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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.
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Sruthi N, Venkataramanujam NC, Karthikeyan P, Kaipuzha RR, Pulimoottil DT. A Comparative Study of Treatment Outcomes of Music Therapy, Tinnitus Maskers and Pharmacotherpy in Chronic Subjective Tinnitus. Indian J Otolaryngol Head Neck Surg 2022; 74:185-189. [PMID: 35813784 PMCID: PMC9256873 DOI: 10.1007/s12070-021-02799-z] [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: 05/02/2021] [Accepted: 08/01/2021] [Indexed: 10/20/2022] Open
Abstract
Tinnitus represents one of the most common and distressing otologic problems, and it causes various somatic and psychological disorders that interfere with the quality of life. This study aimed to compare the outcome of music therapy, tinnitus maskers and pharmacotherapy on patients with chronic tinnitus, to observe and analyse the etiological factors of tinnitus and to find out whether music can be used as an active listening mode by which tinnitus perception can be decreased. This was a comparative longitudinal study involving 90 patients with chronic tinnitus who were randomly assigned to 3 groups of 30 each: Group A (Music therapy), Group B (Pharmacotherapy) and Group C (Tinnitus masker). After a detailed clinical history and examination, Tinnitus Handicap Inventory and Visual Analogue Scores were recorded both prior to and following therapy, and patient were followed up monthly up to 2 months. There is a significant difference in the mean THI score (p = 0.002) and mean VAS(p = 0.0006) at 2 months follow up in patients treated with Music therapy and patients had a satisfactory outcome after music therapy and did not require any further treatment. Patients in pharmacotherapy and hearing aid group had a good clinical improvement but mean THI and mean VAS score was not statically significant. It was also noticed that loud noise exposure and hypertension were main etiological factors in 37.77% and 26% of patients respectively. Music therapy appears to be an effective and cost-efficient mode of therapy for chronic tinnitus and could be suitable for widespread implementation for patients with tinnitus of varying severity. Pharmacotherapy and hearing aid application in the treatment of tinnitus has good outcome in our study but requires long term treatment and follow up.
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Affiliation(s)
- Narayanam Sruthi
- Department of ENT, Sai Children’s Hospital, Chirala, Andhra Pradesh India
| | - Nirmal Coumare Venkataramanujam
- Department of Otorhinolaryngology and Head and Neck Surgery, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pondicherry, India
| | - Padmanabhan Karthikeyan
- Department of Otorhinolaryngology and Head and Neck Surgery, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pondicherry, India
| | | | - Davis Thomas Pulimoottil
- Department of ENT, Al Azhar Medical College and Super Specialty Hospital, Thodupuzha, Kerala 685 605 India
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Bal K, Mendes D, Ismi O, Vayisoglu Y. Intratympanic treatment in chronic subjective tinnitus. INDIAN JOURNAL OF OTOLOGY 2022. [DOI: 10.4103/indianjotol.indianjotol_58_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Tegg-Quinn S, Eikelboom RH, Brennan-Jones CG, Barabash S, Mulders WHAM, Bennett RJ. Reflections on How Tinnitus Impacts the Lives of Children and Adolescents. Am J Audiol 2021; 30:544-556. [PMID: 34139128 DOI: 10.1044/2021_aja-20-00178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objectives The aim of this study was to generate a conceptual framework describing which aspects of children and adolescents' lives are affected by chronic tinnitus. Design Views and experiences of 32 participants from two participant groups informed this study: (a) a tinnitus group, consisting of adults who had experienced tinnitus during childhood and/or adolescence and primary carers of children/adolescents with tinnitus, and (b) a clinicians' group, consisting of clinicians who provided care for children/adolescents with tinnitus. Participants produced statements describing aspects of children/adolescents' lives that may be affected by chronic tinnitus. Key concepts were identified through the processes of sorting the statements and rating them for degree of associated impact. Result Participants identified 118 unique aspects of the lives of children/adolescents who may be affected by chronic tinnitus. These were clustered into four concepts: (a) emotional well-being, (b) academic performances, (c) social/relationa, and (d) auditory/cognitive processing. At a group level, participants rated the impact of tinnitus as above a slight degree but below a moderate degree of impact. However, individual participant's ratings indicated a range of perceived impact for each statement. Conclusions The experience of chronic tinnitus during childhood and adolescence extends beyond the mere perception of sound. The perception of tinnitus may impact a child's emotional well-being, academic performances, social/relational, and auditory/cognitive processing. The impact of tinnitus in one aspect of a child's life may influence other aspects of their life. While at a group level, participants regarded the impact of tinnitus as "somewhat more than mild" to "less than moderate"; individual participant's ratings indicate that the impact from chronic tinnitus may be highly individual and highlighted the importance of individual assessment and management. Clinically, tinnitus management during childhood and adolescence may be improved if clinicians consider the impact and manifestation of tinnitus within each child's daily life and tailor tinnitus education and management strategies accordingly.
