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Alashram AR. Effects of tinnitus retraining therapy on patients with tinnitus: a systematic review of randomized controlled trials. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08907-3. [PMID: 39153142 DOI: 10.1007/s00405-024-08907-3] [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: 07/12/2024] [Accepted: 08/09/2024] [Indexed: 08/19/2024]
Abstract
PURPOSE This review aims to explore the influences of tinnitus retraining therapy (TRT) on patients with tinnitus. METHODS PubMed, MEDLINE, EMBASE, CINAHL, PEDro, SCOPUS, and Web of Science were screened for randomized controlled trials (RCTs) that explored the effects of TRT on patients with tinnitus from inception to June 30, 2024. The methodological quality of the included RCTs was evaluated using the physiotherapy evidence database (PEDro) scale. RESULTS Fifteen studies met our eligibility criteria. A total of 2069 patients with tinnitus (mean age 52.93 years; 66% male) were involved in the present review. The quality of the selected studies ranged from 5 to 8 on the PEDro scale, with a median score of 7. TRT did not provide superior effects in treating patients with tinnitus compared to tinnitus masking (TM), tinnitus educational counselling (TED), TRT with open ear hearing aids, Tailor-made notched music training (TMNMT), partial TRT, usual care, and smart TRT. CONCLUSIONS TRT intervention is considered a treatment option for patients with tinnitus. Combining TRT with other interventions, such as cognitive-behavioral therapy, pharmacotherapy, or tDS, may show even greater efficacy. Additional studies are strongly required to recognize the long-term effects of TRT on tinnitus, determine who most likely would benefit from the intervention regarding tinnitus type and severity, and identify the optimal treatment protocol.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Airport Road 1666, Amman, Jordan.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
- Centre of SpaceBio-Medicine, Department of Systems Medicine, Faculty of Medicine and Surgery, University of Rome "Tor Vergata", 00133, Rome, Italy.
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Yuan L, Li D, Tian Y, Sun Y. Greenness, Genetic Predisposition, and Tinnitus. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2306706. [PMID: 38445888 PMCID: PMC11077638 DOI: 10.1002/advs.202306706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/19/2024] [Indexed: 03/07/2024]
Abstract
This study aimed to investigate the association between residential greenness and tinnitus and the potential interaction between greenness and genetic predisposition to tinnitus. The normalized difference vegetation index (NDVI) is used to measure residential greenness. The tinnitus is defined based on self-reported. In the cross-sectional analyses, logistic regression models are used for the baseline sample of the United Kingdom Biobank cohort. In the secondary analysis, a Cox proportional hazard model is used for a subsample of participants who completed the tinnitus questionnaire at follow-up. In the cross-sectional analysis including 106471 participants, higher residential greenness is associated with lower odds of tinnitus for each interquartile range increase in continuous NDVI, with an adjusted odds ratio of 0.97 (95% confidence interval: 0.95 to 0.99) for tinnitus. A similar association is observed in the longitudinal analysis, with an adjusted hazard ratio of 0.92 (95% confidence interval: 0.86 to 0.98) for the association of NDVI increased per interquartile range with incident tinnitus. Moreover, there is a significant interaction between greenness and genetic predisposition to tinnitus (P < 0.05). This study suggested that residential greenness is negatively associated with tinnitus. Greenness and genetic predisposition to tinnitus are found to have a significant interaction.
