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Caldwell J, Gopal K, Ortu D, Miller S. Electrophysiological auditory measures to identify potential cortical markers of tinnitus. Brain Res 2024; 1842:149100. [PMID: 38942351 DOI: 10.1016/j.brainres.2024.149100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/11/2024] [Accepted: 06/25/2024] [Indexed: 06/30/2024]
Abstract
Tinnitus, or the perception of a sound in the absence of an external acoustic stimulus, is a common condition that cannot yet be objectively diagnosed. Current diagnostic tests of tinnitus consist of case history and behavioral measures that rely on subjective responses. This study examined electrophysiological measures, specifically the auditory late response (ALR), mismatch negativity (MMN), and P300 as potential neural biomarkers of tinnitus in both a tinnitus and non-tinnitus control group while utilizing the pitch-matched tinnitus frequencies as the test stimuli. Results of this study found differences in MMN amplitudes and area under the curve, and in P300 topographic maps between tinnitus and control subjects. The differences in MMN responses across groups suggest that dysfunctional processing of acoustic stimuli located near the tinnitus frequency in individuals with tinnitus manifests as soon as 200 ms after initial onset of the stimulus. In addition, results from a global field power analysis and differences in spatial distributions on topographical maps indicate that deficits persist through higher levels of cortical processing. A secondary goal of this study was to determine if electrophysiological measures correlated with reported tinnitus severity on questionnaires. This analysis indicated that P2 latency was a significant predictor of Tinnitus Reaction Questionnaire, Tinnitus Handicap Inventory, and percent of the time participant's tinnitus was considered bothersome, suggesting that this measure could potentially be used to assess the efficacy of treatment programs for tinnitus.
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Affiliation(s)
- Joshua Caldwell
- Department of Audiology and Speech-Language Pathology, The University of North Texas, Denton, TX, United States.
| | - Kamakshi Gopal
- Department of Audiology and Speech-Language Pathology, The University of North Texas, Denton, TX, United States
| | - Daniele Ortu
- Department of Behavior Analysis, The University of North Texas, Denton, TX, United States
| | - Sharon Miller
- Department of Audiology and Speech-Language Pathology, The University of North Texas, Denton, TX, United States
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2
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Kok T, Varley R, Clark C, Verriotis M, Seunarine K, Shekhawat GS. Resting-state networks in chronic tinnitus: Increased connectivity between thalamus and visual areas. Hear Res 2024; 453:109122. [PMID: 39437583 DOI: 10.1016/j.heares.2024.109122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 09/01/2024] [Accepted: 09/19/2024] [Indexed: 10/25/2024]
Abstract
Tinnitus is thought to be associated with aberrant spontaneous activity in the central nervous system. Previous resting-state fMRI findings support this hypothesis and have shown a variety of alterations in neural activity in people with tinnitus compared to people without tinnitus. However, there is little replication of findings. Therefore, the current study aimed to extend on previous findings by investigating eight common resting-state networks (i.e. auditory, default mode, sensorimotor, visual, salience, dorsal attention, frontoparietal and language networks) using a control group (n = 36) and a group of tinnitus patients (n = 46) matched for age, sex and years of education. Hearing profiles matched up to 2 kHz and had a small but significant difference between groups in the high frequency range. Functional connectivity (FC) with dorsolateral prefrontal cortex (DLPFC) was also investigated separately for the first time, as this region is proposed to be core to tinnitus distress symptoms and most often used as a stimulation target in transcranial direct current stimulation (tDCS) research. The results showed that tinnitus patients had increased FC between bilateral thalamus and right visual association cortex compared to control participants. No differences were found with DLPFC, or with any of the resting-state networks (RSN), contrary to previous studies which have reported alterations in several RSNs.
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Affiliation(s)
- Tori Kok
- Ear Institute, University College London 332 Gray's Inn Rd, London WC1X 8EE, UK
| | - Rosemary Varley
- Language & Cognition Chandler House 2 Wakefield Street London WC1N 1PF, UK
| | - Chris Clark
- Professor of Imaging and Biophysics, Clinical Systems Neuroscience, Developmental Neurosciences Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
| | - Madeleine Verriotis
- Developmental Neurosciences Department UCL Great Ormond Street Institute of Child Health London, United Kingdom 30 Guilford Street London WC1N 1EH, UK
| | - Kiran Seunarine
- Developmental Neurosciences Department UCL Great Ormond Street Institute of Child Health, Department of Neurosurgery Great Ormond Street Hospital for Children NHS Foundation Trust, 30 Guilford Street London WC1N 1EH, UK
| | - Giriraj Singh Shekhawat
- Dean (Research) EPSW, College of Education, Psychology and Social Work, Flinders University, Bedford Park, GPO Box 2100, Adelaide 5001, South Australia.
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Sherlock LP, Gibson KJ, Talian DS, Lake DC. Incidence of Self-Reported Bothersome Tinnitus Versus Tinnitus Diagnosis Among U.S. Army Soldiers. Am J Audiol 2024:1-9. [PMID: 39437262 DOI: 10.1044/2024_aja-24-00053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2024] Open
Abstract
PURPOSE U.S. Army Soldiers undergo annual audiometric surveillance to facilitate prevention of auditory injury. Soldiers are screened for bothersome tinnitus and subsequently referred for a clinical audiological evaluation as warranted. Presumably, most Soldiers seen in the clinic for bothersome tinnitus receive a tinnitus diagnosis. The incidence of self-reported bothersome tinnitus at the time of annual audiometric surveillance and subsequent diagnosis of tinnitus in the medical record has not been examined to date. This study estimated the incidence of tinnitus diagnosis in a population of Soldiers who reported new onset bothersome tinnitus and explored trends associated with tinnitus diagnosis to refine hearing health education. METHOD A subset of hearing conservation records retrieved for a previous study were selected based on change in self-reporting of bothersome tinnitus. Corresponding medical records were retrieved for this sample of Active Duty (AD) Soldiers. The data were retrospectively examined, and analyses were conducted to identify statistically significant differences between Soldiers with and Soldiers without a tinnitus diagnosis. In addition, trend patterns of bothersome tinnitus and significant threshold shift (STS) were examined. RESULTS Of the sample of 730,350 AD Soldiers, 16.7% self-reported new onset bothersome tinnitus and 7.1% of those recorded as having bothersome tinnitus had a diagnosis of tinnitus in their medical record. Soldiers with a tinnitus diagnosis were older and had higher pure-tone averages than Soldiers without a tinnitus diagnosis. Counterintuitively, overall trend percentages of bothersome tinnitus increased per calendar year, while the percentages of STS decreased throughout the study period. CONCLUSIONS The rate of tinnitus diagnosis in the medical record is vastly lower than the prevalence of bothersome tinnitus recorded in the annual surveillance system. Steps should be taken to screen, refer, and diagnose tinnitus more consistently. Based on the outcome of the study analysis, we recommend that screening for bothersome tinnitus more closely follows procedure recommendations from the Department of Veterans Affairs and Department of Defense (VA/DOD) Tinnitus Working Group, which may reduce the rate at which Soldiers report bothersome tinnitus.
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Affiliation(s)
- LaGuinn P Sherlock
- Hearing Conservation and Readiness Branch, Defense Centers for Public Health-Aberdeen, MD
- Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
| | - Kelly J Gibson
- Defense Health Agency, Armed Forces Health Surveillance Division, Falls Church, VA
| | - Daniel S Talian
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia
| | - Deborah C Lake
- Hearing Conservation and Readiness Branch, Defense Centers for Public Health-Aberdeen, MD
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Dunn CC, Zwolan TA, Balkany TJ, Strader HL, Biever A, Gifford RH, Hall MW, Holcomb MA, Hill H, King ER, Larky J, Presley R, Reed M, Shapiro WH, Sydlowski SA, Wolfe J. A Consensus to Revise the Minimum Speech Test Battery-Version 3. Am J Audiol 2024; 33:624-647. [PMID: 38980836 DOI: 10.1044/2024_aja-24-00008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024] Open
Abstract
PURPOSE The Minimum Speech Test Battery (MSTB) for adults was introduced in 1996 (Nilsson et al., 1996) and subsequently updated in 2011 (Advanced-Bionics et al., 2011). The MSTB has been widely used by clinicians as a guide for cochlear implant (CI) candidacy evaluations and to document post-operative speech recognition performance. Due to changes in candidacy over the past 10 years, a revision to the MSTB was needed. METHOD In 2022, the Institute for Cochlear Implant Training (ICIT) recruited a panel of expert CI audiologists to update and revise the MSTB. This panel utilized a modified Delphi consensus process to revise the test battery and to improve its applicability considering recent changes in CI care. RESULTS This resulted in the MTSB-Version 3 (MSTB-3), which includes test protocols for identifying not only traditional CI candidates but also possible candidates for electric-acoustic stimulation and patients with single-sided deafness and asymmetric hearing loss. The MSTB-3 provides information that supplements the earlier versions of the MSTB, such as recommendations of when to refer patients for a CI, recommended patient-reported outcome measures, considerations regarding the use of cognitive screeners, and sample report templates for clinical documentation of pre- and post-operative care. Electronic versions of test stimuli, along with all the materials described above, will be available to clinicians via the ICIT website (https://www.cochlearimplanttraining.com). CONCLUSION The goal of the MSTB-3 is to be an evidence-based test battery that will facilitate a streamlined standard of care for adult CI candidates and recipients that will be widely used by CI clinicians.
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Affiliation(s)
- Camille C Dunn
- Institute for Cochlear Implant Training, Miami, FL
- Department of Otolaryngology-Head and Neck Surgery, The University of Iowa, Iowa City
| | - Teresa A Zwolan
- Institute for Cochlear Implant Training, Miami, FL
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor
- Cochlear Corporation, Denver, CO
| | | | | | - Allison Biever
- Institute for Cochlear Implant Training, Miami, FL
- Rocky Mountain Ear Clinic, Englewood, CO
| | - René H Gifford
- Institute for Cochlear Implant Training, Miami, FL
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Melissa W Hall
- Institute for Cochlear Implant Training, Miami, FL
- Department of Audiology, University of Florida Health, Gainesville
| | - Meredith A Holcomb
- Institute for Cochlear Implant Training, Miami, FL
- Department of Otolaryngology-Head and Neck Surgery, University of Miami, FL
| | - Heidi Hill
- Institute for Cochlear Implant Training, Miami, FL
- Hearing Health Clinic, Osseo, MN
| | - English R King
- Institute for Cochlear Implant Training, Miami, FL
- Department of Otolaryngology-Head and Neck Surgery, The University of North Carolina at Chapel Hill
| | - Jannine Larky
- Institute for Cochlear Implant Training, Miami, FL
- Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, CA
| | - Regina Presley
- Institute for Cochlear Implant Training, Miami, FL
- Presbyterian Board of Governors Cochlear Implant Center, Greater Baltimore Medical Center, MD
| | - Meaghan Reed
- Institute for Cochlear Implant Training, Miami, FL
- Department of Otolaryngology-Head and Neck Surgery and Department of Audiology, Mass Eye and Ear, Boston, MA
| | - William H Shapiro
- Institute for Cochlear Implant Training, Miami, FL
- Department of Otolaryngology, New York University, NY
| | - Sarah A Sydlowski
- Institute for Cochlear Implant Training, Miami, FL
- Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, OH
| | - Jace Wolfe
- Institute for Cochlear Implant Training, Miami, FL
- Hearts for Hearing Foundation, Oklahoma City, OK
- Hearing First, Philadelphia, PA
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Alanazi AA. Tinnitus Prevalence, Associated Characteristics, and Treatment Patterns among Adults in Saudi Arabia. Audiol Res 2024; 14:760-777. [PMID: 39311217 PMCID: PMC11417728 DOI: 10.3390/audiolres14050064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 08/20/2024] [Accepted: 08/30/2024] [Indexed: 09/26/2024] Open
Abstract
Tinnitus affects millions of people around the world and causes significant negative impacts on their quality of life (QoL). Tinnitus is rarely examined in Saudi Arabia. This study aimed to estimate the prevalence of tinnitus among adults, explore their experience with tinnitus, investigate the impact of tinnitus on their QoL, and discover their tinnitus management methods. A descriptive cross-sectional study design was performed utilizing a non-probability purposive sampling technique and a face-to-face in-person administered questionnaire. Descriptive statistics and a chi-square test were used to assess the data and find any correlation between the variables. Out of 4860 adults, 320 (males: n = 172; females: n = 148; age range = 18-90 years) had tinnitus, mainly described as a daily, gradual, continuous, whistling, and ringing tinnitus in both ears. Tinnitus prevalence was estimated at 6.54% with a slight predominance in males (6.9%) compared with females (6.2%). Most of the participants were unaware of the cause of their tinnitus. The modal value of the severity of tinnitus signals was severe for both genders. The modal value of the impact of tinnitus on the QoL was moderate for males and severe for females. Sleep, social activities, quiet settings, and concentration were largely affected by tinnitus. Significant associations (p < 0.05) between the impact of tinnitus on the QoL and risk factors, such as gender, age, hearing loss, and hyperacusis were determined. Also, the impact of tinnitus on the QoL was significantly associated (p < 0.05) with the duration of complaints and the severity of tinnitus signals. Approximately, 61% of the participants did not use any tinnitus treatment, while the remaining participants usually used hearing aids, medications, and counseling to manage their tinnitus. By increasing awareness, establishing standard practice, developing guidelines for managing tinnitus, expanding access to suitable interventions, and carrying out additional research, adults living with tinnitus in Saudi Arabia will have better support and, ultimately, an enhancement of their overall well-being.
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Affiliation(s)
- Ahmad A. Alanazi
- Department of Audiology and Speech Pathology, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia;
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
- Audiology Clinic, ENT Division, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh 11426, Saudi Arabia
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Wang H, Stern JI, Robertson CE, Chiang CC. Pulsatile Tinnitus: Differential Diagnosis and Approach to Management. Curr Pain Headache Rep 2024; 28:815-824. [PMID: 38842617 DOI: 10.1007/s11916-024-01263-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an updated approach to the evaluation and management of pulsatile tinnitus (PT), an uncommon but often treatable subtype of tinnitus. RECENT FINDINGS Secondary PT can be due to either vascular or non-vascular etiologies, including, but not limited to: neoplasm, arteriovenous malformation or fistula, idiopathic intracranial hypertension, dural venous sinus stenosis, otoacoustic etiologies (e.g., otosclerosis, patulous eustachian tube) and bony defects (e.g., superior semicircular canal dehiscence). Computed tomography (CT) and magnetic resonance imaging (MRI) imaging have comparable diagnostic yield, though each may be more sensitive to specific etiologies. If initial vascular imaging is negative and a vascular etiology is strongly suspected, digital subtraction angiography (DSA) may further aid in the diagnosis. Many vascular etiologies of PT can be managed endovascularly, often leading to PT improvement or resolution. Notably, venous sinus stenting is an emerging therapy for PT secondary to idiopathic intracranial hypertension with venous sinus stenosis. Careful history and physical exam can help establish the differential diagnosis for PT and guide subsequent evaluation and management. Additional studies on the efficacy and long-term outcome of venous sinus stenting for venous stenosis are warranted.
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Affiliation(s)
- Han Wang
- Department of Neurology, Mayo Clinic Health System, Mankato, MN, USA.