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Affiliation(s)
- Susan Tegg-Quinn
- Ear Science Institute Australia, Subiaco, Western Australia, Australia
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia
- School of Human Sciences, The University of Western Australia, Nedlands, Australia
| | - Robert H. Eikelboom
- Ear Science Institute Australia, Subiaco, Western Australia, Australia
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | - Christopher G. Brennan-Jones
- Ear Health Group, Telethon Kids Institute, The University of Western Australia, Nedlands, Australia
- Division of Paediatrics, School of Medicine, The University of Western Australia, Nedlands, Australia
- Department of Audiology, Perth Children's Hospital, Western Australia, Australia
| | | | | | - Rebecca J. Bennett
- Ear Science Institute Australia, Subiaco, Western Australia, Australia
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia
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Dawes P, Cruickshanks KJ, Marsden A, Moore DR, Munro KJ. Relationship Between Diet, Tinnitus, and Hearing Difficulties. Ear Hear 2021; 41:289-299. [PMID: 31356390 PMCID: PMC7664714 DOI: 10.1097/aud.0000000000000765] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 05/21/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Diet may affect susceptibility of the inner ear to noise and age-related effects that lead to tinnitus and hearing loss. This study used complementary single nutrient and dietary pattern analysis based on statistical grouping of usual dietary intake in a cross-sectional analysis of tinnitus and hearing difficulties in a large population study sample. DESIGN The research was conducted using the UK Biobank resource. Tinnitus was based on report of ringing or buzzing in one or both ears that lasts more than five minutes at a time and is currently experienced at least some of the time. Identification of a hearing problem was based on self-reported difficulties with hearing. Usual dietary intake and dietary patterns (involving statistical grouping of intake to account for how foods are combined in real-life diets) were estimated based on between two and five administrations of the Oxford Web-Q 24-hour dietary recall questionnaire over the course of a year for 34,576 UK adult participants aged 40 to 69. RESULTS In a multivariate model, higher intake of vitamin B12 was associated with reduced odds of tinnitus, while higher intakes of calcium, iron, and fat were associated with increased odds (B12, odds ratio [OR] 0.85, 95% confidence interval [CI] 0.75 to 0.97; Calcium, OR 1.20, 95% CI 1.08 to 1.34; Iron, OR 1.20, 95% CI 1.05 to 1.37; Fat, OR 1.33, 95% CI 1.09 to 1.62, respectively, for quintile 5 versus quintile 1). A dietary pattern characterised by high protein intake was associated with reduced odds of tinnitus (OR 0.90, 95% CI 0.82 to 0.99 for quintile 5 versus quintile 1). Higher vitamin D intake was associated with reduced odds of hearing difficulties (OR 0.90, 95% CI 0.81 to 1.00 for quintile 5 versus quintile 1), as were dietary patterns high in fruit and vegetables and meat and low in fat (Prudent diet: OR 0.89, 95% CI 0.83 to 0.96; High protein: OR 0.88, 95% CI 0.82 to 0.95; High fat: OR 1.16, 95% CI 1.08 to 1.24, respectively, for quintile 5 versus quintile 1). CONCLUSIONS There were associations between both single nutrients and dietary patterns with tinnitus and hearing difficulties. Although the size of the associations was small, universal exposure for dietary factors indicates that there may be a substantial impact of diet on levels of tinnitus and hearing difficulties in the population. This study showed that dietary factors might be important for hearing health.
