AUDISTIM® Day/Night Alleviates Tinnitus-Related Handicap in Patients with Chronic Tinnitus: A Double-Blind Randomized Placebo-Controlled Trial

The aim of this study is to evaluate the efficacy of taking a daily supplement based on active compounds (AUDISTIM® Day Night: A D/N) in alleviating tinnitus-related disability, as suggested by previous real-life studies. This double-blind randomized placebo-controlled study was conducted in adults with mild to severe tinnitus receiving a 3-month supplementation with A D/N (magnesium, vitamins, phytochemicals) or placebo (excipients without active ingredients). Tinnitus-related handicap (THI), psychological stress (MSP-9), and sleep quality (PSQI) were assessed at baseline and during intervention, perceived impression of tinnitus improvement at the end of the follow-up. The full set analysis included 114 patients (59 A D/N, 55 placebo) aged 53.8 ± 11.4 years, 58% women, with fluctuating (45%) or permanent (55%) tinnitus from 9.3 ± 9.4 years. A D/N supplementation led to greater changes in THI (-13.2 ± 16.0 vs. -6.2 ± 14.4, p = 0.0158,Cohen's d =0.44) at 3 months (primary outcome), especially with continuous tinnitus (-15.0 ± 16.3 vs. -4.6 ± 12.8, p = 0.0065), and, to a lesser extent, at 1 month (-9.8 ± 13.1 for A vs. -4.3 ± 12.1, p = 0.0213). PSQI significantly improved over time in both groups, but MSP-9 only with A D/N. In lines with previous observational studies, both clinical (THI score > 7 pts) and statistical (vs. placebo) improvement, more pronounced in permanent tinnitus, demonstrate the effectiveness of the combination of active compounds and support its use in the management of mild to severe tinnitus.

Intratympanic dexamethasone in Manières disease and symptom control

BACKGROUND

Manières disease (MD) is a chronic inner ear disease characterized by recurrent vertigo and fluctuation in auditory symptoms. Vertigo spells have a sudden onset and are difficult for patients to handle. Therefore, treating a patient with MD is still a challenge for clinicians.

AIMS

This study aims to analyse the short-term effects of intratympanic dexamethasone (ITD) on the various symptoms of unilateral MD.

MATERIALS AND METHODS

The study comprised 27 patients with unilateral MD and severe vertigo who failed medication therapy. Treatment was with ITD as an alternative to destructive therapy. Treatment is evaluated after four months.

RESULTS

Significant improvements were measured with Dizziness Handicap Inventory (DHI), Tinnitus Handicap Inventory (THI), frequency of vertigo attacks longer than 20 min, Functional Level Scale (FLS), and tinnitus sensation measured by the Analog Visual Scale (AVS). Patients with severe symptoms grading with DHI and THI experienced the most improvement. Patients have achieved substantial vertigo control in 73%.

CONCLUSION

ITD application shows improvement in controlling vertigo and tinnitus in patients under exacerbation in MD.

SIGNIFICANCE

It is a promising non-destructive addition to the 'stepwise treatment concept' in MD and can be used as a first-line treatment in vertigo control.

Corrigendum: Atypical functional hierarchy contributed to the tinnitus symptoms in patients with vestibular schwannoma

[This corrects the article DOI: 10.3389/fnins.2023.1084270.].

Development of Machine-Learning Models for Tinnitus-Related Distress Classification Using Wavelet-Transformed Auditory Evoked Potential Signals and Clinical Data

Tinnitus is a highly prevalent condition, affecting more than 1 in 7 adults in the EU and causing negative effects on sufferers' quality of life. In this study, we utilised data collected within the "UNITI" project, the largest EU tinnitus-related research programme. Initially, we extracted characteristics from both auditory brainstem response (ABR) and auditory middle latency response (AMLR) signals, which were derived from tinnitus patients. We then combined these features with the patients' clinical data, and integrated them to build machine learning models for the classification of individuals and their ears according to their level of tinnitus-related distress. Several models were developed and tested on different datasets to determine the most relevant features and achieve high performances. Specifically, seven widely used classifiers were utilised on all generated datasets: random forest (RF), linear, radial, and polynomial support vector machines (SVM), naive bayes (NB), neural networks (NN), and linear discriminant analysis (LDA). Results showed that features extracted from the wavelet-scattering transformed AMLR signals were the most informative data. In combination with the 15 LASSO-selected clinical features, the SVM classifier achieved optimal performance with an AUC value, sensitivity, and specificity of 92.53%, 84.84%, and 83.04%, respectively, indicating high discrimination performance between the two groups.

