is a persistent subjective sound sensation, emergent typically after hearing loss. Although the sensation is experientially simple, it appears to have central a nervous system substrate of unexpected complexity that includes areas outside of those classically defined as auditory. Over the past 27 years animal models have significantly contributed to understanding tinnitus' complex neurophysiology. In that time, a diversity of models have been developed, each with its own strengths and limitations. None has clearly become a standard. Animal models trace their origin to the 1988 experiments of Jastreboff and colleagues. All subsequent models derive some of their features from those experiments. Common features include behavior-dependent psychophysical determination, acoustic conditions that contrast objective sound and silence, and inclusion of at least one normal-hearing control group. In the present review, animal models have been categorized as either interrogative or reflexive. Interrogative models use emitted behavior under voluntary control to indicate hearing. An example would be pressing a lever to obtain food in the presence of a particular sound. In this type of model animals are interrogated about their auditory sensations, analogous to asking a patient, "What do you hear?" These models require at least some training and motivation management, and reflect the perception of tinnitus. Reflexive models, in contrast, employ acoustic modulation of an auditory reflex, such as the acoustic startle response. An unexpected loud sound will elicit a reflexive motor response from many species, including humans. Although involuntary, acoustic startle can be modified by a lower-level preceding event, including a silent sound gap. Sound-gap modulation of acoustic startle appears to discriminate tinnitus in animals as well as humans, and requires no training or

Occupational hearing loss of market mill workers in the city of Accra, Ghana.

PubMed

Kitcher, Emmanuel D; Ocansey, Grace; Abaidoo, Benjamin; Atule, Alidu

2014-01-01

Noise induced hearing loss (NIHL) is an irreversible sensorineural hearing loss associated with exposure to high levels of excessive noise. Prevention measures are not well established in developing countries. This comparative cross sectional study aims to determine the prevalence of hearing loss in both a group of high risk workers and a control group and to assess their knowledge of the effects of noise on hearing health. A total of 101 market mill workers and 103 controls employed within markets in the city of Accra, Ghana, were evaluated using a structured questionnaire and pure tone audiometry. The questionnaire assessed factors including self-reported hearing loss, tinnitus, knowledge on the effects of noise on hearing health and the use of hearing protective devices. Pure tone audiometric testing was conducted for both mill workers and controls. Noise levels at the work premises of the mill workers and controls were measured. Symptoms of hearing loss were reported by 24 (23.76%) and 8 (7.7%) mill workers and controls respectively. Fifty-five (54.5%) and fifty-four (52.37%) mill workers and controls exhibited knowledge of the effects of noise on hearing health. Five (5.0%) mill workers used hearing protective devices. There was significant sensorineural hearing loss and the presence of a 4 kHz audiometric notch among mill workers when compared with controls for the mean thresholds of 2 kHz, 3 kHz and 4 kHz (P = 0. 001). The prevalence of hearing loss in the better hearing ears of the mill workers and controls was 24.8% and 4.8% respectively (P < 0.5). The prevalence of hearing loss, which may be characteristic of NIHL in the better hearing ears of the mill workers and controls was 24.8% and 4.8% respectively. The majority of mill workers did not use hearing protection.

Effect of Direct Stimulation of the Cochleovestibular Nerve on Tinnitus: A Long-Term Follow-Up Study.

PubMed

van den Berge, Minke J C; van Dijk, J Marc C; Free, Rolien H; Stienstra, Janke; van Dijk, Pim; van der Laan, Bernard F A M

2017-02-01

Tinnitus is a common entity that may lead to severe impairment in quality of life. An adequate treatment modality for severe tinnitus is currently lacking. Neurostimulation of the auditory tract may serve as a promising adjunct in tinnitus treatment. The aim is to investigate the effect of direct stimulation on the cochleovestibular nerve for intractable tinnitus. This study was conducted at the University Medical Center Groningen, The Netherlands. We studied 10 patients with severe, unilateral, intractable tinnitus, who were implanted with a cuff electrode around the cochleovestibular nerve between 2001 and 2013. All patients had preoperative ipsilateral hearing loss. Tinnitus Handicap Inventory (THI) scores and audiometric values were collected. Treatment success was determined based on the self-assessment of satisfactory usage by each patient. The mean preoperative tinnitus duration was 8.0 ± 5.9 years. The preoperative THI score was 71 ± 18 points. During mean follow-up of 49 months, the mean THI reduction was 24 ± 26 points (P = 0.02). Treatment was regarded successful in 6 patients (60%). In these patients, tinnitus did not disappear, but transformed into a more bearable sound. In 4 patients, transient complications occurred, and 1 patient experienced permanent vertigo postoperatively. Furthermore, hearing deterioration was a result of implantation in 86% of the patients. Direct neurostimulation resulted in treatment success in a small majority of the patients, with a significant decrease in THI score. However, because of a high risk of additional hearing damage, this technique seems not viable for patients with moderate hearing loss. Copyright © 2016 Elsevier Inc. All rights reserved.

Urine Cotinine Should Be Involved in Initial Evaluation of Tinnitus in Adolescents.

PubMed

Lee, Doh Young; Kim, Young Ho

2018-04-10

Smoking is associated with hearing loss, while the correlation between tinnitus and smoking is not fully elucidated. This study aimed to evaluate risk factors of tinnitus in adolescents in terms of smoking, and we identified a rectifiable parameter that can be serially monitored. A cross-sectional study was conducted using data from the Korea National Health and Nutrition Examination Survey, with 2,782 participants aged 12 to 18 years, from 2008 through 2011. Participants with history of ear disease, hearing loss, and inadequate responses to questionnaires were excluded. We investigated the prevalence of tinnitus and tinnitus-related annoyance by questionnaire and sought potential risk factors in blood and urine tests and smoking history. The prevalence of tinnitus in the 12- to 18-year-old population was 17.5%, with 3.3% reporting tinnitus-related annoyance. On univariate analysis, the prevalence of tinnitus increased with age (P<0.001) and was higher among girls (P=0.012). Blood tests and urinalysis showed significant correlation between tinnitus and red blood cell count, alkaline phosphatase levels, and urine cotinine (P=0.002, P<0.001, P=0.018, respectively). In multivariate analysis, the urine cotinine level was the only parameter associated with tinnitus (odds ratio, 1.000; 95% confidence interval, 0.999 to 1.000; P=0.038). Smoking was also significantly correlated with tinnitus (P=0.043), and amount of smoking with tinnitus-related annoyance (P=0.045). However, current smoking and past smoking were not correlated with tinnitus. Urine cotinine may be a rectifiable marker for management of tinnitus in adolescents. This suggests that smoking cessation should be incorporated in the management of tinnitus in adolescents.

When tinnitus loudness and annoyance are discrepant: audiological characteristics and psychological profile.

PubMed

Hiller, Wolfgang; Goebel, Gerhard

2007-01-01

This study evaluates sociodemographic and clinical characteristics of patients reporting discrepant levels of tinnitus loudness and annoyance. 4958 subjects recruited from a national tinnitus association completed a comprehensive screening questionnaire including Klockhoff and Lindblom's loudness grading system and the psychometric Mini-TQ (Tinnitus Questionnaire). There was a moderate correlation of 0.45 between loudness and annoyance. Of the subjects reporting very loud tinnitus, about one third had only mild or moderate annoyance scores. They were not different from those with high annoyance regarding age, gender and tinnitus duration, but annoyance was increased when subjects had additional hearing loss (OR = 1.71), vertigo/dizziness (OR = 1.94) or hyperacusis (OR = 4.96). Another significant predictor was history of neurological disease (OR = 3.16). Subjects reported low annoyance despite high loudness more often if not feeling low/depressed and not considering themselves as victims of their noises. A specific psychological profile was found to characterize annoyed tinnitus sufferers. Permanent awareness of the noises, decreased ability to ignore them and concentration difficulties were reported frequently even when overall annoyance scores were comparatively low. It is concluded that the coexistence of tinnitus with hearing loss, vertigo/dizziness and hyperacusis as complicating otological conditions seems to be of clinical relevance for the prediction of high annoyance levels. Tinnitus loudness and annoyance are not necessarily congruent and should be assessed separately. (c) 2007 S. Karger AG, Basel.

Speech recognition index of workers with tinnitus exposed to environmental or occupational noise: a comparative study

PubMed Central

2012-01-01

Introduction Tinnitus is considered the third worst symptom affecting humans. The aim of this article is to assess complaints by workers with tinnitus exposed to environmental and occupational noise. Methodology 495 workers went through an epidemiological survey at the Audiology Department of the Center for Studies on Workers’ Health and Human Ecology, from 2003 to 2007. The workers underwent tonal and vocal audiometry, preceded by a clinical and occupational history questionnaire. Two-factor ANOVA and Tukey were the statistical tests used. All the analysis set statistical significance at α=5%. Findings There was a higher prevalence of occupational tinnitus (73.7%), a predominance of female domestic workers (65.4%) in cases of environmental exposure, and predominance of male construction workers (71.5%) for occupational exposure. There was a significant difference in workers with hearing loss, who showed a mean speech recognition index (SRI) of 85%, as compared to healthy workers with a mean SRI greater than 93.5%. Signs and symptoms, speech perception, and interference in sound localization with the type of noise exposure (environmental versus occupational) comparisons found no significant differences. Conclusion Studied group’s high prevalence of tinnitus, major difficulties in speech recognition with hearing loss and the presence of individuals with normal hearing with both types of exposure justify the importance of measures in health promotion, prevention, and hearing surveillance. The findings highlight the importance of valuing the patients’ own perception as the first indication of tinnitus and hearing loss in order to help develop appropriate public policies within the Unified National Health System (SUS). PMID:23259813

British university students' attitudes towards noise-induced hearing loss caused by nightclub attendance.

PubMed

Johnson, O; Andrew, B; Walker, D; Morgan, S; Aldren, A

2014-01-01

Over the past 30 years, the prevalence of noise-induced hearing loss among adolescents and young adults has increased. This study aimed to address the current dearth of literature implicating excessive nightclub sound levels (more than 85 dB) as a direct cause of auditory symptoms related to noise-induced hearing loss. A questionnaire was completed by 325 students to gauge the frequency of auditory symptoms after nightclub attendance, and to explore knowledge and opinions about noise levels in nightclubs. The findings showed that 88.3 per cent of students experienced tinnitus after leaving a nightclub and 66.2 per cent suffered impaired hearing the following morning. In terms of behaviour, 73.2 per cent of students said that the risk of hearing damage would not affect their nightclub attendance, but most students (70.2 per cent) felt that noise levels in nightclubs should be limited to safe volumes. A high proportion of students reported experiencing symptoms related to noise-induced hearing loss after attending a nightclub. These findings are relevant to policy makers.

25 years of tinnitus retraining therapy.

PubMed

Jastreboff, P J

2015-04-01

This year marks 25 years of tinnitus retraining therapy (TRT), the approach that aims to eliminate tinnitus as a problem by extinguishing functional connections between the auditory and the limbic and autonomic nervous systems to achieve habituation of tinnitus-evoked reactions and subsequently habituation of perception. TRT addresses directly decreased sound tolerance (DST) as well as tinnitus. TRT consists of counseling and sound therapy, both based on the neurophysiological model of tinnitus. The main goal of retraining counseling is to reclassify tinnitus into the category of a neutral stimulus, while the main goal of sound therapy is to decrease the strength of tinnitus-related neuronal activity. A unique aspect of TRT is that because treatment is aimed to work above the tinnitus source, and at connections linking the auditory and other systems in the brain, the etiology of tinnitus is irrelevant. Any type of tinnitus, as well as somatosounds, can be successfully treated by TRT. Over 100 publications can be found on Medline when using "tinnitus retraining therapy" as a search term. The majority of these publications indicate TRT offers significant help for about 80 % of patients. A randomized clinical trial showing the effectiveness of TRT has been published and another large study is in progress. The principles of the neurophysiological model of tinnitus, and consequently TRT, have not changed in over 25 years of use, but a number of changes have been introduced in TRT implementation. These changes include the recognition of the importance of conditioned reflexes and the dominant role of the subconscious pathways; the introduction of the concept of misophonia (i.e., negative reactions to specific patterns of sound) and the implementation of specific protocols for its treatment; greater emphasis on the concurrent treatment of tinnitus, hyperacusis, misophonia, and hearing loss; extensive modification of counseling; and refinements in sound therapy. The

Performance Assessment of Hearing Protection and Communication Enhancement Devices: Peltor Comtac III and IV

DTIC Science & Technology

2015-07-01

providing a hear-thru, or active capability while mitigating hearing loss and tinnitus caused by exposure to loud, steady-state and impulse noise. Active...loss and tinnitus caused by exposure to loud, steady-state and impulse noise. The general approach was to use ANSI standard measurement procedures

Tinnitus complaint behaviour in long-standing Menière's disorder: its association with the other cardinal symptoms.

PubMed

Yoshida, T; Stephens, D; Kentala, E; Levo, H; Auramo, Y; Poe, D; Pyykkö, I

2011-10-01

To explore factors that determines tinnitus complaint behaviour in patients with chronic long-standing Menière's disorder. A questionnaire-based cross-sectional investigation. This included the Oto-neurological questionnaire, the Hearing Disability and Handicap Scale (HDHS), Hearing Measurement Scale (HMS) on sound localisation and the Dizziness Handicap Questionnaire (DHQ). Randomly selected 183 members of the Finnish Menière's Federation. Postal questionnaire. International Tinnitus Inventory and impact of tinnitus. The 183 patients,[36 men and 147 women; mean age, 63 years] had their Meniere's disorder-like symptoms, with a mean of 18 years [range, 1-43], 19% of patients ranked tinnitus as their most severe symptom, and 10% experienced tinnitus as causing a severe or very severe impact. Regression analysis indicated that 41% of International Tinnitus Inventory variance and 28% of tinnitus impact variance were explained by the cardinal symptoms of Menière's disorder. Furthermore, 40% of International Tinnitus Inventory and 25% of tinnitus impact variance were explained by symptom-related disabilities (HDHS, HMS and DHQ). Aural pressure, hearing loss and gait problems were the most important predictors of tinnitus complaint. Understanding what people say and limitation of activities because of vertigo were the most important related disabilities. Tinnitus shares a significant variance with the other cardinal symptoms in patients with long-standing Menière's disorder. As the impact is significantly related to activity limitations based on hearing disability and vertigo, the results suggest that therapeutic efforts to reduce tinnitus in Menière's disorder should include the alleviation of balance and hearing problems. © 2011 Blackwell Publishing Ltd.

[Some aspects of tinnitus].

PubMed

Reiss, M; Reiss, G

1999-09-16

Tinnitus is the sensation of sound, a sensation generated by the auditory system because of a pathology, without any external acoustic or electrical stimulation. Most often, it is associated with a sensorineural hearing loss. Tinnitus is still one of the most frequent symptoms encountered by the otorhinolaryngologist and other doctors. Diagnosis and therapy are demanding due to complex etiology and secondary symptoms. Tinnitus is a symptom and not a disease. Therefore a thorough diagnosis is necessary. First of all one has to evaluate whether there is a treatable underlying organic disease possibly responsible for symptoms like tinnitus. The evaluation of the patient includes the history, ENT-status, audiological and vestibular findings, investigative imaging and examinations by other specialists. The therapeutic aim is the compensation of tinnitus. There is no universal medical or surgical treatment. Acute tinnitus is treated like sudden deafness. For chronic forms, the analysis of the causes is particularly important for developing an individual consultation and therapy plan. Providing information to the patient is the first step for a sensible treatment of the symptoms. Supportive therapy includes a psychosomatic therapy and the use of medication or instrumentation.

Tinnitus, Anxiety, Depression and Substance Abuse in Rock Musicians a Norwegian Survey.

PubMed

Stormer, Carl Christian Lein; Sorlie, Tore; Stenklev, Niels Christian

2017-06-01

Rock musicians are known to have an increased prevalence of hearing loss and tinnitus. The aims of the present study were to examine the distribution of anxiety and depression symptoms among rock musicians with or without tinnitus and how these mental health indicators and internal locus of control influenced upon their tinnitus symptom concerns and the degree to which the tinnitus affected their lives. The study was a questionnairebased cross-sectional survey of subjects selected from a cohort of rock musicians. We recruited 111 active musicians from the Oslo region, and a control group of 40 non-musicians from the student population at the University of Tromso. Among the rock musicians 19.8% reported permanent tinnitus vs. 0% among the controls. Musicians more often reported anxiety symptoms than controls (35.1% vs. 17.5%), however this prevalence was not different in musicians with and without tinnitus. Tinnitus-affected musicians reported depressive symptoms, significantly more than controls (13.6% vs. 5%). Rock musicians consumed more alcohol than controls, but alcohol consumption was unrelated to severity of tinnitus. Drug abuse was not more prevalent in rock musicians than in controls. Duration of tinnitus, internal locus of control, sleep disturbance and anxiety were significant predictors of how affected and how concerned musicians were about their tinnitus. Rock musicians are at risk for the development of chronic tinnitus, and they have an increased prevalence of anxiety. There is an association between chronic tinnitus and depressive symptoms in rock musicians, but our results are ambiguous. Although rock musicians have a chronic exposure to noise, noise-induced hearing loss is not the sole causative agent for the development of tinnitus.

Neural plasticity expressed in central auditory structures with and without tinnitus

PubMed Central

Roberts, Larry E.; Bosnyak, Daniel J.; Thompson, David C.

2012-01-01

Sensory training therapies for tinnitus are based on the assumption that, notwithstanding neural changes related to tinnitus, auditory training can alter the response properties of neurons in auditory pathways. To assess this assumption, we investigated whether brain changes induced by sensory training in tinnitus sufferers and measured by electroencephalography (EEG) are similar to those induced in age and hearing loss matched individuals without tinnitus trained on the same auditory task. Auditory training was given using a 5 kHz 40-Hz amplitude-modulated (AM) sound that was in the tinnitus frequency region of the tinnitus subjects and enabled extraction of the 40-Hz auditory steady-state response (ASSR) and P2 transient response known to localize to primary and non-primary auditory cortex, respectively. P2 amplitude increased over training sessions equally in participants with tinnitus and in control subjects, suggesting normal remodeling of non-primary auditory regions in tinnitus. However, training-induced changes in the ASSR differed between the tinnitus and control groups. In controls the phase delay between the 40-Hz response and stimulus waveforms reduced by about 10° over training, in agreement with previous results obtained in young normal hearing individuals. However, ASSR phase did not change significantly with training in the tinnitus group, although some participants showed phase shifts resembling controls. On the other hand, ASSR amplitude increased with training in the tinnitus group, whereas in controls this response (which is difficult to remodel in young normal hearing subjects) did not change with training. These results suggest that neural changes related to tinnitus altered how neural plasticity was expressed in the region of primary but not non-primary auditory cortex. Auditory training did not reduce tinnitus loudness although a small effect on the tinnitus spectrum was detected. PMID:22654738

Discotheques and the Risk of Hearing Loss among Youth: Risky Listening Behavior and Its Psychosocial Correlates

ERIC Educational Resources Information Center

Vogel, Ineke; Brug, Johannes; Van Der Ploeg, Catharina P. B.; Raat, Hein

2010-01-01

There is an increasing population at risk of hearing loss and tinnitus due to increasing high-volume music listening. To inform prevention strategies and interventions, this study aimed to identify important protection motivation theory-based constructs as well as the constructs "consideration of future consequences" and "habit…

Factors influencing tinnitus loudness and annoyance.

PubMed

Hiller, Wolfgang; Goebel, Gerhard

2006-12-01

To evaluate the 2 major components of tinnitus severity, loudness and annoyance, and their degree of dependence on characteristics of tinnitus manifestation, history, and etiology. Cross-sectional survey performed during the first months of 2004. Nonclinical population. A total of 4995 members of the German Tinnitus League. Comprehensive screening questionnaire, including the Klockhoff and Lindblom loudness grading system and the miniversion of the Tinnitus Questionnaire. A moderate correlation of 0.45 was found between tinnitus loudness and annoyance. Both factors were generally higher in men, those older than 50 years, those with binaural and centrally perceived tinnitus, those with increased noise sensitivity, and those who had continuous tinnitus without interruptions. Tinnitus that lasted 12 months or less had a stronger influence on annoyance (odds ratio [OR], 1.96) than on loudness (OR, 0.45), whereas the contrary was found for tinnitus of more than 5 years' duration (ORs, 0.72 and 2.11, respectively). Loudness and annoyance were increased in subjects with coexisting hearing loss, vertigo, and hyperacusis. The impact of hyperacusis on annoyance was clearly stronger than on loudness (ORs, 21.91 vs 9.47). Several clinical factors of tinnitus influence perceived loudness and annoyance. Both are distinguishable components of tinnitus severity.

Randomized trial of four noise-induced hearing loss and tinnitus prevention interventions for children.

PubMed

Martin, William Hal; Griest, Susan E; Sobel, Judith L; Howarth, Linda C

2013-02-01

To evaluate the effectiveness of four NIHL prevention interventions at improving knowledge, attitudes, and intended behaviors regarding sound exposure and appropriate use of hearing protective strategies in children. A randomized trial of the four interventions with a non-intervention comparison group. Questionnaires were completed prior to, immediately after, and three months after each intervention. Interventions included: (1) A classroom presentation by older-peer educators, (2) A classroom presentation by health professionals, (3). Exploration of a museum exhibition, and (4). Exploration of an internet-based virtual museum. A comparison group received no intervention. Fifty-three fourth grade classrooms (1120 students) participated in the study. All interventions produced significant improvements but the number of improvements decreased over time. In terms of effectiveness, the classroom programs were more effective than the internet-based virtual exhibit, which was more effective than the visit to the museum exhibition. Self-reported exposures indicated that as many as 94.5% of participants were at risk for NIHL. Interpersonal, interactive educational interventions such as the classroom program are more effective and have longer impact than self-directed learning experiences for NIHL and tinnitus prevention, however each may have an important role in promoting hearing health in elementary school students.

Sensorineural hearing loss among cerebellopontine-angle tumor patients examined with pure tone audiometry and brainstem-evoked response audiometry

NASA Astrophysics Data System (ADS)

Rinindra, A. M.; Zizlavsky, S.; Bashiruddin, J.; Aman, R. A.; Wulani, V.; Bardosono, S.

2017-08-01

Tumor in the cerebellopontine angle (CPA) accurs for approximately 5-10% of all intracranial tumors, where unilateral hearing loss and tinnitus are the most frequent symptoms. This study aimed to collect data on sensorineural hearing loss in CPA tumor patients in Dr. Cipto Mangunkusumo Hospital (CMH) using pure tone audiometry and brainstem-evoked response audiometry (BERA). It also aimed to obtaine data on CPA-tumor imaging through magnetic resonance imaging (MRI). This was a descriptive, analytic, and cross-sectional study. The subjects of this study were gathered using a total sampling method from secondary data between July 2012 and November 2016. From 104 patients, 30 matched the inclusion criteria. The CPA-tumor patients in the ENT CMH outpatient clinic were mostly female, middle-aged patients (41-60 years) whose clinical presentation was mostly tinnitus and severe, asymmetric sensorineural hearing loss in 10 subjects. From 30 subjects, 29 showed ipsilaterally impaired BERA results, and 17 subjects showed contralaterally impaired BERA results. There were 24 subjects who with large-sized tumors and 19 subjects who had intracanal tumors that had spread until they were extracanal in 19 subjects.

[Expert assessment of hearing loss within the scope of the social compensation law and the law regarding severely handicapped patients].

PubMed

Plath, P

1992-10-01

Special problems are described concerning expert opinions on hearing disability and hearing loss with regard to the German Social Rights for Compensation and the laws for handicapped persons. In some aspects there are similarities to the rights of accident insurance, but disability programs question only the degree of handicap present and not the source of the hearing loss. The expert opinion on the subject's ability to work in his or any other profession must only determine the patient's ability to hear and the tasks needed to fulfill the profession. Special attention is given to the problems arising from tinnitus.

Salicylate-Induced Hearing Loss and Gap Detection Deficits in Rats

PubMed Central

Radziwon, Kelly E.; Stolzberg, Daniel J.; Urban, Maxwell E.; Bowler, Rachael A.; Salvi, Richard J.

