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Tinnitus characteristics in patients with hyperacusis and vertigo (including Ménière's disease) vs. hyperacusis alone. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2023; 74:8-14. [PMID: 36858786 DOI: 10.1016/j.otoeng.2021.09.004] [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: 03/17/2021] [Accepted: 09/03/2021] [Indexed: 03/03/2023]
Abstract
INTRODUCTION AND OBJECTIVES To compare clinical and psychoacoustic tinnitus characteristics in patients with the comorbidity of hyperacusis, hyperacusis and vertigo, and with Ménière's disease (MD). MATERIALS AND METHODS Three hundred and twenty-nine tinnitus patients underwent audiological and otoneurological evaluation. Records of 94 individuals younger than 65 years, 40 women and 54 men (mean age 41.8, range 24-64 years), who complained of tinnitus and hyperacusis, were analyzed. One hundred and thirty-one ears with tinnitus were identified: 67 in the group of patients with tinnitus and hyperacusis (group 1; 41 patients); 28 in the group fulfilling criteria of MD diagnosis (group 2; 28); and 36 in the group with tinnitus, hyperacusis and typical symptoms of vertigo (group 3; 25). RESULTS AND CONCLUSIONS Mean value of interaural difference in canal paresis in group 1 was 6.3%; in group 2: 23.7%; and in group 3: 25.9%; p<.001. Mean tinnitus pitch value was significantly lower in group 3 (1679Hz; SD=1139) and group 2 (2250Hz; SD=1162) compared to group 1 (4538Hz; SD=3123; p=.012). Values of tinnitus intensity and other characteristics did not significantly differ between the groups. Tinnitus and hyperacusis were most frequently preceded by acoustic trauma. Tinnitus coinciding with hyperacusis and vertigo was observed in patients after head trauma. Mean tinnitus pitch was lower in the groups of patients with hyperacusis and peripheral labyrinthine lesion than in tinnitus sufferers with hyperacusis alone. Tinnitus sufferers with low tinnitus pitch should undergo vestibular system evaluation. Hyperacusis and vertigo are likely comorbidities in tinnitus patients after head trauma. Hyperacusis may coincide in tinnitus patients after head trauma.
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de Pont LMH, van Steekelenburg JM, Verhagen TO, Houben M, Goeman JJ, Verbist BM, van Buchem MA, Bommeljé CC, Blom HM, Hammer S. Hydropic Ear Disease: Correlation Between Audiovestibular Symptoms, Endolymphatic Hydrops and Blood-Labyrinth Barrier Impairment. Front Surg 2021; 8:758947. [PMID: 34805261 PMCID: PMC8601159 DOI: 10.3389/fsurg.2021.758947] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 10/12/2021] [Indexed: 01/23/2023] Open
Abstract
Research Objective: To investigate the correlation between clinical features and MRI-confirmed endolymphatic hydrops (EH) and blood-labyrinth barrier (BLB) impairment. Study Design: Retrospective cross-sectional study. Setting: Vertigo referral center (Haga Teaching Hospital, The Hague, the Netherlands). Methods: We retrospectively analyzed all patients that underwent 4 h-delayed Gd-enhanced 3D FLAIR MRI at our institution from February 2017 to March 2019. Perilymphatic enhancement and the degree of cochlear and vestibular hydrops were assessed. The signal intensity ratio (SIR) was calculated by region of interest analysis. Correlations between MRI findings and clinical features were evaluated. Results: Two hundred and fifteen patients with MRI-proven endolymphatic hydrops (EH) were included (179 unilateral, 36 bilateral) with a mean age of 55.9 yrs and median disease duration of 4.3 yrs. Hydrops grade is significantly correlated with disease duration (P < 0.001), the severity of low- and high-frequency hearing loss (both P < 0.001), and the incidence of drop attacks (P = 0.001). Visually increased perilymphatic enhancement was present in 157 (87.7%) subjects with unilateral EH. SIR increases in correlation with hydrops grade (P < 0.001), but is not significantly correlated with the low or high Fletcher index (P = 0.344 and P = 0.178 respectively). No significant differences were found between the degree of EH or BLB impairment and vertigo, tinnitus or aural fullness. Conclusion: The degree of EH positively correlates with disease duration, hearing loss and the incidence of drop attacks. The BLB is impaired in association with EH grade, but without clear contribution to the severity of audiovestibular symptoms.