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Affiliation(s)
- Piers Dawes
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Karen J. Cruickshanks
- Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Antonia Marsden
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - David R. Moore
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Kevin J. Munro
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Luetzenberg FS, Babu S, Seidman MD. Alternative Treatments of Tinnitus: Alternative Medicine. Otolaryngol Clin North Am 2020; 53:637-650. [PMID: 32362562 DOI: 10.1016/j.otc.2020.03.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
"Because Western medicine has remained largely unsuccessful at treating tinnitus symptoms, many physicians as well as patients have turned to alternative treatment options to decrease patients' suffering and improve their quality of life. Although research in complementary/integrative medicine continues to be scarce and inconclusive, studies are pointing toward the positive effects of acupuncture, herbal remedies, dietary supplements, antioxidants, melatonin, and hypnosis on tinnitus. Although the efficacies of these treatments are inconsistent and may depend on a patient's unique circumstances, studies acknowledge that each treatment is worth trying in light of the potential benefits while being both noninvasive and well tolerated."
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Affiliation(s)
- Friederike S Luetzenberg
- University of Central Florida College of Medicine, 6850 Lake Nona Boulevard, Orlando, FL 32827, USA
| | - Seilesh Babu
- Department of Otology, Neurotology, & Skull Base Surgery, Michigan Ear Institute, Farmington Hills, MI 48334, USA; Ascension Macomb Otolaryngology Residency, 11800 East 12 Mile Road, Warren, MI 48093, USA; Department of Otolaryngology, Wayne State University, Detroit, MI, USA
| | - Michael D Seidman
- Otologic/Neurotologic/Skull Base Surgery; Wellness and Integrative Medicine; Advent Health (Celebration and South Campuses); Otolaryngology Head and Neck Surgery, University of Central Florida College of Medicine; AdventHealth Medical Group- Otolaryngology-Head and Neck Surgery, 410Celebration Place Suite 305, Celebration, FL 34747, USA.
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Yeh CW, Tseng LH, Yang CH, Hwang CF. Effects of oral zinc supplementation on patients with noise-induced hearing loss associated tinnitus: A clinical trial. Biomed J 2019; 42:46-52. [PMID: 30987704 PMCID: PMC6468114 DOI: 10.1016/j.bj.2018.10.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 07/19/2018] [Accepted: 10/29/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Zinc plays a vital antioxidant role in human metabolism. Recent studies have demonstrated a correlation between noise-induced hearing loss (NIHL) and oxidative injury; however, no investigation has focused specifically on the subgroup of NIHL associated tinnitus patients. We aimed to evaluate the effectiveness of zinc supplementation in treating NIHL associated tinnitus. METHODS Twenty patients with tinnitus and a typical NIHL audiogram (38 ears) were included in this study. Another 20 healthy subjects were used as the control group. A full medical history assessment was performed, and each subject underwent an otoscopic examination, basic audiologic evaluation, distortion product otoacoustic emissions (DPOAEs), tinnitus-match testing, Tinnitus Handicap Inventory (THI) and serum zinc level analyses. After 2 months of treatment with zinc, all tests were repeated. RESULTS There was a significant difference between pretreatment and post-treatment within the tinnitus group (73.6 vs. 84.6 μg/dl). The pre- and post-treatment difference in serum zinc was significantly higher in the young group (≦50 years) compared to the old group (19.4 ± 11.4 vs. 2.6 ± 9.2 μg/dl, respectively; p = 0.002). There were no statistically significant differences in hearing thresholds, speech reception thresholds, or tinnitus frequency and loudness results before and after treatment. In addition, 17 patients (85%) showed statistically significant improvement of THI-total scores post-treatment, from 38.3 to 30 (p = 0.024). CONCLUSIONS Zinc oral supplementation elevated serum zinc levels, especially in younger patients. THI scores improved significantly following zinc treatment in patients with NIHL associated tinnitus. However, no improvements in objective hearing parameters were observed.