Down-Regulation of Tinnitus Negative Valence via Concurrent HD-tDCS and PEI Technique: A Pilot Study

Around 30% of the general population experience subjective tinnitus, characterized by conscious attended awareness perception of sound without an external source. Clinical distress tinnitus is more than just experiencing a phantom sound, as it can be highly disruptive and debilitating, leading those affected to seek clinical help. Effective tinnitus treatments are crucial for psychological well-being, but our limited understanding of the underlying neural mechanisms and a lack of a universal cure necessitate further treatment development. In light of the neurofunctional tinnitus model predictions and transcranial electrical stimulation, we conducted an open-label, single-arm, pilot study that utilized high-definition transcranial direct current stimulation (HD-tDCS) concurrent with positive emotion induction (PEI) techniques for ten consecutive sessions to down-regulate tinnitus negative valence in patients with clinical distress tinnitus. We acquired resting-state functional magnetic resonance imaging scans of 12 tinnitus patients (7 females, mean age = 51.25 ± 12.90 years) before and after the intervention to examine resting-state functional connectivity (rsFC) alterations in specific seed regions. The results showed reduced rsFC at post-intervention between the attention and emotion processing regions as follows: (1) bilateral amygdala and left superior parietal lobule (SPL), (2) left amygdala and right SPL, (3) bilateral dorsolateral prefrontal cortex (dlPFC) and bilateral pregenual anterior cingulate cortex (pgACC), and (4) left dlPFC and bilateral pgACC (FWE corrected p < 0.05). Furthermore, the post-intervention tinnitus handicap inventory scores were significantly lower than the pre-intervention scores (p < 0.05). We concluded that concurrent HD-tDCS and PEI might be effective in reducing tinnitus negative valence, thus alleviating tinnitus distress.

Anxiety, Depression, and Symptom Severity in Patients with Pulsatile and Non-Pulsatile Tinnitus

OBJECTIVE(S)

To compare the rates of anxiety and depression between patients with pulsatile (PT) and non-pulsatile tinnitus (NPT), and their correlation with tinnitus severity.

METHODS

A prospective cross-sectional study of consecutive patients presenting either to the otolaryngology clinic for pulsatile (PT) and NPT or to a tertiary care tinnitus habituation program (THP) were administered the tinnitus handicap inventory (THI), 7-item general anxiety disorder scale (GAD-7), and 9-item patient health questionnaire (PHQ-9). Median scores between groups and correlation of scores within groups were calculated and compared.

RESULTS

Median THI scores were significantly higher for THP and PT patients as compared with unselected NPT patients (58 and 44 vs. 20, p ≤ 0.001). Median GAD-7 (10 vs. 2.5 and 2, p ≤ 0.001) and PHQ-9 (7 vs. 4 and 4, p = 0.04) scores were highest in THP patients compared with PT and NPT. The strongest correlation between tinnitus handicap and psychiatric measures was seen in THP patients.

CONCLUSION

THP patients report higher levels of anxiety and depression compared with PT and other NPT patients. Tinnitus severity correlates more strongly with GAD-7 and PHQ-9 scores in THP patients compared with other patient groups. PT patients have a greater self-perceived tinnitus handicap than the general cohort of NPT patients, statistically comparable to THP patients. Despite this, anxiety and depression are not more severe in patients with PT as they are in THP patients.

LEVEL OF EVIDENCE

2B Laryngoscope, 133:683-688, 2023.

Atypical functional hierarchy contributed to the tinnitus symptoms in patients with vestibular schwannoma

Objective

Tinnitus is frequently found in patients with vestibular schwannoma (VS), but its underlying mechanisms are currently unclear.

Methods

Both preoperative (VS _pre ) and postoperative (VS _post ) functional MR images were collected from 32 patients with unilateral VS and matched healthy controls (HCs). Connectome gradients were generated for the identification of altered regions and perturbed gradient distances. Tinnitus measurements were conducted for predictive analysis with neuroimaging-genetic integration analysis.

