1
|
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.
Collapse
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
| |
Collapse
|
2
|
Hoare DJ, Smith H, Kennedy V, Fackrell K. Tinnitus in Children. J Assoc Res Otolaryngol 2024; 25:239-247. [PMID: 38709437 PMCID: PMC11150219 DOI: 10.1007/s10162-024-00944-3] [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: 12/31/2023] [Accepted: 03/04/2024] [Indexed: 05/07/2024] Open
Abstract
This perspective reviews the current state of the art and literature on tinnitus in children, prevalence and risk factors, clinical management, and future priorities for healthcare provision and research. Most research in the field to date appears to be prevalence studies, which have reached dramatically different estimates; this reflects the lack of a standard language when asking about the presence of tinnitus, or how bothersome, distressing, or negatively impacting it is for the child. Estimates are also likely affected by a lack of awareness of tinnitus amongst children and parents. Children are less likely to spontaneously report tinnitus than adults, and parents are often unaware their child could even develop tinnitus, considering it a disease of older age for example. It is critical that children are asked and learn about tinnitus. In hearing clinics, clinicians should routinely ask about all children about tinnitus and offer tinnitus care and settings that are child- and family-friendly. As well as asking directly, clinicians should be alert to soft signs of tinnitus such as unexplained listening, speech perception, concentration difficulties, worry or anxiety, or difficulties completing hearing tests or using hearing aids. The recently developed impact of Tinnitus in Children Questionnaire (iTICQ) can then be used to assess problems that are most commonly core to children's experience of tinnitus. Clinical guidelines for tinnitus in children are few but provide recommendations for additional paediatric questionnaires and alternative assessments and for a range of treatment options. Of note, however, is the lack of clinical trials and, therefore, evidence of the effectiveness of any treatment for tinnitus in children. Significant and concerted work is therefore needed to raise awareness of tinnitus in children, understand the scale of clinical need, and standardise and evaluate clinical management options.
Collapse
Affiliation(s)
- Derek J Hoare
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.
- School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, T12 EK59, Republic of Ireland.
| | - Harriet Smith
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Psychology, University of Sheffield, Sheffield, UK
| | | | - Kathryn Fackrell
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- National Institute for Health and Care Research (NIHR) Coordinating Centre, School of Healthcare Enterprise and Innovation, University of Southampton, Southampton, UK
| |
Collapse
|
3
|
Walters RK, Durrant FG, Nguyen SA, Meyer TA, Lambert PR. The Placebo Effect on Tinnitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Otol Neurotol 2024; 45:e263-e270. [PMID: 38361332 DOI: 10.1097/mao.0000000000004139] [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: 02/17/2024]
Abstract
OBJECTIVE To quantify the placebo effect in randomized clinical trials treating tinnitus with oral or intratympanic placebo treatment. DATA SOURCES CINAHL, PubMed, and Scopus were searched for articles from conception to October 2022. MESH and key terms such as "tinnitus," "placebo," and "medication" were used to find randomized, placebo-controlled trials. The search was limited to articles in English. METHODS Randomized controlled trials with adult subjects evaluating tinnitus pretreatment and posttreatment with an oral or intratympanic medication versus a placebo arm were included. Crossover studies, studies involving middle/inner ear operations or devices, and studies that exclusively included nonidiopathic etiologies of tinnitus were excluded. Mean tinnitus symptom survey scores for the Tinnitus Handicap Inventory (THI), Tinnitus Severity Index, Tinnitus Functional Index, Tinnitus Handicap Questionnaire, and Visual Analog Scales for tinnitus Intensity/Loudness (VAS-L), Annoyance (VAS-An), and Awareness (VAS-Aw) were extracted for both placebo and experimental groups. RESULTS 953 studies were screened with 23 studies being included in the final analysis. Meta-analysis of mean difference (MD) was calculated using RevMan 5.4. MD between pretreatment and posttreatment THI scores of the placebo arms was 5.6 (95% confidence interval, 3.3-8.0; p < 0.001). MD between pretreatment and posttreatment VAS scores of the placebo groups for Loudness, Annoyance, and Awareness were 0.8 (0.0 to 1.6, p = 0.05), 0.2 (-0.2 to 0.5, p = 0.34), and 0.3 (-0.0 to 0.7, p = 0.08), respectively. CONCLUSIONS Placebo treatment has shown effectiveness in improving patient-reported evaluations of tinnitus when using some standardized metrics such as THI and VAS-L; however, the improvement is not as substantial as nonplacebo treatment.