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Affiliation(s)
- Chun-Wei Yeh
- Department of Otolaryngology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Leng-Hsuan Tseng
- Graduate Institute of Audiology and Speech Therapy, National Kaohsiung Normal University, Kaohsiung, Taiwan
| | - Chao-Hui Yang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chung-Feng Hwang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Otolaryngology, Chang Gung Memorial Hospital and Xiamen Medical Center, Fujian, China.
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Tetteh H, Lee M, Lau CG, Yang S, Yang S. Tinnitus: Prospects for Pharmacological Interventions With a Seesaw Model. Neuroscientist 2017; 24:353-367. [PMID: 29283017 DOI: 10.1177/1073858417733415] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Chronic tinnitus, the perception of lifelong constant ringing in ear, is one capital cause of disability in modern society. It is often present with various comorbid factors that severely affect quality of life, including insomnia, deficits in attention, anxiety, and depression. Currently, there are limited therapeutic treatments for alleviation of tinnitus. Tinnitus can involve a shift in neuronal excitation/inhibition (E/I) balance, which is largely modulated by ion channels and receptors. Thus, ongoing research is geared toward pharmaceutical approaches that modulate the function of ion channels and receptors. Here, we propose a seesaw model that delineates how tinnitus-related ion channels and receptors are involved in homeostatic E/I balance of neurons. This review provides a thorough account of our current mechanistic understanding of tinnitus and insight into future direction of drug development.
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Affiliation(s)
- Hannah Tetteh
- 1 Department of Biomedical Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong
| | - Minseok Lee
- 2 Department of Nano-Bioengineering, Incheon National University, Incheon, South Korea
| | - C Geoffrey Lau
- 1 Department of Biomedical Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong
| | - Sunggu Yang
- 2 Department of Nano-Bioengineering, Incheon National University, Incheon, South Korea
| | - Sungchil Yang
- 1 Department of Biomedical Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong
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Spankovich C, Bishop C, Johnson MF, Elkins A, Su D, Lobarinas E, Le Prell CG. Relationship between dietary quality, tinnitus and hearing level: data from the national health and nutrition examination survey, 1999–2002. Int J Audiol 2017; 56:716-722. [DOI: 10.1080/14992027.2017.1331049] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Christopher Spankovich
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, MS, USA,
| | - Charles Bishop
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, MS, USA,
| | - Mary Frances Johnson
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, MS, USA,
| | - Alex Elkins
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, MS, USA,
| | - Dan Su
- Department of Data Science, University of Mississippi Medical Center, Jackson, MS, USA, and
| | - Edward Lobarinas
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX, USA
| | - Colleen G. Le Prell
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX, USA
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Yaşar M, Şahin Mİ, Karakükçü Ç, Güneri E, Doğan M, Sağıt M. The Role of Trace Elements in Tinnitus. Biol Trace Elem Res 2017; 176:65-72. [PMID: 27502826 DOI: 10.1007/s12011-016-0815-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 07/29/2016] [Indexed: 10/21/2022]
Abstract
In this study, we aimed to investigate the role of three trace elements, namely, zinc, copper, and lead, in tinnitus by analyzing the serum level of copper and lead and both the serum and tissue level of zinc. Eighty patients, who applied to outpatient otolaryngology clinic with the complaints of having tinnitus, and 28 healthy volunteers were included. High-frequency audiometry was performed, and participants who had hearing loss according to the pure tone average were excluded; tinnitus frequency and loudness were determined and tinnitus reaction questionnaire scores were obtained from the patients. Of all the participants, serum zinc, copper, and lead values were measured; moreover, zinc levels were examined in hair samples. The levels of trace elements were compared between tinnitus and control groups. The level of copper was found to be significantly lower in the tinnitus group (p = 0.02), but there was no significant difference between the groups in terms of the levels of zinc, neither in serum nor in hair, and lead in serum (p > 0.05). The lack of trace elements, especially that of "zinc," have been doubted for the etiopathogenesis of tinnitus in the literature; however, we only found copper levels to be low in patients having tinnitus.