Results

There were 56.25% of preoperative patients and 65.63% of postoperative patients suffering from ipsilateral tinnitus, respectively. No relevant factors were identified including basic demographics info, hearing performances, tumor features, and surgical approaches. Functional gradient analysis confirmed atypical functional features of visual areas in VS _pre were rescued after tumor resection, while the gradient performance in the postcentral gyrus continues to maintain (VS _post vs. HC : P = 0.016). The gradient features of the postcentral gyrus were not only significantly decreased in patients with tinnitus (P _FDR = 0.022), but also significantly correlated with tinnitus handicap inventory (THI) score (r = -0.30, P = 0.013), THI level (r = -0.31, P = 0.010), and visual analog scale (VAS) rating (r = -0.31, P = 0.0093), which could be used to predict VAS rating in the linear model. Neuropathophysiological features linked to the tinnitus gradient framework were linked to Ribosome dysfunction and oxidative phosphorylation.

Conclusion

Altered functional plasticity in the central nervous system is involved in the maintenance of VS tinnitus.

Comparison of Tinnitus Handicap Inventory and Tinnitus Functional Index as Treatment Outcomes

BACKGROUND

Tinnitus is an audiological disorder for which there are no objective measuring tools. Thus, many self-report questionnaires have been proposed to assess its severity. These questionnaires have been judged for their capacity to assess the tinnitus severity at baseline, their sensitivity to treatment-related changes (responsiveness), and their resolution.

METHODS

The most widely used questionnaires for clinical and research studies are the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI). While both questionnaires have been recognized as good evaluators of the baseline tinnitus severity, the latter is considered to be more responsive to changes following treatments.

OBJECTIVES

The aim of this work is to provide a preliminary comparison of the performance of both questionnaires in the initial and final tinnitus severity assessment of a cohort of patients undergoing a four-month Enriched Acoustic Environment (EAE) therapy.

RESULTS

The EAE therapy provided a 30 and 26 point reduction in THI and TFI, respectively. A good correlation is obtained between the THI and TFI questionnaires at baseline and after the treatment.

CONCLUSION

At baseline, the THI provided a higher score than the TFI for a higher degree of tinnitus but a lower score for lower tinnitus severity. Both THI and TFI were good questionnaires for baseline assessment and for treatment-related changes. The THI provided a slightly higher score drop than the TFI following the treatment, although the TFI had better resolution.

Audiometric Characteristics and Tinnitus Features in a Cohort of 170 Spanish Patients

BACKGROUND

Tinnitus is a rather prevalent, quite heterogeneous, and difficult to treat auditory disorder. The aim of this article is to provide the design and results of a cross-sectional study related to audiological and tinnitus features in a group of 170 Spanish patients.

METHODS

Audiometric characteristics were assessed on the basis of the pure-tone audiometry of both ears in 170 tinnitus patients and 85 control subjects. The audiometric status of each tinnitus participant was assessed on the basis of the average auditory threshold (AAT) in the whole frequency range (from 125 Hz to 8 kHz), and low (from 125 Hz to 2 kHz) and high (from 3 kHz to 8 kHz)-frequency intervals. Tinnitus features were evaluated through personal interview with patients and included tinnitus duration, laterality, pitch, sound, and distress (Tinnitus Handicap Inventory, THI). Correlational analysis was carried out between audiological (AAT) and tinnitus (THI) variables.

RESULTS

A very weak Spearman rank correlation factor is found between both variables.

CONCLUSIONS

The subjective outcome of tinnitus distress (THI) was not correlated with the objective measure of hearing loss (AAT) in our cohort.

[Hormone replacement therapy in perimenopausal women with chronic tinnitus]

Objective:To explore and analyze the effect and indication of hormone replacement therapy（HRT） in perimenopausal women with chronic tinnitus. Methods:The perimenopausal women with chronic tinnitus were divided into mild group and moderate to severe group according to Kupperman score of menopause, and then were divided into treatment group and untreated group according to whether they received MHT treatment or not. The serum 5-HT level, tinnitus handicap inventory （THI） and Pittsburgh sleep quality index （PSQI） were compared before and after treatment. Results:In moderate to severe perimenopausal tinnitus, the serum 5-HT level, THI and PSQI in the treatment group were statistically different before and after treatment（P<0.05）, and no significant difference was found in the untreated group. In mild perimenopausal tinnitus, there was no significant difference in 5-HT levels, THI and PSQI between the treated group and the untreated group before and after treatment. The 5-HT levels were correlated with THI. The lower the 5-HT level was, the more severe tinnitus was. Conclusion:HRT is helpful in the treatment of perimenopausal chronic tinnitus, especially in moderate to severe perimenopausal patients, and is recommended for clinical use.