2015-01-01

To test the “tinnitus gap-filling” hypothesis in an animal psychoacoustic paradigm, rats were tested using a go/no-go operant gap detection task in which silent intervals of various durations were embedded within a continuous noise. Gap detection thresholds were measured before and after treatment with a dose of sodium salicylate (200 mg/kg) that reliably induces tinnitus in rats. Noise-burst detection thresholds were also measured to document the amount of hearing loss and aid in interpreting the gap detection results. As in the previous human psychophysical experiments, salicylate had little or no effect on gap thresholds measured in broadband noise presented at high-stimulus levels (30–60 dB SPL); gap detection thresholds were always 10 ms or less. Salicylate also did not affect gap thresholds presented in narrowband noise at 60 dB SPL. Therefore, rats treated with a dose of salicylate that reliably induces tinnitus have no difficulty detecting silent gaps as long as the noise in which they are embedded is clearly audible. PMID:25750635

[Hearing disorders and rock music].

PubMed

Lindhardt, Bjarne Orskov

2008-12-15

Only few studies have investigated the frequency of hearing disorders in rock musicians. Performing rock music is apparently associated with a hearing loss in a fraction of musicians. Tinnitus and hyperacusis are more common among rock musicians than among the background population. It seems as if some sort of resistance against further hearing loss is developed over time. The use of ear protection devices have not been studied systematically but appears to be associated with diminished hearing loss.

Noise-induced tinnitus using individualized gap detection analysis and its relationship with hyperacusis, anxiety, and spatial cognition.

PubMed

Pace, Edward; Zhang, Jinsheng

2013-01-01

Tinnitus has a complex etiology that involves auditory and non-auditory factors and may be accompanied by hyperacusis, anxiety and cognitive changes. Thus far, investigations of the interrelationship between tinnitus and auditory and non-auditory impairment have yielded conflicting results. To further address this issue, we noise exposed rats and assessed them for tinnitus using a gap detection behavioral paradigm combined with statistically-driven analysis to diagnose tinnitus in individual rats. We also tested rats for hearing detection, responsivity, and loss using prepulse inhibition and auditory brainstem response, and for spatial cognition and anxiety using Morris water maze and elevated plus maze. We found that our tinnitus diagnosis method reliably separated noise-exposed rats into tinnitus((+)) and tinnitus((-)) groups and detected no evidence of tinnitus in tinnitus((-)) and control rats. In addition, the tinnitus((+)) group demonstrated enhanced startle amplitude, indicating hyperacusis-like behavior. Despite these results, neither tinnitus, hyperacusis nor hearing loss yielded any significant effects on spatial learning and memory or anxiety, though a majority of rats with the highest anxiety levels had tinnitus. These findings showed that we were able to develop a clinically relevant tinnitus((+)) group and that our diagnosis method is sound. At the same time, like clinical studies, we found that tinnitus does not always result in cognitive-emotional dysfunction, although tinnitus may predispose subjects to certain impairment like anxiety. Other behavioral assessments may be needed to further define the relationship between tinnitus and anxiety, cognitive deficits, and other impairments.

The Gap-Startle Paradigm for Tinnitus Screening in Animal Models: Limitations and Optimization

PubMed Central

Lobarinas, Edward; Hayes, Sarah H.; Allman, Brian L.

2012-01-01

In 2006, Turner and colleagues (Behav Neurosci, 120:188–195) introduced the gap-startle paradigm as a high-throughput method for tinnitus screening in rats. Under this paradigm, gap detection ability was assessed by determining the level of inhibition of the acoustic startle reflex produced by a short silent gap inserted in an otherwise continuous background sound prior to a loud startling stimulus. Animals with tinnitus were expected to show impaired gap detection ability (i.e., lack of inhibition of the acoustic startle reflex) if the background sound containing the gap was qualitatively similar to the tinnitus pitch. Thus, for the gap-startle paradigm to be a valid tool to screen for tinnitus, a robust startle response from which to inhibit must be present. Because recent studies have demonstrated that the acoustic startle reflex could be dramatically reduced following noise exposure, we endeavored to 1) modify the gap-startle paradigm to be more resilient in the presence of hearing loss, and 2) evaluate whether a reduction in startle reactivity could confound the interpretation of gap prepulse inhibition and lead to errors in screening for tinnitus. In the first experiment, the traditional broadband noise (BBN) startle stimulus was replaced by a bandpass noise in which the sound energy was concentrated in the lower frequencies (5–10 kHz) in order to maintain audibility of the startle stimulus after unilateral high frequency noise exposure (16 kHz). However, rats still showed a 57% reduction in startle amplitude to the bandpass noise post-noise exposure. A follow-up experiment on a separate group of rats with transiently-induced conductive hearing loss revealed that startle reactivity was better preserved when the BBN startle stimulus was replaced by a rapid airpuff to the back of the rats neck. Furthermore, it was found that transient unilateral conductive hearing loss, which was not likely to induce tinnitus, caused an impairment in gap prepulse inhibition

Diagnostic approach to patients with tinnitus.

PubMed

Yew, Kenneth S

2014-01-15

Tinnitus, a common symptom encountered in family medicine, is defined as the perception of noise in the absence of an acoustic stimulus outside of the body. Because tinnitus is a symptom and not a disease, its underlying cause must be determined to best help patients. Although tinnitus is often idiopathic, sensorineural hearing loss is the most common identified cause. It can also be caused by other otologic, vascular, neoplastic, neurologic, pharmacologic, dental, and psychological factors. More serious causes, such as Meniere disease or vestibular schwannoma, can be excluded during the evaluation. History and physical examination of the head, eyes, ears, nose, throat, neck, and neurologic system guide subsequent evaluation. Almost all patients with tinnitus should undergo audiometry with tympanometry, and some patients require neuroimaging or assessment of vestibular function with electronystagmography. Supportive counseling should begin during the initial evaluation to help patients cope with tinnitus. Counseling may also improve the chances of successful subsequent treatment.

Tinnitus and Its Effect on the Quality of Life of Sufferers: A Nigerian Cohort Study.

PubMed

Ukaegbe, Onyinyechi C; Orji, Foster T; Ezeanolue, Basil C; Akpeh, James O; Okorafor, Ijeoma A

2017-10-01

Objectives To evaluate the quality of life of patients with ongoing tinnitus. Study Design This was a cross-sectional study of patients with ongoing tinnitus. Setting The study was carried out in a tertiary hospital in southeastern Nigeria. Subjects and Methods Subjects are adults who presented to the otorhinolaryngology clinic with tinnitus as their primary complaint. Pure-tone audiometry, tinnitus pitch, and loudness matching were done. The Tinnitus Handicap Inventory (THI) questionnaire was used in assessing their quality of life. Results There were 63 participants within the age range of 16 to 74 years; 20 (31.7%) were male and 43 (68.3%) were female. The mean duration of tinnitus was 26.7 ± 38.1 months. Nineteen (30.2%) participants had bilateral tinnitus while 44 (69.8%) had unilateral tinnitus. The mean THI score was 36.6 ± 19.7. The most reported handicap was anxiety and difficulty with concentration followed by depression and irritability. There was no correlation between the disability shown by the THI score and the age, sex, duration of the tinnitus, the tinnitus pitch, tinnitus loudness, or the laterality of the tinnitus. There was a significant positive correlation between the grade of hearing loss and the level of disability reported in the THI ( P = .01). Conclusion Tinnitus sufferers appear to have poorer quality of life compared with nonsufferers. This quality-of-life affectation is likely to be worse in those with disabling hearing loss but does not appear to be related to their age, sex, symptom duration, or the loudness and pitch of their tinnitus.

[Subclinical sensorineural hearing loss in female patients with rheumatoid arthritis].

PubMed

Treviño-González, José Luis; Villegas-González, Mario Jesús; Muñoz-Maldonado, Gerardo Enrique; Montero-Cantu, Carlos Alberto; Nava-Zavala, Arnulfo Hernán; Garza-Elizondo, Mario Alberto

2015-01-01

The rheumatoid arthritis is a clinical entity capable to cause hearing impairment that can be diagnosed promptly with high frequencies audiometry. To detect subclinical sensorineural hearing loss in patients with rheumatoid arthritis. Cross-sectional study on patients with rheumatoid arthritis performing high frequency audiometry 125Hz to 16,000Hz and tympanometry. The results were correlated with markers of disease activity and response to therapy. High frequency audiometry was performed in 117 female patients aged from 19 to 65 years. Sensorineural hearing loss was observed at a sensitivity of pure tones from 125 to 8,000 Hz in 43.59%, a tone threshold of 10,000 to 16,000Hz in 94.02% patients in the right ear and in 95.73% in the left ear. Hearing was normal in 8 (6.84%) patients. Hearing loss was observed in 109 (93.16%), and was asymmetric in 36 (30.77%), symmetric in 73 (62.37%), bilateral in 107 (91.45%), unilateral in 2 (1.71%), and no conduction and/or mixed hearing loss was encountered. Eight (6.83%) patients presented vertigo, 24 (20.51%) tinnitus. Tympanogram type A presented in 88.90% in the right ear and 91.46% in the left ear, with 5.98 to 10.25% type As. Stapedius reflex was present in 75.3 to 85.2%. Speech discrimination in the left ear was significantly different (p = 0.02)in the group older than 50 years. No association was found regarding markers of disease activity, but there was an association with the onset of rheumatoid arthritis disease. Patients with rheumatoid arthritis had a high prevalence of sensorineural hearing loss for high and very high frequencies. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Psychological and audiological correlates of perceived tinnitus severity.

PubMed

Erlandsson, S I; Hallberg, L R; Axelsson, A

1992-01-01

Beliefs and attitudes towards tinnitus have been found to play an important role in the process of rehabilitation. The relationship between audiological, psychological and psychosomatic factors (self-assessment of vertigo and headache and the perceived severity of tinnitus) was investigated in a clinical population of 163 subjects. Audiological descriptives comprised pure-tone average (dB HL), etiology of hearing loss, duration of tinnitus and tinnitus localisation. Perceived severity of tinnitus was assessed with a questionnaire focusing on tinnitus impact on aspects of quality of life, concentration and sleep. A 28-item handicap and support questionnaire was used and factor analysed, resulting in three factors: perceived attitudes, social support and disability/handicap. Tinnitus severity was significantly related to perceived attitudes. The influence of social support on tinnitus severity did not seem to be crucial. The results showed that significantly more women than men complained about vertigo. Unilateral tinnitus localisation was also more prevalent in females. The subjects with multiple tinnitus localisations were older and had significantly more sleep disturbance than subjects with tinnitus localized to the ears only. In accordance with previously reported observations, the frequency of headaches was strongly correlated with the severity of tinnitus.

The application of direct current electrical stimulation of the ear and cervical spine kinesitherapy in tinnitus treatment.

PubMed

Mielczarek, Marzena; Konopka, Wieslaw; Olszewski, Jurek

2013-02-01

The aim of the study was to evaluate the effectiveness of electrical stimulations of the hearing organ in tinnitus treatment adapting the frequency of stimulation according to tinnitus frequency, to assess the influence of cervical spine kinesitherapy on tinnitus, as well as to evaluate hearing after electrical stimulations alone and together with cervical spine kinesitherapy. The study comprised 80 tinnitus, sensorineural hearing loss patients (119 tinnitus ears) divided into two groups. In group I (n - 58 tinnitus ears) electrical stimulation of the hearing organ was performed, in group II (n - 61 tinnitus ears) electrical stimulation together with cervical spine kinesitherapy. Hydrotransmissive, selective electrical stimulations were conducted using direct, rectangular current. The passive electrode was placed on the forehead, the active--a silver probe--was immersed in the external ear canal in 0.9% saline solution. The treatment involved fifteen applications of electrical stimulations (each lasted for 4 min) administered three or four times a week (whole treatment lasted approximately 30 days). The evaluation of the results considered a case history (change from permanent to temporary tinnitus), questionnaires (the increase/decrease of the total points) and the audiometric evaluation of hearing level. Before the treatment, group I comprised 51 ears (87.93%) with permanent, and 7 ears (12.07%) with temporary tinnitus; group II - 55 ears (90.17%) with permanent and 6 ears (9.83%) with temporary tinnitus. After the treatment, in both groups the number of ears with permanent tinnitus decreased considerably obtaining the pauses or disappearing of tinnitus. Directly after the treatment, group I comprised 25 ears (43.11%) with permanent, and 10 ears (17.24%) with temporary tinnitus, in 23 ears (39.65%) tinnitus disappeared; group II - 33 ears (54.1%) with permanent and 11 ears (18.03%) with temporary tinnitus, in 17 ears (27.87%) tinnitus disappeared. Regarding

Hearing Loss and Tinnitus in Military Personnel with Deployment-Related Mild Traumatic Brain Injury.

PubMed

Karch, Stephanie J; Capó-Aponte, José E; McIlwain, D Scott; Lo, Michael; Krishnamurti, Sridhar; Staton, Roger N; Jorgensen-Wagers, Kendra

2016-01-01

The objective of this study was to analyze differences in incidence and epidemiologic risk factors for significant threshold shift (STS) and tinnitus in deployed military personnel diagnosed with mild traumatic brain injury (mTBI) due to either a blast exposure or nonblast head injury. A retrospective longitudinal cohort study of electronic health records of 500 military personnel (456 met inclusion criteria) diagnosed with deployment-related mTBI was completed. Chi-square tests and STS incidence rates were calculated to assess differences between blast-exposed and nonblast groups; relative risks and adjusted odds ratios of developing STS or tinnitus were calculated for risk factors. Risk factors included such characteristics as mechanism of injury, age, race, military occupational specialty, concurrent diagnosis of posttraumatic stress disorder (PTSD), and nicotine use. Among blast-exposed and nonblast patients, 67% and 58%, respectively, developed STS, (P=.06); 59% and 40%, respectively, developed tinnitus (P<.001). Incidence of STS was 24% higher in the blast-exposed than nonblast group. Infantry service was associated with STS; Marine Corps service, PTSD, and zolpidem use were associated with tinnitus. Unprotected noise exposure was associated with both STS and tinnitus. This study highlights potential risk factors for STS and tinnitus among blast-exposed and nonblast mTBI patient groups.

Current aspects of hearing loss from occupational and leisure noise

PubMed Central

Plontke, S.; Zenner, H.-P.

2004-01-01

Hearing loss from occupational and leisure noise numbers amongst the most frequent causes of an acquired sensorineural hearing loss. Here we present a review of up-to-date findings on the pathophysiology of acoustic injury to the inner ear, with special attention being paid to its molecular-biological and genetic aspects. Epidemiological aspects shall also be dealt with, as shall the roles of lacking recovery from occupational noise due to additional exposure by leisure noise and the combined exposure of noise and chemicals. Based on the epidemiological and pathophysiological findings and against the background of published animal-experimental, pre-clinical and clinical findings, the various approaches for prevention, protection and therapeutic intervention with acoustic trauma are discussed. Pharmacological strategies involving anti-oxidative, anti-excitotoxic and anti-apoptotic substances as well as non-pharmacological strategies like "sound conditioning" are given attention. Furthermore, systemic and local substance application as well as the therapy of acute acoustic trauma and chronic hearing problems (including modern therapy forms for comorbidities such as tinnitus) shall be delved into. PMID:22073048

Speech Comprehension Difficulties in Chronic Tinnitus and Its Relation to Hyperacusis

PubMed Central

Vielsmeier, Veronika; Kreuzer, Peter M.; Haubner, Frank; Steffens, Thomas; Semmler, Philipp R. O.; Kleinjung, Tobias; Schlee, Winfried; Langguth, Berthold; Schecklmann, Martin

2016-01-01

with speech comprehension difficulties in noisy environments, but not with speech comprehension difficulties in general. Conclusion: Speech comprehension deficits are frequent among tinnitus patients. Whereas speech comprehension deficits in quiet environments are primarily due to peripheral hearing loss, speech comprehension deficits in noisy environments are related to both peripheral hearing loss and dysfunctional central auditory processing. Disturbed speech comprehension in noisy environments might be modulated by a central inhibitory deficit. In addition, attentional and cognitive aspects may play a role. PMID:28018209

Speech Comprehension Difficulties in Chronic Tinnitus and Its Relation to Hyperacusis.

PubMed

Vielsmeier, Veronika; Kreuzer, Peter M; Haubner, Frank; Steffens, Thomas; Semmler, Philipp R O; Kleinjung, Tobias; Schlee, Winfried; Langguth, Berthold; Schecklmann, Martin

2016-01-01

speech comprehension difficulties in noisy environments, but not with speech comprehension difficulties in general. Conclusion: Speech comprehension deficits are frequent among tinnitus patients. Whereas speech comprehension deficits in quiet environments are primarily due to peripheral hearing loss, speech comprehension deficits in noisy environments are related to both peripheral hearing loss and dysfunctional central auditory processing. Disturbed speech comprehension in noisy environments might be modulated by a central inhibitory deficit. In addition, attentional and cognitive aspects may play a role.

Congenital atresia of the external ear and tinnitus: a new syndrome.

PubMed

Shulman, Abraham; Strashun, Arnold M; Goldstein, Barbara; Lenhardt, Martin L

2006-01-01

Congenital atresia of the external ears and severe tinnitus has been reported by two patients to be contralateral to the atretic ear. The use of the nuclear medicine imaging technique of single-photon emission computed tomography (SPECT) of brain has demonstrated hypoperfusion in brain areas supplied by the middle cerebral artery on the side of the atretic ear. Ultrahigh-frequency audiometry (UHFA) has revealed a bilateral loss of hearing greater than expected for the age of affected patients. Quantitative electroencephalography (QEEG) has shown a significant central nervous system electrical dysfunction correlated with the SPECT of brain findings. One case is reported in detail at this time. Completion of the medical audiological tinnitus patient protocol, including SPECT of brain, UHFA, and QEEG, accurately established the clinical tinnitus diagnosis of predominantly a central-type tinnitus, a clinical hypothesis that the medical significance of the tinnitus is a "soft" sign of cerebrovascular disease, and provided a rationale for treatment directed to a presumed ischemia of brain based on a receptor-targeted therapy targeted to the GABA-A receptor, resulting in significant tinnitus relief. Questions that have arisen include (1) the incidence of occurrence of hypoperfusion of the middle cerebral artery in congenital atresia patients; (2) implications and long-term consequences of this finding in this patient population for development of cerebrovascular disease; (3) brain plasticity for tinnitus relief (i.e., neuronal reprogramming, particularly in response to treatment recommendations for complaints of the cochleovestibular system in general and specifically for tinnitus); (4) the clinical significance of the UHFA thresholds of bilateral hearing loss greater than expected for the age of the patient; and (5) whether congenital atresia of the external ear may be part of a syndrome that includes hypoperfusion in brain areas supplied by the middle cerebral artery on

Generational differences in the reporting of tinnitus.

PubMed

Nondahl, David M; Cruickshanks, Karen J; Huang, Guan-Hua; Klein, Barbara E K; Klein, Ronald; Tweed, Ted S; Zhan, Weihai

2012-01-01

Recent research suggests that hearing impairment is declining among older adults compared with earlier generations of the same age. Tinnitus is often associated with hearing impairment, so one might hypothesize that the prevalence of tinnitus is declining in a similar manner. The purpose of this study was to use multigenerational data with repeated measures to determine whether the prevalence of tinnitus is declining among more recent generations. Using data from the Epidemiology of Hearing Loss Study (1993-1995, 1998-2000, 2003-2005, and 2009-2010) and the Beaver Dam Offspring Study (2005-2008), the authors examined birth cohort patterns in the report of tinnitus for adults aged 45 years and older (n =12,689 observations from 5764 participants). Participants were classified as having tinnitus if they reported tinnitus in the past year of at least moderate severity or that caused difficulty falling asleep. A low-frequency (500, 1000, and 2000 Hz) and high-frequency (3000, 4000, 6000, and 8000 Hz) pure tone average from the worse ear was used to summarize hearing status. Other potential risk factors for tinnitus were also explored to determine if changes in the prevalence of these factors over time could explain any observed birth cohort differences in the prevalence of tinnitus. These included the following: education, history of head injury, history of doctor-diagnosed ear infections, history of cardiovascular disease (myocardial infarction, stroke, or angina), current noisy job, longest-held job, target shooting in the past year, number of concerts ever attended, alcohol use in the past year, doctor diagnosis of arthritis, current aspirin use, regular exercise, and consulting with a physician in the past year about any hearing/ear problem. Birth cohort effects were modeled with alternating logistic regression models which use generalized estimating equations to adjust for correlation among repeated measurements over time that are nested within families. The

Adequacy of the Simplified Version of the Tinnitus Handicap Inventory (THI-S) to Measure Tinnitus Handicap and Relevant Distress.

PubMed

Lee, Jae Hee; Ra, Jin-Ju; Kim, Young Ho

2014-04-01

The Tinnitus Handicap Inventory (THI) often requires patients to devote their time to complete the questionnaire than they expect. Given that it limits the effectiveness of THI in a busy clinical practice that desires a quick and easy assessment of tinnitus handicap, this study evaluated clinical usefulness of a Simplified version of Tinnitus Handicap Inventory (THI-S) in measuring the severity of tinnitus handicap as well as predicting the psychological distress associated with tinnitus. A total of 129 outpatients suffering from tinnitus (61 with normal hearing and 68 with hearing loss) participated in this study. The responses of THI-S (10 items) and THI (25 items) were evaluated to quantify the subjective handicap of tinnitus. The self-perceived level of stress, anxiety, and depression of all participants was measured with a series of self-report questionnaires such as Korean version of Brief Encounter Psychosocial Instrument (BEPSI), State Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI), respectively. All the questionnaire responses were analyzed using non-parametric analyses to examine the convergence, comparability, internal consistency reliability and validity of THI-S. The severity of tinnitus handicap and the relevant psychological distress greatly varied across individuals. The THI-S responses were comparable to original THI responses, regardless of hearing status of patients. The internal consistency of THI-S responses was found to be good for total score (Cronbach's α=0.83-0.91), with moderately high consistency for the emotional, functional, and catastrophic subscales. Significant (p<0.01) correlations of the THI-S with the THI (rs =0.95) as well as with the BEPSI, STAI, BDI questionnaires (rs =0.40-0.45) suggest that the THI-S questionnaire appeared to be useful to provide objective data of subjective tinnitus handicap as well as predict psychological distress. Three factors were extracted through factor analysis, which explained

Adequacy of the Simplified Version of the Tinnitus Handicap Inventory (THI-S) to Measure Tinnitus Handicap and Relevant Distress

PubMed Central

Ra, Jin-Ju; Kim, Young Ho

2014-01-01

Background and Objectives The Tinnitus Handicap Inventory (THI) often requires patients to devote their time to complete the questionnaire than they expect. Given that it limits the effectiveness of THI in a busy clinical practice that desires a quick and easy assessment of tinnitus handicap, this study evaluated clinical usefulness of a Simplified version of Tinnitus Handicap Inventory (THI-S) in measuring the severity of tinnitus handicap as well as predicting the psychological distress associated with tinnitus. Subjects and Methods A total of 129 outpatients suffering from tinnitus (61 with normal hearing and 68 with hearing loss) participated in this study. The responses of THI-S (10 items) and THI (25 items) were evaluated to quantify the subjective handicap of tinnitus. The self-perceived level of stress, anxiety, and depression of all participants was measured with a series of self-report questionnaires such as Korean version of Brief Encounter Psychosocial Instrument (BEPSI), State Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI), respectively. All the questionnaire responses were analyzed using non-parametric analyses to examine the convergence, comparability, internal consistency reliability and validity of THI-S. Results The severity of tinnitus handicap and the relevant psychological distress greatly varied across individuals. The THI-S responses were comparable to original THI responses, regardless of hearing status of patients. The internal consistency of THI-S responses was found to be good for total score (Cronbach's α=0.83-0.91), with moderately high consistency for the emotional, functional, and catastrophic subscales. Significant (p<0.01) correlations of the THI-S with the THI (rs=0.95) as well as with the BEPSI, STAI, BDI questionnaires (rs=0.40-0.45) suggest that the THI-S questionnaire appeared to be useful to provide objective data of subjective tinnitus handicap as well as predict psychological distress. Three factors

Prevalence and associated factors of tinnitus: data from the Korean National Health and Nutrition Examination Survey 2009-2011.