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Affiliation(s)
- Mehmet Yaşar
- Department of ENT, Kayseri Training and Research Hospital, Sanayi Mah. Atatürk Bulvarı Hastane Cad. No:7, 38010, Kocasinan, Kayseri, Turkey
| | - Mehmet İlhan Şahin
- Department of Otolaryngology, Erciyes University Medical School, Talas Yolu, 38039, Melikgazi, Kayseri, Turkey.
| | - Çiğdem Karakükçü
- Department of Clinical Biochemistry, Kayseri Training and Research Hospital, Sanayi Mah. Atatürk Bulvarı Hastane Cad. No:7, 38010, Kocasinan, Kayseri, Turkey
| | - Erhan Güneri
- Department of ENT, Kayseri Training and Research Hospital, Sanayi Mah. Atatürk Bulvarı Hastane Cad. No:7, 38010, Kocasinan, Kayseri, Turkey
| | - Murat Doğan
- Department of ENT, Kayseri Training and Research Hospital, Sanayi Mah. Atatürk Bulvarı Hastane Cad. No:7, 38010, Kocasinan, Kayseri, Turkey
| | - Mustafa Sağıt
- Department of ENT, Kayseri Training and Research Hospital, Sanayi Mah. Atatürk Bulvarı Hastane Cad. No:7, 38010, Kocasinan, Kayseri, Turkey
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Zenner HP, Delb W, Kröner-Herwig B, Jäger B, Peroz I, Hesse G, Mazurek B, Goebel G, Gerloff C, Trollmann R, Biesinger E, Seidler H, Langguth B. A multidisciplinary systematic review of the treatment for chronic idiopathic tinnitus. Eur Arch Otorhinolaryngol 2016; 274:2079-2091. [DOI: 10.1007/s00405-016-4401-y] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 11/19/2016] [Indexed: 01/17/2023]
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Sensorineural Tinnitus: Its Pathology and Probable Therapies. Int J Otolaryngol 2016; 2016:2830157. [PMID: 26977153 PMCID: PMC4761664 DOI: 10.1155/2016/2830157] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 01/12/2016] [Indexed: 12/11/2022] Open
Abstract
Tinnitus is not a single disease but a group of different diseases with different pathologies and therefore different treatments. Regarding tinnitus as a single disease is hampering progress in understanding of the pathophysiology of tinnitus and perhaps, more importantly, it is a serious obstacle in development of effective treatments for tinnitus. Subjective tinnitus is a phantom sound that takes many different forms and has similarities with chronic neuropathic pain. The pathology may be in the cochlea, in the auditory nerve, or, most commonly, in the brain. Like chronic neuropathic pain tinnitus is not life threatening but influences many normal functions such as sleep and the ability to concentrate on work. Some forms of chronic tinnitus have two components, a (phantom) sound and a component that may best be described as suffering or distress. The pathology of these two components may be different and the treatment that is most effective may be different for these two components. The most common form of treatment of tinnitus is pharmacological agents and behavioral treatment combined with sound therapy. Less common treatments are hypnosis and acupuncture. Various forms of neuromodulation are becoming in use in an attempt to reverse maladaptive plastic changes in the brain.
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Is Hypozincemia Related to Tinnitus?: A Population Study Using Data From the Korea National Health and Nutrition Examination Survey. Clin Exp Otorhinolaryngol 2015; 8:335-8. [PMID: 26622950 PMCID: PMC4661247 DOI: 10.3342/ceo.2015.8.4.335] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 11/25/2014] [Accepted: 12/01/2014] [Indexed: 11/14/2022] Open
Abstract
Objectives The aim of present study was to determine the relationship between serum zinc level and tinnitus using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods The present study examined the relationship between serum zinc level and tinnitus using data from the KNHANES. A total of 2,225 KNHANES participants responded to the tinnitus questionnaire and provided blood samples to measure serum zinc concentration. Based on questionnaire responses, participants were categorized into control, mild tinnitus, moderate tinnitus, and severe tinnitus subgroups. Results There were no significant differences between groups in serum zinc level after adjustment for sex, age, and hearing loss. Conclusion It was concluded that hypozincemia is not related to tinnitus in a large population.
