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Yazici D, Cihan MC. Correlation of Tinnitus Severity Index and Tinnitus Handicap Inventory with Hematological Parameters in Patients with Subjective Tinnitus. Int Arch Otorhinolaryngol 2023; 27:e608-e612. [PMID: 37876701 PMCID: PMC10593538 DOI: 10.1055/s-0042-1758216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/01/2022] [Indexed: 10/26/2023] Open
Abstract
Introduction Tinnitus etiopathogenesis is still unclear and treatment options are controversial despite current advances in medicine. Objectives To analyze the correlation between patients' symptom scores, systemic inflammation, and trombosis biomarkers. Methods In this prospective study, we evaluated the degree of complaints of subjective tinnitus patients with the tinnitus severity index (TSI) and tinnitus handicap inventory (THI), and correlated these symptom scores with hematological parameters such as the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), mean thrombocyte volume (MPV), and platelet distribution width (PDW). Results A total of 44 patients with subjective tinnitus, 25 (56.8%) men and 19 (43.2%) women, were included in this study. The mean age of the patients was 42.3 ± 14.8 years. When the correlation between TSI and NLR, PLR, PDW, and MPV values of the patients were analyzed, no statistically significant correlation was found between TSI, NLR, and PLR ( p > 0.05). However, there was a statistically weak positive correlation between TSI, MPV, and PDW.( p < 0.05). When the correlation between THI and NLR, PLR, PDW, and MPV values of the patients were analyzed, no statistically significant correlation was found between THI, NLR, and PLR ( p > 0.05). There was a statistically weak positive correlation between THI, MPV, and PDW ( p < 0.05). Conclusion We were unable to detect any relationship between systemic inflammation markers (NLR and PLR) and symptom scores, but a weakly positive correlation was observed between thrombosis markers (MPV and PDW) and symptom scores, and as the subclinical thrombosis markers elevated, so did the symptom scores.
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Affiliation(s)
- Demet Yazici
- Department of Otorhinolaryngology, Adana City Training and Research Hospital, Adana, Turkey.
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Mennink LM, Aalbers MW, van Dijk P, van Dijk JMC. The Role of Inflammation in Tinnitus: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11041000. [PMID: 35207270 PMCID: PMC8878384 DOI: 10.3390/jcm11041000] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/10/2022] [Accepted: 02/12/2022] [Indexed: 12/24/2022] Open
Abstract
Subjective tinnitus is the perception of sound without the presence of an external source. Increasing evidence suggests that tinnitus is associated with inflammation. In this systematic review, the role of inflammation in subjective tinnitus was studied. Nine animal and twenty human studies reporting inflammatory markers in both humans and animals with tinnitus were included. It was established that TNF-α and IL-1β are increased in tinnitus, and that microglia and astrocytes are activated as well. Moreover, platelet activation may also play a role in tinnitus. In addition, we elaborate on mechanisms of inflammation in tinnitus, and discuss potential treatment options targeting inflammatory pathways.
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Affiliation(s)
- Lilian M. Mennink
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (M.W.A.); (J.M.C.v.D.)
- Department of Otorhinolaryngology/Head & Neck Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands;
- Research School of Behavioral and Cognitive Neurosciences (BCN), University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
- Correspondence:
| | - Marlien W. Aalbers
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (M.W.A.); (J.M.C.v.D.)
- Research School of Behavioral and Cognitive Neurosciences (BCN), University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
| | - Pim van Dijk
- Department of Otorhinolaryngology/Head & Neck Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands;
- Research School of Behavioral and Cognitive Neurosciences (BCN), University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
| | - J. Marc C. van Dijk
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (M.W.A.); (J.M.C.v.D.)