PubMed

Park, Kyoung Ho; Lee, Seung Hwan; Koo, Ja-Won; Park, Hun Yi; Lee, Kyu Yup; Choi, Young Seok; Oh, Kyung Won; Lee, Ari; Yang, Ji-Eun; Woo, Sook-Young; Kim, Seon Woo; Cho, Yang-Sun

2014-01-01

Tinnitus is a common condition and frequently can be annoying to affected individuals. We investigated the prevalence and associated factors for tinnitus in South Korea using the data from the Korea National Health and Nutrition Examination Surveys (KNHANES) during 2009-2011. KNHANES is a cross-sectional survey of the civilian, non-institutionalized population of South Korea (n = 21 893). A field survey team that included an otolaryngologist moved with a mobile examination unit and performed interviews and physical examinations. Among the population over 12 years of age, the prevalence of any tinnitus was 19.7% (95% CI 18.8%-20.6%). Tinnitus was more prevalent in women, and the prevalence rate increased with age (P < 0.001). Among those with any tinnitus, 29.3% (95% CI 27.3%-31.3%) experienced annoying tinnitus that affected daily life. Annoying tinnitus also increased with age (P < 0.001), but no sex difference was demonstrated (P = 0.25). In participants aged 40 years or older, age, quality of life, depressive mood, hearing loss, feeling of dizziness, and rhinitis were associated with any tinnitus (P < 0.05). Age, hearing loss, history of cardiovascular disease, and stress were associated with annoying tinnitus (P < 0.05). Tinnitus is a common condition, and a large population suffers from annoying tinnitus in South Korea. Public understanding of associated factors might contribute to better management of tinnitus.

Noise-Induced Tinnitus Using Individualized Gap Detection Analysis and Its Relationship with Hyperacusis, Anxiety, and Spatial Cognition

PubMed Central

Pace, Edward; Zhang, Jinsheng

2013-01-01

Tinnitus has a complex etiology that involves auditory and non-auditory factors and may be accompanied by hyperacusis, anxiety and cognitive changes. Thus far, investigations of the interrelationship between tinnitus and auditory and non-auditory impairment have yielded conflicting results. To further address this issue, we noise exposed rats and assessed them for tinnitus using a gap detection behavioral paradigm combined with statistically-driven analysis to diagnose tinnitus in individual rats. We also tested rats for hearing detection, responsivity, and loss using prepulse inhibition and auditory brainstem response, and for spatial cognition and anxiety using Morris water maze and elevated plus maze. We found that our tinnitus diagnosis method reliably separated noise-exposed rats into tinnitus(+) and tinnitus(−) groups and detected no evidence of tinnitus in tinnitus(−) and control rats. In addition, the tinnitus(+) group demonstrated enhanced startle amplitude, indicating hyperacusis-like behavior. Despite these results, neither tinnitus, hyperacusis nor hearing loss yielded any significant effects on spatial learning and memory or anxiety, though a majority of rats with the highest anxiety levels had tinnitus. These findings showed that we were able to develop a clinically relevant tinnitus(+) group and that our diagnosis method is sound. At the same time, like clinical studies, we found that tinnitus does not always result in cognitive-emotional dysfunction, although tinnitus may predispose subjects to certain impairment like anxiety. Other behavioral assessments may be needed to further define the relationship between tinnitus and anxiety, cognitive deficits, and other impairments. PMID:24069375

The suffering of tinnitus in childhood and adolescence.

PubMed

Holgers, Kajsa-Mia; Juul, Jolanta

2006-05-01

Investigate the profile of young patients complaining of tinnitus and study the prevalence and the severity of tinnitus in schoolchildren. Ninety-five consecutive patients (55 boys), 8-20 years old, seeking help for tinnitus at our clinic were studied using audiometry, structural interviews, Tinnitus Severity Questionnaire (TSQ) and Hospital Anxiety and Depression Scale (HAD), together with Visual Analog Scales (VAS) on tinnitus loudness and annoyance. The onset of tinnitus was twice as often sudden than gradual. In 54% of the children, tinnitus had started after noise exposure, most commonly listening to music. Correlations were found between the pure-tone average (PTA) of 3, 4, and 6 kHz and TSQ scores; between TSQ and HAD subscales; and between TSQ and VAS. According to the Hospital Anxiety Depression Scale, 32% and 14.5%, respectively, were above the cut level for clinical anxiety and depressive disorders. The girls showed more signs of anxiety disorders than the boys. The majority of the help seekers had been exposed to noise, mostly music. Predisposing factors for tinnitus severity are high-frequency hearing loss and anxiety and depressive disorders.

Salivary Stress-Related Responses in Tinnitus: A Preliminary Study in Young Male Subjects with Tinnitus

PubMed Central

Alsalman, Ola A.; Tucker, Denise; Vanneste, Sven

2016-01-01

Objective: This preliminary study examined if baseline measures of stress-related biomarkers as measured by salivary secretions of specific autonomic [measured by salivary α-amylase (sAA)], endocrine (measured by salivary cortisol), and immune (measured by salivary neopterin) responses are greater in male subjects with tinnitus in response to an induced-stress task. Method: Twenty male subjects with no significant hearing loss, 10 with tinnitus, and 10 without tinnitus were enrolled in this study.Salivary secretions were collected before and after the induced stress task at four different time intervals. Results: sAA levels were lower in the tinnitus group in comparison to subjects without tinnitus, suggesting impaired sympathetic activity in the subjects with tinnitus although these levels remained stable throughout the stress experiment.While no significant effects could be obtained for salivary cortisol or neopterin, salivary neopterin levels were trending toward significance over all measurements. Behavioral measures of stress were found to correlate negatively with measures of sAA and salivary neopterin. Conclusion: The results of this study suggest impaired stress-related sAA mechanisms in male subjects with tinnitus, as evidenced by the different stress reactions induced in the endocrine system (as measured by salivary cortisol) and the immune system (as measured by salivary neopterin). PMID:27489534

Associations between cardiovascular disease and its risk factors with hearing loss-A cross-sectional analysis.

PubMed

Tan, H E; Lan, N S R; Knuiman, M W; Divitini, M L; Swanepoel, D W; Hunter, M; Brennan-Jones, C G; Hung, J; Eikelboom, R H; Santa Maria, P L

2018-02-01

To investigate the relationship between hearing loss and cardiovascular disease risk factors. Cross-sectional study. Participants were recruited between May 2010 and December 2015 and answered a health and risk factor questionnaire. Physical and biochemical assessments were performed. A community-based population. A total of 5107 participants born within the years 1946-1964 enrolled in the Busselton Healthy Ageing Study. Hearing was assessed behaviourally through the best ear pure-tone average (500, 1000, 2000, 4000 Hz), low-frequency average (250, 500, 1000 Hz) and high-frequency average (4000, 8000 Hz). Self-reported hearing loss, tinnitus and hyperacusis were assessed via questionnaire. Cardiovascular risk factors were assessed via a patient-completed questionnaire and objective measurements including blood pressure, body mass index, waist circumference, lipid profile and glycated haemoglobin. Of the participants, 54% were female, with the mean age of 58 years (range 45-69 years). Age, sex and family history of hearing loss were consistently strong determinants of hearing loss outcomes. After adjusting for these, obesity, current smoking, peripheral arterial disease and history of cardiovascular disease were significantly associated with pure-tone, low-frequency and high-frequency hearing loss. In addition, high blood pressure, triglyceride and glycated haemoglobin were significantly associated with low-frequency hearing loss. There was a graded association between hearing loss and Framingham Risk Score for cardiovascular risk (P<0.001). Established cardiovascular disease and individual and combined cardiovascular disease risk factors were found to be associated with hearing loss. Future research should prospectively investigate whether targeting cardiovascular disease can prevent hearing loss. © 2017 John Wiley & Sons Ltd.

Association between tinnitus retraining therapy and a tinnitus control instrument.

PubMed

Ito, Mari; Soma, Keiko; Ando, Reiko

2009-10-01

Tinnitus retraining therapy (TRT), which is an adaptation therapy for tinnitus based on the neurophysiological model proposed by Jastreboff in 1990,consists of directive counseling and acoustic therapy with a tinnitus control instrument (TCI) or other devices. For the past 5 years, our hospital has administered TRT characterized by the use of a TCI. In this study, we reviewed the clinical course of patients with tinnitus who presented to our outpatient clinic for tinnitus and hearing loss during the 3-year period from April 2004 to March 2007 and underwent TRT with a TCI. Among 188 patients with tinnitus (105 males and 83 females), 88 patients (51 males and 37 females, excluding dropouts) who purchased a TCI and continued therapy were included in the study. Significant improvement in Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS) scores was found as early as 1 month of treatment and later compared with those on initial examination, suggesting that TRT with a TCI may be an effective treatment for tinnitus. Among the noises generated by the TCI, the sound pressure output from the TCI was set at just below tinnitus loudness level both of the first adjustment and the second adjustment. Speech noise and white noise were frequently selected, whereas high-frequency noise and pink noise were infrequently selected. Speech noise was most frequently selected at the first adjustment, and the number of patients selecting white noise increased at the second adjustment. The results that we compared the two also revealed that the mean hearing level and tinnitus loudness levels were higher in the white noise group than in the speech noise group, which suggested that the inner ear disorder was more harder in the white noise group. Both the THI score and VAS grade improved after 1 month of treatment in the speech noise group, whereas improvement in these parameters was observed in the white noise group after 6 months of treatment. These results suggest that it took

[Natural history of occupational hearing loss induced by noise].

PubMed

de Almeida, S I; Albernaz, P L; Zaia, P A; Xavier, O G; Karazawa, E H

2000-01-01

To evaluate the clinical and audiometric characteristics of occupational hearing loss induced by noise, according to age and time of exposition in years. 222 patients with occupational sensorineural hearing loss induced by noise were studied retrospectively, correlating the auditive clinical claims, alterations of audiometric thresholds at frequencies of 250 Hz to 8000 Hz, speech discrimination indicator with age and time of exposure. As a control group were used the audiometric threshold of a population of same medium age, without morbid antecedents of hearing illness, as preconized by ISO 1999 (1990). The group were divided into subgroups and three decades of exposure were analyzed. It was verified that the clinical claims of hipoacusia increases according to the age and time of exposure. The frequency of tinnitus is constant. The audiometric thresholds in the second decade of exposure present variations that depend on the age. The several audiometric curves are parallel, but they are not horizontal. The worst thresholds were found in the high frequencies from 3000 Hz to 8000 Hz, as a clinical and physiopathological consequences of the commitment of basal areas of cochlea. The speech discrimination showed to be worst according to the increase of age and time of exposure. Patients with hearing loss disacusia induced by occupational noise present characteristic audiometric thresholds that vary according to age and time of exposure to noise. These characteristics defined and resumed in audiometric curves can constitute a standard of comparison, evaluation and control for exposed populations.

The Gap Detection Test: Can It Be Used to Diagnose Tinnitus?

PubMed

Boyen, Kris; Başkent, Deniz; van Dijk, Pim

2015-01-01

Animals with induced tinnitus showed difficulties in detecting silent gaps in sounds, suggesting that the tinnitus percept may be filling the gap. The main purpose of this study was to evaluate the applicability of this approach to detect tinnitus in human patients. The authors first hypothesized that gap detection would be impaired in patients with tinnitus, and second, that gap detection would be more impaired at frequencies close to the tinnitus frequency of the patient. Twenty-two adults with bilateral tinnitus, 20 age-matched and hearing loss-matched subjects without tinnitus, and 10 young normal-hearing subjects participated in the study. To determine the characteristics of the tinnitus, subjects matched an external sound to their perceived tinnitus in pitch and loudness. To determine the minimum detectable gap, the gap threshold, an adaptive psychoacoustic test was performed three times by each subject. In this gap detection test, four different stimuli, with various frequencies and bandwidths, were presented at three intensity levels each. Similar to previous reports of gap detection, increasing sensation level yielded shorter gap thresholds for all stimuli in all groups. Interestingly, the tinnitus group did not display elevated gap thresholds in any of the four stimuli. Moreover, visual inspection of the data revealed no relation between gap detection performance and perceived tinnitus pitch. These findings show that tinnitus in humans has no effect on the ability to detect gaps in auditory stimuli. Thus, the testing procedure in its present form is not suitable for clinical detection of tinnitus in humans.

Tinnitus, anxiety and automatic processing of affective information: an explorative study.

PubMed

Ooms, Els; Vanheule, Stijn; Meganck, Reitske; Vinck, Bart; Watelet, Jean-Baptiste; Dhooge, Ingeborg

2013-03-01

Anxiety is found to play an important role in the severity complaint of tinnitus patients. However, when investigating anxiety in tinnitus patients, most studies make use of verbal reports of affect (e.g., self-report questionnaires and/or interviews). These methods reflect conscious appraisals of anxiety, but do not map underlying processing mechanisms. Nonetheless, such mechanisms, like the automatic processing of affective information, are important as they modulate emotional experience and emotion-related behaviour. Research showed that highly anxious people process threatening information (e.g., fearful and angry faces) faster than non-anxious people. Therefore, this study investigates whether tinnitus patients process affective stimuli (happy, sad, fearful, and angry faces) in the same way as highly anxious people do. Our sample consisted out of 67 consecutive tinnitus patients. Relationships between tinnitus severity, pitch, loudness, hearing loss, and the automatic processing of affective information were explored. Results indicate that especially in severely distressed tinnitus patients, the severity complaint is highly related to the automatic processing of fearful (r = 0.37, p < 0.05), angry (r = 0.44, p < 0.00) and happy (r = -0.44, p < 0.00) faces, and these relationships became even stronger after controlling for hearing loss. Furthermore, in contrast with findings on the relation between audiological characteristics (pitch and loudness) and conscious report of anxiety, we did find that the audiological characteristic, loudness, tends to be in some degree related to the automatic processing of fearful faces (r = 0.25, p = 0.08). We conclude that tinnitus is an anxiety-related problem on an automatic processing level.

When Your Child Has Tinnitus

MedlinePlus

... ENT Doctor Near You When Your Child Has Tinnitus When Your Child Has Tinnitus Patient Health Information News media interested in covering ... and public relations staff at newsroom@entnet.org . Tinnitus is a condition where the patient hears a ...

The effects of a hearing education program on recreational noise exposure, attitudes and beliefs toward noise, hearing loss, and hearing protector devices in young adults.

PubMed

Keppler, Hannah; Ingeborg, Dhooge; Sofie, Degeest; Bart, Vinck

2015-01-01

Excessive recreational noise exposure in young adults might result in noise-induced hearing loss (NIHL) and tinnitus. Inducing behavioral change in young adults is one of the aims of a hearing conservation program (HCP). The goal of the current study was to evaluate the effect of a hearing education program after 6 months in young adults in relation to knowledge regarding their individual hearing status. The results of a questionnaire regarding the weekly equivalent recreational noise exposure, attitudes and beliefs toward noise, and hearing loss and hearing protector devices (HPDs) were compared between both sessions. Seventy-eight young adults completed the questionnaire concerning recreational noise exposure, youth attitude to noise scale (YANS), and beliefs about hearing protection and hearing loss (BAHPHL). Their hearing status was evaluated based on admittance measures, audiometry, transient-evoked otoacoustic emissions (TEOAEs), and distortion-product otoacoustic emissions (DPOAEs). The main analysis consisted of a mixed model analysis of variance with dependent variables of either the noise exposure or the scores on (subscales of) YANS and BAHPHL. The independent variables were hearing status and session one versus session two. There was a significant decrease in recreational noise exposure and several (sub) scales of YANS and BAHPHL between both the sessions. This behavioral change resulted in a more frequent use of HPDs in 12% of the participants. However, the behavioral change was not completely related to the knowledge of young adults' individual hearing status. To prevent hearing damage in young people, investing in HCPs is necessary, apart from regulating sound levels and its compliance at various leisure-time activities. Also, the long-term effect of HCPs and their most cost-efficient repetition rates should be further investigated.

The impact of tinnitus characteristics and associated variables on tinnitus-related handicap.

PubMed

Degeest, S; Corthals, P; Dhooge, I; Keppler, H

2016-01-01

This study aimed to determine the characteristics of tinnitus and tinnitus-related variables and explore their possible relationship with tinnitus-related handicap. Eighty-one patients with chronic tinnitus were included. The study protocol measured hearing status, tinnitus pitch, loudness, maskability and loudness discomfort levels. All patients filled in the Tinnitus Sample Case History Questionnaire, the Hyperacusis Questionnaire and the Tinnitus Handicap Inventory. The relationship of each variable with the Tinnitus Handicap Inventory score was evaluated by univariate and multivariate analyses. Five univariables were associated with the Tinnitus Handicap Inventory score: loudness discomfort level, subjective tinnitus loudness, tinnitus awareness, noise intolerance and Hyperacusis Questionnaire score. Multiple regression analysis showed that the Hyperacusis Questionnaire score and tinnitus awareness were independently associated with the Tinnitus Handicap Inventory score. Hyperacusis and tinnitus awareness were independently associated with the Tinnitus Handicap Inventory score. Questionnaires on tinnitus and hyperacusis are especially suited to providing additional insight into tinnitus-related handicap and are therefore useful for evaluating tinnitus patients.

Quinine-induced hearing loss in the guinea pig is not affected by the Ca2+ channel antagonist verapamil.

PubMed

Jäger, W; Idrizbegovic, E; Karlsson, K K; Alván, G

1997-01-01

It is well documented that quinine induces reversible hearing loss and tinnitus. The purpose in this study was to induce a quinine hearing loss and to investigate if verapamil, a Ca2+ channel antagonist of L-type might affect the response. Pigmented guinea pigs (n = 24) were anaesthetized by atropine. Hypnorm and midazolam but permitting spontaneous respiration. An electrode of platinum was placed on the round window and short (10 msec) tone pulses at 8 kHz were presented to the external ear. A typical deflection of the N1-wave was determined as the hearing threshold. Quinine hydrochloride 40 mg/kg and verapamil 1 mg/kg were given intravenously. Quinine induced a significant and reversible hearing loss (mean 16 dB). This hearing loss was not at all affected by verapamil given before or after quinine. Verapamil often caused acute cardiac arrest and particularly the combination verapamil followed by quinine-induced death to the animal. We conclude that verapamil and quinine had no in vivo interaction with regard to the hearing ability.

Occupational noise-induced tinnitus: does it affect workers' quality of life?

PubMed

Muluk, Nuray Bayar; Oguztürk, Omer

2008-02-01

This prospective study aimed to investigate the quality of life of workers in a steel factory. The study group was composed of 16 male workers with tinnitus and 30 ears. Fifteen male workers without tinnitus and 30 ears were included into the control group. Workers were evaluated by questionnaire, pure-tone audiometry, and the SF-36 Health Survey. In the study group, tinnitus loudness levels (TLLs) were found. In the study group, the domains general mental health and role limitations owing to emotional problems were significantly lower than in the control group. Older age, industrial noise exposure over a long period, higher noise exposure during work, and hearing loss secondary to occupational noise caused workers to experience higher TLLs. Earheadings protected workers more than earplugs, and TLLs were lower. Important factors that affect workers' quality of life are maximum exposed noise levels, daily and total noise exposure time, and exposure to continuous noise. Occupational noise-induced tinnitus mainly causes emotional disability rather than physical disability. Emotionally impaired QOL results may be due to tinnitus-related psychological problems. Workers should have knowledge about the hazardous effects of noise. Periodic health checkups and regular seminars have great importance. Workers must be aware of other ototoxic factors, such as medications and noisy music. In the future, researchers should develop a screening method to detect those with a more hereditary affinity to hearing loss.

Prevalence of tinnitus and hyperacusis in children and adolescents: a systematic review

PubMed Central

Rosing, Susanne Nemholt; Schmidt, Jesper Hvass; Wedderkopp, Niels; Baguley, David M

2016-01-01

Objectives To systematically review studies of the epidemiology of tinnitus and hyperacusis in children and young people, in order to determine the methodological differences implicated in the variability of prevalence estimates and the influence of population characteristics on childhood tinnitus and hyperacusis. Data sources Articles were retrieved from PubMed, EMBASE and Scopus databases and from the relevant reference lists using the methods described in the study protocol, which has previously been published. Reporting Items for Systematic Review (PRISMA) guidelines were followed. Eligibility criteria Studies addressing childhood prevalence, for example, children and young people aged 5–19 years. Data selection 2 reviewers independently assessed the studies for eligibility, extracted data and assessed study consistency. Owing to the heterogeneity in the methodologies among the reported studies, only narrative synthesis of the results was carried out. Results Having identified 1032 publications, 131 articles were selected and 25 articles met the inclusion criteria and had sufficient methodological consistency to be included. Prevalence estimates of tinnitus range from 4.7% to 46% in the general paediatric population and among children with normal hearing, and from 23.5% to 62.2% of population of children with hearing loss. Reported prevalence ranged from 6% to 41.9% when children with hearing loss and normal hearing were both included. The prevalence of hyperacusis varied from 3.2% to 17.1%. Conclusions Data on prevalence vary considerably according to the study design, study population and the research question posed. The age range of children studied was varied and a marked degree of variation between definitions (tinnitus, hyperacusis) and measures (severity, perception, annoyance) was observed. The lack of consistency among studies indicates the necessity of examining the epidemiology of tinnitus and hyperacusis in children and adolescents with a set of

[Good practices with tinnitus in adult].

PubMed

Le Pajolec, Christine; Ohresser, Martine; Nevoux, Jérome

2017-11-01

The interrogation is essential to trace the genesis of the tinnitus and to appreciate its repercussion. Clinical examination should look for a local, vascular or cervical cause. The ENT consultation with audiogram and tinnitus evaluation is essential to know the characteristics of the tinnitus and to consider the treatment. If tinnitus is accompanied by a decrease in hearing, then wearing hearing aids can correct deafness and decrease the tinnitus. The psychological impact of tinnitus must always be taken into account and the use of a multidisciplinary team is an interesting solution. Medical treatments are not very effective; on the other hand psychotherapies (CBT, TRT and sophrology) bring a real improvement. The doctor's speech must always be supportive and provide therapeutic hope. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Combined Amplification and Sound Generation for Tinnitus: A Scoping Review.

PubMed

Tutaj, Lindsey; Hoare, Derek J; Sereda, Magdalena

In most cases, tinnitus is accompanied by some degree of hearing loss. Current tinnitus management guidelines recognize the importance of addressing hearing difficulties, with hearing aids being a common option. Sound therapy is the preferred mode of audiological tinnitus management in many countries, including in the United Kingdom. Combination instruments provide a further option for those with an aidable hearing loss, as they combine amplification with a sound generation option. The aims of this scoping review were to catalog the existing body of evidence on combined amplification and sound generation for tinnitus and consider opportunities for further research or evidence synthesis. A scoping review is a rigorous way to identify and review an established body of knowledge in the field for suggestive but not definitive findings and gaps in current knowledge. A wide variety of databases were used to ensure that all relevant records within the scope of this review were captured, including gray literature, conference proceedings, dissertations and theses, and peer-reviewed articles. Data were gathered using scoping review methodology and consisted of the following steps: (1) identifying potentially relevant records; (2) selecting relevant records; (3) extracting data; and (4) collating, summarizing, and reporting results. Searches using 20 different databases covered peer-reviewed and gray literature and returned 5959 records. After exclusion of duplicates and works that were out of scope, 89 records remained for further analysis. A large number of records identified varied considerably in methodology, applied management programs, and type of devices. There were significant differences in practice between different countries and clinics regarding candidature and fitting of combination aids, partly driven by the application of different management programs. Further studies on the use and effects of combined amplification and sound generation for tinnitus are

Does stapes surgery improve tinnitus in patients with otosclerosis?

PubMed

Ismi, Onur; Erdogan, Osman; Yesilova, Mesut; Ozcan, Cengiz; Ovla, Didem; Gorur, Kemal

Otosclerosis (OS) is the primary disease of the human temporal bone characterized by conductive hearing loss and tinnitus. The exact pathogenesis of tinnitus in otosclerosis patients is not known and factors affecting the tinnitus outcome in otosclerosis patients are still controversial. To find the effect of stapedotomy on tinnitus for otosclerosis patients. Fifty-six otosclerosis patients with preoperative tinnitus were enrolled to the study. Pure tone average Air-Bone Gap values, preoperative tinnitus pitch, Air-Bone Gap closure at tinnitus frequencies were evaluated for their effect on the postoperative outcome. Low pitch tinnitus had more favorable outcome compared to high pitch tinnitus (p=0.002). Postoperative average pure tone thresholds Air-Bone Gap values were not related to the postoperative tinnitus (p=0.213). There was no statistically significant difference between postoperative Air-Bone Gap closure at tinnitus frequency and improvement of high pitch tinnitus (p=0.427). There was a statistically significant difference between Air-Bone Gap improvement in tinnitus frequency and low pitch tinnitus recovery (p=0.026). Low pitch tinnitus is more likely to be resolved after stapedotomy for patients with otosclerosis. High pitch tinnitus may not resolve even after closure of the Air-Bone Gap at tinnitus frequencies. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Hearing impairment and tinnitus: prevalence, risk factors, and outcomes in US service members and veterans deployed to the Iraq and Afghanistan wars.