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Effects of serum zinc level on tinnitus. Am J Otolaryngol 2015; 36:230-4. [PMID: 25554004 DOI: 10.1016/j.amjoto.2014.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 10/27/2014] [Accepted: 11/14/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to assess zinc levels in tinnitus patients, and to evaluate the effects of zinc deficiency on tinnitus and hearing loss. METHODS One-hundred patients, who presented to an outpatient clinic with tinnitus between June 2009 and 2014, were included in the study. Patients were divided into three groups according to age: Group I (patients between 18 and 30years of age); Group II (patients between 31 and 60years of age); and Group III (patients between 61 and 78years of age). Following a complete ear, nose and throat examination, serum zinc levels were measured and the severity of tinnitus was quantified using the Tinnitus Severity Index Questionnaire (TSIQ). Patients were subsequently asked to provide a subjective judgment regarding the loudness of their tinnitus. The hearing status of patients was evaluated by audiometry and high-frequency audiometry. An average hearing sensitivity was calculated as the mean value of hearing thresholds between 250 and 20,000Hz. Serum zinc levels between 70 and 120μg/dl were considered normal. The severity and loudness of tinnitus, and the hearing thresholds of the normal zinc level and zinc-deficient groups, were compared. RESULTS Twelve of 100 (12%) patients exhibited low zinc levels. The mean age of the zinc-deficient group was 65.41±12.77years. Serum zinc levels were significantly lower in group III (p<0.01). The severity and loudness of tinnitus were greater in zinc-deficient patients (p=0.011 and p=0.015, respectively). Moreover, the mean thresholds of air conduction were significantly higher in zinc-deficient patients (p=0.000). CONCLUSION We observed that zinc levels decrease as age increases. In addition, there was a significant correlation between zinc level and the severity and loudness of tinnitus. Zinc deficiency was also associated with impairments in hearing thresholds.
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Smith GS, Romanelli-Gobbi M, Gray-Karagrigoriou E, Artz GJ. Complementary and Integrative Treatments. Otolaryngol Clin North Am 2013; 46:389-408. [DOI: 10.1016/j.otc.2013.02.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Langguth B, Elgoyhen AB. Current pharmacological treatments for tinnitus. Expert Opin Pharmacother 2012; 13:2495-509. [DOI: 10.1517/14656566.2012.739608] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Abstract
Tinnitus, the perception of sound in the absence of an auditory stimulus, is perceived by about 1 in 10 adults, and for at least 1 in 100, tinnitus severely affects their quality of life. Because tinnitus is frequently associated with irritability, agitation, stress, insomnia, anxiety and depression, the social and economic burdens of tinnitus can be enormous. No curative treatments are available. However, tinnitus symptoms can be alleviated to some extent. The most widespread management therapies consist of auditory stimulation and cognitive behavioral treatment, aiming at improving habituation and coping strategies. Available clinical trials vary in methodological rigor and have been performed for a considerable number of different drugs. None of the investigated drugs have demonstrated providing replicable long-term reduction of tinnitus impact in the majority of patients in excess of placebo effects. Accordingly, there are no FDA or European Medicines Agency approved drugs for the treatment of tinnitus. However, in spite of the lack of evidence, a large variety of different compounds are prescribed off-label. Therefore, more effective pharmacotherapies for this huge and still growing market are desperately needed and even a drug that produces only a small but significant effect would have an enormous therapeutic impact. This review describes current and emerging pharmacotherapies with current difficulties and limitations. In addition, it provides an estimate of the tinnitus market. Finally, it describes recent advances in the tinnitus field which may help overcome obstacles faced in the pharmacological treatment of tinnitus. These include incomplete knowledge of tinnitus pathophysiology, lack of well-established animal models, heterogeneity of different forms of tinnitus, difficulties in tinnitus assessment and outcome measurement and variability in clinical trial methodology.
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Affiliation(s)
- Berthold Langguth
- University of Regensburg, Interdisciplinary Tinnitus Clinic, Department of Psychiatry and Psychotherapy, Universitaetsstrabetae 84, 93053 Regensburg, Germany.
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Han BI, Lee HW, Kim TY, Lim JS, Shin KS. Tinnitus: characteristics, causes, mechanisms, and treatments. J Clin Neurol 2009; 5:11-9. [PMID: 19513328 PMCID: PMC2686891 DOI: 10.3988/jcn.2009.5.1.11] [Citation(s) in RCA: 150] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2008] [Revised: 02/13/2009] [Accepted: 02/13/2009] [Indexed: 11/30/2022] Open
Abstract
Tinnitus-the perception of sound in the absence of an actual external sound-represents a symptom of an underlying condition rather than a single disease. Several theories have been proposed to explain the mechanisms underlying tinnitus. Tinnitus generators are theoretically located in the auditory pathway, and such generators and various mechanisms occurring in the peripheral auditory system have been explained in terms of spontaneous otoacoustic emissions, edge theory, and discordant theory. Those present in the central auditory system have been explained in terms of the dorsal cochlear nucleus, the auditory plasticity theory, the crosstalk theory, the somatosensory system, and the limbic and autonomic nervous systems. Treatments for tinnitus include pharmacotherapy, cognitive and behavioral therapy, sound therapy, music therapy, tinnitus retraining therapy, massage and stretching, and electrical suppression. This paper reviews the characteristics, causes, mechanisms, and treatments of tinnitus.
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Affiliation(s)
- Byung In Han
- Do Neurology Clinic, Willis Medical Network, Daegu, Korea
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Vestibular Evaluation Using Videonystagmography of Chronic Zinc Deficient Patients Due to Short Bowell Syndrome. Braz J Otorhinolaryngol 2009; 75:290-4. [PMID: 19575118 PMCID: PMC9450786 DOI: 10.1016/s1808-8694(15)30792-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2007] [Accepted: 07/29/2008] [Indexed: 11/21/2022] Open
Abstract
The presence of zinc in the auditory pathways and its probable participation in tinnitus and hearing loss are known facts, although there are no clinical trials and experimental studies showing the impact of hypozincemia in the vestibular system and zinc existence in the vestibular pathway, respectively. Aim This study is an attempt to correlate hypozincemia and abnormal vestibular function. Methods This is a clinical retrospective case study where nine patients suffering of chronic zinc deficiency had their serum zinc determined and were submitted to videonystagmography. Results were compared to a normal (control) group. Results All vestibular test parameters were altered when we compared experimental and control groups. Conclusion Comparison between groups shows significant differences in many aspects of the vestibular analysis and calls our attention towards a possible participation of zinc on the genesis of vestibular disorders.
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21
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Abstract
Subjective tinnitus, the phantom ringing or buzzing sensation that occurs in the absence of sound, affects 12-14% of adults; in some cases the tinnitus is so severe or disabling that patients seek medical treatment. However, although the economic and emotional impact of tinnitus is large, there are currently no FDA-approved drugs to treat this condition. Clinical trials are now underway to evaluate the efficacy of N-methyl-d-aspartate (NMDA) and dopamine D(2) antagonists, selective serotonin reuptake inhibitors (SSRIs), γ-aminobutyric acid (GABA) agonists and zinc dietary supplements. Previous off-label clinical studies, while not definitive, suggest that patients with severe depression may experience improvement in their tinnitus after treatment with antidepressants such as nortriptyline or sertraline. A small subpopulation of patients with what has been described as "typewriter tinnitus" have been shown to gain significant relief from the anticonvulsant carbamazepine. Preliminary studies with misoprostol, a synthetic prostaglandin E1 analogue, and sulpiride, a dopamine D(2) antagonist, have shown promise. Animal behavioral studies suggest that GABA transaminase inhibitors and potassium channel modulators can suppress tinnitus. Additionally, improvements in tinnitus have also been noted in patients taking melatonin for significant sleep disturbances. Like other complex neurological disorders, one drug is unlikely to resolve tinnitus in all patients; therapies targeting specific subgroups are likely to yield the greatest success.
