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Kim EH, Shin SH, Byun SW, Lee HY. Exploring the origins of decreased sound tolerance in tinnitus patients. Front Neurol 2023; 14:1273705. [PMID: 38020634 PMCID: PMC10657806 DOI: 10.3389/fneur.2023.1273705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
This study aimed to confirm the characteristics of auditory function alterations in tinnitus patients with concomitant decreased sound tolerance (ST) and provide insights for developing tailored therapeutic approaches. A retrospective analysis was conducted on patient records from a tertiary university hospital's tinnitus clinic between March 2020 and June 2023. Demographic attributes and audiological profiles were reviewed. Patients were categorized into Group 1 if loudness discomfort level test outcomes were 77 dB or below, measured using an average of frequencies from 250 Hz to 8 kHz. The remaining patients were allocated to Group 2. Among the 434 tinnitus patients, 115 (26.5%) demonstrated decreased ST and were classified as Group 1. This group exhibited higher DPOAE amplitudes (p < 0.001), shortened latency, and decreased threshold of ABR wave V bilaterally (p < 0.05). No significant disparities were observed in gender, age, tinnitus handicap inventory, visual analog scale, and pure-tone audiometry results except subjective hyperacusis. Binary logistic regression analysis utilizing the forward conditional method revealed that the difference between groups was independently linked to DPOAE response at 7,277 Hz on the left side [B = 0.093, p < 0.001, EXP(B) = 1.07, 95% CI = 1.044-1.153]. Increased DPOAE amplitude and shorter and decreased ABR wave V in tinnitus patients with decreased ST might suggest a possible association with lesions in or around the superior olivary complex or higher central auditory pathway, potentially linked to the inhibition of medial olivocochlear efferents.
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Affiliation(s)
| | | | | | - Ho Yun Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Ewha Womans University School of Medicine, Seoul, Republic of Korea
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Han MS, Jeong YJ, Im GJ, Song JJ, Chae SW, Chan Rah Y, Choi J. Auditory brainstem response test results in normal hearing adolescents with subjective tinnitus. Int J Pediatr Otorhinolaryngol 2021; 146:110775. [PMID: 34022656 DOI: 10.1016/j.ijporl.2021.110775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 04/30/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The objective of the study was to analyze the auditory brainstem response (ABR) test results of adolescents with normal hearing threshold who have subjective tinnitus in an effort to determine the probable site of origin of tinnitus. METHODS Among the patients who visited the outpatient clinic of the Department of Otolaryngology at our tertiary hospital from January 2016 to December 2019, adolescents aged 13-18 years with the chief complaint of unilateral subjective tinnitus and pure tone audiometry (PTA) within 25 dB HL were enrolled and retrospectively reviewed. The ABR test parameters (amplitudes and latencies of waves I, III, and V and interpeak latencies [IPLs] of waves I-III, III-V, and I-V) were analyzed and compared between tinnitus ears and contralateral ears without tinnitus. Study participants were divided into the chronic tinnitus (tinnitus duration ≥6 months) and non-chronic tinnitus (tinnitus duration <6 months) groups, and the difference between the two groups was analyzed. RESULTS Ten adolescents were included in the study, and their ABR test results were reviewed. IPL III-V was significantly prolonged in tinnitus ears compared to non-tinnitus ears (p = 0.035). Although other parameters were found to be statistically non-significant, there was preponderance in ABR wave I amplitude; it was smaller in tinnitus ears of chronic tinnitus adolescents than in those of non-chronic tinnitus adolescents (p = 0.114). CONCLUSION The probable site of origin of tinnitus in adolescents with normal hearing might be in the upper brainstem of the auditory pathway. Further analysis of ABR test results in adolescents with tinnitus and normal hearing can help clarify the pathophysiology of tinnitus in adolescents.
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Affiliation(s)
- Mun Soo Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - Yong Jun Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - Gi Jung Im
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - Jae-Jun Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - Sung-Won Chae
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - Yoon Chan Rah
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - June Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medicine, Korea University Ansan Hospital, Ansan, South Korea.
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Almeida TR, Rocha CH, Rabelo CM, Gomes RF, Neves-Lobo IF, Samelli AG. Personal Audio System: Hearing Symptoms, Habits, and Sound Pressure Levels Measured in Real Ear and a Manikin. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:2016-2026. [PMID: 32521193 DOI: 10.1044/2020_jslhr-19-00053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose The aims of this study were to characterize hearing symptoms, habits, and sound pressure levels (SPLs) of personal audio system (PAS) used by young adults; estimate the risk of developing hearing loss and assess whether instructions given to users led to behavioral changes; and propose recommendations for PAS users. Method A cross-sectional study was performed in 50 subjects with normal hearing. Procedures included questionnaire and measurement of PAS SPLs (real ear and manikin) through the users' own headphones and devices while they listened to four songs. After 1 year, 30 subjects answered questions about their usage habits. For the statistical analysis, one-way analysis of variance, Tukey's post hoc test, Lin and Spearman coefficients, the chi-square test, and logistic regression were used. Results Most subjects listened to music every day, usually in noisy environments. Sixty percent of the subjects reported hearing symptoms after using a PAS. Substantial variability in the equivalent music listening level (Leq) was noted (M = 84.7 dBA; min = 65.1 dBA, max = 97.5 dBA). A significant difference was found only in the 4-kHz band when comparing the real-ear and manikin techniques. Based on the Leq, 38% of the individuals exceeded the maximum daily time allowance. Comparison of the subjects according to the maximum allowed daily exposure time revealed a higher number of hearing complaints from people with greater exposure. After 1 year, 43% of the subjects reduced their usage time, and 70% reduced the volume. A volume not exceeding 80% was recommended, and at this volume, the maximum usage time should be 160 min. Conclusions The habit of listening to music at high intensities on a daily basis seems to cause hearing symptoms, even in individuals with normal hearing. The real-ear and manikin techniques produced similar results. Providing instructions on this topic combined with measuring PAS SPLs may be an appropriate strategy for raising the awareness of people who are at risk. Supplemental Material https://doi.org/10.23641/asha.12431435.
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Affiliation(s)
- Tamara R Almeida
- Curso de Fonoaudiologia, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Brazil
| | - Clayton H Rocha
- Curso de Fonoaudiologia, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Brazil
| | - Camila M Rabelo
- Curso de Fonoaudiologia, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Brazil
| | - Raquel F Gomes
- Curso de Fonoaudiologia, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Brazil
| | - Ivone F Neves-Lobo
- Curso de Fonoaudiologia, Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, Brazil
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Lee DY, Kim YH. Risk factors of pediatric tinnitus: Systematic review and meta‐analysis. Laryngoscope 2017; 128:1462-1468. [DOI: 10.1002/lary.26924] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/21/2017] [Accepted: 08/28/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Doh Young Lee
- Department of Otorhinolaryngology–Head and Neck SurgeryKorea University Anam HospitalSeoul South Korea
| | - Young Ho Kim
- Department of Otorhinolaryngology–Head and Neck SurgerySeoul National University Boramae Medical Center, Seoul National University College of MedicineSeoul South Korea
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Silva PBD, Fiorini AC, Azevedo MFD. Otoacoustic emissions in young adults exposed to drums noise of a college band. REVISTA CEFAC 2017. [DOI: 10.1590/1982-0216201719512216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to identify cochlear dysfunction and occurrence of tinnitus in young adults exposed to drums noise of a college band. Methods: the sample included 50 subjects: 25 musicians (study group) and 25 non-musicians (control group). The procedures included anamnesis, pure tone audiometry, acoustic impedance and Transient Evoked Otoacoustic Emissions, Distortion Product Otoacoustic Emissions and Distortion Product Otoacoustic Emissions Input-Output function. Results: positive correlation between the occurrence of tinnitus and the variables exposure time and use of personal stereos was found. Overall, the study group showed significantly lower Transient Evoked Otoacoustic Emissions, when compared to the control group. In the study group, there was a tendency toward worse response in 6 kHz(f2) in Distortion Product Otoacoustic Emissions in both ears. The Distortion Product Otoacoustic Emissions Input-Output function did not differ between groups nor did its slope. Conclusion: in general, otoacoustic emissions were worse in noise-exposed young people (study group) when compared to the unexposed (control group), indicating that the test may be important in early identification of cochlear changes.