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Affiliation(s)
- Lan‐Lai Yuan
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
| | - Dan‐Kang Li
- Ministry of Education Key Laboratory of Environment and Healthand State Key Laboratory of Environmental Health (Incubating)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China
- Department of Maternal and Child Health, School of Public Health, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China
| | - Yao‐Hua Tian
- Ministry of Education Key Laboratory of Environment and Healthand State Key Laboratory of Environmental Health (Incubating)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China
- Department of Maternal and Child Health, School of Public Health, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China
| | - Yu Sun
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and RegenerationWuhan430022China
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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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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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Xia Q, Yang S, Ji F. The characteristics of hearing loss in outpatients with tinnitus over the age of 60: a 11-year cross-sectional study. Acta Otolaryngol 2023; 143:753-758. [PMID: 37772756 DOI: 10.1080/00016489.2023.2259952] [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: 07/20/2023] [Accepted: 09/07/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND Presbycusis with tinnitus has a significant impact on the quality of life of elderly patients, becoming a serious socioeconomic problem. OBJECTIVES We conducted an 11-year cross-sectional analysis of the audiometry results of elderly patients with tinnitus from 2011 to 2021. METHODS 9642 patients aged 60 and over were divided into three groups: young-old (YO) (60-74), old-old (OO) (75-89), and longevous (LON) (90 and over). Pure-tone audiometry results of all patients were analyzed. RESULTS Among 9642 patients, the cases of female with tinnitus were more than male in all years. The hearing curve showed a typical age-related decline. Hearing level of air conduction in female declined significantly at low frequencies while that of male was worse at high frequencies in YO and OO groups. Compared with right, left hearing level of air conduction was significantly decreased at all frequencies except 0.125 kHz. CONCLUSIONS When the chief complaint was tinnitus, women were likely to experience more distress than men. However, men suffered from more hearing loss than women, at least in high frequencies. The influence weight of presbycusis and tinnitus on the auditory cortices might be a possible reason for the lateral distinction of hearing loss at different ages.
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Affiliation(s)
- Qingqing Xia
- College of Medicine, Nankai University, Tianjin, China
| | - Shiming Yang
- College of Medicine, Nankai University, Tianjin, China
- Department of Otolaryngology Head and Neck Surgery, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
| | - Fei Ji
- Department of Otolaryngology Head and Neck Surgery, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
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Seo HW, Ha JW, Kwak JH, Kim MK, Byun H, Lee SH, Chung JH. A content analysis of YouTube videos on tinnitus in South Korea. Sci Rep 2023; 13:13579. [PMID: 37604936 PMCID: PMC10442411 DOI: 10.1038/s41598-023-40523-9] [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: 04/05/2023] [Accepted: 08/11/2023] [Indexed: 08/23/2023] Open
Abstract
More people use the internet for medical information, especially YouTube. Nevertheless, no study has been conducted to analyze the quality of YouTube videos about tinnitus in Korea. This study aims to review the contents and quality of YouTube videos on tinnitus. The top 100 Korean YouTube videos on tinnitus were reviewed by a tinnitus expert. This study assessed video details: title, creator, length, and popularity indicators-subscribers, views, and likes. The contents of the video clips were analyzed to determine the relevance, understandability, actionability, and quality of information. Out of 100 tinnitus videos, 27 were created by otolaryngologists, 25 by traditional Korean medicine doctors, 25 by other medical professionals, and 3 by lay persons. Sensorineural tinnitus was frequently dealt, and hearing loss, stress, and noise were introduced as main causes of tinnitus. Otolaryngologists' videos covered verified treatments, but others suggested unproven therapies including herbal medicine or acupressure. Otolaryngologists' videos showed significantly higher understandability and quality of information compared to others (p < 0.001). This study found that tinnitus YouTube videos frequently present low-quality and incorrect material, which could have an adverse effect on patients. Results highlight the need for tinnitus specialists to provide accurate information.
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Affiliation(s)
- Hee Won Seo
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Jung Woo Ha
- College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Jin Hye Kwak
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Moo Keon Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Hayoung Byun
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Seung Hwan Lee
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Jae Ho Chung
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea.