- Research School of Behavioral and Cognitive Neurosciences (BCN), University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
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Ahmed R, Shadis A, Ahmed R. Potential inflammatory biomarkers for tinnitus in platelets and leukocytes: a critical scoping review and meta-analysis. Int J Audiol 2022; 61:905-916. [PMID: 34978520 DOI: 10.1080/14992027.2021.2018511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To explore the association between platelets or leukocytes and tinnitus. DESIGN A meta-analysis and scoping review examining the association between tinnitus and platelets and leukocytes. All 11 studies included were critically appraised using the Joanna Briggs Institute (JBI) checklist (2017a). A random effects model was used to pool the results of the studies examining mean platelet volume (MPV) and tinnitus. STUDY SAMPLE 1935 studies were identified in the initial search, 11 of which were included in the scoping review. 6 of the 11 studies had their MPV values pooled in the meta-analysis. RESULTS Pooled results of 818 subjects from 6 studies indicated that MPV was significantly higher in those with tinnitus compared to a comparison group without tinnitus. The overall mean difference was 0.43 fL with a 95% confidence interval (CI) from 0.31 to 0.55 and a p value of < 0.0001 which was statistically significant. MPV is the only haematological parameter which is reliably associated with tinnitus. CONCLUSIONS MPV could be a useful biomarker for tinnitus. Further studies should aim to standardise methodology with more rigorous exclusion criteria to reproduce and define this association. NLR, PLR, WBC count, RDW and PDW do not show a reliable association with tinnitus.
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Affiliation(s)
- Raheel Ahmed
- College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Alice Shadis
- College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Rumana Ahmed
- Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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Bhatt IS, Dias R, Torkamani A. Association Analysis of Candidate Gene Polymorphisms and Tinnitus in Young Musicians. Otol Neurotol 2021; 42:e1203-e1212. [PMID: 34282101 PMCID: PMC10860185 DOI: 10.1097/mao.0000000000003279] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Subjective tinnitus, a perception of phantom sound, is a common otological condition that affects almost 15% of the general population. It is known that noise-induced hearing loss (NIHL) and tinnitus exhibit a high level of comorbidity in individuals exposed to intense noise and music. However, the influence of genetic variants associated with NIHL on tinnitus remains elusive. We hypothesized that young musicians carrying genetic variants associated with NIHL would exhibit a higher prevalence of tinnitus than their counterparts. METHODS To test this hypothesis, we analyzed the database by Bhatt et al. (2020) (originally developed by Phillips et al., 2015) that investigated the genetic links to NIHL in young college-aged musicians. The present study identified 186 participants (average age = 20.3 yrs, range = 18-25 yrs) with normal tympanometry and otoscopic findings and with no missing data. We included 19 single nucleotide polymorphisms in 13 cochlear genes that were previously associated with NIHL. The candidate genes include: KCNE1, KCNQ1, CDH23, GJB2, GJB4, KCNJ10, CAT, HSP70, PCDH70, MYH14, GRM7, PON2, and ESRRB. RESULTS We find that individuals with at least one minor allele of rs163171 (C > T) in KCNQ1 exhibit significantly higher odds of reporting tinnitus compared to individuals carrying the major allele of rs163171. KCNE1 rs2070358 revealed a suggestive association (p = 0.049) with tinnitus, but the FDR corrected p-value did not achieve statistical significance (p < 0.05). A history of ear infection and sound level tolerance showed a statistically significant association with tinnitus. Music exposure showed a suggestive association trend with tinnitus. Biological sex revealed a statistically significant association with distortion product otoacoustic emissions SNR measures. CONCLUSIONS We concluded that KCNQ1/KCNE1 voltage-gated potassium ion channel plays a critical role in the pathogenesis of NIHL and tinnitus. Further research is required to construct clinical tools for identifying genetically predisposed individuals well before they acquire NIHL and tinnitus.
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Affiliation(s)
| | - Raquel Dias
- Scripps Research Translational Institute
- Department of Integrative Structural and Computational Biology, Scripps Research, La Jolla, California
| | - Ali Torkamani
- Scripps Research Translational Institute
- Department of Integrative Structural and Computational Biology, Scripps Research, La Jolla, California
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Objective and Measurable Biomarkers in Chronic Subjective Tinnitus. Int J Mol Sci 2021; 22:ijms22126619. [PMID: 34205595 PMCID: PMC8235100 DOI: 10.3390/ijms22126619] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 12/18/2022] Open
Abstract
Tinnitus is associated with increased social costs and reduced quality of life through sleep disorders or psychological distress. The pathophysiology of chronic subjective tinnitus, which accounts for most tinnitus, has not been clearly elucidated. This is because chronic subjective tinnitus is difficult to evaluate objectively, and there are no objective markers that represent the diagnosis or therapeutic effect of tinnitus. Based on the results of studies on patients with chronic subjective tinnitus, objective and measurable biomarkers that help to identify the pathophysiology of tinnitus have been summarized. A total of 271 studies in PubMed, 303 in EMBASE, and 45 in Cochrane Library were found on biomarkers related to chronic subjective tinnitus published until April 2021. Duplicate articles, articles not written in English, review articles, case reports, and articles that did not match our topic were excluded. A total of 49 studies were included. Three specimens, including blood, saliva, and urine, and a total of 58 biomarkers were used as indicators for diagnosis, evaluation, prognosis, and therapeutic effectiveness of tinnitus. Biomarkers were classified into eight categories comprising metabolic, hemostatic, inflammatory, endocrine, immunological, neurologic, and oxidative parameters. Biomarkers can help in the diagnosis, measure the severity, predict prognosis, and treatment outcome of tinnitus.