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da Silva VG, de Oliveira CACP, Tauil PL, de Castro Silva IM, Sampaio ALL. Amplified music exposure carries risks to hearing. Int J Pediatr Otorhinolaryngol 2017; 93:117-122. [PMID: 28109481 DOI: 10.1016/j.ijporl.2016.12.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 12/18/2016] [Accepted: 12/21/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the association between changes in the outer hair cells and exposure to amplified music in a group of high-school students. MATERIALS AND METHODS In this retrospective, case-control study, 86 subjects underwent audiometry, immittance audiometry, and distortion-product otoacoustic emission tests. The subjects were questioned about their listening habits and divided into 2 groups: exposed and unexposed. RESULTS Most of the subjects had reduced function in their outer hair cells, mainly beginning at 8 kHz. Among 60 subjects-30 cases and 30 controls-75% were considered exposed and 25% unexposed. The exposed subjects were 9.33 times more likely to have altered outer hair cells than the unexposed subjects were. CONCLUSION Exposure to amplified music is associated with reduced function in the hair cells.
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El-Gharib AM, El-Barbary AM, Aboelhawa MA, Elkholy RM. Audiovestibular function in patients with juvenile idiopathic arthritis (JIA). Acta Otolaryngol 2016; 136:1058-63. [PMID: 27268716 DOI: 10.1080/00016489.2016.1185537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
CONCLUSION It was found that JIR children had potential sensory neural hearing loss and vestibular affection. Therefore, this study recommends: early complete audiologic evaluation of JIA child followed by regular follow-up, including TOAEs, extended high-frequency audiometry, and VNG. This follow-up is important for preliminary diagnosis and management in order to prevent the negative impact of hearing loss on a child's life. OBJECTIVE The aim of this study was to assess hearing in children with Juvenile idiopathic arthritis (JIA) and compare them with a healthy control group. In addition to conventional audiometry, extended high-frequency audiometry and Transient otoacoustic emission (TOAEs) were used. This study also tried to investigate the vestibular function in JIR children by videonystagmography (VNG). PATIENTS AND METHODS The study group comprised of 28 children with JIR and 28 healthy children. All subjects were examined audiologically using basic audiological evaluation, high-frequency audiometry, TOAEs, and VNG. RESULTS Children with JIR had apparent normal peripheral hearing in conventional audiometry; sub-clinical sensory neural hearing loss was detected. This sub-clinical hearing loss appeared in statistically significant difference between them and normal in high-frequency audiometry and TOAEs. VNG test results showed affected tracking and second tests.
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Affiliation(s)
| | | | - Marwa Ahmed Aboelhawa
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University, Egypt
| | - Radwa Mostafa Elkholy
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University, Egypt
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Gilles A, Schlee W, Rabau S, Wouters K, Fransen E, Van de Heyning P. Decreased Speech-In-Noise Understanding in Young Adults with Tinnitus. Front Neurosci 2016; 10:288. [PMID: 27445661 PMCID: PMC4923253 DOI: 10.3389/fnins.2016.00288] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 06/09/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Young people are often exposed to high music levels which make them more at risk to develop noise-induced symptoms such as hearing loss, hyperacusis, and tinnitus of which the latter is the symptom perceived the most by young adults. Although, subclinical neural damage was demonstrated in animal experiments, the human correlate remains under debate. Controversy exists on the underlying condition of young adults with normal hearing thresholds and noise-induced tinnitus (NIT) due to leisure noise. The present study aimed to assess differences in audiological characteristics between noise-exposed adolescents with and without NIT. METHODS A group of 87 young adults with a history of recreational noise exposure was investigated by use of the following tests: otoscopy, impedance measurements, pure-tone audiometry including high-frequencies, transient and distortion product otoacoustic emissions, speech-in-noise testing with continuous and modulated noise (amplitude-modulated by 15 Hz), auditory brainstem responses (ABR) and questionnaires.Nineteen students reported NIT due to recreational noise exposure, and their measures were compared to the non-tinnitus subjects. RESULTS No significant differences between tinnitus and non-tinnitus subjects could be found for hearing thresholds, otoacoustic emissions, and ABR results.Tinnitus subjects had significantly worse speech reception in noise compared to non-tinnitus subjects for sentences embedded in steady-state noise (mean speech reception threshold (SRT) scores, respectively -5.77 and -6.90 dB SNR; p = 0.025) as well as for sentences embedded in 15 Hz AM-noise (mean SRT scores, respectively -13.04 and -15.17 dB SNR; p = 0.013). In both groups speech reception was significantly improved during AM-15 Hz noise compared to the steady-state noise condition (p < 0.001). However, the modulation masking release was not affected by the presence of NIT. CONCLUSIONS Young adults with and without NIT did not differ regarding audiometry, OAE, and ABR.However, tinnitus patients showed decreased speech-in-noise reception. The results are discussed in the light of previous findings suggestion NIT may occur in the absence of measurable peripheral damage as reflected in speech-in-noise deficits in tinnitus subjects.