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Zhang C, Wang W, Chang X, Zhan S, Wang S, Feng L, Song Y. Obesity and risk of hearing loss in the middle-aged and elderly: a national cohort of Chinese adults. BMC Public Health 2023; 23:1048. [PMID: 37264346 DOI: 10.1186/s12889-023-15974-4] [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: 10/25/2022] [Accepted: 05/24/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND The relationship between obesity and hearing loss among the middle-aged and older population remained unclear. Moreover, few studies have focused on the impact of gender on this association. METHODS This cohort study extracted the data from the China Health and Retirement Longitudinal Study, a national survey of adults aged 45 years or over. Waist circumference was categorized into three groups: normal, pre-central obesity, and central obesity. We classified BMI into four categories: underweight, normal weight, overweight, and obese. The primary endpoint was the incidence of self-reported hearing loss. RESULTS Of the 14,237 participants, 1972 incidents of hearing loss were identified during a median 6.9 years of follow-up. The cumulative incidence of hearing loss was 13.9% (95% CI 13.3% -14.4%). Our study showed that central obesity was significantly associated with hearing loss (HR 0.84, 95%CI 0.75-0.94), and this relationship was more prominent in males (HR 0.76, 95%CI 0.63-0.91). Among male participants, the underweight group was at the highest risk of hearing loss (HR 1.39, 95%CI 1.08-1.79). Compared with the normal weight group, the adjusted HR for hearing loss in the obese groups was 0.69 (95%CI 0.51-0.94) among men. Among female participants, only the overweight group had a lower risk of hearing loss than the normal weight group (HR 0.83, 95%CI 0.71-0.96). CONCLUSIONS Being overweight and obese were significantly associated with a decreased risk of hearing loss, whereas being underweight was associated with an increased risk of hearing loss.
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Affiliation(s)
- Chen Zhang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jing 5 road, Huaiyin District, Jinan, 250021, China
| | - Weiwei Wang
- National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Xicheng District, Beijing, 100088, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Xiaotian Chang
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, 525 W 120th Street, New York, NY, 10027, USA
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
- Research Center of Clinical Epidemiology, Peking University Third Hospital, 49 Huayuan North Road, Haidian District, Beijing, 100191, China
- Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
| | - Lei Feng
- National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Xicheng District, Beijing, 100088, China.
| | - Yongfeng Song
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jing 5 road, Huaiyin District, Jinan, 250021, China.
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, 324 Jing 5 road, Huaiyin District, Jinan, 250021, China.
- Shandong Institute of Endocrine and Metabolic Diseases, 324 Jing 5 road, Huaiyin District, Jinan, 250021, China.
- Central Hospital Affiliated to Shandong First Medical University, 105 Jiefang road, Lixia District, Jinan, 250013, China.
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Hackenberg B, O'Brien K, Döge J, Lackner KJ, Beutel ME, Münzel T, Pfeiffer N, Schulz A, Schmidtmann I, Wild PS, Matthias C, Bahr-Hamm K. Tinnitus Prevalence in the Adult Population-Results from the Gutenberg Health Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59030620. [PMID: 36984621 PMCID: PMC10052845 DOI: 10.3390/medicina59030620] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/09/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023]
Abstract
Background and Objectives: Tinnitus is a common symptom in medical practice, although data on its prevalence vary. As the underlying pathophysiological mechanism is still not fully understood, hearing loss is thought to be an important risk factor for the occurrence of tinnitus. The aim of this study was to assess tinnitus prevalence in a large German cohort and to determine its dependence on hearing impairment. Materials and Methods: The Gutenberg Health Study (GHS) is a population-based cohort study and representative for the population of Mainz and its district. Participants were asked whether they suffer from tinnitus and how much they are burdened by it. Extensive audiological examinations using bone- and air-conduction were also performed. Results: 4942 participants (mean age: 61.0, 2550 men and 2392 women) were included in the study. The overall prevalence of tinnitus was 26.1%. Men were affected significantly more often than women. The prevalence of tinnitus increased with age, peaking at ages 75 to 79 years. Considering only annoying tinnitus, the prevalence was 9.8%. Logistic regression showed that participants with severe to complete hearing loss (>65 dB) were more likely to have tinnitus. Conclusions: Tinnitus is a common symptom, and given demographic changes, its prevalence is expected to increase.
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Affiliation(s)
- Berit Hackenberg
- Department of Otorhinolaryngology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Karoline O'Brien
- Department of Otorhinolaryngology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Julia Döge
- Department of Otorhinolaryngology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Karl J Lackner
- Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, 55131 Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, 55131 Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology-Cardiology I, University Medical Center Mainz, 55131 Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Andreas Schulz
- Preventive Cardiology and Preventive Medicine-Department of Cardiology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Irene Schmidtmann
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, 55131 Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine-