1
|
Tekumalla S, Perlov NM, Gokhale S, Awosanya S, Urdang ZD, Croce J, Bixler A, Willcox TO, Chiffer RC, Fitzgerald D. Evaluation of Subjective Tinnitus Severity and Distortion Product Otoacoustic Emissions and Extended High-Frequency Audiometry. Otolaryngol Head Neck Surg 2024. [PMID: 38639322 DOI: 10.1002/ohn.777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 01/25/2024] [Accepted: 02/24/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE Tinnitus is a multifactorial phenomenon with quality-of-life detriments for those affected by it. We aim to establish a relationship between subjective tinnitus severity with objective audiometric data in the extended high frequency (EHF) from 9 to 16 khz and with distortion product otoacoustic emissions (DPOAE). We hypothesize that severe subjective tinnitus as measured by the Tinnitus Handicap Inventory (THI) does not correlate with increased hearing thresholds in the EHF range. STUDY DESIGN Prospective. SETTING Single Tertiary Care Center. METHODS Patients identified with tinnitus and normal hearing thresholds within standard frequency range (250-8000 Hz) were consented for participation. Those with underlying otologic disease, trauma, radiotherapy, or ototoxic drug use were excluded. The THI questionnaire was given to eligible patients and audiometric test results were collected. THI scores were categorized by severity groups. An n = 20 to 30 was determined to have an effect size of 0.7 with a significance level of P = .05. RESULTS THI and audiometric data were collected for 38 patients and categorized into mild (n = 18, 47.4%), moderate (n = 8, 21.1%), slight (n = 7, 18.4%), and severe (n = 5, 13.2%) tinnitus severity groups. Mean THI score was 32.3 ± 19.6 with a statistically significant difference in scores by assigned THI severity group (P < .01). There were no significant differences or linear relationship among hearing thresholds in EHF range or DPOAE stratified by subjective tinnitus group (P = .49, r2 = 0.10) CONCLUSION: Subjective tinnitus severity is not predictive of audiometric outcomes. This finding can be used as a counseling tool to help tinnitus patients manage symptoms, expectations, and overall treatment outcomes.
Collapse
Affiliation(s)
- Sruti Tekumalla
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Natalie M Perlov
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Saket Gokhale
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Samiat Awosanya
- Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Zachary D Urdang
- Thomas Jefferson Hospital Department of Otolaryngology-Head and Neck Surgery, Philadelphia, Pennsylvania, USA
| | - Julia Croce
- Thomas Jefferson Hospital Department of Otolaryngology-Head and Neck Surgery, Philadelphia, Pennsylvania, USA
| | - Anna Bixler
- Thomas Jefferson Hospital Department of Otolaryngology-Head and Neck Surgery, Philadelphia, Pennsylvania, USA
| | - Thomas O Willcox
- Thomas Jefferson Hospital Department of Otolaryngology-Head and Neck Surgery, Philadelphia, Pennsylvania, USA
| | - Rebecca C Chiffer
- Thomas Jefferson Hospital Department of Otolaryngology-Head and Neck Surgery, Philadelphia, Pennsylvania, USA
| | - Dennis Fitzgerald
- Thomas Jefferson Hospital Department of Otolaryngology-Head and Neck Surgery, Philadelphia, Pennsylvania, USA
| |
Collapse
|
2
|
Ma X, Shen W, Yang S, Wang F. The significance of extended high-frequency audiometry in tinnitus patients with normal hearing as evaluated via conventional pure tone audiometry. J Laryngol Otol 2024; 138:381-387. [PMID: 38148683 DOI: 10.1017/s0022215123000920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
OBJECTIVE This study was designed to determine whether extended high-frequency audiometry was capable of better differentiating between participants with normal hearing who did or did not have subjective tinnitus. METHODS A total of 96 study participants were enrolled: 36 patients with unilateral tinnitus, 28 patients with bilateral tinnitus and 32 volunteers as controls. All 96 participants exhibited normal audiometry findings and hearing thresholds. Extended high-frequency audiometry was used to evaluate these patients. RESULTS There were differences between the extended high-frequency hearing thresholds of affected and unaffected ears in those with unilateral tinnitus, and in the 20-29-year-old bilateral tinnitus group, at 11.2, 12.5 and 14 kHz. Unilateral tinnitus subgroups had higher extended high-frequency hearing thresholds than those in control subjects, at all extended high frequencies. CONCLUSION Extended high-frequency audiometry can offer additional information regarding the hearing status of patients with tinnitus who exhibit normal pure tone thresholds when analysed via conventional hearing thresholds.
Collapse
Affiliation(s)
- Xiaoyan Ma
- First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Senior Department of Otolaryngology - Head and Neck Surgery, Sixth Medical Center of People's Liberation Army General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Weidong Shen
- Senior Department of Otolaryngology - Head and Neck Surgery, Sixth Medical Center of People's Liberation Army General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing, China
| | - Shiming Yang
- Senior Department of Otolaryngology - Head and Neck Surgery, Sixth Medical Center of People's Liberation Army General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing, China
| | - Fangyuan Wang
- Senior Department of Otolaryngology - Head and Neck Surgery, Sixth Medical Center of People's Liberation Army General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing, China
| |
Collapse
|
3
|
Wójcik J, Kochański B, Cieśla K, Lewandowska M, Karpiesz L, Niedziałek I, Raj-Koziak D, Skarżyński PH, Wolak T. An MR spectroscopy study of temporal areas excluding primary auditory cortex and frontal regions in subjective bilateral and unilateral tinnitus. Sci Rep 2023; 13:18417. [PMID: 37891242 PMCID: PMC10611771 DOI: 10.1038/s41598-023-45024-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 10/14/2023] [Indexed: 10/29/2023] Open
Abstract
Previous studies indicate changes in neurotransmission along the auditory pathway in subjective tinnitus. Most authors, however, investigated brain regions including the primary auditory cortex, whose physiology can be affected by concurrent hearing deficits. In the present MR spectroscopy study we assumed increased levels of glutamate and glutamine (Glx), and other Central Nervous System metabolites in the temporal lobe outside the primary auditory cortex, in a region involved in conscious auditory perception and memory. We studied 52 participants with unilateral (n = 24) and bilateral (n = 28) tinnitus, and a control group without tinnitus (n = 25), all with no severe hearing losses and a similar hearing profile. None of the metabolite levels in the temporal regions of interest were found related to tinnitus status or laterality. Unexpectedly, we found a tendency of increased concentration of Glx in the control left medial frontal region in bilateral vs unilateral tinnitus. Slightly elevated depressive and anxiety symptoms were also shown in participants with tinnitus, as compared to healthy individuals, with the bilateral tinnitus group marginally more affected. We discuss no apparent effect in the temporal lobes, as well as the role of frontal brain areas, with respect to hearing loss, attention and psychological well-being in chronic tinnitus. We furthermore elaborate on the design-related and technical obstacles of MR spectroscopy.
Collapse
Affiliation(s)
- Joanna Wójcik
- Bioimaging Research Center, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mokra 17 Street, Kajetany, 05-830, Nadarzyn, Poland
| | - Bartosz Kochański
- Bioimaging Research Center, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mokra 17 Street, Kajetany, 05-830, Nadarzyn, Poland
| | - Katarzyna Cieśla
- Bioimaging Research Center, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mokra 17 Street, Kajetany, 05-830, Nadarzyn, Poland.
| | - Monika Lewandowska
- Faculty of Philosophy and Social Sciences, Institute of Psychology, Nicolaus Copernicus University, Fosa Staromiejska 1a Street, 87-100, Toruń, Poland
| | - Lucyna Karpiesz
- Tinnitus Department, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mokra 17 Street, Kajetany, 05-830, Nadarzyn, Poland
| | - Iwona Niedziałek
- Tinnitus Department, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mokra 17 Street, Kajetany, 05-830, Nadarzyn, Poland
| | - Danuta Raj-Koziak
- Tinnitus Department, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mokra 17 Street, Kajetany, 05-830, Nadarzyn, Poland
| | - Piotr Henryk Skarżyński
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mokra 17 Street, Kajetany, 05-830, Nadarzyn, Poland
- Institute of Sensory Organs, Mokra 1 Street, Kajetany, 05-830, Nadarzyn, Poland
- Heart Failure and Cardiac Rehabilitation Department, Faculty of Medicine, Medical University of Warsaw, Kondratowicza 8 Street, 03-242, Warsaw, Poland
| | - Tomasz Wolak
- Bioimaging Research Center, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mokra 17 Street, Kajetany, 05-830, Nadarzyn, Poland
| |
Collapse
|
4
|
Remenschneider AK, Cheng JT, Herrmann BS, Rosowski JJ. Characterization and Clinical Use of Bone Conduction Transducers at Extended High Frequencies. Hear Res 2023; 429:108688. [PMID: 36628803 PMCID: PMC9953386 DOI: 10.1016/j.heares.2022.108688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 01/01/2023]
Abstract
Measurement of bone conduction (BC) hearing thresholds at extended high frequencies (EHF; above 8 kHz) is of clinical interest but is technically complicated by limitations in standard BC transducer output, a lack of calibration standards and sparse clinical data from human subjects. A recently described calibration scheme using an artificial mastoid and interposed accelerometer is applied in this study to characterize and compare acceleration and computed force outputs over the 4-20 kHz range of two standard BC transducers: the RadioEar® B71 and B81, as well as two non-standard, commercially available BC transducers: the Tascam® HP-F200 and the Aftershokz® AS400. Measures of linear output growth, harmonic distortion and acoustic radiation are assessed and compared across devices. A maximum linear input voltage is established for each BC transducer using measurements of linear output growth and total harmonic distortion. At maximum linear input level, the Tascam shows superior force output by 25 to 40 dB above 8 kHz and the widest dynamic EHF range. Acoustic radiation per output force was lowest for the Tascam, whereas the AS400 behaved more like an air conduction earphone than a force generator. In a cohort of 15 normal hearing volunteers, BC thresholds, measured with the Tascam and reported in dB re 1 rms μN, were consistent with historical measures of EHF BC thresholds in similar subjects using an alternative BC transducer.