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de Gruy JA, Laurenzo WW, Vu TH, Paul O, Lee C, Spankovich C. Prevalence and predictors of problematic tinnitus. Int J Audiol 2024:1-7. [PMID: 39030727 DOI: 10.1080/14992027.2024.2378804] [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: 12/12/2023] [Accepted: 07/05/2024] [Indexed: 07/21/2024]
Abstract
OBJECTIVE To determine the prevalence and characteristics of problematic tinnitus in a representative United States (US) sample. DESIGN Cross-sectional study of the NHANES database from 2011-2012 and 2015-2016. STUDY SAMPLE 8029 records were included for analysis. RESULTS The prevalence of any tinnitus was 16.32%. Only 1.38% reported tinnitus as a big problem or worse. Univariate analysis revealed a statistically significant relationship between tinnitus constancy and duration with severity, where more constant perception and longer duration was related to increased severity (p < 0.0001). Multivariable models showed a clear relationship of increased odds ratio (OR) of problematic tinnitus with constancy of tinnitus but not duration. Furthermore, multivariable models showed higher Body Mass Index (OR= 1.013, 95% CI: 0.99-1.03), sleep trouble (OR = 2.016, 95% CI: 1.52-2.66) and comorbidities (OR = 1.43, 95%CI: 1.06-1.94) were all associated with increased problematic tinnitus, but not non-problematic tinnitus. CONCLUSIONS Our study demonstrated that the prevalence of problematic tinnitus is much lower than the prevalence of any tinnitus. There was also a relationship between BMI, sleep trouble, other comorbidities and increased odds of problematic tinnitus. Tinnitus severity was significantly related to constancy of perception but had a less clear relationship to duration.
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Affiliation(s)
- Joseph A de Gruy
- Department of Otolaryngology Head and Neck Surgery, University of Mississippi Medical Center, Jackson, MS, USA
| | | | - Thanh-Huyen Vu
- Department of Preventative Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Oishika Paul
- Department of Otolaryngology Head and Neck Surgery, University of Mississippi Medical Center, Jackson, MS, USA
| | - Christopher Lee
- Department of Otolaryngology Head and Neck Surgery, University of Mississippi Medical Center, Jackson, MS, USA
| | - Christopher Spankovich
- Department of Otolaryngology Head and Neck Surgery, University of Mississippi Medical Center, Jackson, MS, USA
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Rammal A, Alsinni H, Alkhamesi AA, Alshahrani G, Bouges RN, Shosho RY, Aljuhani MO. The Prevalence of Insomnia Among Patients With Chronic Tinnitus in the General Population of the Kingdom of Saudi Arabia. Cureus 2024; 16:e64295. [PMID: 39130950 PMCID: PMC11316154 DOI: 10.7759/cureus.64295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND Tinnitus is a perception of sound without external sound stimulation. Subjective tinnitus is the most common type and is unrelated to external sounds. It is a symptom, not an illness, and is often linked to various psychological factors like anxiety and depression. Insomnia is a personal sense of difficulty falling asleep and issues with sleep initiation, length, consolidation, or quality while having ample chance to sleep, which impairs one's ability to function during the day. Sleep problems are prevalent in individuals with chronic tinnitus. OBJECTIVE We aimed to assess insomnia prevalence in chronic tinnitus patients in Saudi Arabia. METHOD Our study, an online cross-sectional survey, included 434 Saudi participants with chronic insomnia, utilizing a Google Forms questionnaire (Google LLC, Mountain View, California, United States). RESULTS A total of 434 participants responded to the online survey. The most represented age group was 18-25 years, and 319 (73.5%) of the respondents were female. Approximately one-third (34.6%, n=150) were from the southern region. In the sample, 184 (42.4%) participants had bilateral tinnitus, and 105 (24.2%) had had tinnitus for over two years. Around 62.7% of the participants suffered from insomnia due to tinnitus. In terms of sleep quality, 174 (40.1%) participants took over 40 minutes to fall asleep, 85 (19.5%) were often afraid to sleep due to disturbed sleep, and 63 (14.5%) frequently used sleep pills. CONCLUSION Our study of over 400 Saudi chronic tinnitus patients revealed that a large percentage of tinnitus patients have insomnia, influenced by geographic region and tinnitus duration. Our findings offer valuable insights, emphasizing the necessity for additional research to inform interventions aimed at enhancing the quality of life of individuals with chronic tinnitus.
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Affiliation(s)
- Almoaidbellah Rammal
- Otolaryngology - Head and Neck Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Hussain Alsinni
- Otolaryngology, Al-Jabr Eye, Nose, and Throat Hospital, Alahsa, SAU
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Lee S, Jin TJ, Lee D, Jin IK. Effectiveness of Computer-Mediated Educational Counseling for Tinnitus Relief: A Randomized Controlled Trial. Brain Sci 2024; 14:629. [PMID: 39061370 PMCID: PMC11275201 DOI: 10.3390/brainsci14070629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 07/28/2024] Open
Abstract
Counseling can help alleviate tinnitus-caused emotional distress and correct misconceptions, making it an effective rehabilitation option for people with tinnitus. Advances in communication technology have increased the demand for computer-mediated tinnitus counseling; however, the effectiveness of such counseling in reducing tinnitus is unclear. Thus, this study aimed to determine the tinnitus-relieving effects of computer-mediated counseling. Thirty-six participants with tinnitus were randomly assigned to online counseling (15 participants) or video-based counseling (21 participants) groups, defining how remote counseling was conducted. Tinnitus counseling, comprising 100 items, lasted 2 weeks and was separated into six sessions for the online counseling group and 8-9 items daily for 12 days for the video-based counseling group. The effectiveness of counseling was determined based on score changes between baseline and 2-week follow-up using the Korean version of the Tinnitus Primary Function Questionnaire and Visual Analog Scales for annoyance and loudness. While no significant improvements were observed in other domains, average emotional aspect-related scores showed significant improvements in both groups. Regarding individual results, four and seven participants in the online and video-based counseling groups reported significant improvements in the emotional domain, respectively. Overall, computer-mediated educational counseling might be a rehabilitation option for individuals with tinnitus.
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Affiliation(s)
- Sumin Lee
- Department of Speech Pathology and Audiology, Graduate School, Hallym University, Chuncheon 24252, Republic of Korea; (S.L.); (T.-J.J.); (D.L.)
| | - Tae-Jun Jin
- Department of Speech Pathology and Audiology, Graduate School, Hallym University, Chuncheon 24252, Republic of Korea; (S.L.); (T.-J.J.); (D.L.)
| | - Donghyeok Lee
- Department of Speech Pathology and Audiology, Graduate School, Hallym University, Chuncheon 24252, Republic of Korea; (S.L.); (T.-J.J.); (D.L.)
| | - In-Ki Jin
- Division of Speech Pathology and Audiology, Research Institute of Audiology and Speech Pathology, College of Natural Sciences, Hallym University, Chuncheon 24252, Republic of Korea
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Jain N, Tai Y, Wilson C, Granato EC, Esquivel C, Tsao A, Husain FT. Comprehensive Characterization of Hearing Loss and Tinnitus in Military-Affiliated and Non-Military-Affiliated Individuals. Am J Audiol 2024; 33:543-558. [PMID: 38652004 DOI: 10.1044/2024_aja-24-00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
PURPOSE Military-affiliated individuals (MIs) are at a higher risk of developing hearing loss and tinnitus. While these disorders are well-studied in MIs, their impact relative to non-military-affiliated individuals (non-MIs) remains understudied. Our study compared hearing, speech-in-noise (SIN) perception, and tinnitus characteristics between MIs and non-MIs. METHOD MIs (n = 84) and non-MIs (n = 193) underwent hearing threshold assessment and Quick Speech-in-Noise Test. Participants with tinnitus completed psychoacoustic tinnitus matching, numeric rating scale (NRS) for loudness and annoyance, and Tinnitus Functional Index. Comorbid conditions such as anxiety, depression, and hyperacusis were assessed. We used a linear mixed-effects model to compare hearing thresholds and SIN scores between MIs and non-MIs. A multivariate analysis of variance compared tinnitus characteristics between MIs and non-MIs, and a stepwise regression was performed to identify predictors of tinnitus severity. RESULTS MIs exhibited better hearing sensitivity than non-MIs; however, their SIN scores were similar. MIs matched their tinnitus loudness to a lower intensity than non-MIs, but their loudness ratings (NRS) were comparable. MIs reported greater tinnitus annoyance and severity on the relaxation subscale, indicating increased difficulty engaging in restful activities. Tinnitus severity was influenced by hyperacusis and depression in both MIs and non-MIs; however, hearing loss uniquely contributed to severity in MIs. CONCLUSIONS Our findings suggest that while MIs may exhibit better or comparable listening abilities, they were significantly more affected by tinnitus than non-MIs. Furthermore, our study highlights the importance of assessing tinnitus-related distress across multiple dimensions, facilitating customization of management strategies for both MIs and non-MIs.
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Affiliation(s)
- Namitha Jain
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign
- The Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign
| | - Yihsin Tai
- Department of Speech Pathology and Audiology, Ball State University, Muncie, IN
| | - Caterina Wilson
- Defense Health Agency Hearing Center of Excellence, San Antonio, TX
- The Geneva Foundation, Tacoma, WA
| | - Elsa C Granato
- Defense Health Agency Hearing Center of Excellence, San Antonio, TX
- zCore Business Solutions, Inc., Round Rock, TX
| | - Carlos Esquivel
- Defense Health Agency Hearing Center of Excellence, San Antonio, TX
| | | | - Fatima T Husain
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign
- The Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign
- The Neuroscience Program, University of Illinois Urbana-Champaign
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11
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Pandey A, Schreiber C, Garton ALA, Araveti N, Goldberg JL, Kocharian G, Carnevale JA, Boddu SR. Foundations of the Diagnosis and Management of Idiopathic Intracranial Hypertension and Pulsatile Tinnitus. World Neurosurg 2024; 184:361-371. [PMID: 38590070 DOI: 10.1016/j.wneu.2023.12.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 04/10/2024]
Abstract
Venous sinus stenosis has garnered increasing academic attention as a potential etiology of idiopathic intracranial hypertension (IIH) and pulsatile tinnitus (PT). The complex anatomy of the cerebral venous sinuses and veins plays a crucial role in the pathophysiology of these conditions. Venous sinus stenosis, often found in the superior sagittal or transverse sinus, can lead to elevated intracranial pressure (ICP) and characteristic IIH symptoms. Stenosis, variations in dural venous anatomy, and flow dominance patterns contribute to aberrant flow and subsequent PT. Accurate imaging plays a vital role in diagnosis, and magnetic resonance (MR) venography is particularly useful for detecting stenosis. Management strategies for IIH and PT focus on treating the underlying disease, weight management, medical interventions, and, in severe cases, surgical or endovascular procedures. Recently, venous sinus stenting has gained interest as a minimally invasive treatment option for IIH and PT. Stenting addresses venous sinus stenosis, breaking the feedback loop between elevated ICP and stenosis, thus reducing ICP and promoting cerebrospinal fluid outflow. The correction and resolution of flow aberrances can also mitigate or resolve PT symptoms. While venous sinus stenting remains an emerging field, initial results are promising. Further research is needed to refine patient selection criteria and evaluate the long-term efficacy of stenting as compared to traditional treatments.
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Affiliation(s)
- Abhinav Pandey
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Craig Schreiber
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Andrew L A Garton
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | | | - Jacob L Goldberg
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Gary Kocharian
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Joseph A Carnevale
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Srikanth R Boddu
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA.
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12
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Tan HT, Smith PF, Zheng Y. Time-dependent effects of acoustic trauma and tinnitus on extracellular levels of amino acids in the inferior colliculus of rats. Hear Res 2024; 443:108948. [PMID: 38219615 DOI: 10.1016/j.heares.2024.108948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/19/2023] [Accepted: 01/02/2024] [Indexed: 01/16/2024]
Abstract
Chronic tinnitus is a debilitating condition with very few management options. Acoustic trauma that causes tinnitus has been shown to induce neuronal hyperactivity in multiple brain areas in the auditory pathway, including the inferior colliculus. This neuronal hyperactivity could be attributed to an imbalance between excitatory and inhibitory neurotransmission. However, it is not clear how the levels of neurotransmitters, especially neurotransmitters in the extracellular space, change over time following acoustic trauma and the development of tinnitus. In the present study, a range of amino acids were measured in the inferior colliculus of rats during acoustic trauma as well as at 1 week and 5 months post-trauma using in vivo microdialysis and high-performance liquid chromatography. Amino acid levels in response to sound stimulation were also measured at 1 week and 5 months post-trauma. It was found that unilateral exposure to a 16 kHz pure tone at 115 dB SPL for 1 h caused immediate hearing loss in all the animals and chronic tinnitus in 58 % of the animals. Comparing to the sham condition, extracellular levels of GABA were significantly increased at both the acute and 1 week time points after acoustic trauma. However, there was no significant difference in any of the amino acid levels measured between sham, tinnitus positive and tinnitus negative animals at 5 months post-trauma. There was also no clear pattern in the relationship between neurochemical changes and sound frequency/acoustic trauma/tinnitus status, which might be due to the relatively poorer temporal resolution of the microdialysis compared to electrophysiological responses.
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Affiliation(s)
- Huey Tieng Tan
- Department of Pharmacology and Toxicology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand; Brain Health Research Centre, University of Otago, Dunedin, New Zealand; Eisdell Moore Centre for Research on Hearing and Balance Disorders, University of Auckland, New Zealand
| | - Paul F Smith
- Department of Pharmacology and Toxicology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand; Brain Health Research Centre, University of Otago, Dunedin, New Zealand; Eisdell Moore Centre for Research on Hearing and Balance Disorders, University of Auckland, New Zealand
| | - Yiwen Zheng
- Department of Pharmacology and Toxicology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand; Brain Health Research Centre, University of Otago, Dunedin, New Zealand; Eisdell Moore Centre for Research on Hearing and Balance Disorders, University of Auckland, New Zealand.
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13
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Choo OS, Kim H, Lee SJ, Kim SY, Lee KY, Lee HY, Moon IS, Seo JH, Rah YC, Song JJ, Nam EC, Park SN, Song JJ, Shim HJ. Consensus Statements on the Definition, Classification, and Diagnostic Tests for Tinnitus: A Delphi Study Conducted by the Korean Tinnitus Study Group. J Korean Med Sci 2024; 39:e49. [PMID: 38317449 PMCID: PMC10843967 DOI: 10.3346/jkms.2024.39.e49] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/06/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Tinnitus is a bothersome condition associated with various symptoms. However, the mechanisms of tinnitus are still uncertain, and a standardized assessment of the diagnostic criteria for tinnitus is required. We aimed to reach a consensus on diagnosing tinnitus with professional experts by conducting a Delphi study with systematic review of the literature. METHODS Twenty-six experts in managing tinnitus in Korea were recruited, and a two-round modified Delphi study was performed online. The experts evaluated the level of agreement of potential criteria for tinnitus using a scale of 1-9. After the survey, a consensus meeting was held to establish agreement on the results obtained from the Delphi process. Consensus was defined when over 70% of the participants scored 7-9 (agreement) and fewer than 15% scored 1-3 (disagreement). To analyze the responses of the Delphi survey, the content validity ratio and Kendall's coefficient of concordance were evaluated. RESULTS Consensus was reached for 22 of the 38 statements. For the definition of tinnitus, 10 out of 17 statements reached consensus, with three statements achieving complete agreement including; 1) Tinnitus is a conscious perception of an auditory sensation in the absence of a corresponding external stimulus, 2) Tinnitus can affect one's quality of life, and 3) Tinnitus can be associated with hearing disorders including sensorineural hearing loss, vestibular schwannoma, Meniere's disease, otosclerosis, and others. For the classification of tinnitus, 11 out of 18 statements reached consensus. The participants highly agreed with statements such as; 1) Vascular origin is expected in pulse-synchronous tinnitus, and 2) Tinnitus can be divided into acute or chronic tinnitus. Among three statements on the diagnostic tests for tinnitus only Statement 3, "There are no reliable biomarkers for sensory or emotional factors of tinnitus." reached consensus. All participants agreed to perform pure-tone audiometry and tinnitus questionnaires, including the Tinnitus Handicap Inventory and Tinnitus Questionnaire. CONCLUSION We used a modified Delphi method to establish a consensus-based definition, a classification, and diagnostic tests for tinnitus. The expert panel reached agreement for several statements, with a high level of consensus. This may provide practical information for clinicians in managing tinnitus.
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Affiliation(s)
- Oak-Sung Choo
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hantai Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon, Korea
| | - Seung Jae Lee
- Department of Otorhinolaryngology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Kyu-Yup Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ho Yun Lee
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University, Seoul, Korea
| | - In Seok Moon
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Hyun Seo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoon Chan Rah
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jae-Jun Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Guro Hospital, Seoul, Korea
| | - Eui-Cheol Nam
- Department of Otorhinolaryngology, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Shi Nae Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Korea.
| | - Hyun Joon Shim
- Department of Otorhinolaryngology-Head and Neck Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
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14
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Henry JA, Folmer RL, Zaugg TL, Theodoroff SM, Quinn CM, Reavis KM, Thielman EJ, Carlson KF. History of Tinnitus Research at the VA National Center for Rehabilitative Auditory Research (NCRAR), 1997-2021: Studies and Key Findings. Semin Hear 2024; 45:4-28. [PMID: 38370521 PMCID: PMC10872658 DOI: 10.1055/s-0043-1770140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
The Veterans Affairs (VA) Rehabilitation Research & Development (RR&D) National Center for Rehabilitative Auditory Research (NCRAR) was first funded by the RR&D Service in 1997 and has been funded continuously since that time. The overall purpose of the NCRAR is to "improve the quality of life of Veterans and others with hearing and balance problems through clinical research, technology development, and education that leads to better patient care" ( www.ncrar.research.va.gov ). An important component of the research conducted at the NCRAR has been a focus on clinical and rehabilitative aspects of tinnitus. Multiple investigators have received grants to conduct tinnitus research and the present article provides an overview of this research from the NCRAR's inception through 2021.
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Affiliation(s)
- James A. Henry
- VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, Oregon
- Department of Otolaryngology/Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
| | - Robert L. Folmer
- VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, Oregon
- Department of Otolaryngology/Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
| | - Tara L. Zaugg
- VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, Oregon
| | - Sarah M. Theodoroff
- VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, Oregon
- Department of Otolaryngology/Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon
| | - Candice M. Quinn
- VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, Oregon
- Durham VA Health Care System, Durham, North Carolina
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Kelly M. Reavis
- VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, Oregon
- School of Public Health, Oregon Health and Science University, Portland, Oregon
| | - Emily J. Thielman
- VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, Oregon
| | - Kathleen F. Carlson
- VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, Oregon
- School of Public Health, Oregon Health and Science University, Portland, Oregon
- Center to Improve Veteran Involvement in Care, Veterans Affairs Portland Health Care System, Portland, Oregon
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15
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Wagenaar O, Gilles A, Van Rompaey V, Blom H. Goal Attainment Scale in tinnitus (GAS-T): treatment goal priorities by chronic tinnitus patients in a real-world setting. Eur Arch Otorhinolaryngol 2024; 281:693-700. [PMID: 37488402 DOI: 10.1007/s00405-023-08134-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 07/13/2023] [Indexed: 07/26/2023]
Abstract
PURPOSE Standard treatment for tinnitus is cognitive behavioral therapy, although level of evidence of effectiveness is low. There is need for a Goal Attainment Scale to evaluate treatment effects based on patient satisfaction. Preliminary work in a clinical sample has identified six common personal treatment goals. The purpose of this study is to determine whether the preliminary identified goals are confirmed by a heterogeneous sample of people with bothersome tinnitus and to identify any other common personal goals with the intention to construct a closed-end Goal Attainment Scale for tinnitus for use in research of effectiveness of (new) tinnitus treatments. METHODS Two consecutive polls were plotted in an online peer support group form a heterogeneous sample. First, members were asked to vote for preliminary identified goals and asked to formulate additional personal goals. Corresponding goals were grouped together. Goals that were acknowledged by at least 10% of respondents were used in the second poll in which respondents could vote for statements that they recognized themselves in. RESULTS The first poll (N = 180) resulted in 15 personal treatment goals. Comparison resulted in five common goals, which were confirmed in the second poll (N = 238): to gain control, to improve well-being and sleep, to reduce effects on hearing and to understand tinnitus. CONCLUSIONS We expect that if a patient achieves personal goals, he will be likely to reduce healthcare consumption. Based on common personal goals, validity of treatment evaluations is increased. We present a closed-end Goal Attainment Scale in tinnitus.
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Affiliation(s)
- Olav Wagenaar
- Department of Neurology, Rijndam Rehabilitation Center, Rotterdam, The Netherlands.
| | - Annick Gilles
- Department of Otorhinolaryngology, Antwerp University Hospital, Antwerp, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Vincent Van Rompaey
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Henk Blom
- Otorhinolaryngology, Haga Teaching Hospital, The Hague, The Netherlands
- Department of Otorhinolaryngology, Antwerp University Hospital, Antwerp, Belgium
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16
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Niemann U, Boecking B, Brueggemann P, Spiliopoulou M, Mazurek B. Heterogeneity in response to treatment across tinnitus phenotypes. Sci Rep 2024; 14:2111. [PMID: 38267701 PMCID: PMC10808188 DOI: 10.1038/s41598-024-52651-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 01/22/2024] [Indexed: 01/26/2024] Open
Abstract
The clinical heterogeneity of chronic tinnitus poses major challenges to patient management and prompts the identification of distinct patient subgroups (or phenotypes) that respond more predictable to a particular treatment. We model heterogeneity in treatment response among phenotypes of tinnitus patients concerning their change in self-reported health burden, psychological characteristics, and tinnitus characteristics. Before and after a 7-day multimodal treatment, 989 tinnitus patients completed 14 assessment questionnaires, from which 64 variables measured general tinnitus characteristics, quality of life, pain experiences, somatic expressions, affective symptoms, tinnitus-related distress, internal resources, and perceived stress. Our approach encompasses mechanisms for patient phenotyping, visualizations of the phenotypes and their change with treatment in a projected space, and the extraction of patient subgroups based on their change with treatment. On average, all four distinct phenotypes identified at the pre-intervention baseline showed improved values for nearly all the considered variables following the intervention. However, a considerable intra-phenotype heterogeneity was noted. Five clusters of change reflected variations in the observed improvements among individuals. These patterns of treatment effects were identified to be associated with baseline phenotypes. Our exploratory approach establishes a groundwork for future studies incorporating control groups to pinpoint patient subgroups that are more likely to benefit from specific treatments. This strategy not only has the potential to advance personalized medicine but can also be extended to a broader spectrum of patients with various chronic conditions.
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Affiliation(s)
- Uli Niemann
- University Library, Otto von Guericke University Magdeburg, Universitätsplatz 2, Magdeburg, 39106, Germany.
- Faculty of Computer Science, Otto von Guericke University Magdeburg, Universitätsplatz 2, Magdeburg, 39106, Germany.
| | - Benjamin Boecking
- Charité-Universitaetsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, Berlin, 10117, Germany
| | - Petra Brueggemann
- Charité-Universitaetsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, Berlin, 10117, Germany
| | - Myra Spiliopoulou
- Faculty of Computer Science, Otto von Guericke University Magdeburg, Universitätsplatz 2, Magdeburg, 39106, Germany
| | - Birgit Mazurek
- Charité-Universitaetsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, Berlin, 10117, Germany
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17
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Haile LM, Orji AU, Reavis KM, Briant PS, Lucas KM, Alahdab F, Bärnighausen TW, Bell AW, Cao C, Dai X, Hay SI, Heidari G, Karaye IM, Miller TR, Mokdad AH, Mostafavi E, Natto ZS, Pawar S, Rana J, Seylani A, Singh JA, Wei J, Yang L, Ong KL, Steinmetz JD. Hearing Loss Prevalence, Years Lived With Disability, and Hearing Aid Use in the United States From 1990 to 2019: Findings From the Global Burden of Disease Study. Ear Hear 2024; 45:257-267. [PMID: 37712826 PMCID: PMC10718207 DOI: 10.1097/aud.0000000000001420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/17/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVES This article describes key data sources and methods used to estimate hearing loss in the United States, in the Global Burden of Disease study. Then, trends in hearing loss are described for 2019, including temporal trends from 1990 to 2019, changing prevalence over age, severity patterns, and utilization of hearing aids. DESIGN We utilized population-representative surveys from the United States to estimate hearing loss prevalence for the Global Burden of Disease study. A key input data source in modeled estimates are the National Health and Nutrition Examination Surveys (NHANES), years 1988 to 2010. We ran hierarchical severity-specific models to estimate hearing loss prevalence. We then scaled severity-specific models to sum to total hearing impairment prevalence, adjusted estimates for hearing aid coverage, and split estimates by etiology and tinnitus status. We computed years lived with disability (YLDs), which quantifies the amount of health loss associated with a condition depending on severity and creates a common metric to compare the burden of disparate diseases. This was done by multiplying the prevalence of severity-specific hearing loss by corresponding disability weights, with additional weighting for tinnitus comorbidity. RESULTS An estimated 72.88 million (95% uncertainty interval (UI) 68.53 to 77.30) people in the United States had hearing loss in 2019, accounting for 22.2% (20.9 to 23.6) of the total population. Hearing loss was responsible for 2.24 million (1.56 to 3.11) YLDs (3.6% (2.8 to 4.7) of total US YLDs). Age-standardized prevalence was higher in males (17.7% [16.7 to 18.8]) compared with females (11.9%, [11.2 to 12.5]). While most cases of hearing loss were mild (64.3%, 95% UI 61.0 to 67.6), disability was concentrated in cases that were moderate or more severe. The all-age prevalence of hearing loss in the United States was 28.1% (25.7 to 30.8) higher in 2019 than in 1990, despite stable age-standardized prevalence. An estimated 9.7% (8.6 to 11.0) of individuals with mild to profound hearing loss utilized a hearing aid, while 32.5% (31.9 to 33.2) of individuals with hearing loss experienced tinnitus. Occupational noise exposure was responsible for 11.2% (10.2 to 12.4) of hearing loss YLDs. CONCLUSIONS Results indicate large burden of hearing loss in the United States, with an estimated 1 in 5 people experiencing this condition. While many cases of hearing loss in the United States were mild, growing prevalence, low usage of hearing aids, and aging populations indicate the rising impact of this condition in future years and the increasing importance of domestic access to hearing healthcare services. Large-scale audiometric surveys such as NHANES are needed to regularly assess hearing loss burden and access to healthcare, improving our understanding of who is impacted by hearing loss and what groups are most amenable to intervention.
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Affiliation(s)
- Lydia M. Haile
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Aislyn U. Orji
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Kelly M. Reavis
- National Center for Rehabilitative Auditory Research, US Department of Veterans Affairs—Portland Healthcare System, Portland, OR, USA
| | - Paul Svitil Briant
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Katia M. Lucas
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Fares Alahdab
- Mayo Evidence-based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, USA
| | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Arielle Wilder Bell
- Department of Global Health and Social Medicine, Harvard University, Boston, MA, USA
- Department of Social Services, Tufts Medical Center, Boston, MA, USA
| | - Chao Cao
- Program in Physical Therapy, Washington University in St. Louis, St. Louis, MO, USA
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Simon I. Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | | | - Ibraheem M. Karaye
- School of Health Professions and Human Services, Hofstra University, Hempstead, NY, USA
| | - Ted R. Miller
- Pacific Institute for Research & Evaluation, Calverton, MD, USA
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Ali H. Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ebrahim Mostafavi
- Department of Medicine, Stanford University, Palo Alto, CA, USA
- Stanford Cardiovascular Institute, Stanford University, Palo Alto, CA, USA
| | - Zuhair S. Natto
- Department of Dental Public Health, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Oral Health Policy and Epidemiology, Harvard University, Boston, USA
| | - Shrikant Pawar
- Department of Genetics, Yale University, New Haven, CT, USA
| | - Juwel Rana
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
- Research and Innovation Division, South Asian Institute for Social Transformation (SAIST), Dhaka, Bangladesh
| | - Allen Seylani
- National Heart, Lung, and Blood Institute, National Institute of Health, Rockville, MD, USA
| | - Jasvinder A. Singh
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Medicine Service, US Department of Veterans Affairs (VA), Birmingham, AL, USA
| | - Jingkai Wei
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Lin Yang
- Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, BC, Canada
- Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - Kanyin Liane Ong
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Jaimie D. Steinmetz
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
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18
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Carmody N, Hunter M, Eikelboom RH. Help-seeker satisfaction with diagnosis and treatment of tinnitus. Int J Audiol 2023:1-8. [PMID: 38117006 DOI: 10.1080/14992027.2023.2292964] [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: 05/23/2023] [Accepted: 12/04/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE To examine help-seeker satisfaction with the first communication of a tinnitus diagnosis by a healthcare provider, whether help-seekers undertook treatment and how they rated this treatment. DESIGN A survey design assessed tinnitus characteristics and distress, health status, help-seeking, diagnosis communication, treatment and patient satisfaction. STUDY SAMPLE A self-selected cohort and a population-based cohort. RESULTS Satisfaction scores were examined against demographic, clinical factors, and type of healthcare provider. A total of 281 adults participated (median age 61.6, IQR = 10.8 years), 52.3% sought help for tinnitus and 22.4% received treatment. The most frequently seen healthcare providers were general practitioners (34.0%), audiologists (29.3%) and ear, nose and throat specialists (25.9%). About two-thirds (64.1%) of help-seekers were unsatisfied with the first communication of a tinnitus diagnosis they received, and 56.5% rated their first tinnitus treatment as poor. Help-seekers were significantly more satisfied with audiologists than other providers regarding the communication of the first tinnitus diagnosis. Higher tinnitus distress scores were significantly associated with lower patient satisfaction with communication of first tinnitus diagnosis. No other factors were associated with patient satisfaction. CONCLUSION There are significant communication barriers along the tinnitus clinical pathway. Identifying and addressing these barriers could improve patient satisfaction.
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Affiliation(s)
- Natalie Carmody
- Centre for Ear Sciences, Medical School, The University of Western Australia, Nedlands, Australia
- Ear Science Institute Australia, Subiaco, Australia
| | - Michael Hunter
- Busselton Health Study Centre, Busselton Population Medical Research Institute, Busselton, Australia
- School of Population and Global Health, The University of Western Australia, Nedlands, Australia
| | - Robert H Eikelboom
- Centre for Ear Sciences, Medical School, The University of Western Australia, Nedlands, Australia
- Ear Science Institute Australia, Subiaco, Australia
- Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Curtin Medical School, Curtin University, Bentley, Australia
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19
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Ungar OJ, Handzel O, Abu Eta R, Martz E, Oron Y. Meta-Analysis of Acceptance and Commitment Therapy for Tinnitus. Indian J Otolaryngol Head Neck Surg 2023; 75:2921-2926. [PMID: 37974721 PMCID: PMC10645678 DOI: 10.1007/s12070-023-03878-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: 01/08/2023] [Accepted: 05/07/2023] [Indexed: 11/19/2023] Open
Abstract
Acceptance and commitment therapy (ACT) was found to be effective with a diverse range of clinical conditions. The aim of this study is to evaluate the efficacy of ACT-based treatment for individuals with tinnitus. Meta-analysis of the scientific literature of Medline via PubMed, EMBASE, Web of Science and Google Scholar. The meta-analysis included 3 studies. The pooled mean difference in the Tinnitus Handicap Inventory (THI) score was 17.67 points lower [95% CI (- 23.50) to (- 11.84)] for the intervention arm compared to the non-treated control arm. The significant clinical reduction in the THI score indicates that ACT is an effective treatment for tinnitus. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03878-z.
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Affiliation(s)
- Omer J. Ungar
- Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906 Tel Aviv, Israel
| | - Ophir Handzel
- Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906 Tel Aviv, Israel
| | - Rani Abu Eta
- Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906 Tel Aviv, Israel
| | - Erin Martz
- Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906 Tel Aviv, Israel
- Rehability LLC, Vancouver, Washington, Oregon USA
| | - Yahav Oron
- Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, 6 Weizmann Street, 6423906 Tel Aviv, Israel
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Vasilkov V, Caswell-Midwinter B, Zhao Y, de Gruttola V, Jung DH, Liberman MC, Maison SF. Evidence of cochlear neural degeneration in normal-hearing subjects with tinnitus. Sci Rep 2023; 13:19870. [PMID: 38036538 PMCID: PMC10689483 DOI: 10.1038/s41598-023-46741-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/04/2023] [Indexed: 12/02/2023] Open
Abstract
Tinnitus, reduced sound-level tolerance, and difficulties hearing in noisy environments are the most common complaints associated with sensorineural hearing loss in adult populations. This study aims to clarify if cochlear neural degeneration estimated in a large pool of participants with normal audiograms is associated with self-report of tinnitus using a test battery probing the different stages of the auditory processing from hair cell responses to the auditory reflexes of the brainstem. Self-report of chronic tinnitus was significantly associated with (1) reduced cochlear nerve responses, (2) weaker middle-ear muscle reflexes, (3) stronger medial olivocochlear efferent reflexes and (4) hyperactivity in the central auditory pathways. These results support the model of tinnitus generation whereby decreased neural activity from a damaged cochlea can elicit hyperactivity from decreased inhibition in the central nervous system.
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Affiliation(s)
- Viacheslav Vasilkov
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA
- Department of Otolaryngology, Harvard Medical School, Boston, MA, 02114, USA
| | - Benjamin Caswell-Midwinter
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA
- Department of Otolaryngology, Harvard Medical School, Boston, MA, 02114, USA
| | - Yan Zhao
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA
| | - Victor de Gruttola
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02114, USA
| | - David H Jung
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA
- Department of Otolaryngology, Harvard Medical School, Boston, MA, 02114, USA
| | - M Charles Liberman
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA
- Department of Otolaryngology, Harvard Medical School, Boston, MA, 02114, USA
| | - Stéphane F Maison
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA.
- Department of Otolaryngology, Harvard Medical School, Boston, MA, 02114, USA.
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21
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Vielsmeier V, van der Loo J, Marcrum SC. [Somatosensory tinnitus]. HNO 2023; 71:731-738. [PMID: 37782343 DOI: 10.1007/s00106-023-01372-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Somatosensory tinnitus represents a clinically significant subgroup of chronic tinnitus. Although not completely understood, increasing evidence suggests interactivity between the somatosensory and auditory systems is responsible for both the development and maintenance of tinnitus. OBJECTIVES The aim of this study is to provide an overview of the evaluation of somatosensory tinnitus and to propose an examination protocol to support the diagnosis and treatment of this patient group. MATERIALS AND METHODS In addition to patient history, various clinical examination maneuvers are presented to establish the diagnosis of somatosensory tinnitus. RESULTS The maneuvers can be divided into examinations of the cervical spine, temporomandibular joint, and soft tissue near the jaw. The maneuvers should be performed in a quiet environment and usually in comparison between sides. CONCLUSION Accurate and efficient diagnosis of somatosensory tinnitus is essential to initiate appropriate treatment. The clinical maneuvers presented here are well suited for this purpose.
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Affiliation(s)
- Veronika Vielsmeier
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
| | - Joachim van der Loo
- Abteilung für Physio- und Ergotherapie, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - Steven C Marcrum
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
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22
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Olze H, Vater J, Gröschel M, Szczepek AJ. [Cochlear implant and tinnitus]. HNO 2023; 71:693-701. [PMID: 37815555 DOI: 10.1007/s00106-023-01376-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2023] [Indexed: 10/11/2023]
Abstract
Cochlear implant (CI) treatment is now established as a successful standard of care for auditory rehabilitation of profoundly deaf or severe hearing loss patients. CI candidates with tinnitus also benefit from improved health-related quality of life (HRQoL) and tinnitus burden. Current CI indications include bilateral (double-sided) profound hearing loss and deafness (DSD), unilateral (single-sided) deafness (SSD), and asymmetric hearing loss (AHL). The new and expanded indications for cochlear implants result in different healthcare situations, which may also be associated with differences in tinnitus burden before and after CI treatment. In this article, we discuss the prevalence of tinnitus in different patient groups and the influence of CI on tinnitus prevalence and severity in these groups. In addition, further therapeutic options for tinnitus suppression based on the CI principle are presented, including the development of an anti-tinnitus implant (proof of concept).
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Affiliation(s)
- Heidi Olze
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
| | - Jana Vater
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - Moritz Gröschel
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - Agnieszka J Szczepek
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
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23
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Habeeb A, Hemaya M, Hemaya M, Kanegaonkar R. Telehealth in treating tinnitus: a systematic review and meta-analysis. J Laryngol Otol 2023; 137:1182-1192. [PMID: 36861426 DOI: 10.1017/s0022215123000373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
OBJECTIVE Treatment for tinnitus focuses on supportive therapies. Long waiting times in the National Health Service encourage telemedicine options as an alternative. This study aimed to review the literature on telemedicine in the management of tinnitus and analyse its impact on the burden of tinnitus, long-term, anxiety, depression, insomnia and quality of life. METHOD PubMed, Embase, Cochrane Library, Google Scholar, Scopus and Web of Science were searched. English randomised, controlled trials with adult participants suffering from tinnitus were included. A random effects model looking at standardised mean differences between intervention and control groups was utilised. RESULTS Eleven randomised, controlled trials were included. Nine studies looked at internet-based cognitive behavioural therapy. A z-value of 9.87 (p < 0.00001; I2 = 21 per cent) showed telemedicine approaches may be better at reducing tinnitus burden compared with passive controls. CONCLUSION Telemedicine options have multiple benefits, but more research will be needed to conclusively say they are better than alternatives.
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Affiliation(s)
- A Habeeb
- Department of Otorhinolaryngology, East and North Hertfordshire NHS Foundation Trust, Stevenage, England, UK
| | - M Hemaya
- Department of Otorhinolaryngology, East and North Hertfordshire NHS Foundation Trust, Stevenage, England, UK
| | - M Hemaya
- Department of Otorhinolaryngology, East and North Hertfordshire NHS Foundation Trust, Stevenage, England, UK
| | - R Kanegaonkar
- Department of Otorhinolaryngology, King's College Hospital NHS Foundation Trust, London, UK
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24
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Zhai XM, Dong JJ, Zhang HL, Yuan J, Hao XJ, Guo R. Development and Validation of a Nomogram to Predict the Risk of Tinnitus Severity in Patients With Unilateral Subjective Tinnitus. EAR, NOSE & THROAT JOURNAL 2023:1455613231200762. [PMID: 37772466 DOI: 10.1177/01455613231200762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
Purpose: To develop and validate a nomogram for predicting the risk of tinnitus severity in patients with unilateral subjective tinnitus. Methods: The objective of this study was to establish and validate a nomogram specifically designed for patients with unilateral subjective tinnitus. We collected data on unilateral subjective tinnitus from the Air Force Medical Center, including 146 participants between January 2021 and June 2022. Risk factors for unilateral subjective tinnitus severity were evaluated by least absolute shrinkage and selection operator (LASSO) and binary logistic regression analysis. Internal verification was used to evaluate the performance of the nomogram. The discriminative ability was measured by the consistency index (C-indices) and the area under the curve (AUC) of the receiver operating characteristic (ROC) curves. Results: All included patients were randomized according to a 7:3 ratio into the training cohort (104 patients) and the validation cohort (42 patients). The LASSO regression model identified sex, tinnitus loudness, and hearing loss as candidate variables. Binary logistic regression analysis showed that gender (OR: 0.76; 95% CI: 0.6-0.95; P = 0.021) and tinnitus loudness (OR: 1.37; 95% CI: 1.09-1.72; P = 0.009) were significant predictors of unilateral subjective tinnitus severity, while age, tinnitus matching frequency, and tinnitus duration were not. The significant predictors were included in the nomogram. Hearing loss was included in the nomogram based on prior clinical experience and previous studies. The training and validation cohorts C-indexes were 0.707 (95% CI: 0.607-0.806) and 0.706 (95% CI: 0.548-0.863), respectively. The training and validation cohort's AUC of the ROC curves were 0.692 and 0.705, respectively. Conclusion: We have developed and validated a nomogram based on gender, hearing loss, and tinnitus loudness, which can effectively predict the risk of tinnitus severity in patients with unilateral subjective tinnitus. The nomogram provides personalized prediction results for patients with unilateral subjective tinnitus, which is beneficial for clinical decision-making and treatment plan development.
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Affiliation(s)
- Xiao-Min Zhai
- Graduate School of Hebei North University, Zhangjiakou, Hebei, China
- Department of Otorhinolaryngology Head and Neck Surgery, Air Force Medical Central, Air Force Medical University, Beijing, China
| | - Jia-Jia Dong
- Department of Otorhinolaryngology Head and Neck Surgery, Air Force Medical Central, Air Force Medical University, Beijing, China
| | - Hong-Lei Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Air Force Medical Central, Air Force Medical University, Beijing, China
| | - Jun Yuan
- Department of Otorhinolaryngology Head and Neck Surgery, Air Force Medical Central, Air Force Medical University, Beijing, China
| | - Xue-Jing Hao
- Department of Otorhinolaryngology Head and Neck Surgery, Air Force Medical Central, Air Force Medical University, Beijing, China
| | - Rui Guo
- Department of Otorhinolaryngology Head and Neck Surgery, Air Force Medical Central, Air Force Medical University, Beijing, China
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25
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Buizza C, Franco E, Ghilardi A. Is Biofeedback for Vertigo Effective in Ordinary Medical Centers? A Controlled Trial in Northern Italy. Appl Psychophysiol Biofeedback 2023; 48:345-354. [PMID: 37231183 PMCID: PMC10412656 DOI: 10.1007/s10484-023-09588-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2023] [Indexed: 05/27/2023]
Abstract
The aim of this study was to assess the therapeutic effectiveness of biofeedback, in a medical center's routine for treating vestibular disorders, reducing emotional, functional, and physical disability at three-month follow-up. A total of 197 outpatients were recruited from a medical center to treat vestibular disorders. Patients in the control group received treatment as usual, consisting of one monthly visit with an otolaryngologist and pharmacological treatment specific for vertigo, while the experimental group attended biofeedback training. Patients in the experimental group received pharmacological therapy only in the phase before the start of biofeedback in order to stabilize the acute phase. During the three-month follow-up, the experimental group did not receive any booster sessions of biofeedback. At three-month follow-up there was a statistically significant difference between the groups, both in the mean total score of the dizziness handicap inventory and in the three subscales: physical, emotional, and functional. Moreover, the biofeedback group had reduced psycho-physiological parameters for all average values at three-month follow-up compared to the baseline. This is one of few studies assessing the effectiveness of biofeedback in a naturalistic setting for vestibular disorder treatment. The data confirmed that biofeedback can impact illness course, in terms of self-perceived disability reduction, assessed on emotional, functional, and physical aspects of daily living.
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Affiliation(s)
- Chiara Buizza
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, Brescia, Italy.
| | - Elena Franco
- Medical Center San Francesco, Via Zadei 16, Brescia, Italy
| | - Alberto Ghilardi
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, Brescia, Italy
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26
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Sirikaku K, Watinaga GK, de Souza Moraes S, Guimarães TB, Onishi ET. Effect of Dry Needling on the Masseter Muscle in the Tinnitus Perception of Patients with Temporomandibular Disorder. J Maxillofac Oral Surg 2023; 22:571-578. [PMID: 37534338 PMCID: PMC10390393 DOI: 10.1007/s12663-022-01696-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 02/01/2022] [Indexed: 11/29/2022] Open
Abstract
Objective To evaluate the effect of dry needling on the masseter muscle in the perception of tinnitus in patients with temporomandibular disorder. Methods Twenty-five patients with tinnitus and muscular temporomandibular disorders were randomly assigned to groups study (n = 13) and control (n = 12). Three sessions of dry needling (study) and sham (control) were performed. Follow-up was performed 30, 60 and 90 days after the end of treatment. The Analog Visual Scale and Tinnitus Handicap Inventory (THI) were used to evaluate the treatment. Results In study group, 76.9% presented a reduction in the intensity and tinnitus discomfort and total THI. In control group, 66.7% presented a decrease in tinnitus intensity and total THI, and 58.3% reported a decrease in tinnitus discomfort. After 90 days, in the study group, 84.6% maintained improvement in pain intensity and reduction in THI score and 69.2% reported improvement in both intensity and discomfort caused by tinnitus. In control group, 75% achieved improvement in pain intensity, 33.2% maintained improvement in tinnitus intensity, and 41.7% maintained improvement in discomfort caused by tinnitus and total THI. In the total THI score, the study group presented improvement (p = 0.041). Conclusion Dry needling combined with counseling was associated with improvement in pain intensity and tinnitus, decrease in tinnitus discomfort and reduction in total THI score.
