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Odes R, Chin DL, Li J, Hong O. Association of Occupational Stress With Tinnitus Among Career Firefighters in the United States. J Occup Environ Med 2023; 65:e30-e35. [PMID: 36306205 DOI: 10.1097/jom.0000000000002742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study explores the relationship between occupational stress and tinnitus among firefighters, a group often exposed to two tinnitus risk factors: high stress and noise. METHODS This cross-sectional study includes 240 firefighters in the United States. Data describing demographic characteristics, occupational stress, noise exposure, and tinnitus were collected by survey. Occupational stress was measured using the short version of the Effort-Reward Imbalance Questionnaire. RESULTS Forty-three percent of participants reported experiencing tinnitus within the past month. For occupational stress, higher effort (odds ratio, 1.25; 95% confidence interval, 1.05 to 1.49) and higher effort-reward ratio (odds ratio, 12.28; 95% confidence interval, 3.08 to 48.86) were associated with increased odds of tinnitus, after adjustment for demographic characteristics and noise exposure. CONCLUSIONS Occupational stress may increase the likelihood of tinnitus for firefighters, an already at-risk group of workers. Health providers should incorporate stress assessment into tinnitus management programs.
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Affiliation(s)
- Rachel Odes
- From the Occupational and Environmental Health Nursing Graduate Program, School of Nursing, University of California San Francisco, San Francisco, California (Drs Odes, Chin, and Hong); National Clinician Scholars Program, Institute for Health Policy Studies, University of California San Francisco, San Francisco, California (Dr Odes); and Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, Los Angeles, California (Dr Li)
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Abstract
Posterior fossa meningiomas that impinge on structures of the temporal bone or clivus may be difficult to access for optimal resection that maximizes tumor control and minimizes short- and long-term morbidities. To address this challenge, the contemporary neurosurgery-neurotology team works collaboratively by managing patients jointly at every stage of care: preoperative evaluation, intraoperative intervention, and postoperative treatment. The neurotologist is important at all stages of posterior fossa meningioma surgery. First, detailed preoperative evaluation of auditory, facial, vestibular, and lower cranial nerve integrity enables assessment of new neurologic deficit risk, prognosis of functional recovery, and pros and cons of candidate surgical approaches. Second, intraoperative partitioning of surgical steps by provider and adopting an overlapping tumor resection philosophy creates an efficient and confident surgical team built on trust. Third, postoperative closure of cerebrospinal fluid leak and treatment of facial weakness, audiovestibular dysfunction, and voicing and swallowing impairments organized by the neurotologist reduces the impact of negative outcomes. The role of the neurotologist in posterior fossa meningioma surgery is to deliver nuanced evaluative metrics, facilitate shared decision making, perform precise bone and soft tissue microsurgery, and mitigate perioperative morbidities.
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Gamma Knife Radiosurgery for Transmodiolar Schwannoma. World Neurosurg 2020; 143:118-120. [DOI: 10.1016/j.wneu.2020.07.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/02/2020] [Accepted: 07/05/2020] [Indexed: 11/24/2022]
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Jamesdaniel S, Elhage KG, Rosati R, Ghosh S, Arnetz B, Blessman J. Tinnitus and Self-Perceived Hearing Handicap in Firefighters: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3958. [PMID: 31627382 PMCID: PMC6844073 DOI: 10.3390/ijerph16203958] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/03/2019] [Accepted: 10/15/2019] [Indexed: 12/23/2022]
Abstract
Firefighters are susceptible to auditory dysfunction due to long-term exposure to noise from sirens, air horns, equipment, and tools used in forcible entry, ventilation, and extrication. In addition, they are exposed to ototoxic chemicals, particularly, during overhaul operations. Studies indicate that 40% of firefighters have hearing loss in the noise-sensitive frequencies of 4 and 6 kHz. Noise-induced hearing loss (NIHL) is often accompanied by tinnitus, which is characterized by ringing noise in the ears. The presence of phantom sounds can adversely affect the performance of firefighters. However, there has been limited research conducted on the prevalence of tinnitus in firefighters. We enrolled firefighters from Michigan, with at least 5 years of continuous service. The hearing handicap inventory for adults (HHIA) was used to determine the difficulty in hearing perceived by the firefighters and the tinnitus functional index (TFI) was used to determine the severity of tinnitus. Self-perceived hearing handicap was reported by 36% of the participants, while tinnitus was reported by 48% of the participants. The TFI survey indicated that 31% perceived tinnitus as a problem. More importantly, self-perceived hearing handicap was significantly associated with the incidence of tinnitus in firefighters, suggesting a potential link between occupational exposure to ototraumatic agents and tinnitus in firefighters.
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Affiliation(s)
- Samson Jamesdaniel
- Institute of Environmental Health Sciences, Wayne State University, Detroit, MI 48202, USA.
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI 48201, USA.
| | - Kareem G Elhage
- Institute of Environmental Health Sciences, Wayne State University, Detroit, MI 48202, USA.
| | - Rita Rosati
- Institute of Environmental Health Sciences, Wayne State University, Detroit, MI 48202, USA.
| | - Samiran Ghosh
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI 48201, USA.
| | - Bengt Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI 49503, USA.
| | - James Blessman
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI 48201, USA.