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Affiliation(s)
- Lisa M H de Pont
- Department of Radiology, Haga Teaching Hospital, The Hague, Netherlands.,Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Thijs O Verhagen
- Department of Radiology, Haga Teaching Hospital, The Hague, Netherlands.,Department of Otorhinolaryngology, Haga Teaching Hospital, The Hague, Netherlands.,Department of Otorhinolaryngology, Leiden University Medical Center, Leiden, Netherlands
| | - Maartje Houben
- Department of Radiology, Haga Teaching Hospital, The Hague, Netherlands.,Department of Otorhinolaryngology, Haga Teaching Hospital, The Hague, Netherlands
| | - Jelle J Goeman
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, Netherlands
| | - Berit M Verbist
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | - Mark A van Buchem
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | - Claire C Bommeljé
- Department of Otorhinolaryngology, Haga Teaching Hospital, The Hague, Netherlands
| | - Henk M Blom
- Department of Otorhinolaryngology, Haga Teaching Hospital, The Hague, Netherlands.,Department of Otorhinolaryngology, Leiden University Medical Center, Leiden, Netherlands.,Department of Otorhinolaryngology, Antwerp University Hospital, Antwerp, Belgium
| | - Sebastiaan Hammer
- Department of Radiology, Haga Teaching Hospital, The Hague, Netherlands
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Zagólski O, Papież P, Kruk B, Kruk D. Tinnitus characteristics in patients with hyperacusis and vertigo (including Ménière's disease) vs. hyperacusis alone. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2021. [DOI: 10.1016/j.otorri.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Subjective hearing ability, physical and mental comorbidities in individuals with bothersome tinnitus in a Swedish population sample. PROGRESS IN BRAIN RESEARCH 2021; 260:51-78. [PMID: 33637232 DOI: 10.1016/bs.pbr.2020.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study investigates associations of subjective hearing ability, physical comorbidities, and mental comorbidities with bothersome (vs. non-bothersome) tinnitus and mediating effects between these influences. METHODS The Swedish LifeGene cohort was used to sample cross-sectional survey data (collected 2009-2016) of 7615 participants with tinnitus, 697 (9.2%) of whom rated their tinnitus as bothersome. Associations between bothersome tinnitus and subjective hearing ability, physical and mental comorbidities were investigated by separate age- and gender-adjusted multiple logistic regression models. Interrelationships between these associations were investigated by logistic mediation models. RESULTS Compared to non-bothersome tinnitus, bothersome tinnitus was associated with higher age, reduced subjective hearing ability, hearing-related difficulties in social situations, cardiovascular disease, chronic shoulder pain, thyroid disease, Ménière's disease, depression, anxiety syndrome, and social anxiety. Subjective hearing impairment or hearing-related difficulties mediated 13-36% of the effects of mental comorbidities on bothersome tinnitus. Depression or anxiety syndrome mediated 5-8% of most relationships between physical comorbidities and bothersome tinnitus. Depression, anxiety syndrome, or social anxiety mediated 2-4% of the effects of subjective hearing impairment or hearing-related difficulties on bothersome tinnitus. CONCLUSION Psychological factors, subjective hearing impairment, and hearing-related difficulties in social situations play key roles in predicting bothersome (vs. non-bothersome) tinnitus in a large population sample. Psychological factors contribute to explaining the impact of physical comorbidities and hearing-related effects on bothersome tinnitus. This highlights their transdiagnostic importance for aggravating varied physical symptom clusters. Interventions to improve or prevent high tinnitus burden should be interdisciplinary/multimodal and target auditory, physical, and psychological factors.