Collapse
Affiliation(s)
| | - Frederick G Durrant
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Ted A Meyer
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Paul R Lambert
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| |
Collapse
|
4
|
Balatsouras DG, Papitsi I, Koukoutsis G, Katotomichelakis M. The effect of MemoVigor 2 on recent-onset idiopathic tinnitus: a randomized double-blind placebo-controlled clinical trial. Front Pharmacol 2024; 15:1252343. [PMID: 38327985 PMCID: PMC10847223 DOI: 10.3389/fphar.2024.1252343] [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: 07/17/2023] [Accepted: 01/10/2024] [Indexed: 02/09/2024] Open
Abstract
Background: Tinnitus is a common symptom associated with the conscious perception of sound in the absence of a corresponding external or internal sound source, which can severely impact quality of life. Because of the current limited understanding of the precise pathophysiological mechanism of idiopathic tinnitus, no curable treatment has been attained yet. A food supplement trading as MemoVigor 2, which contains a combination of therapeutic ingredients with mainly antioxidant activity, has been used in the treatment of tinnitus. The objective of our study was to evaluate the effectiveness of MemoVigor 2 in the treatment of recent-onset idiopathic tinnitus. Methods: In a prospective single-centre randomized, double-blind, placebo-controlled clinical trial we studied 204 patients with idiopathic tinnitus divided into two groups: 104 patients who received MemoVigor 2 and 100 patients treated with placebo. To evaluate changes in tinnitus we used (1) audiometry/tympanometry; (2) specific measures of tinnitus perception, including tinnitus pitch, loudness at tinnitus pitch, loudness at 1 kHz, minimum masking level, and residual inhibition; (3) questionnaires of tinnitus handicap inventory, mini tinnitus questionnaire and patients' global impression of change. All patients underwent this test battery at the beginning of the study and in a repeat post-3-month session. Results: All tinnitus measures, including pitch, loudness, minimum masking level and residual inhibition improved significantly in the intervention group. Most of these measures improved in the placebo group too, but in a lesser degree. All questionnaire scores diminished significantly in both groups, but the degree of decrease was greater in the intervention group. The participants' tinnitus outcome reported after treatment using the patients' global impression of change score differed significantly between the two groups, with greater improvement observed in the intervention group. Conclusion: We found that the use of MemoVigor 2 improved recent-onset tinnitus, as proved by a set of tests performed for its evaluation, including audiometric measures, specific measures of tinnitus perception and tinnitus questionnaires. Tinnitus in the placebo group improved too, but to a lesser degree. Clinical Trial Registration: isrctn.com, Identifier ISRCTN16025480.