Collapse
Affiliation(s)
- Aaron K Remenschneider
- Department of Otolaryngology, Head and Neck Surgery, Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA; Department of Otolaryngology, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, MA 01655, USA.
| | - Jeffrey Tao Cheng
- Department of Otolaryngology, Head and Neck Surgery, Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - Barbara S Herrmann
- Department of Otolaryngology, Head and Neck Surgery, Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - John J Rosowski
- Department of Otolaryngology, Head and Neck Surgery, Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| |
Collapse
|
5
|
A Systematic Review and Meta-Analysis of Extended High-Frequency Hearing Thresholds in Tinnitus With a Normal Audiogram. Ear Hear 2022; 43:1643-1652. [PMID: 35612517 DOI: 10.1097/aud.0000000000001229] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Current evidence supports the growing application of extended high-frequency (EHF: 9 to 20 kHz) audiometry in hearing research, which likely results from the high vulnerability of this frequency region to damage induced by known auditory risk factors. The present systematic review and meta-analysis were performed to investigate whether adults with a normal audiogram and tinnitus show increased EHF hearing thresholds relative to control peers. DESIGN A comprehensive search was undertaken on electronic databases consisting of PubMed, ScienceDirect, Wiley, and Google Scholar using combined keywords: "tinnitus," "extended high frequency," "normal audiogram," and "hidden hearing loss." RESULTS From 261 articles found by searching databases, nine studies met the inclusion criteria for the meta-analysis. A significant difference was observed between tinnitus and control groups in the effect size analysis of hearing thresholds at 10, 12.5, 14, 16, and 18 kHz ( p ≤ 0.001), and the I-square heterogeneity analysis was below 50% in all studies ( p ≥ 0.131). Visual inspection by the Funnel plot and Egger's regression test ( p ≥ 0.211) also exhibited no publication bias in the meta-analyses. CONCLUSIONS Our findings are in support of the idea that in most cases, tinnitus is associated with some degree of cochlear mechanical dysfunction, which may not be detected by conventional audiometry alone. This finding underscores the significance of EHF audiometry in clinical practice, which may help both early identification of individuals susceptible to developing tinnitus and reduce the number of new cases through preventive counseling programs.
Collapse
|
6
|
Ding Z, Zhang C, Wang F, Chen J, Liu P, Xue X, Zhou H, Shen W, Han D. Extended high-frequency audiometric analyses of tinnitus patients exhibiting normal hearing on conventional pure-tone audiometry. Acta Otolaryngol 2022; 142:579-584. [PMID: 36040853 DOI: 10.1080/00016489.2022.2112972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND While hearing loss is the greatest risk factor associated with developing tinnitus, some tinnitus patients exhibit no hearing loss on conventional pure-tone audiometry (PTA). OBJECTIVES This study was developed to assess whether tinnitus patients with normal hearing as measured via conventional PTA would exhibit differences from normal controls upon extended high-frequency (EHF) audiometric evaluation. METHODS In total, 102 tinnitus patients were separated into unilateral and bilateral tinnitus groups. Age- and sex-matched controls without tinnitus were enrolled. RESULTS No significant differences were observed when comparing EHF audiometry results in the 9-14 kHz range between controls and tinnitus patients, with only left-sided tinnitus ears exhibiting higher hearing thresholds than contralateral ears at 9, 10, and 14 kHz. Relative to normal controls, the hearing thresholds in the 2-8 kHz range for tinnitus ears were significantly increased. CONCLUSIONS AND SIGNIFICANCE Relative to controls, tinnitus patients with normal hearing did not exhibit any significant hearing loss in the EHF range. Unexpectedly, tinnitus patients with normal hearing exhibited significant hidden hearing loss in the conventional frequency range rather than in the EHF range. For patients with normal hearing, it appears to be unnecessary to conduct EHF examinations to detect hearing loss in the EHF range.
Collapse
Affiliation(s)
- Zhiwei Ding
- Medical School of Chinese PLA, Beijing, China.,The First Medical Center, Chinese PLA General Hospital, Beijing, China.,College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.,Ministry of Education, State Key Lab of Hearing Science, Beijing, China.,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Chi Zhang
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.,Ministry of Education, State Key Lab of Hearing Science, Beijing, China.,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China.,The Zhantansi outpatient department of Central Medical Branch of PLA General Hospital, Beijing, China
| | - Fangyuan Wang
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.,Ministry of Education, State Key Lab of Hearing Science, Beijing, China.,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Jiyue Chen
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.,Ministry of Education, State Key Lab of Hearing Science, Beijing, China.,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Peng Liu
- Medical School of Chinese PLA, Beijing, China.,The First Medical Center, Chinese PLA General Hospital, Beijing, China.,College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.,Ministry of Education, State Key Lab of Hearing Science, Beijing, China.,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Xinmiao Xue
- Medical School of Chinese PLA, Beijing, China.,The First Medical Center, Chinese PLA General Hospital, Beijing, China.,College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.,Ministry of Education, State Key Lab of Hearing Science, Beijing, China.,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Hanwen Zhou
- Medical School of Chinese PLA, Beijing, China.,The First Medical Center, Chinese PLA General Hospital, Beijing, China.,College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.,Ministry of Education, State Key Lab of Hearing Science, Beijing, China.,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Weidong Shen
- The First Medical Center, Chinese PLA General Hospital, Beijing, China.,College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.,Ministry of Education, State Key Lab of Hearing Science, Beijing, China.,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Dongyi Han
- The First Medical Center, Chinese PLA General Hospital, Beijing, China.,College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China.,Ministry of Education, State Key Lab of Hearing Science, Beijing, China.,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| |
Collapse
|
7
|
Haider HF, Ribeiro D, Ribeiro SF, Trigueiros N, Caria H, Borrego L, Pinto I, Papoila AL, Hoare DJ, Paço J. Audiological biomarkers of tinnitus in an older Portuguese population. Front Aging Neurosci 2022; 14:933117. [PMID: 36092804 PMCID: PMC9449802 DOI: 10.3389/fnagi.2022.933117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
Tinnitus is a phantom sound perceived in the absence of external acoustic stimulation. It is described in a variety of ways (e.g., buzzing, ringing, and roaring) and can be a single sound or a combination of different sounds. Our study evaluated associations between audiological parameters and the presence or severity of tinnitus, to improve tinnitus diagnosis, treatment, and prognosis. Our sample included 122 older participants (63 women and 59 men), aged 55–75 years from the Portuguese population, with or without sensory presbycusis and with or without tinnitus. All participants underwent a clinical evaluation through a structured interview, Ear, Nose, and Throat observation, and audiological evaluation (standard and extended audiometry, psychoacoustic tinnitus evaluation, auditory brainstem responses, and distortion product otoacoustic emissions). The Tinnitus Handicap Inventory was used to measure tinnitus symptom severity. Our data confirmed that the odds of developing tinnitus were significantly higher in the presence of noise exposure and hearing loss. Also, participants who had abrupt tinnitus onset and moderate or severe hyperacusis featured higher odds of at least moderate tinnitus. However, it was in the ABR that we obtained the most exciting and promising results, namely, in wave I, which was the common denominator in all findings. The increase in wave I amplitude is a protective factor to the odds of having tinnitus. Concerning the severity of tinnitus, the logistic regression model showed that for each unit of increase in the mean ratio V/I of ABR, the likelihood of having at least moderate tinnitus was 10% higher. Advancing knowledge concerning potential tinnitus audiological biomarkers can be crucial for the adequate diagnosis and treatment of tinnitus.
Collapse
Affiliation(s)
- Haúla F. Haider
- ENT Department, CUF Tejo Hospital – NOVA Medical School, Faculty of Medical Sciences, NOVA University Lisbon, Lisbon, Portugal
- Comprehensive Health Research Centre, NOVA Medical School, Faculty of Medical Sciences, Lisbon, Portugal
| | - Diogo Ribeiro
- Comprehensive Health Research Centre, NOVA Medical School, Faculty of Medical Sciences, Lisbon, Portugal
- NOVA Medical School, Faculty of Medical Sciences, NOVA University Lisbon, Lisbon, Portugal
- *Correspondence: Diogo Ribeiro,
| | - Sara F. Ribeiro
- ENT Department, CUF Tejo Hospital – NOVA Medical School, Faculty of Medical Sciences, NOVA University Lisbon, Lisbon, Portugal
| | - Nuno Trigueiros
- ENT Department, Hospital Pedro Híspano, Matosinhos, Portugal
| | - Helena Caria
- BTR Unit, Deafness Research Group, BioISI, Faculty of Sciences, University of Lisbon (FCUL), Lisbon, Portugal
- ESS/IPS – Biomedical Sciences Department, School of Health, Polytechnic Institute of Setubal, Setúbal, Portugal
| | - Luís Borrego
- NOVA Medical School, Faculty of Medical Sciences, NOVA University Lisbon, Lisbon, Portugal
- Department of Immunoallergy, CUF Descobertas Hospital, Lisbon, Portugal
| | - Iola Pinto
- Instituto Superior de Engenharia de Lisboa, Lisbon, Portugal
- Centro de Matemática e Aplicações, NOVA School of Science and Technology, FCT NOVA, Costa da Caparica, Portugal
| | - Ana L. Papoila
- NOVA Medical School, Faculty of Medical Sciences, NOVA University Lisbon, Lisbon, Portugal
| | - Derek J. Hoare
- School of Medicine, NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Mental Health and Clinical Neurosciences, University of Nottingham, Nottingham, United Kingdom
| | - João Paço
- ENT Department, CUF Tejo Hospital – NOVA Medical School, Faculty of Medical Sciences, NOVA University Lisbon, Lisbon, Portugal
| |
Collapse
|
8
|
Tinnitus: impact on patients in relation to audiological findings. The Journal of Laryngology & Otology 2022; 136:760-764. [DOI: 10.1017/s002221512100459x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTinnitus is a common auditory disorder in which patients experience noise in the absence of an external source. It is a consequence of irreversible cochlear damage. This study examined the distortion product otoacoustic emissions and P300 components of event-related potentials.MethodThis study included a control group of 25 normal-hearing adults not complaining of tinnitus and a study group that consisted of 45 normal-hearing adults complaining of tinnitus. Measures included patient history, basic audiological evaluation, the Arabic version of Tinnitus Handicap Inventory, distortion product otoacoustic emissions testing and P300 recording.ResultsThe study group showed significantly higher hearing thresholds at all frequencies as well as delayed latencies and reduced amplitude of P300. The Tinnitus Handicap Inventory showed mean scores of 35.2 ± 16.9, and the distortion product gram showed higher amplitudes in the control group.ConclusionPatients with tinnitus might have neural dysfunction at either peripheral or central levels of the auditory pathway.