PubMed

Theodoroff, Sarah M; Lewis, M Samantha; Folmer, Robert L; Henry, James A; Carlson, Kathleen F

2015-01-01

Hearing loss and tinnitus are the 2 most prevalent service-connected disabilities among veterans in the United States. Veterans of Operations Enduring Freedom, Iraqi Freedom, and New Dawn have been exposed to multiple hazards associated with these conditions, such as blasts/explosions, ototoxic chemicals, and most notably high levels of noise. We conducted a systematic literature review of evidence on 1) prevalence of, 2) risk and protective factors for, and 3) functional and quality-of-life outcomes of hearing impairment and tinnitus in US Operations Enduring Freedom, Iraqi Freedom, and New Dawn veterans and military personnel. We identified studies published from 2001 through 2013 using PubMed, PsycINFO, REHABDATA, Cochrane Library, pearling, and expert recommendation. Peer-reviewed English language articles describing studies of 30 or more adults were included if they informed one or more key questions. A total of 839 titles/abstracts were reviewed for relevance by investigators trained in critical analysis of literature; 14 studies met inclusion criteria. Of these, 13 studies presented data on prevalence and 4 on risk/protective factors, respectively. There were no included studies reporting on outcomes. Findings from this systematic review will help inform clinicians, researchers, and policy makers on future resource and research needs pertaining to hearing impairment and tinnitus in this newest generation of veterans. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Natural history of vestibular schwannomas and hearing loss in NF2 patients.

PubMed

Peyre, M; Bernardeschi, D; Sterkers, O; Kalamarides, M

2015-07-13

Bilateral vestibular schwannomas are the hallmark of neurofibromatosis 2 (NF2), occurring in 95% of patients. These tumors are associated with significant morbidity due to hearing loss, tinnitus, imbalance and facial weakness. As radiosurgery and chemotherapy have been recently introduced in the treatment armamentarium in addition to surgery, a thorough evaluation of vestibular schwannoma natural history is mandatory to determine the role and timing of each treatment modality. An exhaustive review of the literature was performed using the PubMed database concerning the natural history of tumor growth and hearing loss in NF2 patients with vestibular schwannomas. Although some aspects of vestibular schwannoma natural history remain uncertain (pattern of tumor growth, mean tumor growth rate), factors influencing growth such as age at presentation and paracrine factors are well established. Studies focusing on the natural history of hearing have highlighted different patterns of hearing loss and the possible role of intralabyrinthine tumors. The polyclonality of vestibular schwannomas in NF2 was recently unveiled, giving a new perspective to their growth mechanisms. An uniform evaluation of tumor growth using volumetric evaluation and hearing with standard classifications will ensure the use of common endpoints and should improve the quality of clinical trials as well as foster comparison among studies while ensuring more consistency in decision-making. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Congenital hearing loss

PubMed Central

Korver, Anna M. H.; Smith, Richard J. H.; Van Camp, Guy; Schleiss, Mark R.; Bitner-Glindzicz, Maria A. K.; Lustig, Lawrence R.; Usami, Shin-ichi; Boudewyns, An N.

2017-01-01

Congenital hearing loss (hearing loss present at birth) is one of the most prevalent chronic conditions in children. In the majority of developed countries, neonatal hearing-screening programmes enable early detection; early intervention will prevent delays in speech and language development and have long-lasting beneficial effects on social and emotional development and quality of life. A hearing loss diagnosis is usually followed by a search for an underlying aetiology. Congenital hearing loss might be attributed to environmental and prenatal factors, which prevail in low-income settings; congenital infections, particularly cytomegalovirus, are also a common risk factor for hearing loss. Genetic causes probably account for the majority of cases in developed countries; mutations can affect any component of the hearing pathway, in particular inner ear homeostasis (endolymph production and maintenance) and mechano-electrical transduction (conversion of a mechanical stimulus into electrochemical activity). Once the underlying cause of hearing loss is established, it might direct therapeutic decision-making and guide prevention and (genetic) counseling. Management options include specific antimicrobial therapies, surgical treatment of cranio-facial abnormalities and hearing aids. An improved understanding of the pathophysiology and molecular mechanisms underlying hearing loss and increased awareness of recent advances in genetic testing will promote the development of new treatment and screening strategies. PMID:28079113

The Role of Trace Elements in Tinnitus.

PubMed

Yaşar, Mehmet; Şahin, Mehmet İlhan; Karakükçü, Çiğdem; Güneri, Erhan; Doğan, Murat; Sağıt, Mustafa

2017-03-01

In this study, we aimed to investigate the role of three trace elements, namely, zinc, copper, and lead, in tinnitus by analyzing the serum level of copper and lead and both the serum and tissue level of zinc. Eighty patients, who applied to outpatient otolaryngology clinic with the complaints of having tinnitus, and 28 healthy volunteers were included. High-frequency audiometry was performed, and participants who had hearing loss according to the pure tone average were excluded; tinnitus frequency and loudness were determined and tinnitus reaction questionnaire scores were obtained from the patients. Of all the participants, serum zinc, copper, and lead values were measured; moreover, zinc levels were examined in hair samples. The levels of trace elements were compared between tinnitus and control groups. The level of copper was found to be significantly lower in the tinnitus group (p = 0.02), but there was no significant difference between the groups in terms of the levels of zinc, neither in serum nor in hair, and lead in serum (p > 0.05). The lack of trace elements, especially that of "zinc," have been doubted for the etiopathogenesis of tinnitus in the literature; however, we only found copper levels to be low in patients having tinnitus.

A multidisciplinary systematic review of the treatment for chronic idiopathic tinnitus.

PubMed

Zenner, Hans-Peter; Delb, Wolfgang; Kröner-Herwig, Birgit; Jäger, Burkhard; Peroz, Ingrid; Hesse, Gerhard; Mazurek, Birgit; Goebel, Gerhard; Gerloff, Christian; Trollmann, Regina; Biesinger, Eberhard; Seidler, Harald; Langguth, Berthold

2017-05-01

The majority of tinnitus patients are affected by chronic idiopathic tinnitus, and almost 60 different treatment modalities have been reported. The present study is a multidisciplinary systematic analysis of the evidence for the different forms of treatment for chronic tinnitus. The results are used to form the basis of an S3 guideline. A systematic search was carried out in PubMed and the Cochrane Library. The basis for presenting the level of evidence was the evidence classification of the Oxford Centre of Evidence-based Medicine. Whenever available, randomised controlled trials were given preference for discussing therapeutic issues. All systematic reviews and meta-analyses were assessed for their methodological quality, and effect size was taken into account. As the need for patient counselling is self-evident, specific tinnitus counselling should be performed. Due to the high level of evidence, validated tinnitus-specific, cognitive behavioural therapy is strongly recommended. In addition, auditory therapeutic measures can be recommended for the treatment of concomitant hearing loss and comorbidities; those should also be treated with drugs whenever appropriate. In particular, depression should be treated, with pharmacological support if necessary. If needed, psychiatric treatment should also be given on a case-by-case basis. With simultaneous deafness or hearing loss bordering on deafness, a CI can also be indicated. For auditory therapeutic measures, transcranial magnetic or direct current stimulation and specific forms of acoustic stimulation (noiser/masker, retraining therapy, music, and coordinated reset) for the treatment of chronic tinnitus the currently available evidence is not yet sufficient for supporting their recommendation.

Temporary Hearing Loss and Rock Music.

ERIC Educational Resources Information Center

Danenberg, Mary A.; And Others

1987-01-01

Pre- and post-exposure testing of normal-hearing secondary school students (N=20) and adult chaperones (N=7) exposed to live rock music indicated that almost all subjects experienced at least a five-decibel threshold shift, with most also reporting tinnitus. Of six subjects retested three days later, four demonstrated partial recovery. (Author/CB)

Limbic-Auditory Interactions of Tinnitus: An Evaluation Using Diffusion Tensor Imaging.

PubMed

Gunbey, H P; Gunbey, E; Aslan, K; Bulut, T; Unal, A; Incesu, L

2017-06-01

Tinnitus is defined as an imaginary subjective perception in the absence of an external sound. Convergent evidence proposes that tinnitus perception includes auditory, attentional and emotional components. The aim of this study was to investigate the thalamic, auditory and limbic interactions associated with tinnitus-related distress by Diffusion Tensor Imaging (DTI). A total of 36 tinnitus patients, 20 healthy controls underwent an audiological examination, as well as a magnetic resonance imaging protocol including structural and DTI sequences. All participants completed the Tinnitus Handicap Inventory (THI) and Visual Analog Scales (VAS) related with tinnitus. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were obtained for the auditory cortex (AC), inferior colliculus (IC), lateral lemniscus (LL), medial geniculate body (MGB), thalamic reticular nucleus (TRN), amygdala (AMG), hippocampus (HIP), parahippocampus (PHIP) and prefrontal cortex (PFC). In tinnitus patients the FA values of IC, MGB, TRN, AMG, HIP decreased and the ADC values of IC, MGB, TRN, AMG, PHIP increased significantly. The contralateral IC-LL and bilateral MGB FA values correlated negatively with hearing loss. A negative relation was found between the AMG-HIP FA values and THI and VAS scores. Bilateral ADC values of PHIP and PFC significantly correlated with the attention deficiency-VAS scores. In conclusion, this is the first DTI study to investigate the grey matter structures related to tinnitus perception and the significant correlation of FA and ADC with clinical parameters suggests that DTI can provide helpful information for tinnitus. Magnifying the microstructures in DTI can help evaluate the three faces of tinnitus nature: hearing, emotion and attention.

The impact of tinnitus upon cognition in adults: A systematic review.

PubMed

Tegg-Quinn, Susan; Bennett, Rebecca J; Eikelboom, Robert H; Baguley, David M

2016-10-01

To systematically review and analyse experimental outcomes of studies exploring the impact of tinnitus upon cognitive function and their implications for clinical management of invasive tinnitus. A systematic and descriptive review. Eighteen studies were identified investigating the impact of tinnitus on cognitive function. The 18 studies evaluated cognitive function using 24 different objective behavioural tests, nine electrophysiological recordings, one oculomotor test, and one self-report questionnaire. The studies spanned 18 years and revealed numerous interactions potentially contributing to the cognitive difficulties frequently reported by people with invasive tinnitus. The studies indicate a clear association between tinnitus and aspects of cognitive function, specifically the executive control of attention. Tinnitus impairs cognitive function by way of impact upon executive control of attention. Clinical management of patients reporting tinnitus and cognitive difficulties requires an understanding of the reciprocal relationship between tinnitus and cognitive function, with additive effects of anxiety, depression, and somatic cognitive bias. Further study is required to establish the impact of advancing age, hearing loss, anxiety, depression tinnitus duration, and distress upon cognitive function in people with invasive tinnitus.

Multivariate analyses of tinnitus complaint and change in tinnitus complaint: a masker study.

PubMed

Jakes, S; Stephens, S D

1987-11-01

Multivariate statistical techniques were used to re-analyse the data from the recent DHSS multi-centre masker study. These analyses were undertaken to three ends. First, to clarify and attempt to replicate the previously found factor structure of complaints about tinnitus. Secondly, to attempt to identify common factors in the change or improvement measures pre- and post-masker treatment. Thirdly, to identify predictors of any such outcome factors. Two complaint factors were identified; 'Distress' and 'intrusiveness'. A series of analyses were conducted on change measures using different numbers of subjects and variables. When only semantic differential scales were used, the change factors were very similar to the complaint factors noted above. When variables measuring other aspects of improvement were included, several other factors were identified. These included; 'tinnitus helped', 'masking effects', 'residual inhibition' and 'matched loudness'. Twenty-five conceptually distinct predictors of outcome were identified. These predictor variables were quite different for different outcome factors. For example, high-frequency hearing loss was a predictor of tinnitus being helped by the masker, and a low frequency match and a low masking threshold predicted therapeutic success on residual inhibition. Decrease in matched loudness was predicted by louder tinnitus initially.

Amino-oxyacetic acid as a palliative in tinnitus.

PubMed

Reed, H T; Meltzer, J; Crews, P; Norris, C H; Quine, D B; Guth, P S

1985-12-01

Amino-oxyacetic acid, previously shown to cause a reversible loss of hearing sensitivity and a reduction in endocochlear potential, was tried as a palliative in human tinnitus. Because the drug seemed to have a cochlear site of action, patients were selected for the study if their audiograms were indicative of cochlear lesions and if there was a reduction in tinnitus following intravenous lidocaine (lidocaine positive). Ten such patients received either 50 or 75 mg of amino-oxyacetic acid four times a day orally for one week or placebo administered in a random, crossover, double-blind design. Of these ten, three reported subjective lessening of tinnitus. One of those three and two others not reporting subjective lessening of tinnitus showed a substantial improvement in speech discrimination scores while receiving amino-oxyacetic acid but not placebo. One additional patient who did not receive lidocaine also reported a subjective lessening of tinnitus. Four patients who were lidocaine negative showed neither subjective nor objective improvement in tinnitus after treatment with amino-oxyacetic acid.

Hearing loss in space

NASA Technical Reports Server (NTRS)

Buckey, J. C. Jr; Musiek, F. E.; Kline-Schoder, R.; Clark, J. C.; Hart, S.; Havelka, J.

2001-01-01

BACKGROUND: Temporary and, in some cases, permanent hearing loss has been documented after long-duration spaceflights. METHODS: We examined all existing published data on hearing loss after space missions to characterize the losses. RESULTS: Data from Russian missions suggest that the hearing loss, when it occurs, affects mainly mid to high frequencies and that using hearing protection often might prevent the loss. Several significant questions remain about hearing loss in space. While the hearing loss has been presumed to be noise-induced, no clear link has been established between noise exposure and hearing loss during spaceflight. In one documented case of temporary hearing loss from the Shuttle-Mir program, the pattern of loss was atypical for a noise-induced loss. Continuous noise levels that have been measured on the Mir and previous space stations, while above engineering standards, are not at levels usually associated with hearing loss in ground-based studies (which have usually been limited to 8-10 h exposure periods). Attempts to measure hearing in space using threshold-based audiograms have been unsuccessful in both the American and Russian programs due to noise interference with the measurements. CONCLUSIONS: The existing data highlight the need for reliable monitoring of both hearing and noise in long-duration spaceflight.

Tinnitus and Associated Handicaps in the French Mountain Artillery: Assessment by the Tinnitus Handicap Inventory.

PubMed

Job, Agnès; Cardinal, Fabien; Michel, Hugues; Klein, Céline; Ressiot, Elodie; Gauthier, Jérome

2018-03-26

Tinnitus and associated handicap related to acoustic trauma sequelae have never been assessed in the French artillery. Although impulsive noise exposure to firearms and canons are thought to increase prevalence of tinnitus among soldiers, recent studies demonstrating this fact are missing. Here, a representative sample of 389 soldiers from an operational mountain artillery regiment was surveyed. Soldiers personally concerned by tinnitus were invited to fill in a questionnaire. We assessed tinnitus and the associated handicap using a French translation of the Tinnitus Handicap Inventory (THI). Questions about attention/concentration problems, impaired speech hearing and understanding, sleep disorders, social and familial tension, irritability, depression, and tiredness as linked to tinnitus were the core of the questionnaire. Soldiers that completed the THI (n = 73, 19%) had a mean THI score of 18 ± 17, this mean score corresponded to a mild handicap. At this grade, tinnitus should be easily masked and should not interfere with daily activities. The percentage of soldiers concerned by tinnitus was slightly higher in the older age class, but there was no significant difference of THI scores between the different age classes. The most reported handicaps were attention/concentration problems, impaired speech hearing, and understanding. Among the THI fillers, eight soldiers (11%) had THI scores >36, indicating a moderate to severe handicap. Despite a mild tinnitus handicap, the percentage of people concerned by tinnitus in this regiment is higher (19%) than that in the estimated percentage of general population of European countries (about 10%). It should be of interest to replicate this type of study from other regiments and from other countries. Education and good fitting of hearing protection for prevention of acoustic trauma sequelae should still be encouraged.

Genetics of Hearing Loss

MedlinePlus

... Hearing Loss Homepage Basics Noise-Induced Hearing Loss Genetics of Hearing Loss Screening & Diagnosis Types of Hearing Loss About Sound Treatment & Intervention Services Learning Language Bacterial Meningitis Studies Data & Statistics EHDI Annual Data 2016 2015 2014 2013 ...

Hearing Loss in Children

MedlinePlus

... Hearing Loss Homepage Basics Noise-Induced Hearing Loss Genetics of Hearing Loss Screening & Diagnosis Types of Hearing Loss About Sound Treatment & Intervention Services Learning Language Bacterial Meningitis Studies Data & Statistics EHDI Annual Data 2016 2015 2014 2013 ...

Tinnitus is associated with reduced sound level tolerance in adolescents with normal audiograms and otoacoustic emissions

PubMed Central

Sanchez, Tanit Ganz; Moraes, Fernanda; Casseb, Juliana; Cota, Jaci; Freire, Katya; Roberts, Larry E.

2016-01-01

Recent neuroscience research suggests that tinnitus may reflect synaptic loss in the cochlea that does not express in the audiogram but leads to neural changes in auditory pathways that reduce sound level tolerance (SLT). Adolescents (N = 170) completed a questionnaire addressing their prior experience with tinnitus, potentially risky listening habits, and sensitivity to ordinary sounds, followed by psychoacoustic measurements in a sound booth. Among all adolescents 54.7% reported by questionnaire that they had previously experienced tinnitus, while 28.8% heard tinnitus in the booth. Psychoacoustic properties of tinnitus measured in the sound booth corresponded with those of chronic adult tinnitus sufferers. Neither hearing thresholds (≤15 dB HL to 16 kHz) nor otoacoustic emissions discriminated between adolescents reporting or not reporting tinnitus in the sound booth, but loudness discomfort levels (a psychoacoustic measure of SLT) did so, averaging 11.3 dB lower in adolescents experiencing tinnitus in the acoustic chamber. Although risky listening habits were near universal, the teenagers experiencing tinnitus and reduced SLT tended to be more protective of their hearing. Tinnitus and reduced SLT could be early indications of a vulnerability to hidden synaptic injury that is prevalent among adolescents and expressed following exposure to high level environmental sounds. PMID:27265722

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

PubMed

Herraiz, Carlos; Diges, I; Cobo, P; Aparicio, J M; Toledano, A

2010-07-01

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

Increased risk of tinnitus in patients with temporomandibular disorder: a retrospective population-based cohort study.

PubMed

Lee, Chun-Feng; Lin, Ming-Chia; Lin, Hui-Tzu; Lin, Cheng-Li; Wang, Tang-Chuan; Kao, Chia-Hung

2016-01-01

This study determined whether there is an increased risk of tinnitus in patients with temporomandibular joint (TMJ). We used information from health insurance claims obtained from Taiwan National Health Insurance (TNHI). Patients aged 20 years and older who were newly diagnosed with TMJ disorder served as the study cohort. The demographic factors and comorbidities that may be associated with tinnitus were also identified, including age, sex, and comorbidities of hearing loss, noise effects on the inner ear, and degenerative and vascular ear disorders. A higher proportion of TMJ disorder patients suffered from hearing loss (5.30 vs. 2.11 %), and degenerative and vascular ear disorders (0.20 vs. 0.08 %) compared with the control patients. The crude hazard ratio (HR) of tinnitus in the TMJ disorder cohort was 2.73-fold higher than that in the control patients, with an adjusted HR of 2.62 (95 % CI = 2.29-3.00). The comorbidity-specific TMJ disorder cohort to the control patients' adjusted HR of tinnitus was higher for patients without comorbidity (adjusted HR = 2.75, 95 % CI = 2.39-3.17). We also observed a 3.22-fold significantly higher relative risk of developing tinnitus within the 3-year follow-up period (95 % CI = 2.67-3.89). Patients with TMJ disorder might be at increased risk of tinnitus.

Noise induced hearing loss in dance music disc jockeys and an examination of sound levels in nightclubs.

PubMed

Bray, Adam; Szymański, Marcin; Mills, Robert

2004-02-01

Noise exposure, hearing loss and associated otological symptoms have been studied in a group of 23 disc jockeys using a questionnaire and pure tone audiometry. The level of noise exposure in the venues where they work has also been studied using Ametek Mk-3 audio dosimeters. Three members of the study group showed clear evidence of noise-induced hearing loss on audiometry, 70 per cent reported temporary threshold shift after sessions and 74 per cent reported tinnitus. Sound levels of up to 108 dB(A) were recorded in the nightclubs. The average level for a typical session was 96 dB(A) which is above the level at which the provision of ear protection is mandatory for employers in industry. It can be concluded that DJs are at substantial risk of developing noise-induced hearing loss and noise exposure in nightclubs frequently exceeds safe levels.

Treatments for Tinnitus

PubMed Central

Noble, William

2008-01-01

The various forms of treatment for tinnitus that have been tested in properly controlled trials can be classified as pharmacological, acoustic-physical, and psychological. In clinical trials, no pharmacological agent has been shown to have lasting effect on the presence or severity of tinnitus, although there are promising signs in an animal model. Acoustic devices do not seem to influence tinnitus, although appropriately fitted hearing aids may slightly reduce its prominence. Of physical treatments, cortical implantation may hold some promise of being effective for tinnitus suppression in selected cases. A psychological treatment that has emerged as consistently beneficial is cognitive-behavior therapy in terms of affecting overall well-being and reducing level of tinnitus annoyance. PMID:18635586

Salicylate toxicity model of tinnitus

PubMed Central

Stolzberg, Daniel; Salvi, Richard J.; Allman, Brian L.

2012-01-01

Salicylate, the active component of the common drug aspirin, has mild analgesic, antipyretic, and anti-inflammatory effects at moderate doses. At higher doses, however, salicylate temporarily induces moderate hearing loss and the perception of a high-pitch ringing in humans and animals. This phantom perception of sound known as tinnitus is qualitatively similar to the persistent subjective tinnitus induced by high-level noise exposure, ototoxic drugs, or aging, which affects ∼14% of the general population. For over a quarter century, auditory scientists have used the salicylate toxicity model to investigate candidate biochemical and neurophysiological mechanisms underlying phantom sound perception. In this review, we summarize some of the intriguing biochemical and physiological effects associated with salicylate-induced tinnitus, some of which occur in the periphery and others in the central nervous system. The relevance and general utility of the salicylate toxicity model in understanding phantom sound perception in general are discussed. PMID:22557950

Maladaptive Neural Synchrony in Tinnitus: Origin and Restoration

PubMed Central

Eggermont, Jos J.; Tass, Peter A.

2015-01-01

Tinnitus is the conscious perception of sound heard in the absence of physical sound sources external or internal to the body, reflected in aberrant neural synchrony of spontaneous or resting-state brain activity. Neural synchrony is generated by the nearly simultaneous firing of individual neurons, of the synchronization of membrane-potential changes in local neural groups as reflected in the local field potentials, resulting in the presence of oscillatory brain waves in the EEG. Noise-induced hearing loss, often resulting in tinnitus, causes a reorganization of the tonotopic map in auditory cortex and increased spontaneous firing rates and neural synchrony. Spontaneous brain rhythms rely on neural synchrony. Abnormal neural synchrony in tinnitus appears to be confined to specific frequency bands of brain rhythms. Increases in delta-band activity are generated by deafferented/deprived neuronal networks resulting from hearing loss. Coordinated reset (CR) stimulation was developed in order to specifically counteract such abnormal neuronal synchrony by desynchronization. The goal of acoustic CR neuromodulation is to desynchronize tinnitus-related abnormal delta-band oscillations. CR neuromodulation does not require permanent stimulus delivery in order to achieve long-lasting desynchronization or even a full-blown anti-kindling but may have cumulative effects, i.e., the effect of different CR epochs separated by pauses may accumulate. Unlike other approaches, acoustic CR neuromodulation does not intend to reduce tinnitus-related neuronal activity by employing lateral inhibition. The potential efficacy of acoustic CR modulation was shown in a clinical proof of concept trial, where effects achieved in 12 weeks of treatment delivered 4–6 h/day persisted through a preplanned 4-week therapy pause and showed sustained long-term effects after 10 months of therapy, leading to 75% responders. PMID:25741316

Atorvastatin in the management of tinnitus with hyperlipidemias.

PubMed

Hameed, Mirza Khizer; Sheikh, Zeeshan Ayub; Ahmed, Azeema; Najam, Atif

2014-12-01

To determine the role of atorvastatin in management of tinnitus in patients with hyperlipidemia. Quasi-experimental study. ENT Department, Combined Military Hospital, Rawalpindi, from July 2011 to August 2012. Ninety eight patients of tinnitus with sensorineural hearing loss having hyperlipidemia were included in the study. Their pre-therapy serum cholesterols were measured, and tinnitus scores were recorded on a 'Tinnitus handicap questionnaire'. They were administered tablet atorvastatin 40 mg once daily with low fat diet for 8 months. After 8 months of therapy, patients were purposefully divided into responsive and unresponsive group depending on serum cholesterol levels. Post therapy serum cholesterol levels and tinnitus scores were also recorded after 8 months and compared with pre-therapy records. Serum cholesterol came to within normal limits in 51 (52%) patients (responsive group), while it remained high in 47 (48%) patients (unresponsive group). Improvement in tinnitus score in the responsive group was seen in 36 (70.5%) patients and in 2 (4.2%) patients of the unresponsive group. Improvement in tinnitus scores was compared in the two groups using Fisher's exact test and were found to be statistically better in the responsive group (p < 0.001). Tinnitus, in patients having hyperlipidemia, can be successfully dealt with by treating hyperlipidemia with lipid lowering agent atorvastatin.

Prevalence of tinnitus and hyperacusis in children and adolescents: a systematic review.

PubMed

Rosing, Susanne Nemholt; Schmidt, Jesper Hvass; Wedderkopp, Niels; Baguley, David M

2016-06-03

To systematically review studies of the epidemiology of tinnitus and hyperacusis in children and young people, in order to determine the methodological differences implicated in the variability of prevalence estimates and the influence of population characteristics on childhood tinnitus and hyperacusis. Articles were retrieved from PubMed, EMBASE and Scopus databases and from the relevant reference lists using the methods described in the study protocol, which has previously been published. Reporting Items for Systematic Review (PRISMA) guidelines were followed. Studies addressing childhood prevalence, for example, children and young people aged 5-19 years. 2 reviewers independently assessed the studies for eligibility, extracted data and assessed study consistency. Owing to the heterogeneity in the methodologies among the reported studies, only narrative synthesis of the results was carried out. Having identified 1032 publications, 131 articles were selected and 25 articles met the inclusion criteria and had sufficient methodological consistency to be included. Prevalence estimates of tinnitus range from 4.7% to 46% in the general paediatric population and among children with normal hearing, and from 23.5% to 62.2% of population of children with hearing loss. Reported prevalence ranged from 6% to 41.9% when children with hearing loss and normal hearing were both included. The prevalence of hyperacusis varied from 3.2% to 17.1%. Data on prevalence vary considerably according to the study design, study population and the research question posed. The age range of children studied was varied and a marked degree of variation between definitions (tinnitus, hyperacusis) and measures (severity, perception, annoyance) was observed. The lack of consistency among studies indicates the necessity of examining the epidemiology of tinnitus and hyperacusis in children and adolescents with a set of standardised criteria. CRD42014013456. Published by the BMJ Publishing Group

The ten-year incidence of tinnitus among older adults.

PubMed

Nondahl, David M; Cruickshanks, Karen J; Wiley, Terry L; Klein, Barbara E K; Klein, Ron; Chappell, Rick; Tweed, Ted S

2010-08-01

As part of a population-based study in Beaver Dam, Wisconsin, we estimated the 10-year cumulative incidence of tinnitus and its risk factors. Participants (n = 2922, aged 48-92 years) not reporting tinnitus at baseline (1993-1995) were followed for up to ten years. In addition to audiometric testing and anthropometric measures, data on tinnitus, health, and other history were obtained via questionnaire. Potential risk factors were assessed with discrete-time proportional hazards models. The 10-year cumulative incidence of tinnitus was 12.7%. The risk of developing tinnitus was significantly associated with: history of arthritis (hazard ratio (HR = 1.37), history of head injury (HR = 1.76), history of ever smoking (HR = 1.40), and among women, hearing loss (HR = 2.59). Alcohol consumption (HR = 0.63 for > or = 141 grams/week vs. <15 grams/week), age (among women, HR = 0.90 for each five-year increase in age), and among men, obesity (HR = 0.55), were associated with decreased risk. The risk of developing tinnitus was high for older adults, and associated with modifiable health and behavioral factors.

Diffusion Tensor Imaging of Central Auditory Pathways in Patients with Sensorineural Hearing Loss: A Systematic Review.

PubMed

Tarabichi, Osama; Kozin, Elliott D; Kanumuri, Vivek V; Barber, Samuel; Ghosh, Satra; Sitek, Kevin R; Reinshagen, Katherine; Herrmann, Barbara; Remenschneider, Aaron K; Lee, Daniel J

2018-03-01

Objective The radiologic evaluation of patients with hearing loss includes computed tomography and magnetic resonance imaging (MRI) to highlight temporal bone and cochlear nerve anatomy. The central auditory pathways are often not studied for routine clinical evaluation. Diffusion tensor imaging (DTI) is an emerging MRI-based modality that can reveal microstructural changes in white matter. In this systematic review, we summarize the value of DTI in the detection of structural changes of the central auditory pathways in patients with sensorineural hearing loss. Data Sources PubMed, Embase, and Cochrane. Review Methods We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement checklist for study design. All studies that included at least 1 sensorineural hearing loss patient with DTI outcome data were included. Results After inclusion and exclusion criteria were met, 20 articles were analyzed. Patients with bilateral hearing loss comprised 60.8% of all subjects. Patients with unilateral or progressive hearing loss and tinnitus made up the remaining studies. The auditory cortex and inferior colliculus (IC) were the most commonly studied regions using DTI, and most cases were found to have changes in diffusion metrics, such as fractional anisotropy, compared to normal hearing controls. Detectable changes in other auditory regions were reported, but there was a higher degree of variability. Conclusion White matter changes based on DTI metrics can be seen in patients with sensorineural hearing loss, but studies are few in number with modest sample sizes. Further standardization of DTI using a prospective study design with larger sample sizes is needed.

Tinnitus: Distinguishing between Subjectively Perceived Loudness and Tinnitus-Related Distress

PubMed Central

Wallhäusser-Franke, Elisabeth; Brade, Joachim; Balkenhol, Tobias; D'Amelio, Roberto; Seegmüller, Andrea; Delb, Wolfgang

2012-01-01

Objectives Overall success of current tinnitus therapies is low, which may be due to the heterogeneity of tinnitus patients. Therefore, subclassification of tinnitus patients is expected to improve therapeutic allocation, which, in turn, is hoped to improve therapeutic success for the individual patient. The present study aims to define factors that differentially influence subjectively perceived tinnitus loudness and tinnitus-related distress. Methods In a questionnaire-based cross-sectional survey, the data of 4705 individuals with tinnitus were analyzed. The self-report questionnaire contained items about subjective tinnitus loudness, type of onset, awareness and localization of the tinnitus, hearing impairment, chronic comorbidities, sleep quality, and psychometrically validated questionnaires addressing tinnitus-related distress, depressivity, anxiety, and somatic symptom severity. In a binary step-wise logistic regression model, we tested the predictive power of these variables on subjective tinnitus loudness and tinnitus-related distress. Results The present data contribute to the distinction between subjective tinnitus loudness and tinnitus-related distress. Whereas subjective loudness was associated with permanent awareness and binaural localization of the tinnitus, tinnitus-related distress was associated with depressivity, anxiety, and somatic symptom severity. Conclusions Subjective tinnitus loudness and the potential presence of severe depressivity, anxiety, and somatic symptom severity should be assessed separately from tinnitus-related distress. If loud tinnitus is the major complaint together with mild or moderate tinnitus-related distress, therapies should focus on auditory perception. If levels of depressivity, anxiety or somatic symptom severity are severe, therapies and further diagnosis should focus on these symptoms at first. PMID:22529921

Effect of lyophilized powder made from enzymolyzed honeybee larvae on tinnitus-related symptoms, hearing levels, and hypothalamus-pituitary-adrenal axis-related hormones.

PubMed

Aoki, Mitsuhiro; Wakaoka, Yoshinori; Hayashi, Hisamitsu; Kuze, Bunya; Mizuta, Keisuke; Ito, Yatsuji

2012-01-01

Tinnitus interferes with sleep and concentration which is associated with depression; however, no drug has been effective in treating tinnitus. Our purpose is to evaluate our hypothesis that the treatment with lyophilized powder of enzymolyzed honeybee larvae as a complementary medicine may provide a therapeutic effect on tinnitus-related symptoms. Sixty tinnitus sufferers participated in a randomized double-blind placebo-controlled trial using the lyophilized powder of enzymolyzed honeybee larvae or a placebo. The Tinnitus Handicap Inventory, a visual analog scale to rate the severity of tinnitus, hearing levels, and hypothalamus-pituitary-adrenal axis-related hormones drawn early in the morning were measured upon entry into the study and after 12 wk of follow-up. The lyophilized powder of enzymolyzed honeybee larvae was not superior to placebo with regard to the total score on the Tinnitus Handicap Inventory and the visual analog scale. However, subjects in the honeybee larvae group showed significant improvements in some items about depression associated with tinnitus, whereas subjects in the placebo group showed no improvement in any items. The honeybee larvae group showed significant improvements in the hearing levels at 2 and 4 kHz in the audiogram of the better ear. The intervention of the lyophilized powder of enzymolyzed honeybee larvae was associated with lower serum cortisol levels, serum prolactin levels, and cortisol/dehydroepiandrosterone sulfate ratios. The ratios in the placebo group significantly were increased. Our results suggest that the lyophilized powder of enzymolyzed honeybee larvae represents an effective complementary medicine to alleviate depression associated with tinnitus by regulating the activity of the hypothalamus-pituitary-adrenal axis.

Left hemisphere fractional anisotropy increase in noise-induced tinnitus: a diffusion tensor imaging (DTI) study of white matter tracts in the brain.

PubMed

Benson, Randall R; Gattu, Ramtilak; Cacace, Anthony T

2014-03-01

Diffusion tensor imaging (DTI) is a contemporary neuroimaging modality used to study connectivity patterns and microstructure of white matter tracts in the brain. The use of DTI in the study of tinnitus is a relatively unexplored methodology with no studies focusing specifically on tinnitus induced by noise exposure. In this investigation, participants were two groups of adults matched for etiology, age, and degree of peripheral hearing loss, but differed by the presence or absence (+/-) of tinnitus. It is assumed that matching individuals on the basis of peripheral hearing loss, allows for differentiating changes in white matter microstructure due to hearing loss from changes due to the effects of chronic tinnitus. Alterations in white matter tracts, using the fractional anisotropy (FA) metric, which measures directional diffusion of water, were quantified using tract-based spatial statistics (TBSS) with additional details provided by in vivo probabilistic tractography. Our results indicate that 10 voxel clusters differentiated the two groups, including 9 with higher FA in the group with tinnitus. A decrease in FA was found for a single cluster in the group with tinnitus. However, seven of the 9 clusters with higher FA were in left hemisphere thalamic, frontal, and parietal white matter. These foci were localized to the anterior thalamic radiations and the inferior and superior longitudinal fasciculi. The two right-sided clusters with increased FA were located in the inferior fronto-occipital fasciculus and superior longitudinal fasciculus. The only decrease in FA for the tinnitus-positive group was found in the superior longitudinal fasciculus of the left parietal lobe. Copyright © 2013 Elsevier B.V. All rights reserved.

Calibration of an In-Ear Dosimeter for a Single Hearing Protection Device

DTIC Science & Technology

2014-02-01

history of ototoxic medication use, audiological history of tinnitus , etc. A total of 54 subjects were screened to participate in this study.1 subject...was excluded from this study based on a history of seizures. 18 subjects were excluded based on hearing threshold results. 15 subjects were...Military Service: Implications for hearing loss and tinnitus ”, Washington, DC, National Academies Press. 7. United States Government Accountability Office

Does multi-modal cervical physical therapy improve tinnitus in patients with cervicogenic somatic tinnitus?

PubMed

Michiels, S; Van de Heyning, P; Truijen, S; Hallemans, A; De Hertogh, W

2016-12-01

Tinnitus can be related to many different aetiologies such as hearing loss or a noise trauma, but it can also be related to the somatosensory system of the cervical spine, called cervicogenic somatic tinnitus (CST). Case studies suggest a positive effect of cervical spine treatment on tinnitus complaints in patients with CST, but no experimental studies are available. To investigate the effect of a multimodal cervical physical therapy treatment on tinnitus complaints in patients with CST. Randomized controlled trial. Patients with a combination of severe subjective tinnitus (Tinnitus Functional Index (TFI): 25-90 points) and neck complaints (Neck Bournemouth Questionnaire (NBQ) > 14 points). All patients received cervical physical therapy for 6 weeks (12 sessions). Patients were randomized in an immediate-start therapy group (n = 19) and a 6-week delayed-start therapy group (n = 19). TFI and NBQ-scores were documented at baseline, after the wait-and-see period in the delayed-start group, after treatment and after 6 weeks follow-up. The Global Perceived Effect (GPE) was documented at all measuring moments, except at baseline. In all patients (n = 38) TFI and NBQ-scores decreased significantly after treatment (p = 0.04 and p < 0.001). NBQ-scores remained significantly lower after follow-up (p = 0.001). Immediately after treatment, 53% (n = 38) experienced substantial improvement of tinnitus. This effect was maintained in 24% of patients after follow-up at six weeks. Cervical physical therapy can have a positive effect on subjective tinnitus complaints in patients with a combination of tinnitus and neck complaints. Larger studies, using more responsive outcome measures, are however necessary to prove this effect. NCT02016313. Copyright © 2016 Elsevier Ltd. All rights reserved.

Tinnitus and Sleep Difficulties After Cochlear Implantation.

PubMed

Pierzycki, Robert H; Edmondson-Jones, Mark; Dawes, Piers; Munro, Kevin J; Moore, David R; Kitterick, Pádraig T

To estimate and compare the prevalence of and associations between tinnitus and sleep difficulties in a sample of UK adult cochlear implant users and those identified as potential candidates for cochlear implantation. The study was conducted using the UK Biobank resource, a population-based cohort of 40- to 69-year olds. Self-report data on hearing, tinnitus, sleep difficulties, and demographic variables were collected from cochlear implant users (n = 194) and individuals identified as potential candidates for cochlear implantation (n = 211). These "candidates" were selected based on (i) impaired hearing sensitivity, inferred from self-reported hearing aid use and (ii) impaired hearing function, inferred from an inability to report words accurately at negative signal to noise ratios on an unaided closed-set test of speech perception. Data on tinnitus (presence, persistence, and related distress) and on sleep difficulties were analyzed using logistic regression models controlling for gender, age, deprivation, and neuroticism. The prevalence of tinnitus was similar among implant users (50%) and candidates (52%; p = 0.39). However, implant users were less likely to report that their tinnitus was distressing at its worst (41%) compared with candidates (63%; p = 0.02). The logistic regression model suggested that this difference between the two groups could be explained by the fact that tinnitus was less persistent in implant users (46%) compared with candidates (72%; p < 0.001). Self-reported difficulties with sleep were similar among implant users (75%) and candidates (82%; p = 0.28), but participants with tinnitus were more likely to report sleep difficulties than those without (p < 0.001). The prevalence of sleep difficulties was not related to tinnitus persistence (p = 0.28) or the extent to which tinnitus was distressing (p = 0.55). The lack of association between tinnitus persistence and sleep difficulties is compatible with the notion that tinnitus is suppressed

Is tinnitus an early voice of masked hypertension? High masked hypertension rate in patients with tinnitus.

PubMed

Gun, Taylan; Özkan, Selçuk; Yavuz, Bunyamin

2018-04-23

Tinnitus is hearing a sound without any external acoustic stimulus. There are some clues of hypertension can cause tinnitus in different ways. The aim of the study was to evaluate the relationship between tinnitus and masked hypertension including echocardiographic parameters and severity of tinnitus. This study included 88 patients with tinnitus of at least 3 months duration and 85 age and gender-matched control subjects. Tinnitus severity index was used to classify the patients with tinnitus. After a complete medical history, all subjects underwent routine laboratory examination, office blood pressure measurement, hearing tests and ambulatory blood pressure monitoring. Masked hypertension is defined as normal office blood pressure measurement and high ambulatory blood pressure level. Baseline characteristics in patients and controls were similar. Prevalence of masked hypertension was significantly higher in patients with tinnitus than controls (18.2% vs 3.5%, p = 0.002). Office diastolic BP (76 ± 8.1 vs. 72.74 ± 8.68, p = 0.01), ambulatory 24-H diastolic BP (70.2 ± 9.6 vs. 66.9 ± 6.1, p = 0.07) and ambulatory daytime diastolic BP (73.7 ± 9.5 vs. 71.1 ± 6.2, p = 0.03) was significantly higher in patients with tinnitus than control group. Tinnitus severity index in patients without masked hypertension was 0 and tinnitus severity index in patients with masked hypertension were 2 (1-5). This study demonstrated that masked hypertension must be kept in mind if there is a complaint of tinnitus without any other obvious reason.

Music-induced Hearing Loss in Children, Adolescents, and Young Adults: A Systematic Review and Meta-analysis.

PubMed

le Clercq, Carlijn M P; van Ingen, Gijs; Ruytjens, Liesbet; van der Schroeff, Marc P

2016-10-01

Exposure to loud music has increased significantly because of the current development of personal music players and mobile phones. The aim of this study was to provide an overview of music-induced hearing loss and its symptoms in children. The search was performed in the databases Embase, Medline (OvidSP), Web-of-science, Scopus, Cinahl, Cochrane, PubMed publisher, and Google Scholar. Only articles written in English were included. Articles describing hearing levels and music exposure in children were used, published from 1990 until April 2015. The quality of the studies was assessed on reporting, validity, power, and the quality of audiometric testing. Data of each publication was extracted into spreadsheet software and analyzed using best evidence synthesis. The prevalence of increased hearing levels (>15 dB HL) was 9.6%, and high-frequency hearing loss was found in 9.3%. The average hearing thresholds were 4.79 dB HL at low frequencies (0.5, 1, and 2 kHz) and 9.54 dB HL at high frequencies (3, 4, and 6 kHz). Most studies reported no significant association between pure-tone air thresholds and exposure to loud music. However, significant changes in hearing thresholds and otoacoustic emissions, and a high tinnitus prevalence suggest an association between music exposure and hearing loss in children.

Decreased Speech-In-Noise Understanding in Young Adults with Tinnitus

PubMed Central

Gilles, Annick; Schlee, Winny; Rabau, Sarah; Wouters, Kristien; Fransen, Erik; Van de Heyning, Paul

2016-01-01

Objectives: Young people are often exposed to high music levels which make them more at risk to develop noise-induced symptoms such as hearing loss, hyperacusis, and tinnitus of which the latter is the symptom perceived the most by young adults. Although, subclinical neural damage was demonstrated in animal experiments, the human correlate remains under debate. Controversy exists on the underlying condition of young adults with normal hearing thresholds and noise-induced tinnitus (NIT) due to leisure noise. The present study aimed to assess differences in audiological characteristics between noise-exposed adolescents with and without NIT. Methods: A group of 87 young adults with a history of recreational noise exposure was investigated by use of the following tests: otoscopy, impedance measurements, pure-tone audiometry including high-frequencies, transient and distortion product otoacoustic emissions, speech-in-noise testing with continuous and modulated noise (amplitude-modulated by 15 Hz), auditory brainstem responses (ABR) and questionnaires.Nineteen students reported NIT due to recreational noise exposure, and their measures were compared to the non-tinnitus subjects. Results: No significant differences between tinnitus and non-tinnitus subjects could be found for hearing thresholds, otoacoustic emissions, and ABR results.Tinnitus subjects had significantly worse speech reception in noise compared to non-tinnitus subjects for sentences embedded in steady-state noise (mean speech reception threshold (SRT) scores, respectively −5.77 and −6.90 dB SNR; p = 0.025) as well as for sentences embedded in 15 Hz AM-noise (mean SRT scores, respectively −13.04 and −15.17 dB SNR; p = 0.013). In both groups speech reception was significantly improved during AM-15 Hz noise compared to the steady-state noise condition (p < 0.001). However, the modulation masking release was not affected by the presence of NIT. Conclusions: Young adults with and without NIT did not

Diphtheria and hearing loss.

PubMed

Schubert, C R; Cruickshanks, K J; Wiley, T L; Klein, R; Klein, B E; Tweed, T S

2001-01-01

To determine if infectious diseases usually experienced in childhood have an effect on hearing ability later in life. The Epidemiology of Hearing Loss Study (N = 3,753) is a population-based study of age-related hearing loss in adults aged 48 to 92 years in Beaver Dam, Wisconsin. As part of this study, infectious disease history was obtained and hearing was tested using pure-tone audiometry. Hearing loss was defined as a pure-tone average of thresholds at 500 Hz, 1,000 Hz, 2,000 Hz, and 4,000 Hz greater than 25 decibels hearing level in either ear. After adjusting for confounders, only a history of diphtheria (n = 37) was associated with hearing loss (odds ratio [OR] 2.79; 95% confidence interval [CI] 1.05, 7.36). There was no relationship between hearing loss and history of chickenpox, measles, mumps, pertussis, polio, rheumatic fever, rubella, or scarlet fever. Only two participants with a history of diphtheria and hearing loss reported having a hearing loss before age 20. Diphtheria in childhood may have consequences for hearing that do not become apparent until later in life. A possible biological mechanism for a diphtheria effect on hearing ability exists: The toxin produced by the Corynebacterium diphtheriae bacteria can cause damage to cranial nerves and therefore may affect the auditory neural pathway. These data may have important implications for areas facing a resurgence of diphtheria cases.

Clinical trials supported by the Tinnitus Research Consortium: Lessons learned, the Southern Illinois University experience.

PubMed

Bauer, Carol A; Berry, Jennifer; Brozoski, Thomas J

2016-04-01

The Tinnitus Research Consortium funded three clinical trials investigating treatments for chronic bothersome tinnitus at Southern Illinois University School of Medicine. The trials were designed to measure the subjective changes in tinnitus distress using standardized questionnaires and objective changes in tinnitus loudness using psychophysical matching procedures. The results of the first two trials have been published and are summarized here. The first trial investigated the effect of gabapentin on the loudness and annoyance of tinnitus in adults with chronic bothersome tinnitus with and without a history of acoustic trauma. A small but significant number of subjects reported decreased tinnitus annoyance that corresponded with a decrease in objective measures of tinnitus loudness during active drug treatment with a washout effect during placebo treatment. The second trial compared the effect of tinnitus retraining therapy (TRT) on adults with normal to near-normal hearing and chronic bothersome tinnitus to treatment with general counseling without acoustic enrichment. Significant improvements in tinnitus severity, but not in objective psychometric measures of tinnitus loudness, occurred in both treatment groups, however a greater effect was observed in the TRT group compared with the control group. The third trial is nearing completion and investigates the long-term results of tinnitus retraining therapy on chronic bothersome tinnitus in adults with hearing loss. Significant lessons and observations on conducting tinnitus clinical trials were learned from these three trials. The challenges of recruiting and retaining study participants is discussed. More importantly, the reliability and stability of the Tinnitus Handicap Inventory (THI) over long intervals is presented. The implications of this variability for the design and interpretation of future tinnitus studies is discussed. This article is part of a Special Issue entitled <Tinnitus>. Copyright © 2015

Effect of prostaglandin E1 on idiopathic sudden sensorineural hearing loss: a double-blinded clinical study.

PubMed

Ogawa, Kaoru; Takei, Satoshi; Inoue, Yasuhiro; Kanzaki, Jin

2002-09-01

The authors conducted a prospective, randomized, double-blinded clinical trial for the purpose of elucidating the effects of prostaglandin E1 (PGE1) on idiopathic sudden sensorineural hearing loss. With the approval of the institute ethics committee, a total of 57 consecutive patients with diagnoses of idiopathic sudden sensorineural hearing loss were included in the study. The patients in the PGE1 group received continuous infusion containing 60 microg PGE1 and 100 mg hydrocortisone for 7 days, and the patients in the placebo group were treated with continuous infusion containing an inactive placebo and 100 mg hydrocortisone. No significant differences were observed in the improvements of pure-tone average and subjective symptoms between the PGE1 and the placebo groups. However, the hearing improvement at high frequencies (4 kHz and 8 kHz) was significantly higher in the PGE1 group than in the placebo group, especially in the patients with severe tinnitus. These results failed to prove a beneficial effect of PGE1 in the treatment of idiopathic sudden sensorineural hearing loss. Further studies will be needed to clarify the pharmacologic actions of PGE1 in the cochlea.