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Jakobs M, Lozano AM. Editorial. Deep brain stimulation for tinnitus: exploring the frontier between sensory perception and awareness. J Neurosurg 2019; 133:988-991. [PMID: 31553941 DOI: 10.3171/2019.4.jns191023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Martin Jakobs
- 1Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; and
- 2Department of Neurosurgery, University Hospital Heidelberg, Germany
| | - Andres M Lozano
- 1Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; and
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Perez PL, Wang SS, Heath S, Henderson-Sabes J, Mizuiri D, Hinkley LB, Nagarajan SS, Larson PS, Cheung SW. Human caudate nucleus subdivisions in tinnitus modulation. J Neurosurg 2019; 132:705-711. [PMID: 30738400 DOI: 10.3171/2018.10.jns181659] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 10/04/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The object of this study was to define caudate nucleus locations responsive to intraoperative direct electrical stimulation for tinnitus loudness modulation and relate those locations to functional connectivity maps between caudate nucleus subdivisions and auditory cortex. METHODS Six awake study participants who underwent bilateral deep brain stimulation (DBS) electrode placement in the caudate nucleus as part of a phase I clinical trial were analyzed for tinnitus modulation in response to acute stimulation at 20 locations. Resting-state 3-T functional MRI (fMRI) was used to compare connectivity strength between centroids of tinnitus loudness-reducing or loudness-nonreducing caudate locations and the auditory cortex in the 6 DBS phase I trial participants and 14 other neuroimaging participants with a Tinnitus Functional Index > 50. RESULTS Acute tinnitus loudness reduction was observed at 5 caudate locations, 4 positioned at the body and 1 at the head of the caudate nucleus in normalized Montreal Neurological Institute space. The remaining 15 electrical stimulation interrogations of the caudate head failed to reduce tinnitus loudness. Compared to the caudate head, the body subdivision had stronger functional connectivity to the auditory cortex on fMRI (p < 0.05). CONCLUSIONS Acute tinnitus loudness reduction was more readily achieved by electrical stimulation of the caudate nucleus body. Compared to the caudate head, the caudate body has stronger functional connectivity to the auditory cortex. These first-in-human findings provide insight into the functional anatomy of caudate nucleus subdivisions and may inform future target selection in a basal ganglia-centric neuromodulation approach to treat medically refractory tinnitus.Clinical trial registration no.: NCT01988688 (clinicaltrials.gov).
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Affiliation(s)
| | | | - Susan Heath
- 3Surgical Services, San Francisco Veterans Affairs Medical Center; and
| | | | | | | | - Srikantan S Nagarajan
- Departments of1Otolaryngology-Head and Neck Surgery and.,Departments of4Radiology and Biomedical Imaging and
| | - Paul S Larson
- 3Surgical Services, San Francisco Veterans Affairs Medical Center; and.,5Neurological Surgery, University of California, San Francisco, California
| | - Steven W Cheung
- Departments of1Otolaryngology-Head and Neck Surgery and.,3Surgical Services, San Francisco Veterans Affairs Medical Center; and
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Hesse G. Evidence and evidence gaps in tinnitus therapy. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2016; 15:Doc04. [PMID: 28025604 PMCID: PMC5169077 DOI: 10.3205/cto000131] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
A nearly endless number of procedures has been tried and in particular sold for the treatment of tinnitus, unfortunately they have not been evaluated appropriately in an evidence-based way. A causal therapy, omitting the tinnitus still does not exist, actually it cannot exist because of the various mechanisms of its origin. However or perhaps because of that, medical interventions appear and reappear like fashion trends that can never be proven by stable and reliable treatment success. This contribution will discuss and acknowledge all current therapeutic procedures and the existing or non-existing evidence will be assessed. Beside external evidence, the term of evidence also encompasses the internal evidence, i.e. the experience of the treating physician and the patient's needs shall be included. While there is no evidence for nearly all direct procedures that intend modulating or stimulating either the cochlea or specific cervical regions such as the auditory cortex, there are therapeutic procedures that are acknowledged in clinical practice and have achieved at least a certain degree of evidence and generate measurable effect sizes. Those are in particular habituation therapy and psychotherapeutic measures, especially if they are combined with concrete measures for improved audio perception (hearing aids, CI, hearing therapies).
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Affiliation(s)
- Gerhard Hesse
- Tinnitus-Klinik, Bad Arolsen, Germany; University of Witten-Herdecke, Germany
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Abstract
The purpose of this study was to determine the prevalence and characteristics of tinnitus and assess the relationship between tinnitus and hearing loss among firefighters and operating engineers, who are exposed to noise on-the-job. The study analyzed existing data from two different populations (154 firefighters and 769 operating engineers) who completed a survey and audiometric tests as part of a hearing loss prevention intervention study. Approximately 40% of both groups reported tinnitus; 34% of firefighters and 59% of operating engineers showed hearing loss at noise-sensitive frequencies (4 kHz and 6 kHz). Firefighters with high frequency hearing loss (odds ratio [OR] = 2.31; 95% confidence interval [CI] = [1.05, 5.11]) and those with perceived impaired hearing status (OR = 3.53; 95% CI = [1.27, 9.80]) were significantly more likely to report tinnitus. Similarly, operating engineers who had hearing loss at both low (OR = 2.10; 95% CI = [1.40, 3.15]) and high frequencies (OR = 2.00; 95% CI = [1.37, 2.90]), and perceived impaired hearing status (OR = 2.17; 95% CI = [1.55, 3.05]) were twice as likely to report tinnitus. This study demonstrated that tinnitus is a considerable problem for noise-exposed workers. Workers with hearing loss demonstrated significantly higher rates of tinnitus. Comprehensive workplace hearing conservation programs should include tinnitus management for noise-exposed workers, along with other key elements such as noise control and hearing protection.
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Overdevest JB, Pross SE, Cheung SW. Tinnitus following treatment for sporadic Acoustic neuroma. Laryngoscope 2015; 126:1639-43. [DOI: 10.1002/lary.25672] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 07/16/2015] [Accepted: 08/24/2015] [Indexed: 12/26/2022]
Affiliation(s)
| | | | - Steven W Cheung
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, U.S.A
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