Collapse
|
9
|
Tai Y, Mertes IB, Chappell J, Jeon CB, Husain FT. Comparison of otoacoustic emissions in tinnitus and hyperacusis in adults with normal hearing sensitivity. Int J Audiol 2022; 62:442-452. [PMID: 35439083 DOI: 10.1080/14992027.2022.2052980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effect of tinnitus and/or hyperacusis on distortion product otoacoustic emission (DPOAE) measures in adults with normal hearing thresholds from 0.25 to 8 kHz, while accounting for extended high-frequency (EHF) thresholds.Design: A behavioural study consisted of comprehensive audiological assessment, validated tinnitus and hyperacusis questionnaires, DPOAE amplitudes and input/output (I/O) functions.Study sample: Data of 56 participants with normal hearing were included for the analysis. Participants were categorised into four groups: (1) without tinnitus or hyperacusis, (2) with tinnitus only, (3) with hyperacusis only, and (4) with both tinnitus and hyperacusis.Results: The groups with tinnitus showed elevated EHF thresholds compared with those without tinnitus. DPOAE amplitudes were not significantly affected by tinnitus and/or hyperacusis status; however, they were significantly affected by EHF thresholds. Further, no appreciable differences in DPOAE I/O functions were found across groups.Conclusions: The reported non-significant differences in DPOAEs in individuals with tinnitus and/or hyperacusis do not support a peripheral mechanism or an interaction between peripheral and central mechanisms underlying tinnitus or hyperacusis. Our findings, however, suggest the need to assess basal cochlear function (e.g. EHF thresholds) for a better understanding of differences in DPOAE measures in tinnitus and/or hyperacusis.
Collapse
Affiliation(s)
- Yihsin Tai
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Department of Speech Pathology and Audiology, Ball State University, Muncie, IN, USA
| | - Ian B Mertes
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Jenise Chappell
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Carolyn B Jeon
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Fatima T Husain
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Neuroscience Program, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| |
Collapse
|
10
|
Huang CY, Li DS, Tsai MH, Chen CH, Cheng YF. The Impact of Acute Tinnitus on Listening Effort: A Study Based on Clinical Observations of Sudden Sensorineural Hearing Loss Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063661. [PMID: 35329346 PMCID: PMC8955353 DOI: 10.3390/ijerph19063661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 03/13/2022] [Accepted: 03/16/2022] [Indexed: 12/04/2022]
Abstract
This study investigates the relationship between listening effort and acute tinnitus over the clinical course of sudden sensorineural hearing loss (SSNHL) before and after treatment. Thirty SSNHL patients with acute tinnitus were enrolled in this prospective study. Each patient was evaluated before treatment and after 1 and 3 months of follow-up. Listening effort was evaluated in the unaffected ears in two conditions (with and without background noise) using a dual-task paradigm, which included a primary (speech recognition) task and a secondary (visual reaction time) task. Tinnitus severity was assessed with the Tinnitus Handicap Inventory (THI). It was observed that background noise significantly increased listening effort in SSNHL patients with acute tinnitus before and after treatment. THI scores and listening effort in quiet conditions (** p = 0.009) were significantly decreased three months after treatment. In an analysis of the relation between tinnitus severity and listening effort, it was found that the THI total score was significantly correlated with listening effort in quiet (* p = 0.0388) and noisy conditions (* p = 0.044) before treatment. We concluded that SSNHL patients with acute tinnitus exerted greater listening effort in the presence of background noise than in quiet conditions. Furthermore, listening effort was reduced as tinnitus improved in SSNHL patients during the three months after treatment. Both before and after 3 months of treatment, patients who were more affected and emotionally distressed by tinnitus tended to exert more listening effort in both quiet and noisy environments.
Collapse
Affiliation(s)
- Chii-Yuan Huang
- Department of Otolaryngology Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-Y.H.); (D.-S.L.); (C.-H.C.)
- Faculty of Medicine, National Yang-Ming Chiao-Tung University, Taipei 112, Taiwan
| | - Dian-Sian Li
- Department of Otolaryngology Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-Y.H.); (D.-S.L.); (C.-H.C.)
- Faculty of Medicine, National Yang-Ming Chiao-Tung University, Taipei 112, Taiwan
| | - Ming-Hsien Tsai
- Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan;
| | - Chih-Hao Chen
- Department of Otolaryngology Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-Y.H.); (D.-S.L.); (C.-H.C.)
| | - Yen-Fu Cheng
- Department of Otolaryngology Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-Y.H.); (D.-S.L.); (C.-H.C.)
- Faculty of Medicine, National Yang-Ming Chiao-Tung University, Taipei 112, Taiwan
- Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan;
- Department of Medical Research, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Correspondence:
| |
Collapse
|
11
|
Jedrzejczak WW, Pilka E, Ganc M, Kochanek K, Skarzynski H. Ultra-High Frequency Distortion Product Otoacoustic Emissions for Detection of Hearing Loss and Tinnitus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042123. [PMID: 35206311 PMCID: PMC8872281 DOI: 10.3390/ijerph19042123] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/02/2022] [Accepted: 02/08/2022] [Indexed: 02/01/2023]
Abstract
Several studies have suggested that distortion product otoacoustic emissions (DPOAEs) may be an early marker not only of hearing loss (HL) but also of tinnitus. The purpose of this study was to investigate whether DPOAEs measured up to 16 kHz are affected by the presence of tinnitus. Pure tone thresholds and DPOAEs were measured in two groups: 55 patients with tinnitus and 63 subjects without tinnitus. The subjects were divided into three groups according to their audiometric results-better than 25 dB HL at all tested frequencies from 0.125 to 16 kHz, better than 25 dB up to 8 kHz, and hearing impaired. Receiver operator characteristics (ROCs) were used to test whether DPOAEs could differentiate between normal hearing, hearing loss, and tinnitus. Comparison of tinnitus subjects with the control group, matched accurately according to thresholds, did not yield any significant difference in DPOAEs. However, in both these groups hearing loss was accompanied by a decrease in DPOAEs, specifically, at 2-6 kHz and 16 kHz. The results suggest that any decrease in DPOAEs seems to be related only to hearing loss and there is no additional effect from tinnitus.
Collapse
Affiliation(s)
- W. Wiktor Jedrzejczak
- Department of Experimental Audiology, Institute of Physiology and Pathology of Hearing, Mochnackiego 10, 02-042 Warsaw, Poland; (E.P.); (M.G.)
- World Hearing Center, ul. Mokra 17, Kajetany, 05-830 Nadarzyn, Poland; (K.K.); (H.S.)
- Correspondence: ; Tel.: +48-22-356-0-384
| | - Edyta Pilka
- Department of Experimental Audiology, Institute of Physiology and Pathology of Hearing, Mochnackiego 10, 02-042 Warsaw, Poland; (E.P.); (M.G.)
- World Hearing Center, ul. Mokra 17, Kajetany, 05-830 Nadarzyn, Poland; (K.K.); (H.S.)
| | - Malgorzata Ganc
- Department of Experimental Audiology, Institute of Physiology and Pathology of Hearing, Mochnackiego 10, 02-042 Warsaw, Poland; (E.P.); (M.G.)
- World Hearing Center, ul. Mokra 17, Kajetany, 05-830 Nadarzyn, Poland; (K.K.); (H.S.)
| | - Krzysztof Kochanek
- World Hearing Center, ul. Mokra 17, Kajetany, 05-830 Nadarzyn, Poland; (K.K.); (H.S.)
- Institute of Physiology and Pathology of Hearing, Mochnackiego 10, 02-042 Warsaw, Poland
| | - Henryk Skarzynski
- World Hearing Center, ul. Mokra 17, Kajetany, 05-830 Nadarzyn, Poland; (K.K.); (H.S.)
- Department of Oto-Rhino-Laryngosurgery, Institute of Physiology and Pathology of Hearing, Mochnackiego 10, 02-042 Warsaw, Poland
| |
Collapse
|
12
|
Sheppard A, Ishida I, Holder T, Stocking C, Qian J, Sun W. Tinnitus Assessment and Management: A Survey of Practicing Audiologists in the United States and Canada. J Am Acad Audiol 2022; 33:75-81. [PMID: 36049753 DOI: 10.1055/s-0041-1736576] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND Tinnitus is a prevalent auditory disorder that can become severely debilitating. Despite decades of investigation, there remains no conclusive cure for tinnitus. Clinical practice guidelines (CPGs) are available for assessing and managing tinnitus. Even though such guidelines have been available for several years, the degree that audiologists adhere to them has remained unexplored. PURPOSE OF STUDY To determine what clinical practices are commonly used by audiologists in the assessment and management of the patient population with tinnitus, we administered an online survey to audiologists practicing in the United States and Canada. RESULTS Among the audiologists that completed the survey and were included in the final analysis (n = 61), 70% were from the United States and 30% were from Canada. The audiologists represented a wide range of clinical experience (1-35 years). On average, those who completed the survey were relatively confident in their ability to assess and manage tinnitus patients indicated by a 0 to 100 Likert scale, with 0 representing no confidence (mean 72.5, ± 21.5 standard deviation). The most commonly reported tinnitus assessment tools were pure tone audiogram (0.25-8 kHz), administration of standardized questionnaires, and tinnitus pitch and loudness matching. Approximately half (55%) of audiologists indicated they include otoacoustic emissions, while less audiologists (<40%) reported measuring high-frequency thresholds, minimum masking levels, or loudness discomfort levels. The most common recommendation for tinnitus patients was amplification (87%), followed by counseling (80%) and sound therapy (79%). CONCLUSION Few audiologists administer a truly comprehensive tinnitus assessment and ∼20% indicated not recommending counseling or sound therapy to manage tinnitus. The results are discussed in the context of what is explicitly indicated in published CPGs, professional organization recommendations, and recent findings of peer-reviewed literature.