Collapse
Affiliation(s)
| | - Isidora Papitsi
- Department of Otorhinolaryngology, Tzaneio General Hospital, Piraeus, Greece
| | - George Koukoutsis
- Department of Otorhinolaryngology, Tzaneio General Hospital, Piraeus, Greece
| | - Michael Katotomichelakis
- Department of Otorhinolaryngology, Medical School, Democritus University of Thrace, Komotini, Greece
| |
Collapse
|
5
|
Sharma D, Gupta V, Bhatia S, Thakur P. Association of Vitamin D Deficiency in Patients with Tinnitus with Normal Audiogram. Indian J Otolaryngol Head Neck Surg 2023; 75:1992-1999. [PMID: 37636653 PMCID: PMC10447690 DOI: 10.1007/s12070-023-03751-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: 11/25/2022] [Accepted: 03/29/2023] [Indexed: 08/29/2023] Open
Abstract
In the present study we aim to evaluate serum vitamin D levels in participants having tinnitus with normal audiometric findings. Total 98 participants in the age range 20-70 year were included in the study. Participants underwent detail case history, ear examination, pure tone audiometry and impedance audiometry. 68 participants with subjective tinnitus for more than 3 months and with normal audiometric thresholds and "A" type tympanogram were included in study group and 30 participants without tinnitus in the control group. The participants fullfillng the inclusion criteria underwent thorough tinnitus evaluation which included administration of tinnitus severity index tinnitus handicap inventory, psychophysical evaluation of tinnitus (pitch matching, loudness matching) and assessment of Vitamin D levels. It was seen that the mean Vitamin D levels were significantly lower in study group, and out of 68 participants only 11 had optimal Vitamin D levels, 57 (83%) had Vitamin D levels less that 30 mg/dl. In the control group 20 (66%) had vitamin D deficiency. The difference came out to be statistically significant. Our study suggests that there is a link between vitamin D and tinnitus, in view of these findings we recommend evaluating serum Vitamin D levels in patients of chronic idiopathic tinnitus, especially in adults with normal hearing. Our study suggests vitamin D deficiency may be one of the risk factor for tinnitus in people with normal hearing in the absence of other manifestations.
Collapse
Affiliation(s)
- Deepika Sharma
- Deptt of ENT, Maharishi Markendeshwar Medical College & Hospital, Kumarhatti solan, India
| | - Vipan Gupta
- Deptt of ENT, Maharishi Markendeshwar Medical College & Hospital, Kumarhatti solan, India
| | - Shenny Bhatia
- Deptt of ENT, Maharishi Markendeshwar Medical College & Hospital, Kumarhatti solan, India
| | - Pooja Thakur
- Deptt of ENT, Maharishi Markendeshwar Medical College & Hospital, Kumarhatti solan, India
| |
Collapse
|
6
|
Li Y, Shen YC, Galvin JJ, Liu JS, Tao DD. Effect of Ipsilateral, Contralateral or Bilateral Repetitive Transcranial Magnetic Stimulation in Patients with Lateralized Tinnitus: A Placebo-Controlled Randomized Study. Brain Sci 2022; 12:brainsci12060733. [PMID: 35741618 PMCID: PMC9220993 DOI: 10.3390/brainsci12060733] [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: 03/31/2022] [Revised: 05/15/2022] [Accepted: 05/30/2022] [Indexed: 12/10/2022] Open
Abstract
The relative benefit of ipsilateral, contralateral, and bilateral repetitive transcranial magnetic stimulation (rTMS) for tinnitus treatment remains unclear, especially for patients with lateralized tinnitus. In this study, we compared outcomes after 10 sessions of 1-Hz rTMS at 110% of resting motor threshold over a two-week period. In total, 104 right-handed patients with lateralized subjective tinnitus were randomly divided into four groups according to rTMS treatment: Left (n = 29), Right (n = 23), Bilateral (n = 30), and Sham stimulation (n = 22). Outcomes included estimates of tinnitus severity, psychological state, and psychoacoustic measures. Patients with left- or right-sided tinnitus were similarly distributed across treatment groups. There were no significant changes in outcome measures for the Right or Sham treatment groups. For the Left and Bilateral groups, tinnitus severity was significantly lower after treatment (p < 0.05). The reduction in tinnitus severity was largest for ipsilateral treatment in the Left group. The overall response rate was 56.1% for the Left group, 46.7% for the Bilateral group, 8.3% for the Right group, and 8.3% for the Sham group. For the Left and Bilateral groups, the response rate was larger for patients with left- than right-sided tinnitus. Changes in tinnitus severity were best predicted by changes in anxiety, depression, and the loudness of the tinnitus. The results suggests that rTMS on the left temporoparietal cortex is more effective for patients with left-sided than with right-sided tinnitus.