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Yildiz S, Karaca H, Toros SZ. Mean platelet volume and neutrophil to lymphocyte ratio in patients with tinnitus: a case-control study. Braz J Otorhinolaryngol 2020; 88:155-160. [PMID: 32571752 PMCID: PMC9422477 DOI: 10.1016/j.bjorl.2020.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 04/29/2020] [Accepted: 05/11/2020] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Different theories have been proposed on the etiology of tinnitus, including metabolic and audiologic causes. We suggest that mean platelet volume and neutrophil to lymphocyte ratio levels change in tinnitus, indicating microcirculatory disturbance and inflammatory process in the etiopathogenesis of tinnitus. OBJECTIVES We aimed to evaluate the mean platelet volume and neutrophil to lymphocyte ratio in patients with tinnitus in comparison to healthy controls. METHODS Retrospective case-control study. Two-hundred and eighty-seven patients aged 18-59 years and diagnosed with tinnitus in the Ear, Nose, and Throat Clinic between December 2014 and May 2017 (patient group) and 275 healthy individuals who applied for a hearing screening within the same time period (control group). Demographics, concomitant diseases, laboratory results, and audiometric data were recorded. Mean platelet volume and neutrophil to lymphocyte ratio were the outcome measures. Patients with hearing loss due to presbycusis or another reasons, and patients with anatomical disorders in the external and middle ear were excluded from the study by using physical examinations, pure audio audiometry results and radiological imaging. The upper age limit was set at 59 to exclude presbycusis patients. RESULTS The ratio of female patients was higher in patient group than control group (58.5%, n=168 vs. 49.4%, n=127; respectively; p=0.033). The mean age of patient group was significantly higher than those of control group (44.89±10.96 years and 38.37±10.65 years, respectively; p=0.001). The percentage of subjects with high mean platelet volume level was significantly higher in patient group than control group (9.4%, n=27, and 3.1%, n=8 respectively; p=0.008). The mean neutrophil to lymphocyte ratio was higher in patients with tinnitus than control group (1.95±1.02 and 1.67±0.57, p=0.012). A neutrophil to lymphocyte ratio level of 2.17 and above is associated with 1.991 times higher risk of tinnitus (odds ratio=1.99, 95% confidence interval 1.31-3.02). CONCLUSION High mean platelet volume and neutrophil to lymphocyte ratio values are associated with idiopathic tinnitus, suggesting the role of vascular pathologies in etiology of tinnitus. Tinnitus may be a sign of underlying systemic or local disorders. Therefore, patients with tinnitus should undergo detailed evaluation including hematological indices.
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Affiliation(s)
- Selçuk Yildiz
- Haydarpaşa Numune Training and Research Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Istanbul, Turkey.
| | - Harun Karaca
- Karakoçan State Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Elazig, Turkey
| | - Sema Zer Toros
- Haydarpaşa Numune Training and Research Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Istanbul, Turkey
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ÇAVUŞ ME, TANYELİ TT, AKCAN FA, BAYIR Ö, GÖKKURT D. Increased mean platelet volume in patients with vestibular migraine. THE EUROPEAN RESEARCH JOURNAL 2020; 6:99-104. [DOI: 10.18621/eurj.463535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Objectives:
The purpose of this study was to investigate relation
between mean platelet volume, platelet distribution width, platelet-to-lymphocyte
ratio, neutrophil-to-lymphocyte ratio and vestibular migraine. Methods: This study was planned in prospective
manner and conducted
in Ankara Polatlı State Hospital between April 2017 and May 2018. Thirty patients
diagnosed with vestibular migraine and thirty healthy, age and sex-matched
subjects were enrolled to the study. Mean platelet volume, platelet
distribution width, platelet count, neutrophil count and lymphocyte count in
blood samples were measured. Results: The mean age of the patients with vestibular
migraine was 39.90 ± 7.16 and the study group consisted
of 11 males and 19 females. The mean platelet volume and platelet
distribution width values in patients with vestibular
migraine were significantly higher than the control group
(p < 0.001). There were no difference
on mean neutrophil/lymphocyte ratio and platelet/lymphocyte ratio values between
patient group and control group.