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Affiliation(s)
- Katia Sirikaku
- Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Universidade Federal de São Paulo – UNIFESP, Rua Pedro de Toledo, 947 - Vila Clementino, São Paulo, SP 04039-002 Brazil
| | - Gilson Kazuo Watinaga
- Departamento de Pós-Graduação da Faculdade de Odontologia, Faculdade de Medicina e Odontologia São Leopoldo Mandic, Campinas, Brazil
| | - Samuel de Souza Moraes
- Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Universidade Federal de São Paulo – UNIFESP, Rua Pedro de Toledo, 947 - Vila Clementino, São Paulo, SP 04039-002 Brazil
| | - Thatiana Bastos Guimarães
- Departamento de Psiquiatria, Universidade Federal de São Paulo – UNIFESP, Avenida Lavandisca52 ap.22-Vila Nova Conceição, São Paulo, SP 04515-010 Brazil
| | - Ektor Tsuneo Onishi
- Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Universidade Federal de São Paulo – UNIFESP, Rua Pedro de Toledo, 947 - Vila Clementino, São Paulo, SP 04039-002 Brazil
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27
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Khan N, Lewis AT. Influence of Bone Conduction Hearing Device Implantation on Health-Related Quality of Life for Patients with and without Tinnitus. Audiol Res 2023; 13:573-585. [PMID: 37622926 PMCID: PMC10451704 DOI: 10.3390/audiolres13040050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/23/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023] Open
Abstract
(1) Background: Tinnitus, often related to hearing loss, is an addressable public health concern affecting health-related quality of life (HRQoL). This study aimed to explore the influence of bone conduction hearing aid (BCHA) implantation on HRQoL and hearing disability in patients with hearing loss suffering from tinnitus. (2) Methods: Data were collected from an international hearing implant registry. Health Utilities Index Mark 3 (HUI-3), Spatial and Qualities of Hearing- 49 Questionnaire (SSQ) and self-reported tinnitus burden data for adult patients implanted with a BCHA (n = 42) who provided baseline as well as follow-up data 1-year post-implantation were extracted from the registry. Wilcoxon signed rank tests and paired samples t-tests were used to analyse outcomes data. (3) Results: Patients, with or without tinnitus, demonstrated clinically important mean improvements in HUI-3 multi-attribute utility scores, HUI-3 hearing attribute and SSQ scores. Hearing loss patients with tinnitus presented with a lower HRQoL than patients without tinnitus. (4) Conclusions: These findings demonstrate the importance of hearing rehabilitation in improving the quality of life and hearing disability of patients with or without tinnitus and in providing tinnitus relief in some patients with hearing loss and tinnitus.
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Affiliation(s)
- Nasrene Khan
- School of Public Health and Community Medicine, University of Gothenburg, 40530 Gothenburg, Sweden;
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28
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Reyes Orozco F, Lin M, Clark B, Doherty JK, Oghalai JS, Voelker CCJ, Choi JS. Association between Cannabis Use and Tinnitus in US Adults. Otol Neurotol 2023; 44:611-618. [PMID: 37254263 DOI: 10.1097/mao.0000000000003895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Assess the association between cannabis use and tinnitus in a nationally representative sample of US adults. STUDY DESIGN Cross-sectional. SETTING Population-based. PATIENTS Adults aged 20 to 59 years who participated in 2011 to 2012 and 2015 to 2016 National Health and Nutrition Examination Survey (NHANES) with available data on tinnitus, audiometry, and substance use. INTERVENTION None. MAIN OUTCOME MEASURE Tinnitus, demographic information, and medical history were obtained from NHANES questionnaires. Tinnitus was defined as bothersome tinnitus in the past year. Cannabis use was categorized as never use, low-volume use (1-2 pipes/joints per day), and high-volume use (3+ pipes/joints per day). Multivariable regression models with interaction and mediation analyses were conducted. Sampling weights were incorporated to yield results generalizable to the US population. RESULTS Tinnitus prevalence was significantly higher among high-volume cannabis users (odds ratio [OR], 20.5%; 95% confidence interval [CI], 16.0-26.0%]) and low-volume users (OR, 17.0%; 95% CI, 14.3-20.0%) than nonusers (OR, 12.0%; 95% CI, 10.4-13.9%). High-volume cannabis use was significantly associated with tinnitus relative to nonusers in multivariable models adjusting for demographics, cardiovascular factors, hearing loss, noise exposure, and depression (OR, 2.05; 95% CI, 1.1-3.9). Tinnitus severity was comparable among high volume, low volume, and noncannabis users. There was no significant mediation or interaction of depression affecting the association between cannabis use and tinnitus. CONCLUSIONS Bothersome tinnitus prevalence was significantly higher among cannabis users relative to nonusers. High-volume cannabis use was independently associated with tinnitus in a multivariable model accounting for relevant factors including depression. Future study is warranted to elucidate the impact of various levels of cannabis use on tinnitus.
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Affiliation(s)
- Francis Reyes Orozco
- Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Matthew Lin
- Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Bhavishya Clark
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck, School of Medicine of the University of Southern California, Los Angeles, California
| | - Joni K Doherty
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck, School of Medicine of the University of Southern California, Los Angeles, California
| | - John S Oghalai
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck, School of Medicine of the University of Southern California, Los Angeles, California
| | | | - Janet S Choi
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota
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Sanfins MD, Donadon C, Gos E, Serra AP, Rezende A, Ferrazoli N, Skarżyński PH. Skarzynski Tinnitus Scale: Cultural Adaptation and Validation to Brazilian Portuguese. Int Arch Otorhinolaryngol 2023; 27:e400-e406. [PMID: 37564479 PMCID: PMC10411171 DOI: 10.1055/s-0042-1742351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/03/2021] [Indexed: 08/12/2023] Open
Abstract
Introduction Tinnitus is a prevalent condition among many different populations. Since tinnitus is subjective, self-report questionnaires are one way of assessing how much the condition interferes with the quality of life of an individual. Objective The aim of the present study was to translate and cross-culturally adapt the Skarzynski Tinnitus Scale (STS) into Brazilian Portuguese and validate its psychometric properties. Methods The STS was translated and cross-culturally adapted using five main steps. Fifty-eight individuals who had continuous tinnitus were invited to complete the questionnaire. Pure tone audiometry (air and bone conduction) were also done. Results No major changes were necessary in translating the scale. The overall score was 1.3 (range 0-4). Internal consistency was tested by Cronbach α, which ranged from 0.54 to 0.85. Differences between genders and between subscales and the total score were not significant. A statistically significant difference was only found in the coping subscale, in which normal hearing subjects had higher scores than those with hearing loss. Conclusion The translation and adaptation of the STS established linguistic and cultural equivalence with the original. In addition, it exhibited good internal consistency. Our results suggest that the STS is suitable for use in a clinical setting.
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Affiliation(s)
- Milaine Dominici Sanfins
- Postgraduate Program in Audiology, Albert Einstein Instituto Israelita de Ensino e Pesquisa, São Paulo, SP, Brazil
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Poland
| | - Caroline Donadon
- Postgraduate Program in Child and Adolescent Health, Universidade de Campinas, Campinas, SP, Brazil
| | - Elżbieta Gos
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Poland
| | - Ana Paula Serra
- Department of Otorhinolaryngology, Clínica Ouvire, Campinas, SP, Brazil
| | - Adriano Rezende
- Department of Otorhinolaryngology, Clínica Ouvire, Campinas, SP, Brazil
| | - Natalia Ferrazoli
- Postgraduate Program in Health, Interdisciplinary Practice and Rehabilitation School of Medical Sciences, Campinas, SP, Brazil
- Departament of Audiology, Clinica Ouvire, Campinas, SP, Brazil
| | - Piotr Henryk Skarżyński
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Poland
- Department of Heart Failure and Cardiac Rehabilitation, Institute of Sensory Organs, Warsaw, Poland
- Department of Otorhinolaryngology, Institute of Sensory Organs, Kajetany, Poland
- ENT Departament, Maria Curie-Sklodowska University, Lublin, Poland
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Singh A, Smith PF, Zheng Y. Targeting the Limbic System: Insights into Its Involvement in Tinnitus. Int J Mol Sci 2023; 24:9889. [PMID: 37373034 DOI: 10.3390/ijms24129889] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Tinnitus is originally derived from the Latin verb tinnire, which means "to ring". Tinnitus, a complex disorder, is a result of sentient cognizance of a sound in the absence of an external auditory stimulus. It is reported in children, adults, and older populations. Patients suffering from tinnitus often present with hearing loss, anxiety, depression, and sleep disruption in addition to a hissing and ringing in the ear. Surgical interventions and many other forms of treatment have been only partially effective due to heterogeneity in tinnitus patients and a lack of understanding of the mechanisms of tinnitus. Although researchers across the globe have made significant progress in understanding the underlying mechanisms of tinnitus over the past few decades, tinnitus is still deemed to be a scientific enigma. This review summarises the role of the limbic system in tinnitus development and provides insight into the development of potential target-specific tinnitus therapies.
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Affiliation(s)
- Anurag Singh
- Department of Pharmacology and Toxicology, School of Biomedical Sciences, University of Otago, Dunedin 9016, New Zealand
- Brain Health Research Centre, University of Otago, Dunedin 9016, New Zealand
- The Eisdell Moore Centre for Research in Hearing and Balance Disorders, University of Auckland, Auckland 1023, New Zealand
| | - Paul F Smith
- Department of Pharmacology and Toxicology, School of Biomedical Sciences, University of Otago, Dunedin 9016, New Zealand
- Brain Health Research Centre, University of Otago, Dunedin 9016, New Zealand
- The Eisdell Moore Centre for Research in Hearing and Balance Disorders, University of Auckland, Auckland 1023, New Zealand
| | - Yiwen Zheng
- Department of Pharmacology and Toxicology, School of Biomedical Sciences, University of Otago, Dunedin 9016, New Zealand
- Brain Health Research Centre, University of Otago, Dunedin 9016, New Zealand
- The Eisdell Moore Centre for Research in Hearing and Balance Disorders, University of Auckland, Auckland 1023, New Zealand
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31
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Zhang H, Ji L, Wang L, Yin Z, Cen J, Guo Y. Clinical characteristics and psychoacoustic analysis of acute and chronic subjective tinnitus. Laryngoscope Investig Otolaryngol 2023; 8:546-553. [PMID: 37090863 PMCID: PMC10116969 DOI: 10.1002/lio2.1037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/08/2023] [Accepted: 02/19/2023] [Indexed: 03/08/2023] Open
Abstract
Objective This study aimed to understand the demographics, clinical characteristics, and psychoacoustic status of subjective tinnitus patients to explore the factors associated with acute and chronic tinnitus in the general hospitals of Shanghai. Methods A cross-sectional study was conducted to investigate the clinical characteristics and psychoacoustic status of subjective tinnitus patients with history greater than 1 month. Data were collected during January 2021 and January 2022 from eight general hospitals in five districts of Shanghai, China. All patients accepted questionnaires and acoustic examination, then SPSS 22.0 and GraphPad Prism 8.0.2 were applied for data analysis. Results Among the 359 tinnitus patients, 126 cases were diagnosed with acute tinnitus, 58 cases were subacute tinnitus, and 175 cases were chronic tinnitus. Patients with acute and chronic tinnitus differed in terms of side of tinnitus, hearing loss, frequency of tinnitus, severity of tinnitus, anxiety, depression, and sleep status. Different characteristics were included in the multivariate ordinal logistic regression analysis. Persistent tinnitus (OR = 2.00, p = .008), high frequency hearing loss (OR = 4.77, p < .001), depression (OR = 1.23, p < .001) were found to be positively associated with the course of tinnitus. Unilateral tinnitus (OR = 0.48, p = .003), mild (OR = 0.29, p = .001) and moderate (OR = 0.46, p = .038) hearing loss, VAS scores (OR = 0.82, p = .032), anxiety (OR = 0.81, p < .001), THI scores (OR = 0.98, p = .002), and sleep disorders (OR = 0.94, p = .025) were found to be negatively associated with the course of tinnitus. Conclusion Patients with acute tinnitus were at greater risk for anxiety, sleep disturbances, and exacerbation of tinnitus perception, and those with chronic tinnitus were at greater risk for depression. Lay Summary Our study demonstrated that patients with acute tinnitus were at greater risk for anxiety, sleep disturbances, and exacerbation of tinnitus perception, and those with chronic tinnitus were at greater risk for depression.
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Affiliation(s)
- Haopeng Zhang
- Department of OtolaryngologyShanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese MedicineShanghaiChina
| | - Lin Ji
- Department of OtolaryngologyShanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese MedicineShanghaiChina
| | - Lihua Wang
- Department of OtolaryngologyShanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese MedicineShanghaiChina
| | - Ziming Yin
- School of Medical Instrument and Food EngineeringUniversity of Shanghai for Science and TechnologyShanghaiChina
| | - Jingtu Cen
- Department of OtolaryngologyShanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese MedicineShanghaiChina
| | - Yu Guo
- Department of OtolaryngologyShanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese MedicineShanghaiChina
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Gallo KEB, Corrêa CDC, Gonçalves CGDO, Correia Baran JB, Marques JM, Zeigelboim BS, José MR. Effect of Tinnitus on Sleep Quality and Insomnia. Int Arch Otorhinolaryngol 2023; 27:e197-e202. [PMID: 37125358 PMCID: PMC10147471 DOI: 10.1055/s-0041-1735455] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 05/07/2021] [Indexed: 05/02/2023] Open
Abstract
Introduction Tinnitus is a conscious perception of a sound resulting from abnormal activity within the nervous system. A relevant percentage of tinnitus patients report symptoms severe enough to significantly affect quality of life, including sleep disorders. Objective To analyze the sleep quality, insomnia, daytime sleepiness, and risk of obstructive sleep apnea (OSA) in participants with tinnitus. Methods The sample comprised 18 adults and older adults aged between 18 and 85 years old (mean age = 58.7 ± 17.5 years old), females and males, with complaint of continuous tinnitus for > 1 month. The instruments used were the Tinnitus Handicap Inventory (THI) questionnaire, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the STOP-Bang questionnaire. Results By means of the THI questionnaire, the tinnitus severity degree reported by most participants was mild (27.8%) and moderate (27.8%), having a positive (r = 0.582) and significant (0.011) correlation to sleep quality, measured by means of the Pittsburgh questionnaire. There was a positive correlation between the Insomnia Severity Index and tinnitus handicap (r = 0.499; p = 0.035). A total of 72.2% of the participants self-assessed their sleep quality as poor, in addition to moderate insomnia (27.8%), although there is low risk of OSA (66.7%), without complaints of excessive daytime sleepiness (72.2%). Conclusion Subjects with tinnitus complaint self-rated their sleep quality as poor. Moreover, the higher the reported tinnitus handicap, the greater the symptoms of insomnia. There was no influence of tinnitus in relation to daytime sleepiness and no relationship between the severity of tinnitus and the risk of OSA.