All for One and One for All? - Examining Convergent Validity and Responsiveness of the German Versions of the Tinnitus Questionnaire (TQ), Tinnitus Handicap Inventory (THI), and Tinnitus Functional Index (TFI)

BACKGROUND

Measurement of tinnitus-related distress and treatment responsiveness is key in understanding, conceptualizing and addressing this often-disabling symptom. Whilst several self-report measures exist, the heterogeneity of patient populations, available translations, and treatment contexts requires ongoing psychometric replication and validation efforts.

OBJECTIVE

To investigate the convergent validity and responsiveness of the German versions of the Tinnitus Questionnaire [TQ], Tinnitus Handicap Inventory [THI], and Tinnitus Functional Index [TFI] in a large German-speaking sample of patients with chronic tinnitus who completed a psychologically anchored 7-day Intensive Multimodal Treatment Programme.

METHODS

Two-hundred-and-ten patients with chronic tinnitus completed all three questionnaires at baseline and post-treatment. Intraclass correlation coefficients determined the convergent validity of each questionnaire's total and subscale scores. Treatment responsiveness was investigated by [a] comparing treatment-related change in responders vs. non-responders as classified by each questionnaire's minimal clinically important difference-threshold, and [b] comparing agreement between the questionnaires' responder classifications.

RESULTS

The total scores of all three questionnaires showed high agreement before and after therapy (TQ | THI: 0.80 [Pre], 0.83 [Post], TQ | TFI: 0.72 [Pre], 0.78 [Post], THI | TFI: 0.76 [Pre] 0.80 [Post]). All total scores changed significantly with treatment yielding small effect sizes. The TQ and TFI yielded comparable (19.65 and 18.64%) and the THI higher responder rates (38.15%). The TQ | THI and TQ | TFI showed fair, and the THI | TFI moderate agreement of responder classifications. Independent of classification, responders showed significantly higher change rates than non-responders across most scores. Each questionnaire's total change score distinguished between responders and non-responders as classified by the remaining two questionnaires.

CONCLUSION

The total scores of all three questionnaires show high convergent validity and thus, comparability across clinical and research contexts. By contrast, subscale scores show high inconsistency. Whilst the TFI appears well suited for research purposes, the THI may be better suited to measure psychological aspects of tinnitus-related distress and their changes with accordingly focused treatment approaches.

Assessment of the Effectiveness of Transcranial Magnetic Stimulation in Subjective Tinnitus

Introduction  Increases in spontaneous activity in the neurons of the auditory cortex are presumed as the pathophysiology of tinnitus.

Objective  To investigate the effectiveness of transcranial magnetic stimulation (TMS) in the treatment of tinnitus.

Methods  A total of 62 patients between the ages of 22 and 74 with chronic subjective tinnitus were enrolled in the study. The inclusion criteria were normal findings on an otolaryngologic examination and normal ranges of complete blood count, routine biochemical parameter levels, thyroid function, air-bone gap on pure-tone audiometry, and middle-ear pressure and stapedial reflex on tympanometry. The patients were randomized into 2 groups: 40 patients were placed in the treatment for TMS (tTMS) group, and the rest (22 patients) were placed in the sham TMS group. The frequency and severity of the tinnitus, as well as the tinnitus handicap inventory (THI) score of each patient were measured before and one month after the treatment, and the values were statistically evaluated.

Results  We observed a statistically significant improvement in the tTMS group ( p  < 0.05 and p  < 0.05 respectively) regarding the THI and tinnitus severity scores. The sham TMS group showed no significant improvement in terms of the THI ( p  > 0.05). However, the tinnitus severity showed a significant increase in this group ( p  < 0.05). The comparison of differences in the changes in the THI and the tinnitus severity scores showed a significant statistical improvement in the tTMS group compared with the sham TMS group ( p  < 0.05 and p  < 0.05 respectively).