Prevalence of tinnitus in workers exposed to noise and organophosphates

PubMed Central

Delecrode, Camila Ribas; de Freitas, Thais Domingues; Frizzo, Ana Claúdia Figueiredo; Cardoso, Ana Claúdia Vieira

2012-01-01

Summary Introduction: Research on the workplace has emphasized the effects of noise exposure on workers' hearing, but has not considered the effects of agrochemicals. Aim: To evaluate and correlate the hearing level and tinnitus of workers exposed simultaneously to noise and organophosphates in their workplace and to measure tinnitus distress on their quality of life. Method: A retrospective clinical study. We evaluated 82 organophosphate sprinklers from the São Paulo State Regional Superintendence who were active in the fight against dengue and who were exposed to noise and organophosphates. We performed pure tone audiometry and applied the translated THI (Tinnitus Handicap Inventory) questionnaire. Results: Of the sample, 28.05% reported current tinnitus or had presented tinnitus, and the workers with tinnitus had an increased incidence of abnormal audiometry. The average hearing threshold for the 4–8-kHz frequency range of the workers with current tinnitus was higher than that of the others, and was most affected at the 4-kHz frequency. The THI score ranged 0–84, with an average score of 13.1. Twelve (52.17%) workers had THI scores consistent with discrete handicap. Conclusion: There is an increased incidence of abnormal pure tone audiometry in workers with tinnitus, and its impact on the workers' quality of life was discrete. The correlation between average hearing threshold and tinnitus distress was weak. PMID:25991953

Pre-enlistment hearing loss and hearing loss disability among US soldiers and marines.

PubMed

Gubata, Marlene E; Packnett, Elizabeth R; Feng, Xiaoshu; Cowan, David N; Niebuhr, David W

2013-01-01

Hearing loss is a common condition among US adults, with some evidence of increasing prevalence in young adults. Noise-induced hearing loss attributable to employment is a significant source of preventable morbidity world-wide. The US military population is largely comprised of young adult males serving in a wide variety of occupations, many in high noise-level conditions, at least episodically. To identify accession and service-related risk factors for hearing-related disability, matched case-control study of US military personnel was conducted. Individuals evaluated for hearing loss disability in the US Army and Marine Corps were frequency matched to controls without history of disability evaluation on service and enlistment year. Conditional logistic regression was used to examine the association between accession and service-related factors and hearing-related disability evaluations between October 2002 and September 2010. Individuals with medically disqualifying audiograms or hearing loss diagnoses at application for military service were 8 and 4 times more likely, respectively, to have a disability evaluation related to hearing loss, after controlling for relevant accession, demographic, and service-related factors. Conservative hearing loss thresholds on pre-enlistment audiograms, stricter hearing loss medical waiver policies or qualified baseline audiograms pre-enlistment are needed in the U.S military. Industrial corporations or labor unions may also benefit from identifying individuals with moderate hearing loss at the time of employment to ensure use of personal protective equipment and engineer controls of noise.

Characteristics of somatic tinnitus patients with and without hyperacusis.

PubMed

Ralli, Massimo; Salvi, Richard J; Greco, Antonio; Turchetta, Rosaria; De Virgilio, Armando; Altissimi, Giancarlo; Attanasio, Giuseppe; Cianfrone, Giancarlo; de Vincentiis, Marco

2017-01-01

Determine if somatic tinnitus patients with hyperacusis have different characteristics from those without hyperacusis. 172 somatic tinnitus patients with (n = 82) and without (n = 90) hyperacusis referred to the Tinnitus Unit of Sapienza University of Rome between June 2012 and June 2016 were compared for demographic characteristics, tinnitus features, self-administered questionnaire scores, nature of somatic modulation and history. Compared to those without hyperacusis, patients with somatic tinnitus and hyperacusis: (a) were older (43.38 vs 39.12 years, p = 0.05), (b) were more likely to have bilateral tinnitus (67.08% vs 55.56%, p = 0.04), (c) had a higher prevalence of somatic modulation of tinnitus (53.65% vs 36.66%, p = 0.02) and (d) scored significantly worse on tinnitus annoyance (39.34 vs 22.81, p<0.001) and subjective hearing level (8.04 vs 1.83, p<0.001). Our study shows significantly higher tinnitus modulation and worse self-rating of tinnitus and hearing ability in somatic tinnitus patients with hyperacusis versus somatic tinnitus patients without hyperacusis. These differences could prove useful in developing a better understanding of the pathophysiology and establishing a course of treatment for these two groups of patients.

The current status of audiologic rehabilitation for profound unilateral sensorineural hearing loss.

PubMed

Bishop, Charles E; Eby, Thomas L

2010-03-01

Audiologic rehabilitation of individuals with profound unilateral sensorineural hearing loss (USNHL) has traditionally been limited to the use of air-conduction contralateral routing of sound (CROS) hearing aids. Treatment for these individuals has expanded with new applications of the bone-anchored hearing aid (BAHA), transcranial hearing aid (t-CROS), and the cochlear implant. In this article, the authors review the literature that addresses these various treatment options. Contemporary review Historical information is available that describes the limited efficacy of air-conduction CROS hearing aids in lifting hearing handicap associated with USNHL. Current investigations on providing cross hearing are generally focused on use of the BAHA. Little is known at present whether new developments in hearing aid technology can improve on conventional air-conduction CROS or t-CROS approaches. Interestingly, the cochlear implant seems to be a viable option for individuals with USNHL and tinnitus who also have intact auditory nerve pathways. There is indication in the literature that BAHA provides greater relief of hearing handicap associated with USNHL than CROS hearing aids; however, both have been found to provide limited patient satisfaction and seemingly fall short of restoring true sound localization. Adequate trials have not been performed comparing BAHA with the best CROS hearing aid technology. Transcranial hearing aids and cochlear implants are experimental methods to treat USNHL and hold promise, although there remains a lack of studies available to fully support this.

Neuroanatomical abnormalities in chronic tinnitus in the human brain

PubMed Central

Adjamian, Peyman; Hall, Deborah A.; Palmer, Alan R.; Allan, Thomas W.; Langers, Dave R.M.

2014-01-01

In this paper, we review studies that have investigated brain morphology in chronic tinnitus in order to better understand the underlying pathophysiology of the disorder. Current consensus is that tinnitus is a disorder involving a distributed network of peripheral and central pathways in the nervous system. However, the precise mechanism remains elusive and it is unclear which structures are involved. Given that brain structure and function are highly related, identification of anatomical differences may shed light upon the mechanism of tinnitus generation and maintenance. We discuss anatomical changes in the auditory cortex, the limbic system, and prefrontal cortex, among others. Specifically, we discuss the gating mechanism of tinnitus and evaluate the evidence in support of the model from studies of brain anatomy. Although individual studies claim significant effects related to tinnitus, outcomes are divergent and even contradictory across studies. Moreover, results are often confounded by the presence of hearing loss. We conclude that, at present, the overall evidence for structural abnormalities specifically related to tinnitus is poor. As this area of research is expanding, we identify some key considerations for research design and propose strategies for future research. PMID:24892904

Comparisons of auditory brainstem response and sound level tolerance in tinnitus ears and non-tinnitus ears in unilateral tinnitus patients with normal audiograms

PubMed Central

An, Yong-Hwi; Kim, Dong Hyun; Yoon, Ji Eun; Yoon, Ji Hyang

2017-01-01

Objective Recently, “hidden hearing loss” with cochlear synaptopathy has been suggested as a potential pathophysiology of tinnitus in individuals with a normal hearing threshold. Several studies have demonstrated that subjects with tinnitus and normal audiograms show significantly reduced auditory brainstem response (ABR) wave I amplitudes compared with control subjects, but normal wave V amplitudes, suggesting increased central auditory gain. We aimed to reconfirm the “hidden hearing loss” theory through a within-subject comparison of wave I and wave V amplitudes and uncomfortable loudness level (UCL), which might be decreased with increased central gain, in tinnitus ears (TEs) and non-tinnitus ears (NTEs). Subjects and methods Human subjects included 43 unilateral tinnitus patients (19 males, 24 females) with normal and symmetric hearing thresholds and 18 control subjects with normal audiograms. The amplitudes of wave I and V from the peak to the following trough were measured twice at 90 dB nHL and we separately assessed UCLs at 500 Hz and 3000 Hz pure tones in each TE and NTE. Results The within-subject comparison between TEs and NTEs showed no significant differences in wave I and wave V amplitude, or wave V/I ratio in both the male and female groups. Individual data revealed increased V/I amplitude ratios > mean + 2 SD in 3 TEs, but not in any control ears. We found no significant differences in UCL at 500 Hz or 3000 Hz between the TEs and NTEs, but the UCLs of both TEs and NTEs were lower than those of the control ears. Conclusions Our ABR data do not represent meaningful evidence supporting the hypothesis of cochlear synaptopathy with increased central gain in tinnitus subjects with normal audiograms. However, reduced sound level tolerance in both TEs and NTEs might reflect increased central gain consequent on hidden synaptopathy that was subsequently balanced between the ears by lateral olivocochlear efferents. PMID:29253030

Noise-induced hearing loss caused by gunshot in South Korean military service.

PubMed

Moon, In Seok

2007-04-01

Noise-induced hearing loss is a preventive disease and yet the effective treatment modality has not been established. Acute acoustic traumas caused by an exposure to gunshot noise are common in young South Korean males in military service. Considering the significant lack of awareness on this serious issue as well as the absence of proper protective gear, an in-depth analysis is desperately needed. All 3650 soldiers performed regular periodic gunfire exercise without any hearing protective measures. Seven patients with hearing impairment after periodic gunfire visited the aeromedical squadron; all were right-handed males. Six were tested with the K-2 rifle and one was tested with a K-5 revolver. History taking, physical examination, pure-tone audiometry, and impedance audiometry were conducted. In the next periodic gunfire exercise, all 3650 soldiers performed gunfire with unilateral hearing protection. The average outcome of postexposure air conduction thresholds was 6.5 dB in the right ear and 33.1 dB in the left ear. After medical treatment, hearing impairment was much improved; however, tinnitus was not diminished. In the next periodic gunfire exercise, the result of a supplement of unilateral earplug protection proved its effectiveness on acoustic trauma caused by gunfire noise. Asymmetry in hearing loss is related to the position of the head during gunfire. A unilateral hearing protection device was enough to protect hearing from gunfire noise. At the same time, it can effectively prevent a potential firearm accident that can be caused by trainees mishearing the instruction of a firearm instructor if both earplugs are worn. Thus, providing a unilateral earplug for protection against acoustic trauma must be taken into serious consideration.

Predictive factors of occupational noise-induced hearing loss in Spanish workers: A prospective study.

PubMed

Pelegrin, Armando Carballo; Canuet, Leonides; Rodríguez, Ángeles Arias; Morales, Maria Pilar Arévalo

2015-01-01

The purpose of our study was to identify the main factors associated with objective noise-induced hearing loss (NIHL), as indicated by abnormal audiometric testing, in Spanish workers exposed to occupational noise in the construction industry. We carried out a prospective study in Tenerife, Spain, using 150 employees exposed to occupational noise and 150 age-matched controls who were not working in noisy environments. The variables analyzed included sociodemographic data, noise-related factors, types of hearing protection, self-report hearing loss, and auditory-related symptoms (e.g., tinnitus, vertigo). Workers with pathological audiograms had significantly longer noise-exposure duration (16.2 ± 11.4 years) relative to those with normal audiograms (10.2 ± 7.0 years; t = 3.99, P < 0.001). The vast majority of those who never used hearing protection measures had audiometric abnormalities (94.1%). Additionally, workers using at least one of the protection devices (earplugs or earmuffs) had significantly more audiometric abnormalities than those using both protection measures simultaneously (Chi square = 16.07; P < 0.001). The logistic regression analysis indicates that the use of hearing protection measures [odds ratio (OR) = 12.30, confidence interval (CI) = 4.36-13.81, P < 0.001], and noise-exposure duration (OR = 1.35, CI = 1.08-1.99, P = 0.040) are significant predictors of NIHL. This regression model correctly predicted 78.2% of individuals with pathological audiograms. The combined use of hearing protection measures, in particular earplugs and earmuffs, associates with a lower rate of audiometric abnormalities in subjects with high occupational noise exposure. The use of hearing protection measures at work and noise-exposure duration are best predictive factors of NIHL. Auditory-related symptoms and self-report hearing loss do not represent good indicators of objective NIHL. Routine monitoring of noise levels and hearing status are of great importance as part

Binaural auditory outcomes in patients with postlingual profound unilateral hearing loss: 3 years after cochlear implantation.

PubMed

Mertens, Griet; Kleine Punte, Andrea; De Bodt, Marc; Van de Heyning, Paul

2015-01-01

The value of cochlear implants (CI) in patients with profound unilateral hearing loss (UHL) and tinnitus has recently been investigated. The authors previously demonstrated the feasibility of CI in a 12- month outcome study in a prospective UHL cohort. The aim of this study was to investigate the binaural auditory outcomes in this cohort 36 months after CI surgery. The 36-month outcome was evaluated in 22 CI users with postlingual UHL and severe tinnitus. Twelve subjects had contralateral normal hearing (single-sided deafness - SSD group) and 10 subjects had a contralateral, mild to moderate hearing loss and used a hearing aid (asymmetric hearing loss - AHL group). Speech perception in noise was assessed in two listening conditions: the CIoff and the CIon condition. The binaural summation effect (S0N0), binaural squelch effect (S0NCI) and the combined head shadow effect (SCIN0) were investigated. Subjective benefit in daily life was assessed by means of the Speech, Spatial and Qualities of Hearing Scale (SSQ). At 36 months, a significant binaural summation effect was observed for the study cohort (2.00, SD 3.82 dB; p < 0.01) and for the AHL subgroup (3.34, SD 5.31 dB; p < 0.05). This binaural effect was not significant 12 months after CI surgery. A binaural squelch effect was significant for the AHL subgroup at 12 months (2.00, SD 4.38 dB; p < 0.05). A significant combined head shadow and squelch effect was also noted in the spatial configuration SCIN0 for the study cohort (4.00, SD 5.89 dB; p < 0.01) and for the AHL subgroup (5.67, SD 6.66 dB; p < 0.05). The SSQ data show that the perceived benefit in daily life after CI surgery remains stable up to 36 months at CIon. CI can significantly improve speech perception in noise in patients with UHL. The positive effects of CIon speech perception in noise increase over time up to 36 months after CI surgery. Improved subjective benefit in daily life was also shown to be sustained in these patients. © 2015 S. Karger AG

Acceptance of Tinnitus As an Independent Correlate of Tinnitus Severity.

PubMed

Hesser, Hugo; Bånkestad, Ellinor; Andersson, Gerhard

2015-01-01

Tinnitus is the experience of sounds without an identified external source, and for some the experience is associated with significant severity (i.e., perceived negative affect, activity limitation, and participation restriction due to tinnitus). Acceptance of tinnitus has recently been proposed to play an important role in explaining heterogeneity in tinnitus severity. The purpose of the present study was to extend previous investigations of acceptance in relation to tinnitus by examining the unique contribution of acceptance in accounting for tinnitus severity, beyond anxiety and depression symptoms. In a cross-sectional study, 362 participants with tinnitus attending an ENT clinic in Sweden completed a standard set of psychometrically examined measures of acceptance of tinnitus, tinnitus severity, and anxiety and depression symptoms. Participants also completed a background form on which they provided information about the experience of tinnitus (loudness, localization, sound characteristics), other auditory-related problems (hearing problems and sound sensitivity), and personal characteristics. Correlational analyses showed that acceptance was strongly and inversely related to tinnitus severity and anxiety and depression symptoms. Multivariate regression analysis, in which relevant patient characteristics were controlled, revealed that acceptance accounted for unique variance beyond anxiety and depression symptoms. Acceptance accounted for more of the variance than anxiety and depression symptoms combined. In addition, mediation analysis revealed that acceptance of tinnitus mediated the direct association between self-rated loudness and tinnitus severity, even after anxiety and depression symptoms were taken into account. Findings add to the growing body of work, supporting the unique and important role of acceptance in tinnitus severity. The utility of the concept is discussed in relation to the development of new psychological models and interventions for

Genetic Effects on Sensorineural Hearing Loss and Evidence-based Treatment for Sensorineural Hearing Loss.

PubMed

Yu, Yong-qiang; Yang, Huai-an; Xiao, Ming; Wang, Jing-wei; Huang, Dong-yan; Bhambhani, Yagesh; Sonnenberg, Lyn; Clark, Brenda; Jin, Yuan-zhe; Fu, Wei-neng; Zhang, Jie; Yu, Qian; Liang, Xue-ting; Zhang, Ming

2015-09-01

In this article, the mechanism of inheritance behind inherited hearing loss and genetic susceptibility in noise-induced hearing loss are reviewed. Conventional treatments for sensorineural hearing loss (SNHL), i.e. hearing aid and cochlear implant, are effective for some cases, but not without limitations. For example, they provide little benefit for patients of profound SNHL or neural hearing loss, especially when the hearing loss is in poor dynamic range and with low frequency resolution. We emphasize the most recent evidence-based treatment in this field, which includes gene therapy and allotransplantation of stem cells. Their promising results have shown that they might be options of treatment for profound SNHL and neural hearing loss. Although some treatments are still at the experimental stage, it is helpful to be aware of the novel therapies and endeavour to explore the feasibility of their clinical application.

Pop-rock musicians: assessment of their satisfaction provided by hearing protectors.

PubMed

Santoni, Cristiane Bolzachini; Fiorini, Ana Claudia

2010-01-01

Pop-rock musicians are at risk of developing hearing loss and other symptoms related to amplified music. The aim of the present study was to assess the satisfaction provided by the use of hearing protection in pop-rock musicians. Contemporary cohort study. A study of 23 male pop-rock musicians, aged between 25 to 45 years. After audiological evaluation (pure tone audiometry, middle ear analysis, TEOAE and DPOAE) hearing protective devices were provided to be used for three months. After that musicians answered a satisfaction assessment questionnaire. The prevalence of hearing loss was of 21.7%. The most common complaints about the hearing protectors were: autophonia, pressure in the ears, interference in high frequencies perception and full time use of the hearing protector during concerts. There was a positive correlation between a reduction in tinnitus after the use of the HPD with the following complaints: tinnitus after beginning the career (p= 0.044), discomfort with the sound intensity in the work place (p= 0.009) and intolerance to loud sound (p= 0.029). There was a high prevalence of hearing loss and a positive tendency towards the use of the ear protector device among the sample population.

[Pre- and posttreatment results of an inpatient neurotologic and psychosomatic tinnitus therapy].

PubMed

Schaaf, H; Hesse, G

2015-08-01

Inpatient treatment of chronic complex tinnitus can be necessary for patients with a high symptomatic strain, mostly accompanied by a corresponding mental comorbidity, and/or for patients that can only perceive their psychogenic suffering through somatization into tinnitus. We report the results of 368 consecutively treated inpatients with chronic complex tinnitus. Patients' audiometric data were collected, and at the beginning and end of treatment, the Mini-Tinnitus Questionnaire (Mini-TQ12; Hiller und Goebel) was completed, as was the German version of the Hospitality Anxiety and Depression Score (HADS). Effect sizes were calculated for both questionnaires. Mean treatment duration was 38.8 days (standard deviation, SD: 13.6 days). The main therapeutic elements were intensive disorder-specific neurotologic counselling and psychoeducation; improvement of hearing by fitting of hearing aids, complemented by an individualized hearing therapy; and intensive individual and group-based psychotherapy. In addition to tinnitus, 82.1% of the patients had reduced hearing requiring rehabilitation with hearing aids. After hospitalization, a highly significant improvement in tinnitus strain could be demonstrated by the Mini-TQ12. Furthermore, a significant reduction in the depression and anxiety components of HADS was also achieved, with high effect sizes of 1.6 to 2.2. No reduction of tinnitus symptoms to a medium- or low-range level was experienced by 8.9% of patients. With corresponding symptomatic suffering, disorder-specific inpatient tinnitus treatment comprising neurotologic and psychosomatic alignment can achieve medium- to high-range therapeutic effects.

Multivariate analysis of prognostic factors for idiopathic sudden sensorineural hearing loss treated with adjuvant hyperbaric oxygen therapy.

PubMed

Xie, Shaobing; Qiang, Qingfen; Mei, Lingyun; He, Chufeng; Feng, Yong; Sun, Hong; Wu, Xuewen

2018-01-01

The objective of this study is to evaluate possible prognostic factors of idiopathic sudden sensorineural hearing loss (ISSNHL) treated with adjuvant hyperbaric oxygen therapy (HBOT) using univariate and multivariate analyses. From January 2008 to October 2016, records of 178 ISSNHL patients treated with auxiliary hyperbaric oxygen therapy were reviewed to assess hearing recovery and evaluate associated prognostic factors (gender, age, localization, initial hearing threshold, presence of tinnitus, vertigo, ear fullness, hypertension, diabetes, onset of HBOT, number of HBOT, and audiogram), by using univariate and multivariate analyses. The overall recovery rate was 37.1%, including complete recovery (19.7%) and partial recovery (17.4%). According to multivariate analysis, later onset of HBOT and higher initial hearing threshold were associated with a poor prognosis in ISSNHL patients treated with HBOT. HBOT is a safe and beneficial adjuvant therapy for ISSNHL patients. 20 sessions of HBOT is possibly enough to show its therapeutic effect. Earlier HBOT onset and lower initial hearing threshold is associated with favorable hearing recovery.

Antioxidant therapy in the elderly with tinnitus.

PubMed

Polanski, José Fernando; Soares, Alexandra Dezani; de Mendonça Cruz, Oswaldo Laércio

2016-01-01

Several approaches have been tried for the treatment of tinnitus, from cognitive-behavioral therapies and sound enrichment to medication. In this context, antioxidants, widely used in numerous areas of medicine, appear to represent a promising approach for the control of this symptom, which often is poorly controlled. To evaluate the effects of antioxidant therapy for tinnitus in a group of elderly patients. Prospective, randomized, double-blinded, placebo-controlled clinical trial. The sample consisted of 58 subjects aged 60 years or older, with a complaint of tinnitus associated with sensorineural hearing loss. These individuals completed the Tinnitus Handicap Inventory (THI) questionnaire before and after six months of therapy. The treatment regimens were: Ginkgo biloba dry extract (120mg/day), α-lipoic acid (60mg/day)+vitamin C (600mg/day), papaverine hydrochloride (100mg/day)+vitamin E (400mg/day), and placebo. There was no statistically significant difference between THI by degree (p=0.441) and by score (p=0.848) before and after treatment. There was no benefit from the use of antioxidant agents for tinnitus in this sample. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Characteristics of somatic tinnitus patients with and without hyperacusis

PubMed Central

Salvi, Richard J.; Greco, Antonio; Turchetta, Rosaria; De Virgilio, Armando; Altissimi, Giancarlo; Attanasio, Giuseppe; Cianfrone, Giancarlo; de Vincentiis, Marco

2017-01-01

Objective Determine if somatic tinnitus patients with hyperacusis have different characteristics from those without hyperacusis. Patients and methods 172 somatic tinnitus patients with (n = 82) and without (n = 90) hyperacusis referred to the Tinnitus Unit of Sapienza University of Rome between June 2012 and June 2016 were compared for demographic characteristics, tinnitus features, self-administered questionnaire scores, nature of somatic modulation and history. Results Compared to those without hyperacusis, patients with somatic tinnitus and hyperacusis: (a) were older (43.38 vs 39.12 years, p = 0.05), (b) were more likely to have bilateral tinnitus (67.08% vs 55.56%, p = 0.04), (c) had a higher prevalence of somatic modulation of tinnitus (53.65% vs 36.66%, p = 0.02) and (d) scored significantly worse on tinnitus annoyance (39.34 vs 22.81, p<0.001) and subjective hearing level (8.04 vs 1.83, p<0.001). Conclusion Our study shows significantly higher tinnitus modulation and worse self-rating of tinnitus and hearing ability in somatic tinnitus patients with hyperacusis versus somatic tinnitus patients without hyperacusis. These differences could prove useful in developing a better understanding of the pathophysiology and establishing a course of treatment for these two groups of patients. PMID:29161302

Attitudes toward noise, perceived hearing symptoms, and reported use of hearing protection among college students: Influence of youth culture

PubMed Central

Balanay, Jo Anne G.; Kearney, Gregory D.

2015-01-01

The purpose of this study was to assess the attitude toward noise, perceived hearing symptoms, noisy activities that were participated in, and factors associated with hearing protection use among college students. A 44-item online survey was completed by 2,151 college students (aged 17 years and above) to assess the attitudes toward noise, perceived hearing symptoms related to noise exposure, and use of hearing protection around noisy activities. Among the participants, 39.6% experienced at least one hearing symptom, with ear pain as the most frequently reported (22.5%). About 80% of the participants were involved in at least one noise activity, out of which 41% reported the use of hearing protection. A large majority of those with ear pain, hearing loss, permanent tinnitus, and noise sensitivity was involved in attending a sporting event, which was the most reported noisy activity. The highest reported hearing protection use was in the use of firearms, and the lowest in discos/ dances. The reported use of hearing protection is associated with having at least one hearing symptom but the relationship is stronger with tinnitus, hearing loss, and ear pain (χ2 = 30.5-43.5, P < 0.01) as compared to noise sensitivity (χ2 = 3.8, P = 0.03); it is also associated with anti-noise attitudes, particularly in youth social events. Universities and colleges have important roles in protecting young adults’ hearing by integrating hearing conservation topic in the college curriculum, promoting hearing health by student health services, involving student groups in noise-induced hearing loss (NIHL) awareness and prevention, and establishing noise level limitations for all on-campus events. PMID:26572699

Attitudes toward noise, perceived hearing symptoms, and reported use of hearing protection among college students: Influence of youth culture.

PubMed

Balanay, Jo Anne G; Kearney, Gregory D

2015-01-01

The purpose of this study was to assess the attitude toward noise, perceived hearing symptoms, noisy activities that were participated in, and factors associated with hearing protection use among college students. A 44-item online survey was completed by 2,151 college students (aged 17 years and above) to assess the attitudes toward noise, perceived hearing symptoms related to noise exposure, and use of hearing protection around noisy activities. Among the participants, 39.6% experienced at least one hearing symptom, with ear pain as the most frequently reported (22.5%). About 80% of the participants were involved in at least one noise activity, out of which 41% reported the use of hearing protection. A large majority of those with ear pain, hearing loss, permanent tinnitus, and noise sensitivity was involved in attending a sporting event, which was the most reported noisy activity. The highest reported hearing protection use was in the use of firearms, and the lowest in discos/ dances. The reported use of hearing protection is associated with having at least one hearing symptom but the relationship is stronger with tinnitus, hearing loss, and ear pain (χ² = 30.5-43.5, P< 0.01) as compared to noise sensitivity (χ² = 3.8, P= 0.03); it is also associated with anti-noise attitudes, particularly in youth social events. Universities and colleges have important roles in protecting young adults' hearing by integrating hearing conservation topic in the college curriculum, promoting hearing health by student health services, involving student groups in noise-induced hearing loss (NIHL) awareness and prevention, and establishing noise level limitations for all on-campus events.

Functional and structural aspects of tinnitus-related enhancement and suppression of auditory cortex activity.

PubMed

Diesch, Eugen; Andermann, Martin; Flor, Herta; Rupp, Andre

2010-05-01

The steady-state auditory evoked magnetic field was recorded in tinnitus patients and controls, both either musicians or non-musicians, all of them with high-frequency hearing loss. Stimuli were AM-tones with two modulation frequencies and three carrier frequencies matching the "audiometric edge", i.e. the frequency above which hearing loss increases more rapidly, the tinnitus frequency or the frequency 1 1/2 octaves above the audiometric edge in controls, and a frequency 1 1/2 octaves below the audiometric edge. Stimuli equated in carrier frequency, but differing in modulation frequency, were simultaneously presented to the two ears. The modulation frequency-specific components of the dual steady-state response were recovered by bandpass filtering. In both hemispheres, the source amplitude of the response was larger for contralateral than ipsilateral input. In non-musicians with tinnitus, this laterality effect was enhanced in the hemisphere contralateral and reduced in the hemisphere ipsilateral to the tinnitus ear, especially for the tinnitus frequency. The hemisphere-by-input laterality dominance effect was smaller in musicians than in non-musicians. In both patient groups, source amplitude change over time, i.e. amplitude slope, was increasing with tonal frequency for contralateral input and decreasing for ipsilateral input. However, slope was smaller for musicians than non-musicians. In patients, source amplitude was negatively correlated with the MRI-determined volume of the medial partition of Heschl's gyrus. Tinnitus patients show an altered excitatory-inhibitory balance reflecting the downregulation of inhibition and resulting in a steeper dominance hierarchy among simultaneous processes in auditory cortex. Direction and extent of this alteration are modulated by musicality and auditory cortex volume. 2010 Elsevier Inc. All rights reserved.

Source Space Estimation of Oscillatory Power and Brain Connectivity in Tinnitus

PubMed Central

Zobay, Oliver; Palmer, Alan R.; Hall, Deborah A.; Sereda, Magdalena; Adjamian, Peyman

2015-01-01

Tinnitus is the perception of an internally generated sound that is postulated to emerge as a result of structural and functional changes in the brain. However, the precise pathophysiology of tinnitus remains unknown. Llinas’ thalamocortical dysrhythmia model suggests that neural deafferentation due to hearing loss causes a dysregulation of coherent activity between thalamus and auditory cortex. This leads to a pathological coupling of theta and gamma oscillatory activity in the resting state, localised to the auditory cortex where normally alpha oscillations should occur. Numerous studies also suggest that tinnitus perception relies on the interplay between auditory and non-auditory brain areas. According to the Global Brain Model, a network of global fronto—parietal—cingulate areas is important in the generation and maintenance of the conscious perception of tinnitus. Thus, the distress experienced by many individuals with tinnitus is related to the top—down influence of this global network on auditory areas. In this magnetoencephalographic study, we compare resting-state oscillatory activity of tinnitus participants and normal-hearing controls to examine effects on spectral power as well as functional and effective connectivity. The analysis is based on beamformer source projection and an atlas-based region-of-interest approach. We find increased functional connectivity within the auditory cortices in the alpha band. A significant increase is also found for the effective connectivity from a global brain network to the auditory cortices in the alpha and beta bands. We do not find evidence of effects on spectral power. Overall, our results provide only limited support for the thalamocortical dysrhythmia and Global Brain models of tinnitus. PMID:25799178

Incidence of tinnitus in mp3 player users.

PubMed

Figueiredo, Ricardo Rodrigues; Azevedo, Andreia Aparecida de; Oliveira, Patrícia Mello de; Amorim, Sandro Pereira Vasconcellos; Rios, Artur Guedes; Baptista, Vanderlei

2011-06-01

Exposure to loud noise is one of the main causes of tinnitus. To analyze the incidence of tinnitus in mp3 player users and non-users. One hundred subjects aged from 15 to 30 years were enrolled, 54 of them were regular mp3 player users and 46 were not. Patients with continuous tinnitus for at least 6 months completed the Tinnitus Handicap Inventory (THI) and were tested with high frequency audiometry and transient-evoked otoacoustic emissions (TAOE). A cross-sectional cohort study. The incidence of tinnitus in non-users was about 8 %; in mp3 player users it was about 28 %, a statistically significant difference. Hearing thresholds at 8 kHz were significantly higher in tinnitus patients that used mp3 portable players.TAOE were reduced at 2 kHz in the users group. No statistically significant difference was found in the THI scores between the two groups. Tinnitus was more frequent in teenagers and young adults who regularly listen to mp3 music in players. Moreover, the incidence of tinnitus among mp3 player users was associated with higher hearing thresholds at 8 kHz and lower TOAE at 2 kHz.

Tinnitus and Cognitive Interference: A Stroop Paradigm Study.

ERIC Educational Resources Information Center

Andersson, Gerhard; Eriksson, Jan; Lundh, Lars-Gunnar; Lyttkens, Leif

2000-01-01

This study examined the performance of 23 tinnitus patients on three versions of the Stroop color-word test. Results showed that tinnitus patients performed significantly slower than controls on all test conditions. Results suggest that tinnitus patients have impaired cognitive performance overall, possibly confounded by hearing impairment.…

[Chronic complex tinnitus: therapeutic results of inpatient treatment in a tinnitus clinic].

PubMed

Hesse, G; Rienhoff, N K; Nelting, M; Laubert, A

2001-09-01

In-patient treatment of patients with chronic tinnitus is necessary only when these patients have a severe psychosomatic co-morbidity and suffer severely. However this therapeutic approach has to be supervised and evaluated properly. We present data and results of 1841 patients suffering from chronic tinnitus. Due to the severity of the symptom and psycho-neurotic side effects in-patient treatment was necessary. Therapy lasted 5 - 6 weeks, the main aspect was an intensive psychotherapeutic evaluation and stabilisation next to retraining and habituation programmes. Relaxation techniques were taught. Patients suffered from their tinnitus more than six month; 95 % further suffered from hearing-loss, mainly in high frequencies. The study evaluates results of patients from October 1994 until June 2000. Basis of the study was the evaluation of a specific tinnitus-questionnaire (TQ), published by Hallam in the UK and translated by Goebel and Hiller in Germany. Data was recorded at registration in our clinic, 4 - 6 months later during admission and at the end of the therapy. Final data was gained during a special meeting or questioning 6 months after dismissal from the clinic. Patients that suffered most showed the greatest improvement; directly after therapy there was a highly significant improvement in the TQ for an average of 13.01 points. Highly significant improvements were found in all the TQ-subscales respectively. Only 10 % of the patients did not show any improvement at all. Therapy of most severe cases of chronic tinnitus is possible, using an integrated concept of otologic and psychosomatic treatments. With large numbers of patients and sufficient data a thorough and necessary evaluation of this therapy can be achieved.

Improving the Reliability of Tinnitus Screening in Laboratory Animals.

PubMed

Jones, Aikeen; May, Bradford J

2017-02-01

Behavioral screening remains a contentious issue for animal studies of tinnitus. Most paradigms base a positive tinnitus test on an animal's natural tendency to respond to the "sound" of tinnitus as if it were an actual sound. As a result, animals with tinnitus are expected to display sound-conditioned behaviors when no sound is present or to miss gaps in background sounds because tinnitus "fills in the gap." Reliable confirmation of the behavioral indications of tinnitus can be problematic because the reinforcement contingencies of conventional discrimination tasks break down an animal's tendency to group tinnitus with sound. When responses in silence are rewarded, animals respond in silence regardless of their tinnitus status. When responses in silence are punished, animals stop responding. This study introduces stimulus classification as an alternative approach to tinnitus screening. Classification procedures train animals to respond to the common perceptual features that define a group of sounds (e.g., high pitch or narrow bandwidth). Our procedure trains animals to drink when they hear tinnitus and to suppress drinking when they hear other sounds. Animals with tinnitus are revealed by their tendency to drink in the presence of unreinforced probe sounds that share the perceptual features of the tinnitus classification. The advantages of this approach are illustrated by taking laboratory rats through a testing sequence that includes classification training, the experimental induction of tinnitus, and postinduction screening. Behavioral indications of tinnitus are interpreted and then verified by simulating a known tinnitus percept with objective sounds.

Interaction of tinnitus suppression and hearing ability after cochlear implantation.

PubMed

Wang, Qian; Li, Jia-Nan; Lei, Guan-Xiong; Chen, Dai-Shi; Wang, Wei-Ze; Chen, Ai-Ting; Mong, Meng-Di; Li, Sun; Jiao, Qing-Shan; Yang, Shi-Ming

2017-10-01

To study the postoperative impact of cochlear implants (CIs) on tinnitus, as well as the impact of tinnitus on speech recognition with CI switched on. Fifty-two postlingual deafened CI recipients (21 males and 31 females) were assessed using an established Tinnitus Characteristics Questionnaire and Tinnitus Handicap Inventory (THI) before and after cochlear implantation. The tinnitus loudness was investigated when CI was switched on and off in CI recipients with persistent tinnitus. The relation between tinnitus loudness and recipients' satisfaction of cochlear implantation was analyzed by the visual analogue scale (VAS) score. With CI 'OFF', 42 CI recipients experienced tinnitus postimplant ipsilaterally and 44 contralaterally. Tinnitus was totally suppressed ipsilateral to the CI with CI 'ON' in 42.9%, partially suppressed in 42.9%, unchanged in 11.9% and aggravated in 2.4%. Tinnitus was totally suppressed contralaterally with CI 'ON' in 31.8% of CI recipients, partially suppressed in 47.7%, unchanged in 20.5%. Pearson correlation analysis showed that tinnitus loudness and the results of cochlear implant patients satisfaction was negatively correlated (r = .674, p < .001). The study suggests six-month CI activation can be effective for suppressing tinnitus. The tinnitus loudness may affect patients' satisfaction with the use of CI.

Genetics of Tinnitus: An Emerging Area for Molecular Diagnosis and Drug Development

PubMed Central

Lopez-Escamez, Jose A.; Bibas, Thanos; Cima, Rilana F. F.; Van de Heyning, Paul; Knipper, Marlies; Mazurek, Birgit; Szczepek, Agnieszka J.; Cederroth, Christopher R.

2016-01-01

Subjective tinnitus is the perception of sound in the absence of external or bodily-generated sounds. Chronic tinnitus is a highly prevalent condition affecting over 70 million people in Europe. A wide variety of comorbidities, including hearing loss, psychiatric disorders, neurodegenerative disorders, and temporomandibular joint (TMJ) dysfunction, have been suggested to contribute to the onset or progression of tinnitus; however, the precise molecular mechanisms of tinnitus are not well understood and the contribution of genetic and epigenetic factors remains unknown. Human genetic studies could enable the identification of novel molecular therapeutic targets, possibly leading to the development of novel pharmaceutical therapeutics. In this article, we briefly discuss the available evidence for a role of genetics in tinnitus and consider potential hurdles in designing genetic studies for tinnitus. Since multiple diseases have tinnitus as a symptom and the supporting genetic evidence is sparse, we propose various strategies to investigate the genetic underpinnings of tinnitus, first by showing evidence of heritability using concordance studies in twins, and second by improving patient selection according to phenotype and/or etiology in order to control potential biases and optimize genetic data output. The increased knowledge resulting from this endeavor could ultimately improve the drug development process and lead to the preventive or curative treatment of tinnitus. PMID:27594824

Hereditary Hearing Loss.

ERIC Educational Resources Information Center

Tran, LenhAnh P.; Grundfast, Kenneth M.

1997-01-01

This article discusses inheritance patterns in hearing loss, epidemiology, clues to genetic causes, locating genes that cause hereditary disorders, genes related to hearing loss disorders in individuals with Usher syndrome, Waardenburg syndrome, Treacher-Collins syndrome, Branchio-oto-renal and Pendred syndromes, and the significance of finding…

Functional MRI evidence for a role of ventral prefrontal cortex in tinnitus

PubMed Central

Seydell-Greenwald, Anna; Leaver, Amber M.; Turesky, Ted K.; Morgan, Susan; Kim, Hung J.; Rauschecker, Josef P.

2012-01-01

It has long been known that subjective tinnitus, a constant or intermittent phantom sound perceived by 10 to 15 % of the adult population, is not a purely auditory phenomenon but is also tied to limbic-related brain regions. Supporting evidence comes from data indicating that stress and emotion can modulate tinnitus, and from brain imaging studies showing functional and anatomical differences in limbic-related brain regions of tinnitus patients and controls. Recent studies from our lab revealed altered blood oxygen level-dependent (BOLD) responses to stimulation at the tinnitus frequency in the ventral striatum (specifically, the nucleus accumbens) and gray-matter reductions (i.e. anatomical changes) in ventromedial prefrontal cortex (vmPFC), of tinnitus patients compared to controls. The present study extended these findings by demonstrating functional differences in vmPFC between 20 tinnitus patients and 20 age-matched controls. Importantly, the observed BOLD response in vmPFC was positively correlated with tinnitus characteristics such as subjective loudness and the percent of time during which the tinnitus was perceived, whereas correlations with Tinnitus Handicap Inventory scores and other variables known to be affected in tinnitus (e.g. depression, anxiety, noise sensitivity, hearing loss) were weaker or absent. This suggests that the observed group differences are indeed related to the tinnitus percept and not to an affective reaction to tinnitus. The results further corroborate vmPFC as a region of high interest for tinnitus research. PMID:22982009

An epidemiologic study of tinnitus in a population in Jiangsu Province, China.

PubMed

Xu, Xia; Bu, Xingkuan; Zhou, Ling; Xing, Guangqian; Liu, Cheng; Wang, Dengyuan

2011-10-01

Tinnitus is a common complaint and often of no clinical significance. There are a number of unresolved issues concerning the etiology, pathogenesis, and natural history of tinnitus. There are a few current population-based estimates of the prevalence of tinnitus done in representative large geographic areas, but there is little data from multi-area, large sample studies of tinnitus in China. To investigate the prevalence of tinnitus and related factors in a Chinese population. These data would be used to plan and evaluate health-care services. We carried out an epidemiologic study of tinnitus as part of an epidemiologic study of ear and hearing disorders that was undertaken in Jiangsu Province, China. A question about tinnitus history was included in a comprehensive questionnaire about hearing. All participants also had both pure tone audiometry and an otological examination. The sample consisted of 6333 people 10 yr of age or older, selected by the methods of probability proportional to size. All participants answered a questionnaire concerning their tinnitus and had pure tone audiometry testing and an ear examination. All data were entered using EPIDATD 3.0 software and analyzed by a chi-squared test and test for trends. The overall prevalence of tinnitus was 14.5%, and the standardized rates were 11.4% in the whole country and 12.4% in Jiangsu province. Its prevalence increased with age. The prevalence of tinnitus was 11.9 and 15.6% in urban and rural residents, respectively There was no significant difference in prevalence between men and women. Hearing impairment, history of middle ear infections, and noise exposure were the main risk factors for tinnitus. Tinnitus is a common problem in the population. With the aging of the population, the prevalence of tinnitus will increase. The prevention of tinnitus should focus on hearing impairment screening, otitis media treatment, and noise exposure reduction. Health services in rural areas should emphasize prevention

Tinnitus after Simultaneous and Sequential Bilateral Cochlear Implantation.

PubMed

Ramakers, Geerte G J; Kraaijenga, Véronique J C; Smulders, Yvette E; van Zon, Alice; Stegeman, Inge; Stokroos, Robert J; Free, Rolien H; Frijns, Johan H M; Huinck, Wendy J; Van Zanten, Gijsbert A; Grolman, Wilko

2017-01-01

There is an ongoing global discussion on whether or not bilateral cochlear implantation should be standard care for bilateral deafness. Contrary to unilateral cochlear implantation, however, little is known about the effect of bilateral cochlear implantation on tinnitus. To investigate tinnitus outcomes 1 year after bilateral cochlear implantation. Secondarily, to compare tinnitus outcomes between simultaneous and sequential bilateral cochlear implantation and to investigate long-term follow-up (3 years). This study is a secondary analysis as part of a multicenter randomized controlled trial. Thirty-eight postlingually deafened adults were included in the original trial, in which the presence of tinnitus was not an inclusion criterion. All participants received cochlear implants (CIs) because of profound hearing loss. Nineteen participants received bilateral CIs simultaneously and 19 participants received bilateral CIs sequentially with an inter-implant interval of 2 years. The prevalence and severity of tinnitus before and after simultaneous and sequential bilateral cochlear implantation were measured preoperatively and each year after implantation with the Tinnitus Handicap Inventory (THI) and Tinnitus Questionnaire (TQ). The prevalence of preoperative tinnitus was 42% (16/38). One year after bilateral implantation, there was a median difference of -8 (inter-quartile range (IQR): -28 to 4) in THI score and -9 (IQR: -17 to -9) in TQ score in the participants with preoperative tinnitus. Induction of tinnitus occurred in five participants, all in the simultaneous group, in the year after bilateral implantation. Although the preoperative and also the postoperative median THI and TQ scores were higher in the simultaneous group, the median difference scores were equal in both groups. In the simultaneous group, tinnitus scores fluctuated in the 3 years after implantation. In the sequential group, four patients had an additional benefit of the second CI: a total

[The role of the cervical spine and the craniomandibular system in the pathogenesis of tinnitus. Somatosensory tinnitus].

PubMed

Biesinger, E; Reisshauer, A; Mazurek, B

2008-07-01

The causes of tinnitus, vertigo, and hearing disturbances may be pathological processes in the cervical spine and temporomaxillary joint. In these cases, tinnitus is called somatosensory tinnitus (SST). For afferences of the cervical spine, projections of neuronal connections in the cochlear nucleus were found. A reflex-like impact of the cervical spine on the cochlear nucleus can be assumed. The tinnitus treatment concept of the Charité University Hospital in Berlin involves the cooperation of ENT specialists with many other disciplines in an outpatient clinic. A standardized examination protocol has been established, and physical therapy has been integrated into the interdisciplinary tinnitus treatment. For tinnitus-modulating therapy of muscular trigger points, local anesthetics as well as self-massage or treatment by a physiotherapist or osteopath are useful.

No auditory experience, no tinnitus: Lessons from subjects with congenital- and acquired single-sided deafness.

PubMed

Lee, Sang-Yeon; Nam, Dong Woo; Koo, Ja-Won; De Ridder, Dirk; Vanneste, Sven; Song, Jae-Jin

2017-10-01

Recent studies have adopted the Bayesian brain model to explain the generation of tinnitus in subjects with auditory deafferentation. That is, as the human brain works in a Bayesian manner to reduce environmental uncertainty, missing auditory information due to hearing loss may cause auditory phantom percepts, i.e., tinnitus. This type of deafferentation-induced auditory phantom percept should be preceded by auditory experience because the fill-in phenomenon, namely tinnitus, is based upon auditory prediction and the resultant prediction error. For example, a recent animal study observed the absence of tinnitus in cats with congenital single-sided deafness (SSD; Eggermont and Kral, Hear Res 2016). However, no human studies have investigated the presence and characteristics of tinnitus in subjects with congenital SSD. Thus, the present study sought to reveal differences in the generation of tinnitus between subjects with congenital SSD and those with acquired SSD to evaluate the replicability of previous animal studies. This study enrolled 20 subjects with congenital SSD and 44 subjects with acquired SSD and examined the presence and characteristics of tinnitus in the groups. None of the 20 subjects with congenital SSD perceived tinnitus on the affected side, whereas 30 of 44 subjects with acquired SSD experienced tinnitus on the affected side. Additionally, there were significant positive correlations between tinnitus characteristics and the audiometric characteristics of the SSD. In accordance with the findings of the recent animal study, tinnitus was absent in subjects with congenital SSD, but relatively frequent in subjects with acquired SSD, which suggests that the development of tinnitus should be preceded by auditory experience. In other words, subjects with profound congenital peripheral deafferentation do not develop auditory phantom percepts because no auditory predictions are available from the Bayesian brain. Copyright © 2017 Elsevier B.V. All rights

Effects of sleep bruxism related tinnitus on quality of life.

PubMed

Saltürk, Ziya; Özçelik, Erdinç; Kumral, Tolgar Lütfi; Çakır, Ozan; Kasımoğlu, Şeref; Atar, Yavuz; Yıldırım, Güven; Berkiten, Güler; Göker, Ayşe Enise; Uyar, Yavuz

2015-01-01

This study aims to analyze the subjective and objective characteristics of tinnitus in sleep bruxism patients. The study included 57 patients (12 males; 45 females; mean age 33.89±12.50 years; range 19 to 55 years) with sleep bruxism and tinnitus (sleep bruxism group) and 24 patients (6 males, 18 females; mean age 43.75±16.19 years; range 21 to 58 years) only with tinnitus (control group). Sleep bruxism was diagnosed by the diagnostic criteria of American Academy of Sleep Medicine. Patients were performed pure tone audiometry to detect hearing thresholds at standard and high frequencies. Tinnitus frequency and loudness were assessed. Subjective aspects of tinnitus were identified by tinnitus handicap inventory. The statistical analysis revealed that the sleep bruxism group had significantly lower hearing thresholds except 1000 Hz and 2000 Hz. Tinnitus frequency was between 3000 Hz and 18000 Hz in sleep bruxism group while it was between 6000 and 16000 Hz in control group with no statistically significant difference (p=0.362). Sleep bruxism group had significantly lower tinnitus loudness and tinnitus handicap inventory scores in comparison to control group (p=0.024 and p=0.000, respectively). Tinnitus caused by sleep bruxism and temporomandibular joint issues has higher frequency and lower loudness compared to patients with only tinnitus.