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Affiliation(s)
| | - Camila de Castro Corrêa
- Curso de Fonoaudiologia, Centro Universitário Planalto do Distrito Federal, Brasília, DF, Brazil
| | | | | | - Jair Mendes Marques
- Programa de Pós-Graduação em Distúrbios da Comunicação, Universidade Tuiuti do Paraná, Curitiba, PR, Brazil
| | - Bianca Simone Zeigelboim
- Programa de Pós-Graduação em Distúrbios da Comunicação, Universidade Tuiuti do Paraná, Curitiba, PR, Brazil
| | - Maria Renata José
- Programa de Pós-Graduação em Distúrbios da Comunicação, Universidade Tuiuti do Paraná, Curitiba, PR, Brazil
- Address for correspondence Maria Renata José, PhD Universidade Tuiuti do ParanáRua Padre Ladislau Kula, n° 395, Santo Inácio, Curitiba, PR, CEP 82.010–210Brasil
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Bommakanti K, Seist R, Kukutla P, Cetinbas M, Batts S, Sadreyev RI, Stemmer-Rachamimov A, Brenner GJ, Stankovic KM. Comparative Transcriptomic Analysis of Archival Human Vestibular Schwannoma Tissue from Patients with and without Tinnitus. J Clin Med 2023; 12:jcm12072642. [PMID: 37048724 PMCID: PMC10095534 DOI: 10.3390/jcm12072642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/22/2023] [Accepted: 03/25/2023] [Indexed: 04/05/2023] Open
Abstract
Vestibular schwannoma (VS) is an intracranial tumor that commonly presents with tinnitus and hearing loss. To uncover the molecular mechanisms underlying VS-associated tinnitus, we applied next-generation sequencing (Illumina HiSeq) to formalin-fixed paraffin-embedded archival VS samples from nine patients with tinnitus (VS-Tin) and seven patients without tinnitus (VS-NoTin). Bioinformatic analysis was used to detect differentially expressed genes (DEG; i.e., ≥two-fold change [FC]) while correcting for multiple comparisons. Using RNA-seq analysis, VS-Tin had significantly lower expression of GFAP (logFC = −3.04), APLNR (logFC = −2.95), PREX2 (logFC = −1.44), and PLVAP (logFC = −1.04; all p < 0.01) vs. VS-NoTin. These trends were validated by using real-time RT-qPCR. At the protein level, immunohistochemistry revealed a trend for less PREX2 and apelin expression and greater expression of NLRP3 inflammasome and CD68-positive macrophages in VS-Tin than in VS-NoTin, suggesting the activation of inflammatory processes in VS-Tin. Functional enrichment analysis revealed that the top three protein categories—glycoproteins, signal peptides, and secreted proteins—were significantly enriched in VS-Tin in comparison with VS-NoTin. In a gene set enrichment analysis, the top pathway was allograft rejection, an inflammatory pathway that includes the MMP9, CXCL9, IL16, PF4, ITK, and ACVR2A genes. Future studies are needed to examine the importance of these candidates and of inflammation in VS-associated tinnitus.
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Affiliation(s)
- Krishna Bommakanti
- Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical School, Boston, MA 02114, USA
- Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Richard Seist
- Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical School, Boston, MA 02114, USA
- Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
- Department of Otorhinolaryngology–Head and Neck Surgery, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Phanidhar Kukutla
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Murat Cetinbas
- Department of Molecular Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Shelley Batts
- Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Ruslan I. Sadreyev
- Department of Molecular Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Anat Stemmer-Rachamimov
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Gary J. Brenner
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Konstantina M. Stankovic
- Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical School, Boston, MA 02114, USA
- Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, USA
- Wu Tsai Neuroscience Institute, Stanford University, Stanford, CA 94305, USA
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Sherlock LP, Gibson KJ, Talian DS, Lake DC. Prevalence of Self-Reported Bothersome Tinnitus in U.S. Army Soldiers From January 1, 2015, Through September 30, 2019. Am J Audiol 2023:1-11. [PMID: 36940481 DOI: 10.1044/2022_aja-22-00201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Abstract
PURPOSE Tinnitus is a symptom of auditory dysfunction or injury and can be a precursor to permanent hearing loss. Tinnitus can interfere with communication, sleep, concentration, and mood; when this occurs, it is referred to as bothersome tinnitus. Annual hearing surveillance in the U.S. Army includes screening for bothersome tinnitus. Estimating the prevalence of self-reported bothersome tinnitus can facilitate prioritization of prevention and education efforts. The objective of this study was to examine Army hearing conservation data to estimate the prevalence of self-reported bothersome tinnitus as a function of age, hearing, sex, service component, and pay grade. METHOD The study employed a cross-sectional, retrospective design. Records from 1,485,059 U.S. Army Soldiers retrieved from the Defense Occupational and Environmental Health Readiness System-Hearing Conservation were analyzed. Descriptive statistics and multinomial logistic regression analysis were used to estimate the prevalence of bothersome tinnitus and its associations with Soldiers' demographic characteristics. RESULTS The estimated prevalence of self-reported bothersome tinnitus was 17.1% between January 1, 2015, and September 30, 2019; 13.6% of the Soldiers reported "bothered a little" and 3.5% reported "bothered a lot." Proportionally, the prevalence of self-reported bothersome tinnitus was higher for males, older Soldiers, and Reserve Component Soldiers. For every 1-year increase in age, the odds of self-reporting "bothered a little" tinnitus relative to "bothered not at all tinnitus" would be expected to increase by 2.2% (2.1%, 2.3%), and the odds of self-reporting "bothered a lot" tinnitus relative to "bothered not at all" tinnitus would be expected to increase by 3.6% (3.5%, 3.7%). CONCLUSIONS The self-reported prevalence of bothersome tinnitus in the U.S. Army (17.1%) is substantially higher than that of the general population, where prevalence of bothersome tinnitus is estimated at 6.6%. Examination of bothersome tinnitus among Soldiers is an important step toward optimizing prevention, education, and intervention efforts.
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Affiliation(s)
- LaGuinn P Sherlock
- Hearing Conservation and Readiness Branch, U.S. Army Public Health Center, Aberdeen Proving Ground, MD
- Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
| | - Kelly J Gibson
- Armed Forces Health Surveillance Division, Defense Health Agency, Falls Church, VA
| | - Daniel S Talian
- Hearing Conservation and Readiness Branch, U.S. Army Public Health Center, Aberdeen Proving Ground, MD
- Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
| | - Deborah C Lake
- Hearing Conservation and Readiness Branch, U.S. Army Public Health Center, Aberdeen Proving Ground, MD
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Salvari V, Korth D, Paraskevopoulos E, Wollbrink A, Ivansic D, Guntinas-Lichius O, Klingner C, Pantev C, Dobel C. Tinnitus-frequency specific activity and connectivity: A MEG study. Neuroimage Clin 2023; 38:103379. [PMID: 36933347 PMCID: PMC10031544 DOI: 10.1016/j.nicl.2023.103379] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 03/15/2023]
Abstract
Tinnitus pathophysiology has been associated with an atypical cortical network that involves functional changes in auditory and non-auditory areas. Numerous resting-state studies have replicated a tinnitus brain network to be significantly different from healthy-controls. Yet it is still unknown whether the cortical reorganization is attributed to the tinnitus frequency specifically or if it is frequency-irrelevant. Employing magnetoencephalography (MEG), the current study aimed to identify frequency-specific activity patterns by using an individual tinnitus tone (TT) and a 500 Hz-control tone (CT) as auditory stimuli, across 54 tinnitus patients. MEG data were analyzed in a data-driven approach employing a whole-head model in source space and in sources' functional connectivity. Compared to the CT, the event related source space analysis revealed a statistically significant response to TT involving fronto-parietal regions. The CT mainly involved typical auditory activation-related regions. A comparison of the cortical responses to a healthy control group that underwent the same paradigm rejected the alternative interpretation that the frequency-specific activation differences were due to the higher frequency of the TT. Overall, the results suggest frequency-specificity of tinnitus-related cortical patterns. In line with previous studies, we demonstrated a tinnitus-frequency specific network comprising left fronto-temporal, fronto-parietal and tempo-parietal junctions.
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Affiliation(s)
- Vasiliki Salvari
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, P.C. D-48149, Münster, Germany
| | - Daniela Korth
- Department of Otorhinolaryngology, Jena University Hospital, Friedrich-Schiller-University of Jena, P.C. D-07747 Jena, Germany
| | - Evangelos Paraskevopoulos
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, P.C. 54124 Thessaloniki, Greece; Department of Psychology, University of Cyprus, P.C. CY 1678, Nicosia, Cyprus
| | - Andreas Wollbrink
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, P.C. D-48149, Münster, Germany
| | - Daniela Ivansic
- Department of Otorhinolaryngology, Jena University Hospital, Friedrich-Schiller-University of Jena, P.C. D-07747 Jena, Germany
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Jena University Hospital, Friedrich-Schiller-University of Jena, P.C. D-07747 Jena, Germany
| | - Carsten Klingner
- Department of Neurology, Jena University Hospital, Friedrich-Schiller-University of Jena, D-07747 Jena Germany
| | - Christo Pantev
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, P.C. D-48149, Münster, Germany
| | - Christian Dobel
- Department of Otorhinolaryngology, Jena University Hospital, Friedrich-Schiller-University of Jena, P.C. D-07747 Jena, Germany
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Hayes SH, Beh K, Typlt M, Schormans AL, Stolzberg D, Allman BL. Using an appetitive operant conditioning paradigm to screen rats for tinnitus induced by intense sound exposure: Experimental considerations and interpretation. Front Neurosci 2023; 17:1001619. [PMID: 36845432 PMCID: PMC9950262 DOI: 10.3389/fnins.2023.1001619] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 01/25/2023] [Indexed: 02/12/2023] Open
Abstract
In an effort to help elucidate the neural mechanisms underlying tinnitus in humans, researchers have often relied on animal models; a preclinical approach which ultimately required that behavioral paradigms be designed to reliably screen animals for tinnitus. Previously, we developed a two-alternative forced-choice (2AFC) paradigm for rats that allowed for the simultaneous recording of neural activity at the very moments when they were reporting the presence/absence of tinnitus. Because we first validated our paradigm in rats experiencing transient tinnitus following a high-dose of sodium salicylate, the present study now sought to evaluate its utility to screen for tinnitus caused by intense sound exposure; a common tinnitus-inducer in humans. More specifically, through a series of experimental protocols, we aimed to (1) conduct sham experiments to ensure that the paradigm was able to correctly classify control rats as not having tinnitus, (2) confirm the time course over which the behavioral testing could reliably be performed post-exposure to assess chronic tinnitus, and (3) determine if the paradigm was sensitive to the variable outcomes often observed after intense sound exposure (e.g., hearing loss with our without tinnitus). Ultimately, in accordance with our predictions, the 2AFC paradigm was indeed resistant to false-positive screening of rats for intense sound-induced tinnitus, and it was able to reveal variable tinnitus and hearing loss profiles in individual rats following intense sound exposure. Taken together, the present study documents the utility of our appetitive operant conditioning paradigm to assess acute and chronic sound-induced tinnitus in rats. Finally, based on our findings, we discuss important experimental considerations that will help ensure that our paradigm is able to provide a suitable platform for future investigations into the neural basis of tinnitus.
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Affiliation(s)
- Sarah H. Hayes
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada,*Correspondence: Sarah H. Hayes,
| | - Krystal Beh
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada,National Centre for Audiology, Elborn College, The University of Western Ontario, London, ON, Canada
| | - Marei Typlt
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada,Audifon GmbH & Co. KG, Kölleda, Germany
| | - Ashley L. Schormans
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
| | - Daniel Stolzberg
- Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
| | - Brian L. Allman
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada,National Centre for Audiology, Elborn College, The University of Western Ontario, London, ON, Canada
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Demoen S, Chalimourdas A, Timmermans A, Van Rompaey V, Vanderveken OM, Jacquemin L, Schlee W, Marneffe W, Luyten J, Gilles A, Michiels S. Effectiveness of Telerehabilitation Interventions for Self-management of Tinnitus: Systematic Review. J Med Internet Res 2023; 25:e39076. [PMID: 36757768 PMCID: PMC9951082 DOI: 10.2196/39076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 12/16/2022] [Accepted: 12/31/2022] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Tinnitus is a highly prevalent symptom affecting 10%-20% of the adult population. Most patients with tinnitus have chronic tinnitus, which can directly or indirectly disrupt their daily life and negatively affect the health-related quality of life. Therefore, patients with tinnitus are frequently in need of costly and time-consuming treatments. As an answer, telerehabilitation interventions are on a rise to promote self-management in patients with tinnitus and reduce their dependency on in-person care. OBJECTIVE This systematic review aimed to provide an overview of the research concerning the effectiveness of telerehabilitation interventions for self-management of tinnitus. METHODS This systematic review adheres to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were eligible for inclusion if study participants were adult patients with complaints of primary subjective tinnitus and the study intervention comprised any possible telerehabilitation form for the self-management of tinnitus complaints. A search for eligible studies was conducted on PubMed, ScienceDirect, Scopus, Web of Science, and Cochrane Library. The Cochrane Risk of Bias 2 tool was used to the assess risk of bias. RESULTS In total, 29 articles were found eligible, and of these, 5 (17%) studied multiple telerehabilitation forms. Internet-based cognitive behavioral treatment with guidance by a psychologist or audiologist was examined in 17 studies (n=1767), internet-based cognitive behavioral treatment without guidance was examined in 4 studies (n=940), self-help manuals were examined in 1 study (n=72), technological self-help devices were examined in 2 studies (n=82), smartphone apps were examined in 8 studies (n=284), and other internet-based interventions were examined in 2 studies (n=130). These rehabilitation categories were proven to be effective in decreasing tinnitus severity and relieving tinnitus distress as measured by tinnitus questionnaires such as Tinnitus Functional Index, Tinnitus Handicap Inventory, or Tinnitus Reactions Questionnaire. However, dropout rates were often high (range 4%-71.4%). All studies reported between some concerns and high concerns of risk of bias, resulting in low to moderate certainty levels. CONCLUSIONS Overall, there is low to moderate quality evidence that telerehabilitation interventions effectively reduce tinnitus severity and distress. These interventions form a possible tool to improve the self-management capacities of the patient and the accessibility of tinnitus care as a replacement or an addition to in-person care. Nevertheless, barriers such as lack of time, engagement, motivation, and openness of the patient causing high dropout should be considered. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42021285450; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=285450.
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Affiliation(s)
- Sara Demoen
- Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Department of translational neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Antonios Chalimourdas
- Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Annick Timmermans
- Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Department of translational neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Olivier M Vanderveken
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Department of translational neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Laure Jacquemin
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Department of translational neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Wim Marneffe
- Faculty of Business Economics, Hasselt University, Hasselt, Belgium
| | - Janis Luyten
- Faculty of Business Economics, Hasselt University, Hasselt, Belgium
| | - Annick Gilles
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Department of translational neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium
| | - Sarah Michiels
- Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
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Marcinkowska-Gapińska A, Maciejewska B, Majewska A, Kawałkiewicz W, Urbaniak-Olejnik M, Loba W, Stieler O, Komar D, Kubisz L, Karlik M, Hojan-Jezierska D. Can Assessment of Rheological Properties of Whole Blood and Plasma Be Useful in the Diagnosis of Tinnitus? A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1977. [PMID: 36767344 PMCID: PMC9915230 DOI: 10.3390/ijerph20031977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/04/2023] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
Tinnitus is a sensation of ringing in the ears in the absence of any physical source in the environment. Between 9-35% of adults experience some form of tinnitus. Common causes of tinnitus include noise, head injury, ototoxic substances, as well as disorders of blood and blood vessels. Vascular causes include: head-neck tumours, turbulent blood flow, problems with blood supply and inner ear cell damage. The aspect of rheology in terms of tinnitus has not been described yet. In the present study, which comprised 12 patients aged 30 to 74 years presenting with tinnitus, rheological properties of whole blood and plasma were assessed. All the subjects underwent audiological and neurological evaluation. The Quemada model was used to describe the variability of red blood cell shape, as well as their tendency to form aggregates. On the basis of the experimental study, statistically different results of haemorheological measurements were observed in the evaluated group in comparison to a reference group.