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Affiliation(s)
- R. Salvi
- Center for Hearing and Deafness and Department of Communicative Disorders and Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - E. Lobarinas
- Center for Hearing and Deafness and Department of Communicative Disorders and Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - W. Sun
- Center for Hearing and Deafness and Department of Communicative Disorders and Sciences, University at Buffalo, Buffalo, NY 14214, USA
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22
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Coelho CB, Tyler R, Hansen M. Zinc as a possible treatment for tinnitus. PROGRESS IN BRAIN RESEARCH 2007; 166:279-85. [DOI: 10.1016/s0079-6123(07)66026-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Henry JA, Dennis KC, Schechter MA. General review of tinnitus: prevalence, mechanisms, effects, and management. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2005; 48:1204-35. [PMID: 16411806 DOI: 10.1044/1092-4388(2005/084)] [Citation(s) in RCA: 411] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2004] [Accepted: 01/05/2005] [Indexed: 05/06/2023]
Abstract
Tinnitus is an increasing health concern across all strata of the general population. Although an abundant amount of literature has addressed the many facets of tinnitus, wide-ranging differences in professional beliefs and attitudes persist concerning its clinical management. These differences are detrimental to tinnitus patients because the management they receive is based primarily on individual opinion (which can be biased) rather than on medical consensus. It is thus vitally important for the tinnitus professional community to work together to achieve consensus. To that end, this article provides a broad-based review of what is presently known about tinnitus, including prevalence, associated factors, theories of pathophysiology, psychological effects, effects on disability and handicap, workers' compensation issues, clinical assessment, and various forms of treatment. This summary of fundamental information has relevance to both clinical and research arenas.
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Affiliation(s)
- James A Henry
- Veterans Affairs Medical Center, Portland, OR 97207, USA.
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Kalcioglu MT, Bayindir T, Erdem T, Ozturan O. Objective evaluation of the effects of intravenous lidocaine on tinnitus. Hear Res 2005; 199:81-8. [PMID: 15574302 DOI: 10.1016/j.heares.2004.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2004] [Accepted: 08/05/2004] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Tinnitus is one of the most common and distressing otological symptoms. Although numerous therapeutic modalities have been tried, there is no consensus regarding effective therapeutic agents up to now. The effects of lidocaine on tinnitus have been reported in literature using either subjective or audiologic tests. Nevertheless, the otoacoustic emissions (OAEs) have not been utilized to demonstrate lidocaine's effect on the cochlea in the English literature. The aim of this study was to evaluate the effect of lidocaine on tinnitus by considering the alterations with tinnitus, it induces on OAEs and subjective symptoms. METHODS This study was performed in 30 patients with tinnitus. Twenty-eight of the patients had normal hearing and two of them evidenced mild sensorineural hearing loss. To determine the severity of tinnitus, the patients were required to fill out a tinnitus scoring scale before lidocaine infusion on the same day. Then, lidocaine was administered intravenously to each patient at a dose of 1.5 mg/kg body weight over a period of 30 min. Spontaneous otoacoustic emissions (SOAEs) and distortion product otoacoustic emissions (DPOAEs) were measured three times; namely before lidocaine injection, at 25 min after injection and on the next day. The severity of tinnitus was scored again 1 d, 1 wk and 1 mo after lidocaine administration. RESULTS Immediately after infusion, four patients (13.3%) declared total suppression of tinnitus, whereas three patients (10%) reported only partial relief in tinnitus subjectively. The patients, who had a subjective improved response (group 1) were compared with the patients, who had no response (group 2). Statistically significant changes (p<0.05) in DPOAE response/growth or input/output (I/O) functions were observed at 1, 2, 3, 4 and 6 kHz frequencies in lidocaine responders and at 1, 2, 3, 4 and 5 kHz frequencies in no responders at different primary stimulus levels. Statistically significant changes (p<0.05) were seen at 2 kHz for 53 dB and at 3 kHz for 62 dB SPL primaries in both groups. When the significant results of these two groups were compared with each other, differences were found insignificant. CONCLUSION Systematic OAE measurements revealed that no changes occurred in SOAE and DPOAE levels in that alterations disappeared the next day. Subjective relief from tinnitus was stated in some of the patients and lasted for 4 wk at longest.
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Affiliation(s)
- M Tayyar Kalcioglu
- Department of Otorhinolaryngology; Inonu University, School of Medicine, Turgut Ozal Medical Center, Malatya 44069, Turkey.
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