Collapse
Affiliation(s)
- Yi Li
- Department of Ear, Nose, and Throat, Dushu Lake Hospital Affiliated of Soochow University, Suzhou 215000, China;
| | - Yong-Cong Shen
- Department of Ear, Nose, and Throat, The First Affiliated of Soochow University, Suzhou 215000, China;
| | - John J. Galvin
- House Institute Foundation, Los Angeles, CA 90057, USA;
- University Hospital Center of Tours, 37000 Tours, France
| | - Ji-Sheng Liu
- Department of Ear, Nose, and Throat, The First Affiliated of Soochow University, Suzhou 215000, China;
- Correspondence: (J.-S.L.); (D.-D.T.)
| | - Duo-Duo Tao
- Department of Ear, Nose, and Throat, Shaanxi Provincial People’s Hospital, Xi’an 710068, China
- Correspondence: (J.-S.L.); (D.-D.T.)
| |
Collapse
|
7
|
Shin SH, Byun SW, Kim SJ, Lee HY. Measures of Subjective Tinnitus: What Does Visual Analog Scale Stand for? J Am Acad Audiol 2022; 33:92-97. [PMID: 36049754 DOI: 10.1055/s-0041-1736649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND Patients with tinnitus may have different severity levels of tinnitus distress. Visual analog scale (VAS) is a simple method to measure the extent of subjective distress caused by tinnitus. It includes ratings of tinnitus loudness, awareness, annoyance, and impact of tinnitus on life. PURPOSE The purpose of this study was to evaluate what led to different distress levels in patients with bilateral tinnitus by analyzing the relationships among all subscales of VAS scores for tinnitus distress and the documented variables. RESEARCH DESIGN This study was a retrospective cohort study. STUDY SAMPLE The medical records of 268 patients who visited a tinnitus clinic between March and December 2020 were reviewed. DATA COLLECTION AND ANALYSIS Epidemiologic characteristics, subjective tinnitus distress factors including tinnitus loudness, awareness, annoyance, and impact of tinnitus on life, questionnaire results including those from the Tinnitus Handicap Inventory (THI) and Beck Depression Inventory (BDI), and audiometric profiles were documented. Based on a bivariate analysis between variables and subtypes of subjective tinnitus distress, stepwise logistic regression was performed to identify potential influencing factors for aggravating each subtype. RESULTS Data from a total of 122 patients with bilateral tinnitus were collected. The cohort included 77 males and 45 females with a mean age of 51.16 ± 13.50 years. Tinnitus loudness was associated with an accompanying headache (p < 0.001), the BDI score (p = 0.001), and the duration of tinnitus (p = 0.006). A high THI (p < 0.001) and an accompanying headache (p = 0.016) were both associated with tinnitus annoyance. Hearing thresholds at 250 Hz (p = 0.011) and 500 Hz (p = 0.002) on the left side were associated with an impact of tinnitus on life. The hearing threshold at 4 kHz on the left side alone was associated with tinnitus awareness (p = 0.013). CONCLUSION Psychologic complaints are mainly associated with tinnitus loudness and annoyance. On the other hand, hearing loss is linked with tinnitus awareness and its impact on life. Thus, an individualized, sequential approach that considers different subtypes of tinnitus severity to assess subjective tinnitus distress is needed.
Collapse
Affiliation(s)
- Seung-Ho Shin
- Department of Otorhinolaryngology - Head and Neck Surgery, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Sung Wan Byun
- Department of Otorhinolaryngology - Head and Neck Surgery, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Soo Jin Kim
- Department of Otorhinolaryngology - Head and Neck Surgery, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Ho Yun Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| |
Collapse
|
8
|
Durankaya S, Cetin A, Mutlu B, Gurkan S, Kirkim G, Serbetcioglu M. Tinnitus and Underlying Theoretical Mechanism: The Key and Lock? NEUROL SCI NEUROPHYS 2022. [DOI: 10.4103/nsn.nsn_55_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
|
9
|
Ledesma ALL, Leite Rodrigues D, Monteiro de Castro Silva I, Oliveira CA, Bahmad F. The effect of caffeine on tinnitus: Randomized triple-blind placebo-controlled clinical trial. PLoS One 2021; 16:e0256275. [PMID: 34543285 PMCID: PMC8452027 DOI: 10.1371/journal.pone.0256275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 07/19/2021] [Indexed: 11/18/2022] Open
Abstract
Objective To test the hypothesis that caffeine can influence tinnitus, we recruited 80 patients with chronic tinnitus and randomly allocated them into two groups (caffeine and placebo) to analyze the self-perception of tinnitus symptoms after caffeine consumption, assuming that this is an adequate sample for generalization. Methods The participants were randomized into two groups: one group was administered a 300-mg capsule of caffeine, and the other group was given a placebo capsule (cornstarch). A diet that restricted caffeine consumption for 24 hours was implemented. The participants answered questionnaires (the Tinnitus Handicap Inventory—THI, the Visual Analog Scale—VAS, the profile of mood state—POMS) and underwent examinations (tonal and high frequency audiometry, acufenometry (frequency measure; intensity measure and the minimum level of tinnitus masking), transient otoacoustic emissions—TEOAE and distortion product otoacoustic emissions—DPOAE assessments) at two timepoints: at baseline and after capsule ingestion. Results There was a significant change in mood (measured by the POMS) after caffeine consumption. The THI and VAS scores were improved at the second timepoint in both groups. The audiometry assessment showed a significant difference in some frequencies between baseline and follow-up measurements in both groups, but these differences were not clinically relevant. Similar findings were observed for the amplitude and signal-to-noise ratio in the TEOAE and DPOAE measurements. Conclusions Caffeine (300 mg) did not significantly alter the psychoacoustic measures, electroacoustic measures or the tinnitus-related degree of discomfort.
Collapse
Affiliation(s)
- Alleluia Lima Losno Ledesma
- Postgraduate Program in Health Sciences at the Faculty of Health Sciences, University of Brasília, Brasília, DF, Brazil
| | | | | | - Carlos Augusto Oliveira
- Postgraduate Program in Health Sciences at the Faculty of Health Sciences, University of Brasília, Brasília, DF, Brazil
| | - Fayez Bahmad
- Postgraduate Program in Health Sciences at the Faculty of Health Sciences, University of Brasília, Brasília, DF, Brazil
- Institute of Otorhinolaryngology, Brasília, DF, Brazil
- * E-mail:
| |
Collapse
|
10
|
Nowaczewska M, Osiński S, Marzec M, Wiciński M, Bilicka K, Kaźmierczak W. The role of vitamin D in subjective tinnitus-A case-control study. PLoS One 2021; 16:e0255482. [PMID: 34407088 PMCID: PMC8372974 DOI: 10.1371/journal.pone.0255482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/18/2021] [Indexed: 11/29/2022] Open
Abstract
Regarding the high prevalence of vitamin D (25(OH)D) deficiency in the population and its possible association with ear diseases, we aimed to investigate the 25(OH)Dserum level in patients with subjective, nonpulsating tinnitus and its effect on tinnitus severity. The study included 201 tinnitus patients and 99 controls. Patient clinical information, including tinnitus characteristics and severity according to Tinnitus Handicap Inventory (THI), loudness assessed by Visual Analogue Scale (VAS), audiometry, and the blood level of vitamin D, was recorded. The level of 25(OH)D in tinnitus patients was significantly decreased compared with the controls (19.86 ± 7.53 and 27.43 ± 8.85 ng/ml, respectively; P value < 0.0001). More patients in the tinnitus group were deficient in vitamin D, compared with the controls (50.7% vs. 22.2% respectively, p < 0.0001). Tinnitus patients with a lower serum level of 25(OH)D (≤15 ng/dl) were significantly younger, had a higher degree of tinnitus severity measured with THI and VAS scales, had higher triglyceride and TSH levels, and a lower HDL level compared with individuals who had higher 25(OH)D level (>15 ng/dl). There was a strong correlation between the 25(OH)D level and THI. Our findings suggest that a large proportion of tinnitus patients suffers from vitamin D deficiency and that the vitamin D level correlates with tinnitus impact. We recommend a vitamin D assessment for all tinnitus patients.