Collapse
Affiliation(s)
- Adam Sheppard
- Department of Communicative Disorders and Sciences, Center for Hearing and Deafness, State University of New York at Buffalo, Buffalo, New York
| | - Ieda Ishida
- Innovation Centre Toronto, Sonova Canada, Mississauga, Ontario
| | - Thea Holder
- Department of Communicative Disorders and Sciences, UB Speech-Language and Hearing Clinic, State University of New York at Buffalo, Buffalo, New York
| | - Christina Stocking
- Department of Communicative Disorders and Sciences, UB Speech-Language and Hearing Clinic, State University of New York at Buffalo, Buffalo, New York
| | - Jinyu Qian
- Department of Communicative Disorders and Sciences, Center for Hearing and Deafness, State University of New York at Buffalo, Buffalo, New York.,Innovation Centre Toronto, Sonova Canada, Mississauga, Ontario
| | - Wei Sun
- Department of Communicative Disorders and Sciences, Center for Hearing and Deafness, State University of New York at Buffalo, Buffalo, New York
| |
Collapse
|
13
|
Noise exposure levels predict blood levels of the inner ear protein prestin. Sci Rep 2022; 12:1154. [PMID: 35064195 PMCID: PMC8783004 DOI: 10.1038/s41598-022-05131-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 12/30/2021] [Indexed: 12/20/2022] Open
Abstract
Serological biomarkers of inner ear proteins are a promising new approach for studying human hearing. Here, we focus on the serological measurement of prestin, a protein integral to a human’s highly sensitive hearing, expressed in cochlear outer hair cells (OHCs). Building from recent nonhuman studies that associated noise-induced OHC trauma with reduced serum prestin levels, and studies suggesting subclinical hearing damage in humans regularly engaging in noisy activities, we investigated the relation between serum prestin levels and environmental noise levels in young adults with normal clinical audiograms. We measured prestin protein levels from circulating blood and collected noise level data multiple times over the course of the experiment using body-worn sound recorders. Results indicate that serum prestin levels have a negative relation with noise exposure: individuals with higher routine noise exposure levels tended to have lower prestin levels. Moreover, when grouping participants based on their risk for a clinically-significant noise-induced hearing loss, we found that prestin levels differed significantly between groups, even though behavioral hearing thresholds were similar. We discuss possible interpretations for our findings including whether lower serum levels may reflect subclinical levels of OHC damage, or possibly an adaptive, protective mechanism in which prestin expression is downregulated in response to loud environments.
Collapse
|
14
|
Mohd Salehuddin NS, Md Daud MK, Nik Othman NA, Abd Rahman N. Extended high frequency hearing loss in tinnitus-positive chronic suppurative otitis media patient. Laryngoscope Investig Otolaryngol 2021; 6:1137-1141. [PMID: 34667858 PMCID: PMC8513419 DOI: 10.1002/lio2.651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/14/2021] [Accepted: 08/26/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES To determine the association between extended high frequency hearing loss and tinnitus in normal cochlear function based on a conventional audiometry chronic suppurative otitis media (CSOM) patient. DESIGN AND METHODS A cross-sectional study was conducted on 220 ears diagnosed as having CSOM with an equal number of tinnitus and without tinnitus groups. Only those with normal cochlear function based on conventional pure tone audiometry (250 Hz to 8 kHz) were included. They were further tested for hearing at extended high frequencies of up to 16 kHz. The severity of tinnitus was tested using a tinnitus questionnaire. RESULTS The prevalence of extended high frequency hearing loss in the normal cochlear function CSOM patients with tinnitus was 81.8% (95% CI 74.5%, 89.1%), whereas the prevalence in the tinnitus negative group was 30.0% (95% CI 21.3%, 38.7%). There was a significant association between extended high frequency hearing loss and tinnitus in CSOM patients (P < .001). The average thresholds were significantly higher in the tinnitus group at all extended high frequencies tested with an increasing trend of significance toward the higher frequencies. However, this study did not observe any association between the severity of tinnitus and extended high frequency hearing loss. CONCLUSION The development of tinnitus among normal cochlear function CSOM patients indicates that the damage has occurred at a higher frequency level. However, the severity of tinnitus does not predict the degree of higher frequency hearing loss. Therefore, the presence of tinnitus warrants more aggressive monitoring and treatment to prevent sensorineural hearing loss from developing into the speech frequencies. LEVEL OF EVIDENCE 4.
Collapse
Affiliation(s)
- Nur Syazwani Mohd Salehuddin
- Department of Otorhinolaryngology, School of Medical SciencesUniversiti Sains MalaysiaKubang KerianKelantanMalaysia
| | - Mohd Khairi Md Daud
- Department of Otorhinolaryngology, School of Medical SciencesUniversiti Sains MalaysiaKubang KerianKelantanMalaysia
- Hospital Universiti Sains MalaysiaKubang KerianKelantanMalaysia
| | - Nik Adilah Nik Othman
- Department of Otorhinolaryngology, School of Medical SciencesUniversiti Sains MalaysiaKubang KerianKelantanMalaysia
- Hospital Universiti Sains MalaysiaKubang KerianKelantanMalaysia
| | - Normastura Abd Rahman
- School of Dental Sciences, Health Campus, Universiti Sains MalaysiaKubang KerianKelantanMalaysia
| |
Collapse
|
15
|
Park E, Song I, Jeong YJ, Im GJ, Jung HH, Choi J, Rah YC. Evidence of Cochlear Synaptopathy and the Effect of Systemic Steroid in Acute Idiopathic Tinnitus With Normal Hearing. Otol Neurotol 2021; 42:978-984. [PMID: 33900233 DOI: 10.1097/mao.0000000000003189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the electrophysiologic evidence of cochlear synaptopathy and the effects of systemic steroids in acute idiopathic tinnitus with normal hearing. STUDY DESIGN Retrospective review of medical data. SETTING Tertiary referral center. PATIENTS Fifty-nine patients who experienced acute-onset idiopathic tinnitus (within 12 weeks) with normal hearing and the same number of age- and pure-tone threshold-matched control groups. INTERVENTION Electrophysiologic studies of the auditory pathway, oral steroids, and ginkgo biloba. MAIN OUTCOME MEASURES Pure-tone thresholds, wave I and wave V amplitudes of the auditory brainstem response (ABR), tinnitus handicap inventory (THI), and visual analog scale (VAS). RESULTS Significantly reduced ABR wave I amplitude and wave I/wave V ratio were found in the tinnitus group compared with the no tinnitus group. Age and pure-tone threshold were significantly correlated with reduced wave I amplitude and small wave I/wave V ratio. The THI and VAS scores were decreased at 3 and 12 weeks after steroid administration; however, overall changes in THI and VAS scores were not significantly different between the steroid and ginkgo biloba groups. CONCLUSION Potential cochlear synaptopathy was suspected in the early stage of acute idiopathic tinnitus, even in patients with normal hearing. Age and hearing threshold were potentially associated with the development of cochlear synaptopathy. Low-dose oral steroids and ginkgo biloba induced early subjective relief of tinnitus, which maintained up to 12 weeks, however, those changes did not differ between groups.
Collapse
Affiliation(s)
- Euyhyun Park
- Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | | | | | | | | | | | | |
Collapse
|
16
|
Fetoni AR, Di Cesare T, Settimi S, Sergi B, Rossi G, Malesci R, Marra C, Paludetti G, De Corso E. The evaluation of global cognitive and emotional status of older patients with chronic tinnitus. Brain Behav 2021; 11:e02074. [PMID: 34288570 PMCID: PMC8413806 DOI: 10.1002/brb3.2074] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/26/2021] [Accepted: 02/05/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Tinnitus is a common symptom largely impactful on quality of life, especially in the elderly. Our aim was to evaluate the efficacy of self-administered screening tests to correlate the severity of subjective perception of tinnitus with emotional disorders and the overall cognitive status. METHODS Patients aged ≥ 55 years with chronic tinnitus were recruited and submitted to a complete audiological evaluation; Tinnitus Handicap inventory (THI); Hospital Anxiety and Depression Scale (HADS-A and HADS-D) and Mini-Mental State Examination (MMSE). Demographic and audiological features of patients with and without cognitive impairment (MMSE score cut-off of 24/30) were analyzed in order to reveal the relationship among tinnitus, emotional disorders, and cognitive dysfunction. RESULTS 102 patients were recruited (mean age: 70.4 ± 9.6). THI score was directly related to HADS-A score (r = .63) HADS-D score (r = .66), whereas there was no relationship between tinnitus severity and MMSE (r = .13). CI and n-CI groups did not differ in the characteristics of tinnitus (p > .05), however, hearing threshold (p = .049) and anxious depressive traits measured with HADS-A (p = .044) and HADS-D (p = .016) were significantly higher in the group with cognitive impairment. Furthermore, age ≥ 75 years (p = .002, OR = 13.8), female sex (p = .032; OR = 6.5), severe hearing loss (p = .036; OR = 2.3), and anxiety (p = .029; OR = 9.2) resulted risk factors for CI. Therefore, in CI group MMSE score was inversely related to age (r = -.84). CONCLUSIONS Cognitive impairment and psychiatric discomfort should be considered in tinnitus patients, related to increasing age, female sex, and severe hearing loss. Thus, self-administered questionnaires can be useful in addressing clinical approach.
Collapse
Affiliation(s)
- Anna Rita Fetoni
- Institute of Otolaryngology, Fondazione Policlinico Agostino Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | - Bruno Sergi
- Institute of Otolaryngology, Fondazione Policlinico Agostino Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Rita Malesci
- Audiology and Vestibology Unit, Neuroscience Department, Federico II University Naples, Naples, Italy
| | - Camillo Marra
- Università Cattolica del Sacro Cuore, Rome, Italy.,Memory Clinic, Fondazione Policlinico Agostino Gemelli, IRCCS, Rome, Italy
| | - Gaetano Paludetti
- Institute of Otolaryngology, Fondazione Policlinico Agostino Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eugenio De Corso
- Institute of Otolaryngology, Fondazione Policlinico Agostino Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
17
|
Distortion Product Otoacoustic Emissions (DPOAEs) In Tinnitus Patients. Int Arch Otorhinolaryngol 2021; 26:e046-e057. [PMID: 35096158 PMCID: PMC8789488 DOI: 10.1055/s-0040-1722248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/08/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction
Tinnitus is the perception of sound in the absence of external sound stimulation. There is a general agreement that it is a direct consequence of irreversible and permanent cochlear damage.
Objectives
The present work is designed to study the distortion product otoacoustic emissions (DPOAEs) in tinnitus patients with normal hearing in comparison with normal hearing control and to study any possible correlation between DPOAEs recording and patients' complaints.