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Affiliation(s)
| | - Barbara Maciejewska
- Department and Clinic of Phoniatrics and Audiology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Anna Majewska
- Department of Hearing Healthcare Profession, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Weronika Kawałkiewicz
- Department of Biophysics, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Marta Urbaniak-Olejnik
- Department of Hearing Healthcare Profession, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Wawrzyniec Loba
- Department of Hearing Healthcare Profession, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Olgierd Stieler
- Department of Hearing Healthcare Profession, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Dariusz Komar
- Department of Hearing Healthcare Profession, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Leszek Kubisz
- Department of Biophysics, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Michał Karlik
- Department and Clinic of Phoniatrics and Audiology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Dorota Hojan-Jezierska
- Department of Hearing Healthcare Profession, Poznan University of Medical Sciences, 61-701 Poznań, Poland
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39
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Ye T, Chen K, Li D, Yin K, Li Y, Long J, Hui L. Global research hot spot and trends in tinnitus treatment between 2000 and 2021: A bibliometric and visualized study. Front Neurol 2023; 13:1085684. [PMID: 36686526 PMCID: PMC9847583 DOI: 10.3389/fneur.2022.1085684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/08/2022] [Indexed: 01/05/2023] Open
Abstract
Background In the 21st century, the prevalence of tinnitus is increasing, impacting approximately one in five people. It is a very complicated condition that significantly affects quality of life. Despite the availability of hundreds of tinnitus treatment options, none are very successful. In light of this, there has been a steady increase in studies on tinnitus treatments in the recent past. To comprehend them better, this study used bibliometric approaches to analyze and summarize 21st century scientific research accomplishments in tinnitus treatment. Methods The Web of Science Core Collection (WoSCC) was searched for papers that had been published and related to the treatment of tinnitus. VOSviewer, CiteSpace, R, and Tableau software programs were used to conduct bibliometric studies. To evaluate and visualize the results. Results 2,933 publications on tinnitus treatment were found in 74 countries. Between 2000 and 2021, publications increased steadily. Otolaryngology-Head & Neck Surgery had the highest impact factor, whereas Otology & Neurotology had the most magazines and the highest h, g, and m index. Langguth B was the most prolific author in terms of productivity during the past 21 years. Numerous eminent authors and organizations from multiple nations collaborated. With 626 papers, the United States of America (USA) contributed the most to this field, making them the leading contributor. Neuroplasticity, sound therapy, and cognitive behavioral therapy (CBT) have attracted the attention of researchers, leading to the development of innovative diagnostic and treatment strategies for tinnitus. Conclusion This bibliometric study provides a comprehensive analysis of worldwide publications, cooperation, and research hotspots in tinnitus therapy, revealing the present status of research on this issue and guiding tinnitus treatment research in the coming years.
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Affiliation(s)
- Tao Ye
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Kefan Chen
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Dongyang Li
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Kailong Yin
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yuan Li
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jin Long
- Department of Pancreatic-Biliary Surgery, The First Hospital of China Medical University, Shenyang, Liaoning, China,Jin Long ✉
| | - Lian Hui
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Hospital of China Medical University, Shenyang, Liaoning, China,*Correspondence: Lian Hui ✉
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Grundfast KM, Jamil TL. Evaluation and Management of Tinnitus: Are There Opportunities for Improvement? Otolaryngol Head Neck Surg 2023; 168:45-58. [PMID: 35349391 DOI: 10.1177/01945998221088286] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 03/02/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To review current information about diagnosis and management of tinnitus aiming to identify opportunities for achieving a cost-effective, efficient, evidence-based approach that meets the needs of tinnitus sufferers. DATA SOURCES PubMed/MEDLINE. REVIEW METHODS In total, 249 relevant published reports were reviewed. Pertinent keywords and MeSH terms identified reports via PubMed and EMBASE. Acknowledged experts were consulted on ways to improve tinnitus management. CONCLUSIONS There may be opportunities to improve evaluation and management of patients with tinnitus using modern modes of communication and a multidisciplinary therapeutic approach. IMPLICATIONS FOR PRACTICE Tinnitus can adversely affect quality of life while being time-consuming and costly to evaluate and manage. Based on both personal experience and the reports of others, patients with tinnitus who choose to see a physician primarily want to know two things: (1) that the tinnitus that is so distressing will not remain at the same level of severity forever and (2) that something can be done to help cope with the tinnitus that is so annoying. Recent advancements in internet communications, social media, information technology, artificial intelligence, machine learning, holistic medical care, mind-body integrative health care, and multidisciplinary approaches in medical therapeutics may be possibly making new ways of meeting the needs of patients with tinnitus.
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Affiliation(s)
- Kenneth M Grundfast
- Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts, USA
- Otology Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Taylor L Jamil
- Boston University School of Medicine, Boston, Massachusetts, USA
- Boston University School of Public Health, Boston, Massachusetts, USA
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Patil JD, Alrashid MA, Eltabbakh A, Fredericks S. The association between stress, emotional states, and tinnitus: a mini-review. Front Aging Neurosci 2023; 15:1131979. [PMID: 37207076 PMCID: PMC10188965 DOI: 10.3389/fnagi.2023.1131979] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/17/2023] [Indexed: 05/21/2023] Open
Abstract
Extensive literature supporting the view of tinnitus induced stress in patients is available. However, limited evidence has been produced studying the opposite, that is, does stress cause tinnitus? The hypothalamus pituitary adrenal axis, one of the main neuroendocrine systems involved in stress response, is commonly disturbed in tinnitus patients. Patients with chronic tinnitus have been shown to develop abnormal responses to psycho-social stress, where the hypothalamus pituitary adrenal axis response is weaker and delayed, suggesting chronic stress contributes to the development of chronic tinnitus. The sympathetic branch of the autonomic nervous system also plays a major role in stress response and its chronic hyperactivity seems to be involved in developing tinnitus. Psycho-social stress has been shown to share the same probability of developing tinnitus as occupational noise and contributes to worsening tinnitus. Additionally, exposure to high stress levels and occupational noise doubles the likelihood of developing tinnitus. Interestingly, short-term stress has been shown to protect the cochlea in animals, but chronic stress exposure has negative consequences. Emotional stress also worsens pre-existing tinnitus and is identified as an important indicator of tinnitus severity. Although there is limited body of literature, stress does seem to play a vital role in the development of tinnitus. This review aims to highlight the association between stress, emotional states, and the development of tinnitus while also addressing the neural and hormonal pathways involved.
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Affiliation(s)
- Jayaditya Devpal Patil
- Department of Surgery, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
- *Correspondence: Jayaditya Devpal Patil,
| | | | - Ayah Eltabbakh
- Royal College of Surgeons in Ireland, Al Muharraq, Bahrain
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A Protocol to Investigate Deep Brain Stimulation for Refractory Tinnitus: From Rat Model to the Set-Up of a Human Pilot Study. Audiol Res 2022; 13:49-63. [PMID: 36648926 PMCID: PMC9844413 DOI: 10.3390/audiolres13010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Chronic tinnitus can have an immense impact on quality of life. Despite recent treatment advances, many tinnitus patients remain refractory to them. Preclinical and clinical evidence suggests that deep brain stimulation (DBS) is a promising treatment to suppress tinnitus. In rats, it has been shown in multiple regions of the auditory pathway that DBS can have an alleviating effect on tinnitus. The thalamic medial geniculate body (MGB) takes a key position in the tinnitus network, shows pathophysiological hallmarks of tinnitus, and is readily accessible using stereotaxy. Here, a protocol is described to evaluate the safety and test the therapeutic effects of DBS in the MGB in severe tinnitus sufferers. METHODS Bilateral DBS of the MGB will be applied in a future study in six patients with severe and refractory tinnitus. A double-blinded, randomized 2 × 2 crossover design (stimulation ON and OFF) will be applied, followed by a period of six months of open-label follow-up. The primary focus is to assess safety and feasibility (acceptability). Secondary outcomes assess a potential treatment effect and include tinnitus severity measured by the Tinnitus Functional Index (TFI), tinnitus loudness and distress, hearing, cognitive and psychological functions, quality of life, and neurophysiological characteristics. DISCUSSION This protocol carefully balances risks and benefits and takes ethical considerations into account. This study will explore the safety and feasibility of DBS in severe refractory tinnitus, through extensive assessment of clinical and neurophysiological outcome measures. Additionally, important insights into the underlying mechanism of tinnitus and hearing function might be revealed. TRIAL REGISTRATION ClinicalTrials.gov NCT03976908 (6 June 2019).
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Marcrum SC, Engelke M, Goedhart H, Langguth B, Schlee W, Vesala M, Simoes JP. The Influence of Diet on Tinnitus Severity: Results of a Large-Scale, Online Survey. Nutrients 2022; 14:nu14245356. [PMID: 36558515 PMCID: PMC9784733 DOI: 10.3390/nu14245356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/30/2022] [Accepted: 12/03/2022] [Indexed: 12/24/2022] Open
Abstract
Optimization of dietary intake is an essential component in the multidimensional effort to prevent and manage chronic disease. Recently, demand has increased for nutrition-focused management strategies for chronic tinnitus. The primary aim of this study was to evaluate 10 dietary items for their association with changes in subjective tinnitus severity. A secondary aim was to develop an algorithm to better identify those individuals who might benefit from dietary modification strategies. A total of 5017 anonymous users of the TinnitusTalk forum completed an online survey regarding how various dietary items affected the severity of their tinnitus. Results suggest that, while intake of caffeine [positive effect (PE): 0.4%; negative effect (NE): 16.2%], alcohol (PE: 2.7%; NE: 13.3%, and salt (PE: 0.1%; NE: 9.9%) was most likely to influence tinnitus severity, it did so only for a small proportion of participants and reported effects were most commonly mild. Further, though a classification algorithm was able to leverage participant demographic, comorbidity, and tinnitus characteristics to identify those individuals most likely to benefit from dietary modification above chance levels, further efforts are required to achieve significant clinical utility. Taken together, these results do not support dietary modification as a primary treatment strategy for chronic tinnitus in the general population, though clinically meaningful effects might be observable in certain individuals.
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Affiliation(s)
- Steven C. Marcrum
- Department of Otolaryngology, University Hospital Regensburg, 93053 Regensburg, Germany
- Correspondence: ; Tel.: +49-941-944-9462
| | - Milena Engelke
- Department of Psychiatry and Psychotherapy, University of Regensburg, Bezirksklinikum Regensburg, 93053 Regensburg, Germany
| | | | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Bezirksklinikum Regensburg, 93053 Regensburg, Germany
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Bezirksklinikum Regensburg, 93053 Regensburg, Germany
- Institute for Information and Process Management, Eastern University of Applied Sciences, 9000 St. Gallen, Switzerland
| | | | - Jorge P. Simoes
- Department of Psychiatry and Psychotherapy, University of Regensburg, Bezirksklinikum Regensburg, 93053 Regensburg, Germany
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Lee SJ, Park J, Lee SY, Koo JW, Vanneste S, De Ridder D, Lim S, Song JJ. Triple network activation causes tinnitus in patients with sudden sensorineural hearing loss: A model-based volume-entropy analysis. Front Neurosci 2022; 16:1028776. [PMID: 36466160 PMCID: PMC9714300 DOI: 10.3389/fnins.2022.1028776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/02/2022] [Indexed: 11/04/2023] Open
Abstract
Tinnitus can be defined as the conscious perception of phantom sounds in the absence of corresponding external auditory signals. Tinnitus can develop in the setting of sudden sensorineural hearing loss (SSNHL), but the underlying mechanism is largely unknown. Using electroencephalography, we investigated differences in afferent node capacity between 15 SSNHL patients without tinnitus (NT) and 30 SSNHL patients with tinnitus (T). Where the T group showed increased afferent node capacity in regions constituting a "triple brain network" [default mode network (DMN), central executive network (CEN), and salience network (SN)], the NT group showed increased information flow in regions implicated in temporal auditory processing and noise-canceling pathways. Our results demonstrate that when all components of the triple network are activated due to sudden-onset auditory deprivation, tinnitus ensues. By contrast, auditory processing-associated and tinnitus-suppressing networks are highly activated in the NT group, to overcome the activation of the triple network and effectively suppress the generation of tinnitus.