Collapse
Affiliation(s)
- Magdalena Nowaczewska
- Department of Otolaryngology, Head and Neck Surgery, and Laryngological Oncology, Ludwik, Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland
- * E-mail:
| | - Stanisław Osiński
- Department of Otolaryngology, Head and Neck Surgery, and Laryngological Oncology, Ludwik, Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Maria Marzec
- Department of Otolaryngology, Head and Neck Surgery, and Laryngological Oncology, Ludwik, Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Michał Wiciński
- Department of Pharmacology and Therapeutics, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Katarzyna Bilicka
- Department of Otolaryngology, Head and Neck Surgery, and Laryngological Oncology, Ludwik, Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Wojciech Kaźmierczak
- Department of Sensory Organs Examination, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland
| |
Collapse
|
11
|
Using a visual analog scale (VAS) to measure tinnitus-related distress and loudness: Investigating correlations using the Mini-TQ results of participants from the TrackYourTinnitus platform. PROGRESS IN BRAIN RESEARCH 2021; 263:171-190. [PMID: 34243888 DOI: 10.1016/bs.pbr.2020.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Tinnitus, a perception of ringing and buzzing sound in the ear, has not been completely understood yet. It is well known that tinnitus-related distress and loudness can change over time. However, proper comparability for the data collection approaches requires further focused studies. In this context, technology such as the use of mobile devices may be a promising approach. Repeated assessments of tinnitus-related distress and loudness in Ecological Momentary Assessment (EMA) studies require a short assessment, and a Visual Analogic Scale (VAS) is often used in this context. Yet, their comparability with psychometric questionnaires remains unclear and thus was the focus of this study. Research goals: The evaluation of the appropriateness of VAS in measuring tinnitus-related distress and loudness is pursued in this paper. METHODS The Mini Tinnitus Questionnaire (Mini-TQ) measured tinnitus-related distress once. Tinnitus-related distress and tinnitus loudness were measured repeatedly using VAS on a daily basis during 7 days in the TrackYourTinnitus (TYT) smartphone app and were summarized per day using mean and median results. Then, correlations between summarized VAS tinnitus-related distress and summarized VAS tinnitus loudness, on the one side, and Mini-TQ, on the other side, were calculated. RESULTS Correlations between Mini-TQ and VAS tinnitus-related distress ranged between r = 0.36 and r = 0.52, while correlations between Mini-TQ and VAS tinnitus loudness ranged between r = 0.25 and r = 0.36. The more time difference between the Mini-TQ and the VAS assessments is, the lower the correlations between them. Mean and median VAS values per day resulted in similar correlations. CONCLUSIONS Mobile-based VAS seems to be an appropriate approach to utilize daily measurements of tinnitus-related distress.
Collapse
|
12
|
Gos E, Rajchel JJ, Dziendziel B, Kutyba J, Bienkowska K, Swierniak W, Gocel M, Raj-Koziak D, Skarzynski PH, Skarzynski H. How to Interpret Tinnitus Functional Index Scores: A Proposal for a Grading System Based on a Large Sample of Tinnitus Patients. Ear Hear 2020; 42:654-661. [PMID: 33156124 DOI: 10.1097/aud.0000000000000967] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The Tinnitus Functional Index (TFI) is considered the gold standard in measuring tinnitus severity. The aim of the study was to establish reference values to improve the interpretability of TFI scores. DESIGN Results from 1114 patients with tinnitus were retrospectively analyzed. The participants were consecutive patients who attended our tertiary referral Ear, Nose, and Throat Center. The eligibility criteria were: at least 18 years old, persistent tinnitus, completed pure-tone audiometry, and answered all 25 items on the TFI. Hearing status (normal hearing vs. hearing impairment) was established according to the recommendation of the Bureau International d'Audiophonologie. Means (M) and SD on the TFI were the basis for grading tinnitus severity on four levels: low, lower moderate, upper moderate, and high. To gauge individual scores in clinical practice, percentiles are also proposed. RESULTS All 1114 patients (586 women and 528 men) were Caucasian and aged from 19 to 87 years (M = 50.96; SD = 13.10 years). Tinnitus duration ranged from 0.5 to 50 years (M = 7.17; SD = 7.71 years). There were 258 patients with normal hearing and 856 patients with hearing loss. A score of above 65 points on TFI was established as the cutoff point for diagnosing high tinnitus severity. A regression model associating tinnitus severity with gender, age, tinnitus duration, and hearing loss was statistically significant: F(4,1109) = 8.99; p < 0.001, but the effect was very small (R2adj = 0.028) and only gender and age were associated with TFI global score, while tinnitus severity was not related to tinnitus duration or hearing loss. CONCLUSIONS The reference values proposed here support those reported previously by Meikle et al. They are empirically based and can be used as benchmarks in clinical practice and scientific research. They make it possible to assess tinnitus severity, evaluate individual scores, and categorize individuals with tinnitus. This allows researchers to set inclusion or exclusion criteria when assigning patients to specific groups during clinical trials involving tinnitus intervention strategies.