Methods
The present study included 80 subjects divided into 2 groups: Control group: consisted of 30 normal-hearing adults not complaining of tinnitus and Study group: consisted of 50 normal-hearing adults complaining of tinnitus. The methodology includes full audiological history, otoscopic examination, basic audiological evaluation, DPOAEs including both DP-gram and DPOAEs input/output functions.
Results
Basic audiological evaluation showed within normal hearing sensitivity in both groups, however, with significant higher hearing thresholds in tinnitus patients at all frequency ranges. The Tinnitus Handicap Inventory Questionnaire showed mean scores of 35.2 ± 16.9 in the study group. The DP-gram showed higher amplitudes in the control group when compared with tinnitus patients. The DPOAEs input-output functions at different frequencies (1, 2, 4 and 6kHz) also showed higher amplitudes at all frequencies and different input levels. The slope of the I/O function tends to be steeper in tinnitus cases.
Conclusion
Patients with tinnitus might have neural dysfunction at either the level of the cochlea, as shown in reduced DPOAE levels, and changes in the normal DP-I/O function recorded in the present work.
Collapse
|
18
|
Song Z, Wu Y, Tang D, Lu X, Qiao L, Wang J, Li H. Tinnitus Is Associated With Extended High-frequency Hearing Loss and Hidden High-frequency Damage in Young Patients. Otol Neurotol 2021; 42:377-383. [PMID: 33196532 PMCID: PMC7879827 DOI: 10.1097/mao.0000000000002983] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To analyze the results of extended high-frequency (EHF) and high-frequency hearing tests in young patients with tinnitus who show normal response in conventional pure-tone audiometry (PTA), and to explore the correlation between tinnitus and hearing loss (HL). STUDY DESIGN A case-control study. SETTING A Tertiary Eye Ear Nose & Throat Hospital of China. PARTICIPANTS Patients with tinnitus, aged 18 to 35 years old, and with normal conventional PTA (125 Hz-8 kHz) were enrolled in the tinnitus group. Volunteers without tinnitus of the same age were enrolled in the control group. MAIN OUTCOME MEASURES The incidence of EHF-HL and the hearing thresholds at each frequency, as well as the distribution of maximum HL frequency and edge frequency in all participants were compared. RESULTS In total, 28 cases (43 ears) were enrolled in the tinnitus group and 34 cases (68 ears) in the control group. The incidence of EHF-HL, average hearing threshold of each frequency ranging from 4 to 16 kHz, and the maximum hearing threshold were significantly higher in the tinnitus group. The edge frequency in the tinnitus group was lower than that in the control group (10.4 ± 3.1 kHz versus 12.3 ± 2.5 kHz, p = 0.010). The dominant tinnitus pitch in cases whose EHF was impaired was positively correlated with the hearing-level loudness of tinnitus (r = 0.627, p < 0.001). CONCLUSION Patients with tinnitus and normal hearing in conventional PTA showed signs of EHF-HL and hidden damage in the high-frequencies more easily. EHF hearing tests and the follow-up of HF hearing tests are recommended to facilitate early detection of hearing impairment for timely intervention.
Collapse
Affiliation(s)
- Zijun Song
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital
| | - Yongzhen Wu
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital
- National Health Commission Key Laboratory of Hearing Medicine
| | - Dongmei Tang
- Ear Nose & Throat Institute and Otorhinolaryngology Department of Affiliated Eye Ear Nose & Throat Hospital, State Key Laboratory of Medical Neurobiology
| | - Xiaoling Lu
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital
| | - Liang Qiao
- Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University
| | - Jing Wang
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital
- National Health Commission Key Laboratory of Hearing Medicine
| | - Huawei Li
- Ear Nose & Throat Institute and Otorhinolaryngology Department of Affiliated Eye Ear Nose & Throat Hospital, State Key Laboratory of Medical Neurobiology
- Institutes of Biomedical Sciences
- National Health Commission Key Laboratory of Hearing Medicine
- Shanghai Engineering Research Centre of Cochlear Implant
- The Institutes of Brain Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China
| |
Collapse
|
19
|
Anderson S, Bieber R, Schloss A. Peripheral deficits and phase-locking declines in aging adults. Hear Res 2021; 403:108188. [PMID: 33581668 DOI: 10.1016/j.heares.2021.108188] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 01/16/2021] [Accepted: 01/20/2021] [Indexed: 10/22/2022]
Abstract
Age-related difficulties in speech understanding may arise from a decrease in the neural representation of speech sounds. A loss of outer hair cells or decrease in auditory nerve fibers may lead to a loss of temporal precision that can affect speech clarity. This study's purpose was to evaluate the peripheral contributors to phase-locking strength, a measure of temporal precision, in recordings to a sustained vowel in 30 younger and 30 older listeners with normal to near normal audiometric thresholds. Thresholds were obtained for pure tones and distortion-product otoacoustic emissions (DPOAEs). Auditory brainstem responses (ABRs) were recorded in quiet and in three levels of continuous white noise (+30, +20, and +10 dB SNR). Absolute amplitudes and latencies of Wave I in quiet and of Wave V across presentation conditions, in addition to the slope of Wave V amplitude and latency changes in noise, were calculated from these recordings. Frequency-following responses (FFRs) were recorded to synthesized /ba/ syllables of two durations, 170 and 260 ms, to determine whether age-related phase-locking deficits are more pronounced for stimuli that are sustained for longer durations. Phase locking was calculated for the early and late regions of the steady-state vowel for both syllables. Group differences were found for nearly every measure except for the slopes of Wave V latency and amplitude changes in noise. We found that outer hair cell function (DPOAEs) contributed to the variance in phase locking. However, the ABR and FFR differences were present after covarying for DPOAEs, suggesting the existence of temporal processing deficits in older listeners that are somewhat independent of outer hair cell function.
Collapse
Affiliation(s)
- Samira Anderson
- Department of Hearing and Speech Sciences, University of Maryland, College Park, MD 20742, United States.
| | - Rebecca Bieber
- Department of Hearing and Speech Sciences, University of Maryland, College Park, MD 20742, United States.
| | - Alanna Schloss
- Department of Hearing and Speech Sciences, University of Maryland, College Park, MD 20742, United States.
| |
Collapse
|
20
|
Anderson S, Karawani H. Objective evidence of temporal processing deficits in older adults. Hear Res 2020; 397:108053. [PMID: 32863099 PMCID: PMC7669636 DOI: 10.1016/j.heares.2020.108053] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 07/15/2020] [Accepted: 07/28/2020] [Indexed: 12/17/2022]
Abstract
The older listener's ability to understand speech in challenging environments may be affected by impaired temporal processing. This review summarizes objective evidence of degraded temporal processing from studies that have used the auditory brainstem response, auditory steady-state response, the envelope- or frequency-following response, cortical auditory-evoked potentials, and neural tracking of continuous speech. Studies have revealed delayed latencies and reduced amplitudes/phase locking in subcortical responses in older vs. younger listeners, in contrast to enhanced amplitudes of cortical responses in older listeners. Reconstruction accuracy of responses to continuous speech (e.g., cortical envelope tracking) shows over-representation in older listeners. Hearing loss is a factor in many of these studies, even though the listeners would be considered to have clinically normal hearing thresholds. Overall, the ability to draw definitive conclusions regarding these studies is limited by the use of multiple stimulus conditions, small sample sizes, and lack of replication. Nevertheless, these objective measures suggest a need to incorporate new clinical measures to provide a more comprehensive assessment of the listener's speech understanding ability, but more work is needed to determine the most efficacious measure for clinical use.
Collapse
Affiliation(s)
- Samira Anderson
- Department of Hearing and Speech Sciences, University of Maryland, College Park, MD 20742, United States.
| | - Hanin Karawani
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel.
| |
Collapse
|
21
|
Abu-Eta R, Gavriel H, Pitaro J. Extended High Frequency Audiometry for Revealing Sudden Sensory Neural Hearing Loss in Acute Tinnitus Patients. Int Arch Otorhinolaryngol 2020; 25:e413-e415. [PMID: 34377177 PMCID: PMC8321644 DOI: 10.1055/s-0040-1713921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/06/2020] [Indexed: 11/12/2022] Open
Abstract
Introduction
The measurement of extended high-frequency (EHF) audiometry has become more popular recently, mainly in connection with ototoxicity and noiseinduced hearing loss. New-onset tinnitus evaluation includes a standard hearing test that shows no pathology.
Objective
The aim of the present study was to evaluate the possibility that acute tinnitus is essentially connected to sudden sensory neural hearing loss (SSNHL), by utilizing EHF audiometry in cases in which standard audiometry for frequencies between 250 Hz to 8 kHz is within normal limits.
Methods
A retrospective study was conducted between January 2009 and May 2014 that included all patients presenting with acute tinnitus and normal standard audiometry. All patients underwent EHF audiometry and were treated accordingly.
Results
Thirty-two patients with acute tinnitus and asymmetric sensorineural hearing loss on EHF audiometry were identified. The average deltas between the ears were between 9.2 and 33dB (worse in the affected ear).
Conclusion
Extended high-frequency audiometry up to 20,000 Hz should be performed in all patients with acute tinnitus and standard audiometry within normal limits.
Collapse
Affiliation(s)
- Rani Abu-Eta
- Department of Otolaryngology-Head and Neck Surgery, Shamir (Previously Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Haim Gavriel
- Department of Otolaryngology-Head and Neck Surgery, Shamir (Previously Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Jacob Pitaro
- Department of Otolaryngology-Head and Neck Surgery, Shamir (Previously Assaf Harofeh) Medical Center, Zerifin, Israel
| |
Collapse
|
22
|
Kara E, Aydın K, Akbulut AA, Karakol SN, Durmaz S, Yener HM, Gözen ED, Kara H. Assessment of Hidden Hearing Loss in Normal Hearing Individuals with and Without Tinnitus. J Int Adv Otol 2020; 16:87-92. [PMID: 32209515 PMCID: PMC7224424 DOI: 10.5152/iao.2020.7062] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/19/2019] [Accepted: 06/30/2019] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES To evaluate the functions of cochlear structures and the distal part of auditory nerve as well as dead regions within the cochlea in individuals with normal hearing with or without tinnitus by using electrophysiological tests. MATERIALS AND METHODS Nine individuals (ages: 21-59 years) with normal hearing with tinnitus were included in the study group. Thirteen individuals (ages: 25-60 years) with normal hearing without tinnitus were included in the control group. Immitancemetric examination, pure-tone audiometry (125Hz-16kHz), speech audiometry in quiet and noise environments, transient evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAEs), threshold equalizing noise (TEN test (500Hz-4kHz), and ECochG tests, Beck Depression Questionnaire, Tinnitus Handicap Questionnaire, and Visual Analog Scale were performed. RESULTS In the study group, three patients were found to have a minimal depression and six were found to have a mild depression. In pure-tone audiometry, the threshold (6-16 kHz) in the study group was significantly higher than that of the control group at all frequencies. In the study group, lower performance scores were obtained in speech discrimination in noise in both ears. In the control group, no dead region was detected in the TEN test whereas 75% of subjects in the study group had dead regions. DPOAE and TEOAE responses between study and control group subjects were not different. In the ECochG test, subjects in the study group showed an increase in the summating potential/action potential (SP/AP) ratio in both ears. CONCLUSION Determination of the SP/AP ratio in patients with tinnitus may be useful in diagnosing hidden hearing loss. Detection of dead regions in 75% of patients in the TEN test may indicate that inner hair cells may be responsible for tinnitus.
Collapse
Affiliation(s)
- Eyyup Kara
- Department of Audiology, İstanbul University-Cerrahpaşa School of Health Sciences, İstanbul, Turkey
| | - Kübra Aydın
- Department of Audiology, İstanbul University-Cerrahpaşa School of Health Sciences, İstanbul, Turkey
| | - A Alperen Akbulut
- Department of Audiology, İstanbul University-Cerrahpaşa School of Health Sciences, İstanbul, Turkey
| | - Sare Nur Karakol
- Department of Audiology, İstanbul University-Cerrahpaşa School of Health Sciences, İstanbul, Turkey
| | - Serkan Durmaz
- Department of Audiology, İstanbul University-Cerrahpaşa School of Health Sciences, İstanbul, Turkey
| | - H Murat Yener
- Department of Otorhinolaryngology, İstanbul University- Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - E Deniz Gözen
- Department of Otorhinolaryngology, İstanbul University- Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Halide Kara
- Department of Audiology, İstanbul University-Cerrahpaşa School of Health Sciences, İstanbul, Turkey
| |
Collapse
|
23
|
Sena TRRD, Dourado SSF, Antoniolli ÂR. [High frequency hearing among rural workers exposed to pesticides]. CIENCIA & SAUDE COLETIVA 2020; 24:3923-3932. [PMID: 31577022 DOI: 10.1590/1413-812320182410.18172017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 04/07/2018] [Indexed: 12/20/2022] Open
Abstract
Pesticides may cause a number of health problems and are considered oto-agressive agents. The objective of this study was to investigate the high frequency hearing characteristics of workers both with and without exposure to pesticides, that presented normal conventional audiometry. It involved a cross-sectional study with 87 workers, of both genders, between 19 and 59 years, with formal or informal jobs and some of whom worked with family agriculture, either using pesticides or not, who had taken High-Frequency Audiometry tests. The use of glyphosate was reported by 73% of workers and several pesticide mixtures occurred in 78% of them. There were no cases of proper use of personal protective equipment recommended for the activity. The workers exposed to pesticides had worse results in High-Frequency Audiometry tests in comparison with those who had no contact with pesticides (p < 0.0001). High-Frequency Audiometry has proved to be a useful and effective tool in the early detection of hearing loss caused by pesticides.
Collapse
Affiliation(s)
- Tereza Raquel Ribeiro de Sena
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Sergipe (UFS). R. Cláudio Batista s/n, Cidade Nova. 49060-108 Aracaju, SE, Brasil.
| | | | - Ângelo Roberto Antoniolli
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Sergipe (UFS). R. Cláudio Batista s/n, Cidade Nova. 49060-108 Aracaju, SE, Brasil.
| |
Collapse
|
24
|
Campbell J, LaBrec A, Bean C, Nielsen M, So W. Auditory Gating and Extended High-Frequency Thresholds in Normal-Hearing Adults With Minimal Tinnitus. Am J Audiol 2019; 28:209-224. [PMID: 31022362 DOI: 10.1044/2019_aja-ttr17-18-0036] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Purpose The goal of this study was to assess whether peripheral auditory sensitivity in frequency regions above 8 kHz is related to central inhibitory function, as measured through a sensory gating paradigm, in normal-hearing adults with tinnitus (TINN) and without tinnitus (NTINN). The contribution of gating processes and peripheral sensitivity in extended high frequencies to tinnitus severity was evaluated via a hierarchical multiple regression method. Method Cortical auditory evoked potentials (CAEPs) were recorded in response to pairs of tones in normal-hearing adults without tinnitus, NTINN ( n = 45), and adults with tinnitus, TINN ( n = 21). CAEP peak component amplitude, latency, and gating indices were compared and correlated with extended high-frequency (EHF) pure-tone averages (PTAs) across groups and with tinnitus severity. An exploratory analysis was performed to investigate gating variability within the TINN group. Based on Tinnitus Handicap Inventory (Newman, Jacobson, & Spitzer, 1996) median scores, the TINN group was categorized into low- and high-median subgroups, and gating indices were compared between these subgroups. A hierarchical multiple regression analysis was performed to determine the amount of variance accounted for in the TINN group. Results Decreased gating via the CAEP Pa component and increased gating via the N1 component correlated with increased tinnitus severity, even in individuals who would traditionally be classified as having no tinnitus handicap. In the TINN group, lower EHF PTA thresholds correlated with tinnitus severity and decreased Pa gating. Individuals with a greater severity of tinnitus demonstrated atypical gating function reflected in both Pa and N1 components. Gating function and EHF PTA accounted for significant variance regarding tinnitus severity. Conclusions A trade-off between lower and higher level gating function was observed in adults with normal hearing and tinnitus, indicative of higher order compensatory mechanisms. Better cochlear sensitivity in extended high frequencies was related to decreased lower level gating processes and increased tinnitus THI scores, suggestive of an interaction between decreased gating and heightened auditory awareness. We are currently exploring whether gating processes in this population are compensatory, and the role of gating in auditory awareness.
Collapse
Affiliation(s)
- Julia Campbell
- Department of Communication Sciences and Disorders, The University of Texas at Austin
- Central Sensory Processes Laboratory, The University of Texas at Austin
| | - Alison LaBrec
- Department of Communication Sciences and Disorders, The University of Texas at Austin
- Central Sensory Processes Laboratory, The University of Texas at Austin
| | - Connor Bean
- Department of Communication Sciences and Disorders, The University of Texas at Austin
- Central Sensory Processes Laboratory, The University of Texas at Austin
| | - Mashhood Nielsen
- Department of Communication Sciences and Disorders, The University of Texas at Austin
- Central Sensory Processes Laboratory, The University of Texas at Austin
| | - Won So
- Department of Communication Sciences and Disorders, The University of Texas at Austin
- Central Sensory Processes Laboratory, The University of Texas at Austin
| |
Collapse
|
25
|
Tzounopoulos T, Balaban C, Zitelli L, Palmer C. Towards a Mechanistic-Driven Precision Medicine Approach for Tinnitus. J Assoc Res Otolaryngol 2019; 20:115-131. [PMID: 30825037 PMCID: PMC6453992 DOI: 10.1007/s10162-018-00709-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 12/18/2018] [Indexed: 12/17/2022] Open
Abstract
In this position review, we propose to establish a path for replacing the empirical classification of tinnitus with a taxonomy from precision medicine. The goal of a classification system is to understand the inherent heterogeneity of individuals experiencing and suffering from tinnitus and to identify what differentiates potential subgroups. Identification of different patient subgroups with distinct audiological, psychophysical, and neurophysiological characteristics will facilitate the management of patients with tinnitus as well as the design and execution of drug development and clinical trials, which, for the most part, have not yielded conclusive results. An alternative outcome of a precision medicine approach in tinnitus would be that additional mechanistic phenotyping might not lead to the identification of distinct drivers in each individual, but instead, it might reveal that each individual may display a quantitative blend of causal factors. Therefore, a precision medicine approach towards identifying these causal factors might not lead to subtyping these patients but may instead highlight causal pathways that can be manipulated for therapeutic gain. These two outcomes are not mutually exclusive, and no matter what the final outcome is, a mechanistic-driven precision medicine approach is a win-win approach for advancing tinnitus research and treatment. Although there are several controversies and inconsistencies in the tinnitus field, which will not be discussed here, we will give a few examples, as to how the field can move forward by exploring the major neurophysiological tinnitus models, mostly by taking advantage of the common features supported by all of the models. Our position stems from the central concept that, as a field, we can and must do more to bring studies of mechanisms into the realm of neuroscience.
Collapse
Affiliation(s)
- Thanos Tzounopoulos
- Pittsburgh Hearing Research Center and Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, 15261, USA.
| | - Carey Balaban
- Pittsburgh Hearing Research Center and Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Lori Zitelli
- Pittsburgh Hearing Research Center and Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, 15261, USA
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Catherine Palmer
- Pittsburgh Hearing Research Center and Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, 15261, USA
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| |
Collapse
|
26
|
Raj-Koziak D, Gos E, Swierniak W, Rajchel JJ, Karpiesz L, Niedzialek I, Wlodarczyk E, Skarzynski H, Skarzynski PH. Visual Analogue Scales as a Tool for Initial Assessment of Tinnitus Severity: Psychometric Evaluation in a Clinical Population. Audiol Neurootol 2018; 23:229-237. [PMID: 30439712 DOI: 10.1159/000494021] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 09/21/2018] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to evaluate the psychometric properties of patient-reported visual analogue scale (VAS) ratings. All of the participants (100 Polish-speaking adults) completed a Tinnitus Functional Index (TFI) once and a 4-component VAS twice over a period of 3 days. Spearman's correlation coefficients between the VAS score and global TFI ranged from ρ = 0.52 for VAS-coping (VAS-C) to ρ = 0.81 for VAS-annoyance (VAS-A). Using the Bland-Altman method, the agreement ranged from 93% for VAS-A to 96% for VAS-distress (VAS-D). Interclass correlation coefficients ranged from 0.67 for VAS-C to 0.90 for VAS-A. The VAS cutoff points representing significant tinnitus severity ranged from 45 points for VAS-C to 66 points for VAS-D. VAS scales are a valid and reliable brief screening tool for obtaining quick information about tinnitus.