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Lee HY, Kim SJ, Chang DS, Shin SA. Tinnitus in the side with better hearing. Am J Otolaryngol 2019; 40:400-403. [PMID: 30799211 DOI: 10.1016/j.amjoto.2019.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 02/18/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES We aimed to confirm the characteristics of patients with tinnitus in the better-hearing side. MATERIALS AND METHODS Among the 778 patients who visited the tinnitus clinic complaining of unilateral tinnitus at a local university hospital between March 2014 and December 2017, we recruited 62 patients who showed tinnitus in the better-hearing side on pure-tone audiometry. The mean hearing threshold was calculated using the arithmetic mean of the pure tone thresholds at 1, 2, 3, and 4 kHz. In addition, patients' medical history, tinnitus questionnaires, and other audiologic test results were thoroughly analyzed together for diagnosis. RESULTS Fluctuating hearing loss without vertigo or Ménière's disease were the most common etiologies (n = 16, 25.8%), followed by high-frequency hearing loss (n = 13, 21.0%), sudden idiopathic hearing loss (n = 6, 9.7%), and presbycusis (n = 6, 9.7%). Somatosensory tinnitus was also observed in seven patients. Neck pain was associated with tinnitus in five patients (8.1%), and two other patients (3.2%) experienced temporomandibular disorder in the same side as the tinnitus. CONCLUSION Tinnitus was associated with deterioration of hearing even when it occurred in the better-hearing side. Among the possible etiologies, fluctuating hearing loss in the tinnitus side was the most common audiologic finding. Assessment of hearing level at each frequency was more effective in detecting high-frequency hearing loss rather than the use of the mean hearing level. In addition, somatosensory tinnitus should not be ignored.
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Pyykkő I, Manchaiah V, Kentala E, Levo H, Juhola M. Internet-Based Self-Help for Ménière's Disease: Details and Outcome of a Single-Group Open Trial. Am J Audiol 2017; 26:496-506. [PMID: 29049634 DOI: 10.1044/2017_aja-16-0068] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 05/16/2017] [Indexed: 11/09/2022] Open
Abstract
PURPOSE In this article, we present the details and the pilot outcome of an Internet-based self-help program for Ménière's disease (MD). METHOD The Norton-Kaplan model is applied to construct a strategic, person-focused approach in the enablement process. The program assesses the disorder profile and diagnosis. In the therapeutic component of the program, the participant defines vision and time frame, inspects confounding factors, determines goals, establishes a strategy, and starts to work on the important problems caused by the disorder. The program works interactively, utilizes collaboration with significant others, and enhances positive thinking. Participants took part in an Internet-based self-help program. Data were collected interactively using open-ended and structured questionnaires on various disease-specific and general health aspects. The pilot outcome of 41 patients with MD was evaluated. RESULTS The analysis of the pilot data showed statistically significant improvement in their general health-related quality of life (p < .001). Also, the outcome of the Posttraumatic Growth Inventory (Cann et al., 2010) showed small to moderate change as a result of the intervention. CONCLUSIONS The Internet-based self-help program can be helpful in the rehabilitation of patients with MD to supplement medical therapy.