Conclusion  Transcranial magnetic stimulation was found to be effective in the treatment of tinnitus, and may be adopted as a treatment for tinnitus after further comprehensive studies.

Single-Session of Combined tDCS-TMS May Increase Therapeutic Effects in Subjects With Tinnitus

To treat motor and psychiatric disorders, transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) are used in clinics worldwide. We combined these two types of neuromodulation technique to increase the effective response of a single session of neuromodulation in subjective tinnitus. Eighty tinnitus subjects were split into four different treatment groups: tDCS, tDCS with sham TMS, tDCS-TMS, and TMS group. Subjects were given 1.5 mA tDCS on the bi-frontal area and TMS stimulated the contralateral single side of the temporo-parietal cortex with 200 pulses at 1 Hz stimulation. Comparing pre-treatment questionnaire scores to post-treatment questionnaire scores, all four groups showed statistically significant improvements. Although there was no significant difference among group comparison, the largest mean difference was shown in the combined group, especially for tinnitus intensity and tinnitus-related distress. Responders in the combined group were the highest for VAS intensity, with a maximum of 80% of twenty subjects. To summarize, dual-neuromodulation responders could consist of responders of frontal tDCS and temporal TMS. In addition, abnormal activity in the frontal or temporal area of the responders is presumed to be modulated by treatment and will be suggested as the target areas in future studies.

[Study on treatment of chronic tinnitus by tetanus stimulation and evaluation methods of tinnitus]

Objective:The purpose of this study was to explore the efficacy of tetanus stimulation in tinnitus treatment and the correlation between the mainstream questionnaires of tinnitus and tinnitus-matching in order to find a more convenient and accurate method for tinnitus evaluation. Method:Ten patients with chronic tinnitus and normal or mild hearing impairment were enrolled in this study, totaling 13 ears. Their age ranged from 23 to 53 years old. The stimulus sound（white noise, frequency modulation 14.1 Hz, repetitive amplitude modulation, duty cycle 0.5） was selected and the sound intensity was 50 dB SL. Experimental procedure: （4 minutes sound stimulation+4 minutes rest） ×4 times, totaling 32 minutes. The patients were treated three times a week for 5 weeks. The loudness of tinnitus was matched before and after each treatment, and tinnitus handicap inventory（THI）, tinnitus handicap questionnaire（THQ） and visual analog scales（VAS） were also used for assessment before the first treatment each week. The loudness matching and the above scales were performed once more at follow-up for one week after end-of-treatment. Result:①Single treatment: the matched loudness value decreased by 1.000（0.000, 3.000） dB（Z=7.553, P<0.01） after each single treatment. ②After five weeks' treatment: the matched loudness value decreased（9.692±8.038） dB（t=4.348, P<0.01）; VAS value decreased by 2.000（1.000, 3.000）（Z=2.890, P<0.01）; total score of THQ decreased（7.389%±8.847%）（t=2.641, P<0.05）. ③Correlation analysis: there was positive correlation between total scores of THI and THQ（r=0.747, P<0.01）; the matched loudness values have positive correlation with VAS value（r=0.593, P<0.01）, THI-F（r=0.346, P<0.01） and THQ-factor 3 score（r=0.294, P<0.05）; there was positive correlation between the VAS value and THI-F（r=0.326, P<0.05）, the total score of THI（r=0.466, P<0.01）, THQ-factor 3 score（r=0.291, P<0.05）, the total score of THQ（r=0.497, P<0.01）. Conclusion:The loudness of tinnitus declined with significant fluctuation during tetanus sound therapy. THQ scale is recommended as a sensitive indicator for evaluating the efficacy of tinnitus treatment; VAS is recommended for rapid assessment of tinnitus. Tetanus stimulation is expected to become an important direction in tinnitus sound therapy.

Vestibular functions in patients with tinnitus only

OBJECTIVE

Tinnitus is the perception of sound in the ears or head without any external or internal acoustic stimulation, and it is usually associated with hearing loss. In addition, it has been reported that there is a relationship between vestibular problems and sensorineural hearing loss. The aim of this study was to evaluate the vestibular function in patients with tinnitus without hearing loss.