Collapse
Affiliation(s)
- Danuta Raj-Koziak
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Elzbieta Gos
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Weronika Swierniak
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Joanna J Rajchel
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Lucyna Karpiesz
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Iwona Niedzialek
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Elzbieta Wlodarczyk
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Henryk Skarzynski
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Piotr H Skarzynski
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland, .,Heart Failure and Cardiac Rehabilitation Department, Medical University of Warsaw, Warsaw, Poland, .,Institute of Sensory Organs, Warsaw/Kajetany, Poland,
| |
Collapse
|
27
|
Cordeiro FP, da Costa Monsanto R, Kasemodel ALP, de Almeida Gondra L, de Oliveira Penido N. Extended high-frequency hearing loss following the first episode of otitis media. Laryngoscope 2018; 128:2879-2884. [DOI: 10.1002/lary.27309] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/18/2018] [Accepted: 05/03/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Francisco Polanski Cordeiro
- Department of Otolaryngology-Head and Neck Surgery; Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM); São Paulo Brazil
| | - Rafael da Costa Monsanto
- Department of Otolaryngology-Head and Neck Surgery; Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM); São Paulo Brazil
| | - Ana Luiza Papi Kasemodel
- Department of Otolaryngology-Head and Neck Surgery; Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM); São Paulo Brazil
| | - Luiza de Almeida Gondra
- Department of Otolaryngology-Head and Neck Surgery; Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM); São Paulo Brazil
| | - Norma de Oliveira Penido
- Department of Otolaryngology-Head and Neck Surgery; Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM); São Paulo Brazil
| |
Collapse
|
28
|
Lechowicz U, Pollak A, Raj-Koziak D, Dziendziel B, Skarżyński PH, Skarżyński H, Ołdak M. Tinnitus in patients with hearing loss due to mitochondrial DNA pathogenic variants. Eur Arch Otorhinolaryngol 2018; 275:1979-1985. [PMID: 29936625 PMCID: PMC6060765 DOI: 10.1007/s00405-018-5028-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/01/2018] [Indexed: 12/28/2022]
Abstract
Purpose 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. Methods 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. Results 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. Conclusions Our data suggest that the mtDNA variants causative of HL may affect tinnitus development but this effect seems to be ethnic-specific.
Collapse
Affiliation(s)
- Urszula Lechowicz
- Department of Genetics, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mochnackiego 10, 02-042, Warsaw, Poland
| | - Agnieszka Pollak
- Department of Genetics, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mochnackiego 10, 02-042, Warsaw, Poland
| | - Danuta Raj-Koziak
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Beata Dziendziel
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Piotr Henryk Skarżyński
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,Department of Heart Failure and Cardiac Rehabilitation, Second Faculty, Medical University of Warsaw, Warsaw, Poland.,Institute of Sensory Organs, Nadarzyn, Poland
| | - Henryk Skarżyński
- Oto-Rhino-Laryngology Surgery Clinic, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Monika Ołdak
- Department of Genetics, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mochnackiego 10, 02-042, Warsaw, Poland. .,Department of Histology and Embryology, Medical University of Warsaw, Warsaw, Poland.
| |
Collapse
|
29
|
Lee K, Makino K, Yamahara K. Evaluation of tinnitus retraining therapy for patients with normal audiograms versus patients with hearing loss. Auris Nasus Larynx 2018; 45:215-221. [DOI: 10.1016/j.anl.2017.03.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 03/08/2017] [Indexed: 10/19/2022]
|
30
|
Sena TRR, Dourado SSF, Lima LV, Antoniolli ÂR. The hearing of rural workers exposed to noise and pesticides. Noise Health 2018; 20:23-26. [PMID: 29457603 PMCID: PMC5843986 DOI: 10.4103/nah.nah_70_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In work environments, different physical and chemical agents that may pose a risk to workers‘ hearing health coexist. In this context, occupational hearing loss stands out. It has mostly been attributed to only noise exposure, although there are other agents, that is, pesticides that might contribute to occupational hearing loss. In this report, two cases will be presented that consider rural workers exposed to pesticides and intense noise generated by an adapted rudimentary vehicle. The noise measured in this vehicle was 88.3 dBA up to 93.4 dBA. Pure-tone audiometry, distortion product otoacoustic emissions, and high-frequency audiometry tests were performed. This report is unusual because of the short time of exposure to noise and pesticides and the hearing loss found, indicating a synergy between those agents.
Collapse
Affiliation(s)
- Tereza R R Sena
- Department of Audiology and Speech Therapy, Doctoral Program in Health Science, Federal University of Sergipe, Brazil
| | - Solano S F Dourado
- Graduate Program in Physiological Science, Doctoral Program in Health Science, Federal University of Sergipe, Brazil
| | - Lucas V Lima
- Graduate Program in Physiological Science, Doctoral Program in Health Science, Federal University of Sergipe, Brazil
| | - Ângelo R Antoniolli
- Department of Physiology, Doctoral Program in Health Science, Federal University of Sergipe, Brazil
| |
Collapse
|
31
|
Raj-Koziak D, Gos E, Rajchel J, Piłka A, Skarżyński H, Rostkowska J, Skarzynski PH. Tinnitus and Hearing Survey: A Polish Study of Validity and Reliability in a Clinical Population. Audiol Neurootol 2017; 22:197-204. [DOI: 10.1159/000481338] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 09/06/2017] [Indexed: 11/19/2022] Open
|
32
|
Skarzynski PH, Raj-Koziak D, J. Rajchel J, Pilka A, Wlodarczyk AW, Skarzynski H. Adaptation of the Tinnitus Handicap Inventory into Polish and its testing on a clinical population of tinnitus sufferers. Int J Audiol 2017; 56:711-715. [DOI: 10.1080/14992027.2017.1319080] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Piotr H. Skarzynski
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland,
- Heart Failure and Cardiac Rehabilitation Department, 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland, and
- Institute of Sensory Organs, Warsaw/Kajetany, Poland
| | - Danuta Raj-Koziak
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland,
| | - Joanna J. Rajchel
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland,
| | - Adam Pilka
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland,
| | - Andrzej W. Wlodarczyk
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland,
| | - Henryk Skarzynski
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland,
| |
Collapse
|
33
|
Riga M, Komis A, Marangoudakis P, Naxakis S, Ferekidis E, Kandiloros D, Danielides V. Differences in the suppression of distortion product otoacoustic emissions by contralateral white noise between patients with acute or chronic tinnitus. Int J Audiol 2017; 56:589-595. [DOI: 10.1080/14992027.2017.1305516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Maria Riga
- University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece,
| | - Agis Komis
- Attikon University Hospital, National University of Athens, Athens, Greece,
| | | | - Stefanos Naxakis
- University Hospital of Patras, University of Patras, Patras, Greece, and
| | | | | | | |
Collapse
|
34
|
Riga M, Komis A, Maragkoudakis P, Korres G, Danielides V. Objective assessment of subjective tinnitus through contralateral suppression of otoacoustic emissions by white noise; suggested cut-off points. Int J Audiol 2016; 55:775-781. [DOI: 10.1080/14992027.2016.1219778] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- M. Riga
- University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece,
| | - A. Komis
- Attikon University Hospital, National University of Athens, Greece, and
| | - P. Maragkoudakis
- Attikon University Hospital, National University of Athens, Greece, and
| | - G. Korres
- Attikon University Hospital, National University of Athens, Greece, and
| | - V. Danielides
- University Hospital of Patras, University of Patras, Greece
| |
Collapse
|
35
|
Influence of Tinnitus on Auditory Spectral and Temporal Resolution and Speech Perception in Tinnitus Patients. J Neurosci 2016; 35:14260-9. [PMID: 26490865 DOI: 10.1523/jneurosci.5091-14.2015] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED Although cochlear damage is believed to trigger the perception of tinnitus in the central auditory system, its pathophysiological mechanism is still unclear. We aimed to investigate the pathophysiology of tinnitus using psychoacoustic assessments of auditory spectral and temporal resolution and speech perception in noise. Human subjects with tinnitus and symmetric hearing thresholds were divided into three groups: nine unilateral tinnitus subjects with normal hearing thresholds (Group 1), 12 unilateral tinnitus subjects with hearing loss (HL; Group 2), and nine bilateral tinnitus subjects with HL. Fifteen normal-hearing subjects without tinnitus were also tested as a control group. Four different tests were administered: (1) the spectral-ripple discrimination (SRD) test, (2) the temporal modulation detection (TMD) test, (3) the Schroeder-phase discrimination (SPD) test, and (4) the speech recognition threshold (SRT) in noise test. There were no significant differences in SRD, TMD, and SPD between the tinnitus-affected ears (TEs) and non-tinnitus ears (NTEs) in Groups 1 and 2 (p > 0.05). In contrast, the TEs showed poorer SRTs than the NTEs in these two subject groups (p = 0.022 and 0.049). No inferiority of spectral/temporal resolution in TEs compared with NTEs suggests that there may be no more outer hair cell (OHC) damage on the tinnitus side given that damaged OHCs are associated with broadening the auditory filters. The decoupling of the SRT results from the spectral/temporal resolution data could imply that the occurrence of tinnitus does not depend upon the degree of damage to the OHCs, but rather upon different plastic changes in the central auditory system after cochlear damage. SIGNIFICANCE STATEMENT We can easily find unilateral tinnitus patients who have symmetric hearing thresholds. Our research question was what kind of difference would be responsible for the tinnitus in the tinnitus-affected ears but not in the non-tinnitus ears of subjects with symmetric hearing thresholds. The answer to this fundamental question could help us to understand the pathophysiology of tinnitus. We evaluated the potential influence of tinnitus upon the subjects' auditory spectral and temporal resolution and speech perception in noise by comparing these psychoacoustic performances between tinnitus-affected ears and non-tinnitus ears in the same subjects.