The Stigma of Hearing Loss

PubMed Central

Wallhagen, Margaret I.

2010-01-01

Purpose: To explore dimensions of stigma experienced by older adults with hearing loss and those with whom they frequently communicate to target interventions promoting engagement and positive aging. Design and Methods: This longitudinal qualitative study conducted interviews over 1 year with dyads where one partner had hearing loss. Participants were naive to or had not worn hearing aids in the past year. Data were analyzed using grounded theory, constant comparative methodology. Results: Perceived stigma emerged as influencing decision-making processes at multiple points along the experiential continuum of hearing loss, such as initial acceptance of hearing loss, whether to be tested, type of hearing aid selected, and when and where hearing aids were worn. Stigma was related to 3 interrelated experiences, alterations in self-perception, ageism, and vanity and was influenced by dyadic relationships and external societal forces, such as health and hearing professionals and media. Implications: Findings are discussed in relation to theoretical perspectives regarding stigma and ageism and suggest the need to destigmatize hearing loss by promoting its assessment and treatment as well as emphasizing the importance of remaining actively engaged to support positive physical and cognitive functioning. PMID:19592638

Predictive factors of occupational noise-induced hearing loss in Spanish workers: A prospective study

PubMed Central

Pelegrin, Armando Carballo; Canuet, Leonides; Rodríguez, Ángeles Arias; Morales, Maria Pilar Arévalo

2015-01-01

The purpose of our study was to identify the main factors associated with objective noise-induced hearing loss (NIHL), as indicated by abnormal audiometric testing, in Spanish workers exposed to occupational noise in the construction industry. We carried out a prospective study in Tenerife, Spain, using 150 employees exposed to occupational noise and 150 age-matched controls who were not working in noisy environments. The variables analyzed included sociodemographic data, noise-related factors, types of hearing protection, self-report hearing loss, and auditory-related symptoms (e.g., tinnitus, vertigo). Workers with pathological audiograms had significantly longer noise-exposure duration (16.2 ± 11.4 years) relative to those with normal audiograms (10.2 ± 7.0 years; t = 3.99, P < 0.001). The vast majority of those who never used hearing protection measures had audiometric abnormalities (94.1%). Additionally, workers using at least one of the protection devices (earplugs or earmuffs) had significantly more audiometric abnormalities than those using both protection measures simultaneously (Chi square = 16.07; P < 0.001). The logistic regression analysis indicates that the use of hearing protection measures [odds ratio (OR) = 12.30, confidence interval (CI) = 4.36-13.81, P < 0.001], and noise-exposure duration (OR = 1.35, CI = 1.08-1.99, P = 0.040) are significant predictors of NIHL. This regression model correctly predicted 78.2% of individuals with pathological audiograms. The combined use of hearing protection measures, in particular earplugs and earmuffs, associates with a lower rate of audiometric abnormalities in subjects with high occupational noise exposure. The use of hearing protection measures at work and noise-exposure duration are best predictive factors of NIHL. Auditory-related symptoms and self-report hearing loss do not represent good indicators of objective NIHL. Routine monitoring of noise levels and hearing status are of great importance as part

Impact of noise on hearing in the military.

PubMed

Yong, Jenica Su-Ern; Wang, De-Yun

2015-01-01

Hearing plays a vital role in the performance of a soldier and is important for speech processing. Noise-induced hearing loss is a significant impairment in the military and can affect combat performance. Military personnel are constantly exposed to high levels of noise and it is not surprising that noise induced hearing loss and tinnitus remain the second most prevalent service-connected disabilities. Much of the noise experienced by military personnel exceeds that of maximum protection achievable with double hearing protection. Unfortunately, unlike civilian personnel, military personnel have little option but to remain in noisy environments in order to complete specific tasks and missions. Use of hearing protection devices and follow-up audiological tests have become the mainstay of prevention of noise-induced hearing loss. This review focuses on sources of noise within the military, pathophysiology and management of patients with noise induced hearing loss.

Impact of Multiple Factors on the Degree of Tinnitus Distress.

PubMed

Brüggemann, Petra; Szczepek, Agnieszka J; Rose, Matthias; McKenna, Laurence; Olze, Heidi; Mazurek, Birgit

2016-01-01

The primary cause of subjective tinnitus is a dysfunction of the auditory system; however, the degree of distress tinnitus causes depends largely on the psychological status of the patient. Our goal was to attempt to associate the grade of tinnitus-related distress with the psychological distress, physical, or psychological discomfort patients experienced, as well as potentially relevant social parameters, through a simultaneous analysis of these factors. We determined the level of tinnitus-related distress in 531 tinnitus patients using the German version of the tinnitus questionnaire (TQ). In addition, we used the Perceived Stress Questionnaire (PSQ); General Depression Scale Allgemeine Depression Skala (ADS), Berlin Mood Questionnaire (BSF); somatic symptoms inventory (BI), and SF-8 health survey as well as general information collected through a medical history. The TQ score significantly correlated with a score obtained using PSQ, ADS, BSF, BI, and SF-8 alongside psychosocial factors such as age, gender, and marital status. The level of hearing loss and the auditory properties of the specific tinnitus combined with perceived stress and the degree of depressive mood and somatic discomfort of a patient were identified as medium-strong predictors of chronic tinnitus. Social factors such as gender, age, or marital status also had an impact on the degree of tinnitus distress. The results that were obtained were implemented in a specific cortical distress network model. Using a large representative sample of patients with chronic tinnitus permitted a simultaneous statistical measurement of psychometric and audiological parameters in predicting tinnitus distress. We demonstrate that single factors can be distinguished in a manner that explains their causative association and influence on the induction of tinnitus-related distress.

Impact of Multiple Factors on the Degree of Tinnitus Distress

PubMed Central

Brüggemann, Petra; Szczepek, Agnieszka J.; Rose, Matthias; McKenna, Laurence; Olze, Heidi; Mazurek, Birgit

2016-01-01

Objective: The primary cause of subjective tinnitus is a dysfunction of the auditory system; however, the degree of distress tinnitus causes depends largely on the psychological status of the patient. Our goal was to attempt to associate the grade of tinnitus-related distress with the psychological distress, physical, or psychological discomfort patients experienced, as well as potentially relevant social parameters, through a simultaneous analysis of these factors. Methods: We determined the level of tinnitus-related distress in 531 tinnitus patients using the German version of the tinnitus questionnaire (TQ). In addition, we used the Perceived Stress Questionnaire (PSQ); General Depression Scale Allgemeine Depression Skala (ADS), Berlin Mood Questionnaire (BSF); somatic symptoms inventory (BI), and SF-8 health survey as well as general information collected through a medical history. Results: The TQ score significantly correlated with a score obtained using PSQ, ADS, BSF, BI, and SF-8 alongside psychosocial factors such as age, gender, and marital status. The level of hearing loss and the auditory properties of the specific tinnitus combined with perceived stress and the degree of depressive mood and somatic discomfort of a patient were identified as medium-strong predictors of chronic tinnitus. Social factors such as gender, age, or marital status also had an impact on the degree of tinnitus distress. The results that were obtained were implemented in a specific cortical distress network model. Conclusions: Using a large representative sample of patients with chronic tinnitus permitted a simultaneous statistical measurement of psychometric and audiological parameters in predicting tinnitus distress. We demonstrate that single factors can be distinguished in a manner that explains their causative association and influence on the induction of tinnitus-related distress. PMID:27445776

Iloprost-induced sudden hearing loss.

PubMed

Dursun, E; Dogru, S; Cincik, H; Cekin, E; Gungor, A; Poyrazoglu, E

2007-06-01

We report a patient who developed sudden, bilateral, sensorineural hearing loss during therapeutic use of iloprost for Raynaud's phenomenon. The sudden hearing loss was attributed to iloprost use and completely reversed in eight days with conservative therapy. Iloprost may be a potentially ototoxic drug, causing sudden hearing loss.

Asymmetric hearing loss in a random population of patients with mild to moderate sensorineural hearing loss.

PubMed

Segal, Nili; Shkolnik, Mark; Kochba, Anat; Segal, Avichai; Kraus, Mordechai

2007-01-01

We evaluated the correlation of asymmetric hearing loss, in a random population of patients with mild to moderate sensorineural hearing loss, to several clinical factors such as age, sex, handedness, and noise exposure. We randomly selected, from 8 hearing institutes in Israel, 429 patients with sensorineural hearing loss of at least 30 dB at one frequency and a speech reception threshold not exceeding 30 dB. Patients with middle ear disease or retrocochlear disorders were excluded. The results of audiometric examinations were compared binaurally and in relation to the selected factors. The left ear's hearing threshold level was significantly higher than that of the right ear at all frequencies except 1.0 kHz (p < .05). One hundred fifty patients (35%) had asymmetric hearing loss (more than 10 dB difference between ears). In most of the patients (85%) the binaural difference in hearing threshold level, at any frequency, was less than 20 dB. Age, handedness, and sex were not found to be correlated to asymmetric hearing loss. Noise exposure was found to be correlated to asymmetric hearing loss.

Deafness Simulation: A Model for Enhancing Awareness and Sensitivity among Hearing Educators.

ERIC Educational Resources Information Center

Sevigny-Skyer, Solange C.; Dagel, Delbert D.

1990-01-01

The National Technical Institute for the Deaf developed and implemented a school-based deafness simulation project for hearing faculty members called "Keeping in Touch." Faculty members wore tinnitus maskers which produced a moderate-to-severe hearing loss and subsequently discussed their experiences, feelings, and communication…

Learning for Everyday Life: Pupils' Conceptions of Hearing and Knowledge about Tinnitus from a Teaching-Learning Sequence

ERIC Educational Resources Information Center

West, Eva

2011-01-01

As a result of young people frequently exposing themselves to loud sounds, researchers are advocating education about the risks of contracting tinnitus. However, how pupils conceive of and learn about the biological aspects of hearing has not been extensively investigated. Consequently, the aim of the present study is to explore pupils' learning…

Results of an Interdisciplinary Day Care Approach for Chronic Tinnitus Treatment: A Prospective Study Introducing the Jena Interdisciplinary Treatment for Tinnitus

PubMed Central

Ivansic, Daniela; Dobel, Christian; Volk, Gerd F.; Reinhardt, Daniel; Müller, Boris; Smolenski, Ulrich C.; Guntinas-Lichius, Orlando

2017-01-01

Objective: Considering the heterogeneity of the symptoms shown by patients suffering from chronic tinnitus, there are surprisingly few interdisciplinary treatments available, and mostly available only for inpatients. In order to provide an interdisciplinary treatment, we developed a day care concept in which each patient was treated by an ENT doctor, a cognitive behavioral therapist, a specialist for medical rehabilitation and an audiologist (Jena Interdisciplinary Treatment for Tinnitus, JITT). The aim of this study was to observe the changes of tinnitus related distress due to interdisciplinary day care treatment and to determine which factors mediate this change. Subjects and Methods: Tinnitus annoyance was measured using the Tinnitus Questionnaire on 308 patients with chronic tinnitus. They were treated in the day care unit over five consecutive days between July 2013 and December 2014. Data were collected before treatment when screened (T0), at the beginning (T1) and at the end of the 5 day treatment (T2), as well as 20 days (T3) and 6 months after treatment (T4). Results: Overall, tinnitus annoyance improved significantly from the screening day to the beginning of treatment, and to a much larger degree from the beginning to the end of treatment. The treatment outcome remained stable 6 months after treatment. Patients with the following symptoms displayed higher tinnitus annoyance at T0: dizziness at tinnitus onset, tinnitus sound could not be masked with background noise, tinnitus worsening during physical stress, comorbid psychiatric diagnosis, higher age and higher hearing loss. Loudness of tinnitus perceived in the right ear correlated with tinnitus annoyance significantly. Demographic, tinnitus and strain variables could only explain 12.8% of the variance of the change in tinnitus annoyance from T0 to T4. Out of 39 predictors, the only significant ones were “sick leave 6 months before treatment” and “tinnitus annoyance at T0.” Conclusion: The

[An assessment of tinnitus retraining therapy].

PubMed

von Wedel, H; von Wedel, U C

2000-12-01

Based on the neurophysiological model of tinnitus developed by Jastreboff and Hazell [39] there have been some important developments in understanding and therapy of tinnitus over the last decade. The clinical applications of this model are known as "tinnitus retraining therapy", which has the objective of reducing both the distress associated with tinnitus and the tinnitus perception itself. As a form of systematic, repeated and skilled counselling over a long period of up to 2 years supported by sound therapy (hearing aid or noise generator) the evidence for their high degree of effectiveness is overwhelming. On the basis of a "German concept" of tinnitus retraining therapy developed and proposed by the ADANO (Arbeitsgemeinschaft deutschsprachiger Audiologen und Neurootologen) the current status of this treatment will be briefly reviewed including some actual studies of Goebel et al. [14] that confirm the world wide critical comments on the recent developments in the management of tinnitus especially with regard to tinnitus retraining therapy [79].

The Correlation of the Tinnitus Handicap Inventory with Depression and Anxiety in Veterans with Tinnitus

PubMed Central

Hu, Jinwei; Xu, Jane; Streelman, Matthew; Xu, Helen; Guthrie, O'neil

2015-01-01

Objective. The mechanisms of tinnitus are known to alter neuronal circuits in the brainstem and cortex, which are common to several comorbid conditions. This study examines the relationship between tinnitus and anxiety/depression. Subjects and Methods. Ninety-one male veterans with subjective tinnitus were enrolled in a Veterans Affairs Tinnitus Clinic. The Tinnitus Handicap Inventory (THI) was used to assess tinnitus severity. ICD-9 codes for anxiety/depression were used to determine their prevalence. Pure tone averages (PTA) were used to assess hearing status. Results. Descriptive analyses revealed that 79.1% of the 91 tinnitus sufferers had a diagnosis of anxiety, 59.3% had depression, and 58.2% suffered from both anxiety/depression. Patients with anxiety had elevated total THI scores as compared to patients without anxiety (p < 0.05). Patients with anxiety or depression had significantly increased Functional and Emotional THI scores, but not Catastrophic THI score. Significant positive correlations were illustrated between the degree of tinnitus and anxiety/depression (p < 0.05). There were no differences in PTA among groups. Conclusions. A majority of patients with tinnitus exhibited anxiety and depression. These patients suffered more severe tinnitus than did patients without anxiety and depression. The data support the need for multidisciplinary intervention of veterans with tinnitus. PMID:26697070

Temporomandibular Joint Disorder Complaints in Tinnitus: Further Hints for a Putative Tinnitus Subtype

PubMed Central

Vielsmeier, Veronika; Strutz, Jürgen; Kleinjung, Tobias; Schecklmann, Martin; Kreuzer, Peter Michael; Landgrebe, Michael; Langguth, Berthold

2012-01-01

Objective Tinnitus is considered to be highly heterogeneous with respect to its etiology, its comorbidities and the response to specific interventions. Subtyping is recommended, but it remains to be determined which criteria are useful, since it has not yet been clearly demonstrated whether and to which extent etiologic factors, comorbid states and interventional response are related to each other and are thus applicable for subtyping tinnitus. Analyzing the Tinnitus Research Initiative Database we differentiated patients according to presence or absence of comorbid temporomandibular joint (TMJ) disorder complaints and compared the two groups with respect to etiologic factors. Methods 1204 Tinnitus patients from the Tinnitus Research Initiative (TRI) Database with and without subjective TMJ complaints were compared with respect to demographic, tinnitus and audiological characteristics, questionnaires, and numeric ratings. Data were analysed according to a predefined statistical analysis plan. Results Tinnitus patients with TMJ complaints (22% of the whole group) were significantly younger, had a lower age at tinnitus onset, and were more frequently female. They could modulate or mask their tinnitus more frequently by somatic maneuvers and by music or sound stimulation. Groups did not significantly differ for tinnitus duration, type of onset (gradual/abrupt), onset related events (whiplash etc.), character (pulsatile or not), hyperacusis, hearing impairment, tinnitus distress, depression, quality of life and subjective ratings (loudness etc.). Conclusion Replicating previous work in tinnitus patients with TMJ complaints, classical risk factors for tinnitus like older age and male gender are less relevant in tinnitus patients with TMJ complaints. By demonstrating group differences for modulation of tinnitus by movements and sounds our data further support the notion that tinnitus with TMJ complaints represents a subgroup of tinnitus with clinical features that are

Sensorineural hearing loss in hemorrhagic dengue?

PubMed

Ribeiro, Bruna Natália Freire; Guimarães, Alexandre Caixeta; Yazawa, Felipe; Takara, Tammy Fumiko Messias; de Carvalho, Guilherme Machado; Zappelini, Carlos Eduardo Monteiro

2015-01-01

Dengue is an acute febrile infectious disease, with high fever followed by symptoms flu-like. Dengue hemorrhagic fever (DHF) is a vascular leak syndrome and could present spontaneous bleeding and worsening of symptoms after some days. Dengue could have some ENT manifestations, however hearing loss is not one of them. Sudden hearing loss is considered as sensorineural or perceptual hearing loss with a sudden onset in a person without other prior otological history. The relation between infectious diseases and sudden hearing are been investigated, some viruses were already linked, but the relation between dengue virus and sudden hearing still remains unknown. This article has the goal of presenting a case of DHF that evolved with SSHL in his hospitalization process. We report a 60 years-male patient of with DHF who developed bilateral secretory otitis media and sensorineural hearing loss after the fifth day of onset of symptoms. His hearing loss remained even after 7 months and the patient was referred for hearing aid fitting. This is the first case report that brings together DHF and sudden hearing loss. In the development of this case no other cause to sudden hearing loss was found and the correlation between dengue and hearing loss was questioned. In the literature review was found that some viruses, as mumps virus, varicella-zoster virus and HSV-1 and HSV-2 are related to sudden hearing loss, all of them fit in the viral theory. Besides the viral theory of sudden hearing loss, there is the vascular theory that is the occlusion of the end artery that supplies the cochlea. DHF has a vascular commitment, and the hypothesis of a vascular cause could be elicited in this case. Many studies in this area are needed and this article has the objective of elicit the discussion about the subject. Could dengue be associated with sensorineural hearing loss? Copyright © 2015. Published by Elsevier Ltd.

Epidemiology and risk factors for tinnitus after leisure noise exposure in Flemish young adults.

PubMed

Degeest, Sofie; Keppler, Hannah; Corthals, Paul; Clays, Els

2017-02-01

Young people regularly expose themselves to leisure noise and are at risk of acquiring tinnitus. This study examined the prevalence of leisure noise-induced tinnitus among Flemish young adults as well as the relation with sociodemographic factors, health-related variables and attitudes and beliefs towards noise. A self-administered questionnaire was used to evaluate the presence of noise-induced tinnitus, the amount of leisure noise and attitudes towards noise and hearing protection. 517 subjects between 18 and 30 years were included. Temporary and chronic tinnitus occurred in 68.5% and 6.4% of the sample, respectively. Chronic tinnitus was more prevalent in male subjects and associated with more hearing-related symptoms. Furthermore, subjects with chronic tinnitus were more aware of the risks of noise and the importance of hearing protection. Finally, higher levels of leisure noise were independently associated with chronic tinnitus. Tinnitus is observed frequently in young adults. Results also indicate that persons with chronic tinnitus were exposed to a higher noise dose during their lives. Longitudinal studies may be useful to evaluate whether the experience of chronic tinnitus has led to behavioural changes. These findings further underpin the importance of educating youth about the risks of leisure noise exposure.

The Physiological Bases of Hidden Noise-Induced Hearing Loss: Protocol for a Functional Neuroimaging Study

PubMed Central

Hall, Deborah A; Guest, Hannah; Prendergast, Garreth; Plack, Christopher J; Francis, Susan T

2018-01-01

Background Rodent studies indicate that noise exposure can cause permanent damage to synapses between inner hair cells and high-threshold auditory nerve fibers, without permanently altering threshold sensitivity. These demonstrations of what is commonly known as hidden hearing loss have been confirmed in several rodent species, but the implications for human hearing are unclear. Objective Our Medical Research Council–funded program aims to address this unanswered question, by investigating functional consequences of the damage to the human peripheral and central auditory nervous system that results from cumulative lifetime noise exposure. Behavioral and neuroimaging techniques are being used in a series of parallel studies aimed at detecting hidden hearing loss in humans. The planned neuroimaging study aims to (1) identify central auditory biomarkers associated with hidden hearing loss; (2) investigate whether there are any additive contributions from tinnitus or diminished sound tolerance, which are often comorbid with hearing problems; and (3) explore the relation between subcortical functional magnetic resonance imaging (fMRI) measures and the auditory brainstem response (ABR). Methods Individuals aged 25 to 40 years with pure tone hearing thresholds ≤20 dB hearing level over the range 500 Hz to 8 kHz and no contraindications for MRI or signs of ear disease will be recruited into the study. Lifetime noise exposure will be estimated using an in-depth structured interview. Auditory responses throughout the central auditory system will be recorded using ABR and fMRI. Analyses will focus predominantly on correlations between lifetime noise exposure and auditory response characteristics. Results This paper reports the study protocol. The funding was awarded in July 2013. Enrollment for the study described in this protocol commenced in February 2017 and was completed in December 2017. Results are expected in 2018. Conclusions This challenging and comprehensive

Noise-induced tinnitus: auditory evoked potential in symptomatic and asymptomatic patients.

PubMed

Santos-Filha, Valdete Alves Valentins dos; Samelli, Alessandra Giannella; Matas, Carla Gentile

2014-07-01

We evaluated the central auditory pathways in workers with noise-induced tinnitus with normal hearing thresholds, compared the auditory brainstem response results in groups with and without tinnitus and correlated the tinnitus location to the auditory brainstem response findings in individuals with a history of occupational noise exposure. Sixty individuals participated in the study and the following procedures were performed: anamnesis, immittance measures, pure-tone air conduction thresholds at all frequencies between 0.25-8 kHz and auditory brainstem response. The mean auditory brainstem response latencies were lower in the Control group than in the Tinnitus group, but no significant differences between the groups were observed. Qualitative analysis showed more alterations in the lower brainstem in the Tinnitus group. The strongest relationship between tinnitus location and auditory brainstem response alterations was detected in individuals with bilateral tinnitus and bilateral auditory brainstem response alterations compared with patients with unilateral alterations. Our findings suggest the occurrence of a possible dysfunction in the central auditory nervous system (brainstem) in individuals with noise-induced tinnitus and a normal hearing threshold.

Catamnesis results of an inpatient neuro-otologic and psychosomatic tinnitus therapy 1-5 years after discharge.

PubMed

Schaaf, H; Weiß, S; Hesse, G

2017-02-01

Treating tinnitus with the resources offered in hospitals can become necessary for patients suffering from complex tinnitus if a high symptom severity, usually accompanied by a corresponding psychosomatic comorbidity, is present. For such costly therapies, for example, the neuro-otologic psychosomatic tinnitus therapy (NPT) examined here, the long-term effect is particularly important; however, reliable catamnesis studies for inpatient treatments are not yet available. Data from 169 (from a total of 327 contacted) inpatients suffering from complex tinnitus were analysed here. To assess the tinnitus stress, the Mini-Tinnitus Questionnaire (Mini-TF12-In German language) according to Hiller and Goebel [1], and for the assessment of the anxiety and depression element, the German version of the Hospitality Anxiety and Depression Score (HADS) [2] were analysed at the start of the therapy, at the end of the therapy and at the earliest 1 year (up to 5 years) after discharge from inpatient treatment. The data were correlated with the current hearing status. In addition, the subjectively perceived effect factors of the therapy as well as the therapies continued outside of hospital were queried. On average, the therapy lasted 39.3 days (SD 13.6) = 5.6 weeks, and the mean of the follow-up time was 38.5 months (12-70 months) (SD 18). The therapy focused on daily neuro-otologic counselling, the improvement of the concrete hearing ability, an audio-therapy as well as frequent individual and group psychotherapy based on neuro-otology. 53.8 % of patients experienced relevant hearing loss (according to WHO criteria) which needed to be treated in addition to tinnitus. Both at the end of the therapy and the follow-up consultation, a significant improvement of the tinnitus stress and a continuing significant improvement of the depression and anxiety element could be achieved in the HADS with high effect levels ranging from 1 to 2.5. Patients who did not improve (n = 7) or