METHODS

A total of 32 patients who complained only of tinnitus without hearing loss and 30 control subjects without tinnitus or hearing loss were included in this study. Oculomotor and caloric tests were performed on all subjects with videonystagmography. The tinnitus handicap inventory questionnaire, side and duration of tinnitus were recorded in all patients.

RESULTS

The caloric test was abnormal in 13 of 32 (40.6%) patients in the tinnitus group and was normal in all of the control group. Abnormal caloric responses in patients with severe tinnitus were more frequent than in patients with mild or moderate tinnitus. There was a statistically significant difference in the optokinetic gain values between the tinnitus and control groups.

CONCLUSION

A relationship between tinnitus and abnormal caloric responses was determined. Tinnitus may be the first symptom of vestibular dysfunction.

Hearing disorder from music; a neglected dysfunction

CONCLUSION

Music-induced acute acoustic trauma is not inevitably linked to hearing dysfunction as validated by conventional pure tone audiometry. Tinnitus is often in combination with hyperacusis. Our results point at 'silent hearing loss' as the underlying pathology, having afferent nerve terminal damage rather than hair cell loss as the structural correlate.

OBJECTIVES

Exposure to loud music is one of the most common causes of acute acoustic trauma, which adolescents and teenagers experience by voluntary exposure to loud music of sound levels up to 110 dB(A).

METHODS

The clinical and psychophysical data of 104 consecutive patients with music-induced hearing disorder (MIHD) were analyzed to construct individual hearing and tinnitus profiles. In all cases, tinnitus was the presenting symptom.

RESULTS

Hearing abilities were normal in about two-thirds of the tinnitus patients. Tinnitus was experienced most often as a high-frequency tone (83%). The Tinnitus Handicap Inventory (THI) scores ranged from 0 to 94 with an average score of 43.1. Visual analog scales (VAS) were used to assess tinnitus loudness (average 42.4) and annoyance (average 54.2), and tinnitus awareness was estimated (average 60.3). All VAS values correlated strongly with the THI. Hyperacusis was present in 65% and 71% of the patients reported sleeping disorders.

[The effects of tympanoplasty on improvements of hearing and tinnitus for chronic otitis media patients with tinnitus]

Objective:The purpose of this study is to investigate the correlation of hearing and tinnitus improvement levels in chronic otitis media (COM) patients after tympanoplasty.Method:Thirty-five cases with COM, accompanied with tinnitus on the affected side or undefined sides, were enrolled and accepted for tympanoplasty between May 2015 and Dec 2016. Audiologic evaluation by pure tone audiometry and assessment of Tinnitus Handicap Inventory scores were conducted in pre-operation and 3 months post-operation. The mean air conduction (AC), boneconduction (BC), air-bone gap (ABG) at 500, 1 000, 2 000 and 4 000 Hz was calculated. THI scores were recorded and analyzed.Result:All the patients healed well and the felthearing was improved and tinnitus symptoms alleviated. There was a significant difference between post-operative THI score (15.0±5.6) and pre-operative score (21.2±7.4), t= 7.8, P< 0.01. Significant differenceswerealso found in comparison of pre-operative AC (41.6±9.9)dBHL and post-operative AC(32.5±10.0)dBHL, t= 5.9, P< 0.01, pre-operative ABG (27.0±7.4)dBHL and post-operative ABG (18.3±7.7)dBHL,t= 6.5, P< 0.01. However, the value of BC in the pre-operation (14.5±5.9)dBHL was almost the same as that in post-operation(13.9±6.0)dBHL, t= 1.2, P> 0.05. Hearing improve levels aboutAC and ABG were positively correlated with the remission degree of tinnitus post-operatively (t= 0.9, P< 0.01).Conclusion:Patients accompanied with tinnitus experienced a remarkableremission in tinnitus and recoveryin hearing levelfollowed bytympanoplasty.Tympanoplasty was a positive treatment for relievingtinnitus in COM patients.

Customized Versus Noncustomized Sound Therapy for Treatment of Tinnitus: A Randomized Crossover Clinical Trial

OBJECTIVES

To determine the effectiveness of a customized sound therapy and compare its effectiveness to that of masking with broadband noise.

METHODS

Subjects were randomized to receive either customized sound therapy or broadband noise for 2 hours per day for 3 months and then switched to the other treatment after a washout period. The outcome variables were tinnitus loudness (scored 0-10), Tinnitus Handicap Inventory (THI), Beck Anxiety Inventory (BAI), minimum masking levels (MML), and residual inhibition (RI).