Collapse
|
36
|
Abstract
There are a number of auditory symptom syndromes that can develop without an organic basis. Some of these, such as nonorganic hearing loss, affect populations similar to those presenting with functional somatosensory and motor symptoms, while others, such as musical hallucination, affect populations with a significantly different demographic and require different treatment strategies. Many of these conditions owe their origin to measurably abnormal peripheral sensory pathology or brain network activity, but their pathological impact is often due, at least in part, to overamplification of the salience of these phenomena. For each syndrome, this chapter briefly outlines a definition, demographics, investigations, putative mechanisms, and treatment strategies. Consideration is given to what extent they can be considered to have a functional basis. Treatments are in many cases pragmatic and rudimentary, needing more work to be done in integrating insights from behavioral and cognitive psychology to auditory neuroscience. The audiology literature has historically equated the term functional with malingering, although this perception is, thankfully, slowly changing. These disorders transcend the disciplines of audiology, otorhinolaryngology, neurology and psychiatry, and a multidisciplinary approach is often rewarding.
Collapse
|
37
|
Jain S, Dwarkanath VM. Effect of tinnitus location on the psychoacoustic measures of hearing. HEARING BALANCE AND COMMUNICATION 2015. [DOI: 10.3109/21695717.2016.1099885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
38
|
The Relevance of the High Frequency Audiometry in Tinnitus Patients with Normal Hearing in Conventional Pure-Tone Audiometry. BIOMED RESEARCH INTERNATIONAL 2015; 2015:302515. [PMID: 26583098 PMCID: PMC4637018 DOI: 10.1155/2015/302515] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 01/08/2015] [Indexed: 02/04/2023]
Abstract
Objective. The majority of tinnitus patients suffer from hearing loss. But a subgroup of tinnitus patients show normal hearing thresholds in the conventional pure-tone audiometry (125 Hz–8 kHz). Here we explored whether the results of the high frequency audiometry (>8 kHz) provide relevant additional information in tinnitus patients with normal conventional audiometry by comparing those with normal and pathological high frequency audiometry with respect to their demographic and clinical characteristics. Subjects and Methods. From the database of the Tinnitus Clinic at Regensburg we identified 75 patients with normal hearing thresholds in the conventional pure-tone audiometry. We contrasted these patients with normal and pathological high-frequency audiogram and compared them with respect to gender, age, tinnitus severity, pitch, laterality and duration, comorbid symptoms and triggers for tinnitus onset. Results. Patients with pathological high frequency audiometry were significantly older and had higher scores on the tinnitus questionnaires in comparison to patients with normal high frequency audiometry. Furthermore, there was an association of high frequency audiometry with the laterality of tinnitus. Conclusion. In tinnitus patients with normal pure-tone audiometry the high frequency audiometry provides useful additional information. The association between tinnitus laterality and asymmetry of the high frequency audiometry suggests a potential causal role for the high frequency hearing loss in tinnitus etiopathogenesis.
Collapse
|
39
|
Prognostic factors for the outcomes of intratympanic dexamethasone in the treatment of acute subjective tinnitus. Otol Neurotol 2015; 35:1330-7. [PMID: 25080038 DOI: 10.1097/mao.0000000000000526] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the prognostic factors for the outcomes of treating acute subjective tinnitus with intratympanic dexamethasone (ITD). STUDY DESIGN Retrospective chart review. SETTING Tertiary referral center. PATIENTS We enrolled 139 subjects who were treated with ITD for acute subjective tinnitus with symptoms lasting for 3 months or less. Overall, 114 of 139 subjects completed questionnaires 3 months after treatment or fully recovered within 3 months. Audiograms were performed 3 months after treatment in 43 patients. INTERVENTION ITD for acute subjective tinnitus. MAIN OUTCOME MEASURE Quantitative assessment of the severity of tinnitus by questionnaires and changes in hearing thresholds at all frequencies by pure-tone audiometry. RESULTS Tinnitus was cured in 43 of 114 patients (37.7%) within 3 months. The mean tinnitus loudness score, the mean tinnitus awareness score, and the mean tinnitus handicap inventory score were significantly reduced at 3 months after ITD. Audiometric responses were detected in 12 of 43 patients (27.9%) who underwent follow-up audiograms. The cure rate was significantly greater in patients with symptoms lasting for 2 weeks or less than in patients with symptoms lasting for more than 1 month (64.7% vs. 15.7%; p < 0.05). The mean global improvement index for tinnitus was significantly greater in patients with unilateral tinnitus than in patients with bilateral tinnitus (6.2 ± 1.9 vs. 5.0 ± 2.0; p < 0.05). Among patients with unilateral tinnitus, the audiometric response rate was significantly greater in patients with asymmetric hearing threshold than in patients with symmetric hearing threshold (48.8% vs. 4.8%; p < 0.01). The cure rate was significantly associated with the duration of symptoms. Unilateral tinnitus and audiologic asymmetry were positively associated with the audiometric response rate. CONCLUSIONS The duration of symptoms affected the cure rate of ITD for acute subjective tinnitus. Unilateral tinnitus was associated with better improvements in symptoms than bilateral tinnitus. Furthermore, unilateral tinnitus and audiologic asymmetry were positively associated with the audiometric response.
Collapse
|
40
|
da Cruz Fernandes L, Momensohn-Santos TM, Carvalho JSM, Carvalho FLDQ. Tinnitus and normal hearing: a study on contralateral acoustic reflex. Am J Audiol 2015; 22:291-6. [PMID: 23824442 DOI: 10.1044/1059-0889(2013/13-0005)] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the difference of the contralateral acoustic reflex (AR) threshold between adult subjects with hearing within clinically normal limits, with and without tinnitus. METHOD The study sample in this exploratory, descriptive, and comparative study comprised 40 female subjects who were evaluated: 20 had tinnitus and 20 formed the control group. The contralateral AR threshold was evaluated at the frequencies of 500, 1000, and 2000 Hz. RESULTS Elevated or absent AR thresholds were found only in subjects with complaints of tinnitus. At all frequencies and in either ear, the median AR threshold was higher in the group that complained of tinnitus (100.0 dB; range = 95.0–100.0 dB) compared with the control group (90.0 dB; range = 86.3–95.0 dB; p < .01). There was a statistically significant difference ( p < .05) in the group with tinnitus, in each of the frequencies studied and in both the right and left ear. CONCLUSION The results suggest that evaluation of the efferent system, through AR, could be an important tool for the differential diagnosis of tinnitus in patients whose hearing was within clinically normal limits.
Collapse
|
41
|
Emadi M, Rezaei M, Najafi S, Faramarzi A, Farahani F. Comparison of the Transient Evoked Otoacoustic Emissions (TEOAEs) and Distortion Products Otoacoustic Emissions (DPOAEs) in Normal Hearing Subjects With and Without Tinnitus. Indian J Otolaryngol Head Neck Surg 2015; 70:115-118. [PMID: 29456954 DOI: 10.1007/s12070-015-0824-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 01/12/2015] [Indexed: 10/24/2022] Open
Abstract
The aim of this study was to investigate the possible role of cochlear outer hair cell function with TEOAE and DPOAE tests in patients with normal hearing and tinnitus. 25 tinnitus patients with normal hearing sensitivity selected as study group. Control group consist of 50 normal hearing subjects without tinnitus. All subjects had thresholds below 25 dBHL at frequencies 250-8,000 Hz, tympanogram type A and normal acoustic reflex thresholds. TEOAE were recorded with click stimulus at 80 dB SPL at 1,000, 2,000, 3,000 and 4000 Hz. DPOAE were measured at frequencies 1,000-8,000 Hz and intensity of L1 55 dB SPL and L2 65 dB SPL. Amplitude of DPOAE and TEOAE were decreased in all frequencies in study group. There was significant difference regarding prevalence abnormal TEOAE and DPOAE between study group and control group. There was relationship between dysfunction of outer hair cells and tinnitus in subjects with normal hearing.
Collapse
Affiliation(s)
- Maryam Emadi
- 1School of Rehabilitation Sciences, Hamadan University of Medical Sciences & Health Services, Hamadan, Iran
| | - Mohammad Rezaei
- 1School of Rehabilitation Sciences, Hamadan University of Medical Sciences & Health Services, Hamadan, Iran
| | - Sirvan Najafi
- 2Hamadan University of Medical Sciences & Health Services, Hamadan, Iran
| | - Ali Faramarzi
- 4Department of Otolaryngology, School of Medicine, Hamadan University of Medical Sciences & Health Services, Hamadan, Iran
| | - Farhad Farahani
- 3School of Public Health, Hamadan University of Medical Sciences & Health Services, Hamadan, Iran
- 4Department of Otolaryngology, School of Medicine, Hamadan University of Medical Sciences & Health Services, Hamadan, Iran
| |
Collapse
|
42
|
Kochanek KM, Śliwa LK, Puchacz K, Piłka A. Repeatability of transient-evoked otoacoustic emissions in young adults. Med Sci Monit 2015; 21:36-43. [PMID: 25556878 PMCID: PMC4292768 DOI: 10.12659/msm.891365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The aim of this study was to evaluate the repeatability and variability of TEOAE characteristics in hearing screening tests performed under practical conditions on normal subjects. Material/Methods A group of 11 young, normal-hearing subjects aged 19–24 years was tested. They were examined otologically and audiologically prior to the tests and no ear pathologies were found. Responses were acquired with a commercially available instrument (Integrity, Vivosonic Inc.) using a standardized OAE protocol. The TEOAE tests were repeated 3 times in each subject at random intervals within 24 h. The analyzed parameters of interest were: (i) whole wave reproducibility (WWR) and; (ii) signal-to-noise ratio (SNR). Results WWR and SNR did not differ significantly among the 3 measurement sessions. In most cases the differences in WWR among measurements were around 1–2% and for SNRs they were 1–4 dB SNRs and were highest in the 1–2 kHz range. TEOAE-based tests can be useful tools for hearing screening. Conclusions The tests can give reliable results provided that adequate procedures are used and low-noise conditions are ensured. The tests are best complemented with other examinations to widen the range of ear pathologies able to be detected.
Collapse
Affiliation(s)
- Krzysztof M Kochanek
- Department of Experimental Audiology, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Lech K Śliwa
- Department of Experimental Audiology, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Klaudia Puchacz
- Department of Logopedics and Applied Linguistics, Marie-Curie University, Lublin, Poland
| | - Adam Piłka
- Department of Experimental Audiology, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| |
Collapse
|
43
|
Abstract
OBJECTIVE 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. DESIGN 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. STUDY SAMPLE 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. RESULTS 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. CONCLUSIONS Tinnitus pitch and MML are etiology dependent.
Collapse
Affiliation(s)
- Olaf Zagólski
- * ENT Department, St. John Grande's Hospital , Kraków , Poland
| | | |
Collapse
|