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Affiliation(s)
- Ilmari Pyykkő
- Hearing and Balance Research Unit, Department of Otolaryngology, University of Tampere, Finland
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX
- Swedish Institute for Disability Research, Department of Behavioral Sciences and Learning, Linköping University, Sweden
- Audiology India, Karnataka, Mysore
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Karnataka, India
| | - Erna Kentala
- Department of Otolaryngology, University of Helsinki, Finland
| | - Hilla Levo
- Department of Otolaryngology, University of Helsinki, Finland
| | - Martti Juhola
- School of Information Sciences, University of Tampere, Finland
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Rasku J, Pyykkö I, Levo H, Kentala E, Manchaiah V. Disease Profiling for Computerized Peer Support of Ménière's Disease. JMIR Rehabil Assist Technol 2015; 2:e9. [PMID: 28582248 PMCID: PMC5454554 DOI: 10.2196/rehab.4109] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 06/16/2015] [Accepted: 07/12/2015] [Indexed: 01/09/2023] Open
Abstract
Background Peer support is an emerging form of person-driven active health care. Chronic conditions such as Ménière’s disease (a disorder of the inner ear) need continuing rehabilitation and support that is beyond the scope of routine clinical medical practice. Hence, peer-support programs can be helpful in supplementing some of the rehabilitation aspects. Objective The aim of this study was to design a computerized data collection system for the peer support of Menière’s disease that is capable in profiling the subject for diagnosis and in assisting with problem solving. Methods The expert program comprises several data entries focusing on symptoms, activity limitations, participation restrictions, quality of life, attitude and personality trait, and an evaluation of disease-specific impact. Data was collected from 740 members of the Finnish Ménière’s Federation and utilized in the construction and evaluation of the program. Results The program verifies the diagnosis of a person by using an expert system, and the inference engine selects 50 cases with matched symptom severity by using a nearest neighbor algorithm. These cases are then used as a reference group to compare with the person’s attitude, sense of coherence, and anxiety. The program provides feedback for the person and uses this information to guide the person through the problem-solving process. Conclusions This computer-based peer-support program is the first example of an advanced computer-oriented approach using artificial intelligence, both in the profiling of the disease and in profiling the person’s complaints for hearing loss, tinnitus, and vertigo.
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Affiliation(s)
- Jyrki Rasku
- School of Information Sciences, Tampere University, Tampere, Finland.,Hearing and Balance Research Unit, Department of Otorhinolaryngology, Tampere University, Tampere, Finland
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Department of Otorhinolaryngology, Tampere University, Tampere, Finland
| | - Hilla Levo
- Department of Otolaryngology, University of Helsinki, Helsinki, Finland
| | - Erna Kentala
- Department of Otolaryngology, University of Helsinki, Helsinki, Finland
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, United States.,The Swedish Institute for Disability Research, Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.,Audiology India, Mysore, India
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Pyykkő I, Manchaiah V, Levo H, Kentala E, Rasku J. Attitudes of significant others of people with Ménière's disease vary from coping to victimization. Int J Audiol 2015; 54:316-22. [DOI: 10.3109/14992027.2014.989547] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Stephens D, Pyykkö I, Yoshida T, Kentala E, Levo H, Auramo Y, Poe D. The consequences of tinnitus in long-standing Ménière's disease. Auris Nasus Larynx 2011; 39:469-74. [PMID: 22093767 DOI: 10.1016/j.anl.2011.10.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 10/22/2011] [Accepted: 10/24/2011] [Indexed: 10/15/2022]
Abstract
OBJECTIVE To explore the perceived consequences of tinnitus in patients with long-standing Ménière's disease (MD). METHOD A questionnaire-based cross-sectional investigation of 183 randomly selected members of the Finnish Ménière's Federation. It assessed general health related quality of life (EQ-5D), a participation restriction scale, self-listed consequences and a rating of effects of MD on life. RESULTS When the effects of the other cardinal symptoms of Ménière's disease were partialled out, the main reported impacts of tinnitus related to anxiety, sleep and depression. It also contributed to some difficult listening situations and to interactions with significant others. Tinnitus explained a significant component of disease-specific quality of life (QoL), but did not relate significantly to the generic measures used. However, the measure 'mood' in the QoL scale was significantly associated with severe tinnitus. CONCLUSION The most important specific impacts of tinnitus in chronic Ménière's disease relate to broadly psychological factors and mood.
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Affiliation(s)
- Dafydd Stephens
- Department of Psychological Medicine and Neurology, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom.
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