RESULTS

Eighteen subjects completed the study. Mean age was 53 ± 11 years, and mean tinnitus duration was 118 ± 99 months. With customized sound therapy, mean loudness decreased from 6.4 ± 2.0 to 4.9 ± 1.9 ( P = .001), mean THI decreased from 42.8 ± 21.6 to 31.5 ± 20.3 ( P < .001), mean BAI decreased from 10.6 ± 10.9 to 8.3 ± 9.9 ( P = .01), and MML decreased from 22.3 ± 11.6 dB SL to 17.2 ± 10.6 dB SL ( P = .005). After 3 months of broadband noise therapy, only BAI and, to a lesser degree, MML decreased ( P = .003 and .04, respectively).

CONCLUSIONS

Customized sound therapy can decrease the loudness and THI scores of tinnitus patients, and the results may be superior to broadband noise.

[The clinical application of tinnitus handicap index(THI-12) Chinese version]

Objective:The original prospective of this study is to explore a convenient tinnitus severity assessment tool, using Chinese version of THI-12.Method:We surveyed 229 outpatients on their first hospital visits with primary tinnitus as chief complaint. Both the Chinese version THI-12 and the standard THI-25 were administrated. Their tinnitus grading and administration time were compared. The correlation between the two scores was evaluated. A reliability and factor analysis of the Chinese version of THI-12 was also performed.Result:Two hundred and fifteen of the 229 questionnaires were valid with a 93.9% response rate. The average administration time was(18.9±21.0) min for the standard THI-25 and(8.96±4.70)min for the Chinese version THI-12, which was significantly different. Pearson's correlation coefficient between the two total scores was r=0.833(P <0.01), which indicates a strong positive correlation.The tinnitus grading was not statistically significant(Z=-0.307，P >0.05).Cronbach's coefficient of THI-12 was α=0.765, suggesting good reliability and internal consistency. Factor analysis found three entries with characteristic values greater than 1. These three common factors explained 51.77% of the overall variance, suggesting that the 12 entries can be grouped into three dimensions(emotionality, sociality, concentration). Entry"Because of your tinnitus is it difficult for you to concentrate? "had the highest common value(0.78), suggesting that this entry would contribute the most should all entries be divided into three dimensions.Conclusion:The Chinese version THI-12 is time-efficient, has good reliability and internal structural validity, and provides good assessment of tinnitus severity.It can be widely applied in clinical practice.

Impact of reduction of tinnitus intensity on patients' quality of life

OBJECTIVE

Assess the impact of a reduction of tinnitus intensity achieved through sound stimulation during sleep on the improvement in the patients' quality of life.

DESIGN

Acoustic stimuli consisted of a highly customized sound that reproduced the spectral and intensity characteristics of the tinnitus in each patient. This stimulus was uploaded into a portable electronic device and delivered through customized ear buds during sleep, every night for three months.

STUDY SAMPLE

Twelve patients with subjective idiopathic chronic tinnitus were studied.

RESULTS

Results were assessed through: (1) the measurement in dB SPL of tinnitus intensity reduction over time; (2) the results of three psychometric tests: Tinnitus handicap inventory (THI), Tinnitus reaction questionnaire (TRQ), Tinnitus functional index (TFI); and (3) a Visual analog scale (VAS) for tinnitus annoyance. After three months of treatment, we observed an average decrease in tinnitus intensity of 14.1 dB SPL (p < 0.001), implying a 62% reduction of the perceived sound. This improvement was followed by a statistically significant decrease of TRQ (78%), THI (65%), and TFI (77%).

CONCLUSIONS

These results suggested that the intensity reduction achieved through the protocol used in this study had a direct impact on the improvement in the patients' quality of life.

Cochrane Corner: Amplification with Hearing Aids for Patients with Tinnitus and Co-existing Hearing Loss

The "Cochrane Corner" is a section in the journal that highlights systematic reviews relevant to otolaryngology-head and neck surgery, with invited commentary to aid clinical decision making. This installment features a Cochrane review, "Amplification with Hearing Aids for Patients with Tinnitus and Co-existing Hearing Loss," which identified only 1 randomized controlled trial and concluded that current evidence for use of hearing aids is limited.