Collapse
Affiliation(s)
- Elzbieta Gos
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw
| | - Joanna J Rajchel
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw
| | - Beata Dziendziel
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw
| | - Justyna Kutyba
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw
| | - Katarzyna Bienkowska
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw
| | - Weronika Swierniak
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw
| | - Maria Gocel
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw
| | - Danuta Raj-Koziak
- Department of Audiology and Phoniatrics, Tinnitus Clinic, Institute of Physiology and Pathology of Hearing, Warsaw
| | - Piotr H Skarzynski
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw.,Heart Failure and Cardiac Rehabilitation Department, Faculty of Medicine, Medical University of Warsaw, Warsaw.,Institute of Sensory Organs, Nadarzyn/Kajetany
| | - Henryk Skarzynski
- Department of Otorhinolaryngosurgery, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw
| |
Collapse
|
13
|
Skarzynski PH, Dziendziel B, Gos E, Wlodarczyk E, Miaskiewicz B, Rajchel JJ, Skarzynski H. Prevalence and Severity of Tinnitus in Otosclerosis: Preliminary Findings from Validated Questionnaires. J Int Adv Otol 2020; 15:277-282. [PMID: 31418718 DOI: 10.5152/iao.2019.5512] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES In addition to progressive hearing loss, subjective tinnitus is one of the primary symptoms of the otosclerosis development. The aim of this study was to evaluate the prevalence and severity of preoperative tinnitus among a group of consecutive adult patients with otosclerosis, using standardized research tools. MATERIALS AND METHODS The study included 157 cases of clinical otosclerosis (106 women, 51 men). All patients were tested using pure-tone audiometry. The preoperative prevalence and severity of tinnitus were tested using three validated questionnaires: The Tinnitus and Hearing Survey (THS-POL), Tinnitus Handicap Inventory (THI-POL), and Tinnitus Functional Index (TFI-Pl). RESULTS Preliminary results showed that 107 of 157 patients with otosclerosis (68.2%) had preoperative tinnitus. Of them, 51 (47.7%) had unilateral tinnitus (in the ear that qualified for stapes surgery), and 56 (52.3%) had bilateral tinnitus. The THS results showed that for 23.4% patients, tinnitus was a problem equal to or greater than hearing loss. The average result of the TFI-Pl questionnaire was 31.6 points, and for THI-POL, it was 38.6 points, indicating that preoperative tinnitus was moderately severe. The statistical analysis did not reveal a correlation between the tinnitus severity and audiometric results (p>0.05). The severity of tinnitus did not differ significantly between men and women (p>0.05), although the TFI-Pl and THI-POL questionnaires indicated that the tinnitus severity generally increased with age in women, while it decreased in men. CONCLUSION This is a scientific study conducted to evaluate the prevalence and severity of preoperative tinnitus in Polish patients with otosclerosis, using three validated questionnaires.