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Affiliation(s)
- Seung Jae Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Jaemin Park
- Department of Mathematical Sciences, Seoul National University, Seoul, South Korea
| | - Sang-Yeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, South Korea
- Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, South Korea
| | - Ja-Won Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, South Korea
- Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, South Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Sven Vanneste
- Lab for Clinical and Integrative Neuroscience, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Dirk De Ridder
- Unit of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Seonhee Lim
- Department of Mathematical Sciences, Seoul National University, Seoul, South Korea
| | - Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, South Korea
- Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, South Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
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Abstract
BACKGROUND Tinnitus is a symptom defined as the perception of sound in the absence of an external source. In England alone there are an estimated ¾ million general practice consultations every year where the primary complaint is tinnitus, equating to a major burden on healthcare services. Clinical management strategies include education and advice, relaxation therapy, tinnitus retraining therapy (TRT), cognitive behavioural therapy (CBT), sound enrichment using ear-level sound generators or hearing aids, and drug therapies to manage co-morbid symptoms such as insomnia, anxiety or depression. OBJECTIVES: To assess the effects of Ginkgo biloba for tinnitus in adults and children. SEARCH METHODS The Cochrane ENT Information Specialist searched the Cochrane ENT Register; CENTRAL (2022, Issue 6); Ovid MEDLINE; Ovid Embase; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 7 June 2022. SELECTION CRITERIA Randomised controlled trials (RCTs) recruiting adults and children with acute or chronic subjective tinnitus. We included studies where the intervention involved Ginkgo biloba and this was compared to placebo, no intervention, or education and information. Concurrent use of other medication or other treatment was acceptable if used equally in each group. Where an additional intervention was used equally in both groups, we analysed this as a separate comparison. The review included all courses of Ginkgo biloba, regardless of dose regimens or formulations, and for any duration of treatment. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were tinnitus symptom severity measured as a global score on a multi-item tinnitus questionnaire and serious adverse effects (bleeding, seizures). Our secondary outcomes were tinnitus loudness (change in subjective perception), tinnitus intrusiveness, generalised depression, generalised anxiety, health-related quality of life and other adverse effects (gastrointestinal upset, headache, allergic reaction). We used GRADE to assess the certainty of the evidence for each outcome. MAIN RESULTS This review included 12 studies (with a total of 1915 participants). Eleven studies compared the effects of Ginkgo biloba with placebo and one study compared the effects of Ginkgo biloba with hearing aids to hearing aids alone. All included studies were parallel-group RCTs. In general, risk of bias was high or unclear due to selection bias and poor reporting of allocation concealment and blinding of participants, personnel and outcome assessments. Due to heterogeneity in the outcomes measured and measurement methods used, only limited data pooling was possible. Ginkgo biloba versus placebo When we pooled data from two studies for the primary outcome tinnitus symptom severity, we found that Ginkgo biloba may have little to no effect (Tinnitus Handicap Inventory scores) at three to six months compared to placebo, but the evidence is very uncertain (mean difference (MD) -1.35 (scale 0 to 100), 95% confidence interval (CI) -8.26 to 5.55; 2 studies; 85 participants) (very low-certainty). Ginkgo biloba may result in little to no difference in the risk of bleeding or seizures, with no serious adverse effects reported in either group (4 studies; 1154 participants; low-certainty). For the secondary outcomes, one study found that there may be little to no difference between the effects of Ginkgo biloba and placebo on tinnitus loudness measured with audiometric loudness matching at 12 weeks, but the evidence is very uncertain (MD -4.00 (scale -10 to 140 dB), 95% CI -13.33 to 5.33; 1 study; 73 participants) (very low-certainty). One study found that there may be little to no difference between the effects of Ginkgo biloba and placebo on health-related quality of life measured with the Glasgow Health Status Inventory at three months (MD -0.58 (scale 0 to 100), 95% CI -4.67 to 3.51; 1 study; 60 participants) (low-certainty). Ginkgo biloba may not increase the frequency of other adverse effects (gastrointestinal upset, headache, allergic reaction) at three months compared to placebo (risk ratio 0.91, 95% CI 0.52 to 1.60; 4 studies; 1175 participants) (low-certainty). None of the studies reported the other secondary outcomes of tinnitus intrusiveness or changes in depressive symptoms or depression, anxiety symptoms or generalised anxiety. Gingko biloba with concurrent intervention versus concurrent intervention only One study compared Ginkgo biloba with hearing aids to hearing aids only. It assessed the mean difference in the change in Tinnitus Handicap Inventory scores and tinnitus loudness using a 10-point visual analogue scale (VAS) at three months. The study did not report adverse effects, tinnitus intrusiveness, changes in depressive symptoms or depression, anxiety symptoms or generalised anxiety, or health-related quality of life. This was a single, very small study (22 participants) and for all outcomes the certainty of the evidence was very low. We were unable to draw meaningful conclusions from the numerical results. AUTHORS' CONCLUSIONS There is uncertainty about the benefits and harms of Ginkgo biloba for the treatment of tinnitus when compared to placebo. We were unable to draw meaningful conclusions regarding the benefits and harms of Ginkgo biloba when used with concurrent intervention (hearing aids). The certainty of the evidence for the reported outcomes, assessed using GRADE, ranged from low to very low. Future research into the effectiveness of Ginkgo biloba in patients with tinnitus should use rigorous methodology. Randomisation and blinding should be of the highest quality, given the subjective nature of tinnitus and the strong likelihood of a placebo response. The CONSORT statement should be used in the design and reporting of future studies. We also recommend the use of validated, patient-centred outcome measures for research in the field of tinnitus.
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Affiliation(s)
- Magdalena Sereda
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jun Xia
- Nottingham China Health Institute, The University of Nottingham Ningbo, Ningbo, China
| | - Polly Scutt
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Amr El Refaie
- Department of Speech and Hearing Sciences, University College Cork, Cork, Ireland
| | - Derek J Hoare
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
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Haines RH, Hepburn T, Tan W, Jackson C, Lathe J, White J, Almey C, Nicholson R, Stockdale D, Leighton P, James M, Sereda M. Effectiveness and cost effectiveness of digital hearing aids in patients with tinnitus and hearing loss: a randomised feasibility trial (THE HUSH Trial). Pilot Feasibility Stud 2022; 8:235. [PMID: 36329548 PMCID: PMC9630825 DOI: 10.1186/s40814-022-01188-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
Background Education and advice is provided for tinnitus management in all UK audiology clinics. Sound therapy, including provision of hearing aids may be offered, but this is often dependent on a clinician’s decision rather than UK policy. This inconsistent management reflects a lack of evidence around the effectiveness of hearing aids for tinnitus. This open-label, two-arm multicentre randomised controlled feasibility trial gathered data around recruitment, acceptability and outcome assessments to determine the feasibility of conducting a large randomised controlled trial investigating the effectiveness of hearing aids for tinnitus management. Methods Adults referred to audiology for tinnitus, with an aidable hearing loss were recruited at five UK audiology clinics. They were randomised 1:1 to either education and advice (treatment as usual (TAU), n = 41) or TAU plus hearing aids (n = 42). Outcomes were collected by questionnaires 12 weeks after randomisation. After participation, interviews were conducted with a subset of both participants and clinicians from each trial centre. Results Eighty three participants from five sites were randomised. Non-aidable hearing loss was the main reason for ineligibility to participate in the trial reported by the sites. Seventy three percent of participants returned the 12-week questionnaires, with return rates by site ranging from 61 to 100%. Fifteen out of 33 participants (45%) reported using hearing aids for the clinician-recommended time, or longer, during the day. The Tinnitus Functional Index (TFI) was the outcome measure most responsive to change. The majority of participants also agreed it was relevant to their tinnitus and hearing loss. Qualitative data demonstrated that the trial was acceptable to participants. Feedback from clinicians revealed a potential lack of equipoise. It also highlighted the differences in referral and treatment pathways between departments and differences in audiometric criteria for fitting hearing aids. Health economic measures were well completed for those returned. No change in health-related quality of life was observed. Costs were higher in the intervention arm, but self-reports of healthcare service use indicated participant confusion in treatment pathways. Conclusions This feasibility trial is the first step towards obtaining high quality evidence to determine potential clinical effectiveness and cost effectiveness of hearing aids for tinnitus versus usual care. A definitive trial was deemed to be feasible, with some modifications based on feasibility findings and using the TFI as the primary outcome. This trial was funded by the National Institute for Health Research, Research for Patient Benefit Programme (PB-PG-0816–20,014) and registered with ISRCTN (ISRCTN14218416). Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01188-9.
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Affiliation(s)
- Rachel H. Haines
- grid.4563.40000 0004 1936 8868Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Trish Hepburn
- grid.4563.40000 0004 1936 8868Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Wei Tan
- grid.4563.40000 0004 1936 8868Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Clare Jackson
- grid.4563.40000 0004 1936 8868School of Medicine, University of Nottingham, Nottingham, UK
| | - James Lathe
- grid.4563.40000 0004 1936 8868Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jennifer White
- grid.4563.40000 0004 1936 8868Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Christine Almey
- grid.511312.50000 0004 9032 5393PPI Representative, National Institute for Health and Care Research Nottingham Biomedical Research Centre, Nottingham, UK
| | - Richard Nicholson
- grid.240404.60000 0001 0440 1889Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - David Stockdale
- grid.489509.90000 0004 8512 0393British Tinnitus Association, Sheffield, UK
| | - Paul Leighton
- grid.4563.40000 0004 1936 8868Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Marilyn James
- grid.4563.40000 0004 1936 8868Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Magdalena Sereda
- grid.511312.50000 0004 9032 5393National Institute for Health and Care Research Nottingham Biomedical Research Centre, Nottingham, UK ,grid.4563.40000 0004 1936 8868Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
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Nieto-Álvarez R, de la Hoz-Torres ML, Aguilar AJ, Martínez-Aires MD, Ruiz DP. Proposal of Combined Noise and Hand-Arm Vibration Index for Occupational Exposure: Application to a Study Case in the Olive Sector. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14345. [PMID: 36361218 PMCID: PMC9654875 DOI: 10.3390/ijerph192114345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
In many production and industrial sectors, workers are exposed to noise and hand-arm vibrations (HAV). European directives have established the maximum limit values or exposure action values for noise and vibration independently. However, in many cases, workers who endure hand-arm vibration also receive high noise levels. This research suggests a procedure to aid the establishment of precautionary measures for workers with simultaneous exposure to both physical agents. This procedure defines a combined index based on the energy doses for both noise and HAV. From this combined index, the suggested methodology allows a recommended exposure time for workers with simultaneous noise and HAV exposure to be calculated. This methodology can be adapted to tackle the relative importance assigned to both agents according to the safety manager and new knowledge on combined health effects. To test this method, a measurement campaign under real working conditions was conducted with workers from the olive fruit-harvesting sector, where a variety of hand-held machinery is used. The results of the study case show that the suggested procedure can obtain reliable exposure time recommendations for simultaneous noise and HAV exposures and is therefore a useful tool for establishing prevention measures.
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Affiliation(s)
- Raquel Nieto-Álvarez
- Department of Architectural Graphic Expression and Engineering, University of Granada, Av. Severo Ochoa s/n, 18071 Granada, Spain
| | - María L. de la Hoz-Torres
- Department of Building Construction, University of Granada, Av. Severo Ochoa s/n, 18071 Granada, Spain
| | - Antonio J. Aguilar
- Department of Applied Physics, University of Granada, Av. Severo Ochoa s/n, 18071 Granada, Spain
| | | | - Diego P. Ruiz
- Department of Applied Physics, University of Granada, Av. Severo Ochoa s/n, 18071 Granada, Spain
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Simonetti P, Vasconcelos LG, Gândara MR, Lezirovitz K, Medeiros ÍRTD, Oiticica J. Hearing aid effectiveness on patients with chronic tinnitus and associated hearing loss. Braz J Otorhinolaryngol 2022; 88 Suppl 3:S164-S170. [PMID: 35729042 DOI: 10.1016/j.bjorl.2022.03.002] [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: 08/31/2021] [Revised: 02/08/2022] [Accepted: 03/08/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Our study aimed to measure the effectiveness of using HA in reducing the disturbance caused by tinnitus. METHODS Study was designed as a within-subjects clinical trial. Nineteen patients with chronic tinnitus and untreated sensorineural hearing loss were under counseling, HA fitting and 6 months follow-up. Tinnitus assessment was performed with Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS), pitch and loudness matching, and Minimum Masking Level measurements (MML). RESULTS following 6 months of HA use, a reduction in reported tinnitus and hearing handicap scales scores was observed both statistically and clinically. The pitch and loudness matching, as well as MML at the baseline and final evaluation were compared. MML's thresholds reduced significantly after 6 months of HA use. CONCLUSION Our study has provided evidence that HA fitting is a valuable treatment strategy for chronic tinnitus relief and associated hearing loss subtype of patient. LEVEL OF EVIDENCE: 3
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Affiliation(s)
- Patricia Simonetti
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas (HCFMUSP), Departamento de Otorrinolaringologia, São Paulo, SP, Brazil.
| | - Laura Garcia Vasconcelos
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas (HCFMUSP), Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
| | - Mara Rocha Gândara
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas (HCFMUSP), Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
| | - Karina Lezirovitz
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas (HCFMUSP), Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
| | - Ítalo Roberto Torres de Medeiros
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas (HCFMUSP), Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
| | - Jeanne Oiticica
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas (HCFMUSP), Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
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Obstructive Sleep Apnea and Auditory Dysfunction—Does Snoring Sound Play a Role? Diagnostics (Basel) 2022; 12:diagnostics12102374. [PMID: 36292063 PMCID: PMC9600079 DOI: 10.3390/diagnostics12102374] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/10/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
The objective of the study was to investigate the relationship between obstructive sleep apnea (OSA) and auditory dysfunction, and to clarify the role of snoring sounds in contributing to auditory dysfunction. A comprehensive assessment of OSA and the auditory system was performed, including overnight polysomnography, detection of the intra-ear canal snoring sound energy (SSE), pure tone average (PTA), tinnitus pitch matching, the tinnitus handicap inventory (THI), and the Epworth sleepiness scale (ESS). The patients were identified as having tinnitus if their THI score was higher than zero or their tinnitus pitches were matched to specific frequencies. The median age, body mass index, and apnea–hypopnea index score were 41 years, 26.4 kg/m2, and 29.9 events/h, respectively. Among the 50 participants, 46 (92%) had a normal PTA, and only 4 (8%) patients had mild hearing loss. There was no significant difference in PTA among OSA severities (p = 0.52). Among the 50 participants, 33 patients (66%) were identified as having tinnitus. In the tinnitus group (n = 33), the ESS score (p = 0.01) and intra-ear canal SSE of 851–1500 Hz (p = 0.04) were significantly higher than those in the non-tinnitus group (n = 17). OSA patients with a higher ESS score had a higher risk of tinnitus (odds ratio 1.22 [95% CI: 1.01–1.46]). OSA-related auditory dysfunction emerged in tinnitus rather than in hearing impairment. OSA patients with daytime sleepiness had a higher risk of tinnitus. High-frequency SSE can jeopardize cochlea and is a potential mechanism contributing to tinnitus. Detection of snoring sounds through an intra-ear canal device may be more precise in assessing acoustic trauma from snoring sounds to vulnerable auditory system and thus warrants further research.
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Van Hoof L, Kleinjung T, Cardon E, Van Rompaey V, Peter N. The correlation between tinnitus-specific and quality of life questionnaires to assess the impact on the quality of life in tinnitus patients. Front Neurol 2022; 13:969978. [PMID: 36226082 PMCID: PMC9549357 DOI: 10.3389/fneur.2022.969978] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/29/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Subjective tinnitus is often associated with a reduction in health-related quality of life (HRQoL). The HRQoL represents the impact of tinnitus on an individual's life by addressing the physical, social, and psychological domains of 1. A limited amount of studies has investigated the association between tinnitus and HRQoL questionnaires. The aim of this study was to examine the correlation between tinnitus-specific and HRQoL questionnaires in order to shorten fulfilling questionnaires, as it is often time-consuming. Material and method Eighty-five patients with tinnitus as primary complaint completed five questionnaires, including one general, two tinnitus-specific, and two generic HRQoL questionnaires: Tinnitus Sample Case History Questionnaire (TSCHQ), Tinnitus Functional Index (TFI), Tinnitus Handicap Inventory (THI), short version of World Health Organization Quality of Life (WHOQOL-BREF), and the eight-item Short-Form (SF-8). Four simple linear regression models were used to analyze the relationship between the THI and TFI and the WHOQOL-BREF and SF-8. Results A negative and strong correlation was found between the tinnitus questionnaires and the SF-8. More than half of the variability in the SF-8 scores could be explained by the TFI and THI, respectively 50.6 and 54.4% (all p < 0.001). A strong negative regression was also found between the WHOQOL-BREF and the THI and TFI with a decrease in the determination coefficient of approximately 10% compared with the SF-8. The weakest correlation (regression coefficient of 0.628, p < 0.001) was observed between the WHOQOL-BREF and the TFI, indicating that the WHOQOL-BREF mean score explained 39.4% of the TFI. When looking at the subdomain scores, a strong correlation was observed between the QoL subdomain of the TFI and a combination of the physical and psychological subdomain of the WHOQOL-BREF (r = -0.627, p < 0.001). Conclusion The QoL subdomain of the TFI gives good information about the physical and psychological health. Thus, the TFI is suitable to assess both tinnitus severity and the HRQoL. The coefficients of determination of the WHOQOL-BREF were significantly lower compared to the SF-8, suggesting that the WHOQOL-BREF provides more specific information about HRQoL. If more specific information on HRQoL, such as "environment" and "social relationships", is required, it is recommended to use the WHOQOL-BREF.
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Affiliation(s)
- Lauren Van Hoof
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Edegem, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Emilie Cardon
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Edegem, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Vincent Van Rompaey
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Edegem, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Nicole Peter
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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