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Affiliation(s)
- Annick Gilles
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University HospitalEdegem, Belgium; Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of AntwerpWilrijk, Belgium; Department of Human and Social Welfare, University College GhentGhent, Belgium
| | - Winny Schlee
- University Department of Psychology, University of Konstanz Konstanz, Germany
| | - Sarah Rabau
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University HospitalEdegem, Belgium; Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of AntwerpWilrijk, Belgium
| | - Kristien Wouters
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of AntwerpWilrijk, Belgium; University Department of Scientific Coordination and Biostatistics, Antwerp University HospitalEdegem, Belgium
| | - Erik Fransen
- Department of Medical Genetics, Faculty of Medicine and Health Sciences, University of Antwerp Wilrijk, Belgium
| | - Paul Van de Heyning
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University HospitalEdegem, Belgium; Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of AntwerpWilrijk, Belgium
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Rosing SN, Schmidt JH, Wedderkopp N, Baguley DM. Prevalence of tinnitus and hyperacusis in children and adolescents: a systematic review. BMJ Open 2016; 6:e010596. [PMID: 27259524 PMCID: PMC4893873 DOI: 10.1136/bmjopen-2015-010596] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To systematically review studies of the epidemiology of tinnitus and hyperacusis in children and young people, in order to determine the methodological differences implicated in the variability of prevalence estimates and the influence of population characteristics on childhood tinnitus and hyperacusis. DATA SOURCES Articles were retrieved from PubMed, EMBASE and Scopus databases and from the relevant reference lists using the methods described in the study protocol, which has previously been published. Reporting Items for Systematic Review (PRISMA) guidelines were followed. ELIGIBILITY CRITERIA Studies addressing childhood prevalence, for example, children and young people aged 5-19 years. DATA SELECTION 2 reviewers independently assessed the studies for eligibility, extracted data and assessed study consistency. Owing to the heterogeneity in the methodologies among the reported studies, only narrative synthesis of the results was carried out. RESULTS Having identified 1032 publications, 131 articles were selected and 25 articles met the inclusion criteria and had sufficient methodological consistency to be included. Prevalence estimates of tinnitus range from 4.7% to 46% in the general paediatric population and among children with normal hearing, and from 23.5% to 62.2% of population of children with hearing loss. Reported prevalence ranged from 6% to 41.9% when children with hearing loss and normal hearing were both included. The prevalence of hyperacusis varied from 3.2% to 17.1%. CONCLUSIONS Data on prevalence vary considerably according to the study design, study population and the research question posed. The age range of children studied was varied and a marked degree of variation between definitions (tinnitus, hyperacusis) and measures (severity, perception, annoyance) was observed. The lack of consistency among studies indicates the necessity of examining the epidemiology of tinnitus and hyperacusis in children and adolescents with a set of standardised criteria. TRIAL REGISTRATION NUMBER CRD42014013456.
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Affiliation(s)
- Susanne Nemholt Rosing
- Institute of Regional Health Service Research, University of Southern Denmark, Odense, Denmark
- The Social Division in the Capital Region of Denmark and Department of Audiology, Kommunikationscentret, Odense University Hospital, Odense, Denmark
- Department of Audiology, Odense University Hospital, Odense, Denmark
| | - Jesper Hvass Schmidt
- Department of Audiology, Odense University Hospital, Odense, Denmark
- Department of ENT Head and Neck Surgery, Odense University Hospital and Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Niels Wedderkopp
- Sport Medicine Clinic, Orthopedic Department, Hospital of Lillebaelt Institute of Regional Health Service Research and Center for Research in Childhood Health University of Southern Denmark, Odense, Denmark
- Department of Psychology and Exercise Science, Murdoch University, Perth, Western Australia, Australia
| | - David M Baguley
- Department of Audiology, Cambridge University Hospitals, Cambridge, UK
- Department of Hearing and Vision Sciences, Anglia Ruskin University, Cambridge, UK
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