Conclusions: We found a positive relation of
increased levels of mean
platelet volume and platelet distribution width with vestibular
migraine. Higher mean platelet volume is associated with atherosclerosis and thromboembolism.
Vascular pathologies are blamed for both headache syndromes like migraine and vertiginous
syndromes. This theory supports our study but pathophysiological mechanism is
not clear.
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Affiliation(s)
- Mehmet Emin ÇAVUŞ
- Department of Otorhinolaryngology, University of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Talip Talha TANYELİ
- Department of Otorhinolaryngology, Ministry of Health Polatlı State Hospital, Ankara, Turkey
| | - Fatih Alper AKCAN
- Department of Otorhinolaryngology, Düzce University School of Medicine, Düzce, Turkey
| | - Ömer BAYIR
- Department of Otorhinolaryngology, University of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Didem GÖKKURT
- Department of Neurology, Ministry of Health Polatlı State Hospital, Ankara, Turkey
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Gunes A, Karali E, Ural A, Ruzgar F, Bayatkara T. The relationship of high-frequency distortion product otoacoustic emission (DPOAE) values with hematological parameters in tinnitus patients. Eur Arch Otorhinolaryngol 2019; 276:3013-3019. [PMID: 31372714 DOI: 10.1007/s00405-019-05585-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 07/23/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE In this study, we aimed to investigate whether there is any positive or negative correlation between high-frequency distortion product otoacoustic emission (DPOAE) values and mean platelet volume (MPV) and neutrophil/lymphocyte ratio (NLR) in tinnitus patients. METHODS The study was performed with 52 volunteers (27 females, 25 males) aged between 35 and 50 years who presented with tinnitus to the otolaryngology outpatient clinic of a tertiary care center. Pure voice audiometric examination, DPOAE measurement, complete blood count values of the study participants were examined. RESULTS In both ears, a significant and negative correlation was observed between 4000 and 8000 Hz airway and 4000 Hz bone conduction pathways with NLR rates (p < 0.05). A statistically significant relationship was found between the bone conduction pathway PTA and discrimination values for both ears and NLR s (p < 0.05). A positive correlation was detected between NLRs and DPOAE measurements recorded at 4444 Hz, 5000 Hz, 8000 Hz, 8889 Hz, 10,000 Hz and 11,429 Hz frequencies in the right and 4444 Hz, 5000 Hz, 6154 Hz, 8000 Hz, 10,000 Hz and 11,429 Hz frequencies in the left ears, respectively (p < 0.05). CONCLUSIONS We concluded that there is a significant correlation between high-frequency pure tone audiometry measurements and high frequency DPOAE measurements and NLR. Further studies are needed to determine the utility of NLR as a marker for the recognition and follow-up of hearing loss in patients with tinnitus.
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Affiliation(s)
- Akif Gunes
- Department of Otorhinolaryngology, Medical School, Bolu Abant Izzet Baysal University, Bolu, Turkey.
| | - Elif Karali
- Department of Otorhinolaryngology, Medical School, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Ahmet Ural
- Department of Otorhinolaryngology, Medical School, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Fatih Ruzgar
- Department of Audiology, Medical School, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Tugba Bayatkara
- Department of Otorhinolaryngology, Medical School, Bolu Abant Izzet Baysal University, Bolu, Turkey
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Investigation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume in patients with tinnitus. The Journal of Laryngology & Otology 2018; 132:129-132. [PMID: 29332609 DOI: 10.1017/s0022215117002481] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This study aimed to evaluate patients with tinnitus in terms of mean platelet volume and platelet distribution width, and to explore neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio, recently reported in the literature as being possible inflammation markers. METHODS This study comprised 64 tinnitus patients and 64 age-matched healthy controls. Statistical significance level was accepted as p < 0.05. RESULTS Mean platelet volume (t = 3.245, p = 0.002) and platelet distribution width (Z = 3.945, p < 0.001) were significantly higher in the patient group than the control group. CONCLUSION The results suggest that a prothrombotic condition might play a role in the pathophysiology of tinnitus.
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