Collapse
Affiliation(s)
| | - Beata Dziendziel
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw, Poland
| | - Elzbieta Gos
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw, Poland
| | - Elzbieta Wlodarczyk
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw, Poland
| | - Beata Miaskiewicz
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw, Poland
| | | | - Henryk Skarzynski
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw, Poland
| |
Collapse
|
14
|
Vajsakovic D, Maslin M, Searchfield GD. Principles and Methods for Psychoacoustic Evaluation of Tinnitus. Curr Top Behav Neurosci 2020; 51:419-459. [PMID: 33550568 DOI: 10.1007/7854_2020_211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Tinnitus, the perception of sound in the absence of a physical sound in the environment, is highly heterogeneous. It varies in its etiology, characteristics, and impact on an individual's life. The sound is commonly described as "ringing," "buzzing," "crickets," "hissing," "humming." Tinnitus can be acute or chronic, mild or disabling. It can be perceived unilaterally or, more commonly, bilaterally. The sound and its location differ from person to person and fluctuate in the same individual over a certain period of time. This heterogeneity in characterization has important implications for research and clinical practice. Identifying patterns in how tinnitus sounds and its relationship to hearing may aid in identifying different forms of tinnitus and revealing their underlying mechanisms. However, the subjective nature of characterizing tinnitus makes it difficult to reliably define and measure. This chapter will focus on reviewing the psychoacoustic assessment of tinnitus, its relationship to cognitive and behavioral aspects of tinnitus, and its neuropathophysiology. In particular, it will describe the heterogeneity of tinnitus and tinnitus matching, and how individual variability in measures may be used to guide treatment and as a prognostic factor.
Collapse
Affiliation(s)
- Dunja Vajsakovic
- Section of Audiology, The University of Auckland, Auckland, New Zealand.,Eisdell Moore Centre, The University of Auckland, Auckland, New Zealand.,Centre for Brain Research, The University of Auckland, Auckland, New Zealand.,Brain Research New Zealand, A Centre of Research Excellence, Auckland, New Zealand
| | - Michael Maslin
- Eisdell Moore Centre, The University of Auckland, Auckland, New Zealand.,School of Psychology, Speech and Hearing, The University of Canterbury, Canterbury, New Zealand
| | - Grant D Searchfield
- Section of Audiology, The University of Auckland, Auckland, New Zealand. .,Eisdell Moore Centre, The University of Auckland, Auckland, New Zealand. .,Centre for Brain Research, The University of Auckland, Auckland, New Zealand. .,Brain Research New Zealand, A Centre of Research Excellence, Auckland, New Zealand.
| |
Collapse
|
15
|
Abstract
Purpose Although tinnitus is highly prevalent among patients receiving audiology services, audiologists are generally untrained in tinnitus management. Audiology graduate programs, as a rule, do not provide comprehensive instruction in tinnitus clinical care. Training programs that do exist are inconsistent in their recommendations. Furthermore, no standards exist to prevent the delivery of unvetted audiologic services, which can be expensive for patients. Patients seeking professional services by an audiologist, therefore, have no basis upon which to be assured they will receive research-based care. The purpose of this article is to describe the current status of tinnitus management services that exist within the general field of audiology and to suggest specific approaches for improving those services. Conclusion Audiologists may be in the best position to serve as the primary health care providers for patients experiencing tinnitus. Tinnitus care services by audiologists, however, must achieve a level of evidence-based standardization.
Collapse
Affiliation(s)
- James A. Henry
- Veterans Affairs Rehabilitation Research & Development, National Center for Rehabilitative Auditory Research,VA Portland Health Care System, OR
- Department of Otolaryngology–Head and Neck Surgery, Oregon Health & Science University, Portland
| | | | - Arnaud Norena
- Laboratory of Sensory and Cognitve Neurosciences UMR CNRS 7260, Aix-Marseille University, France
| | - Philippe Fournier
- Laboratory of Sensory and Cognitve Neurosciences UMR CNRS 7260, Aix-Marseille University, France
| |
Collapse
|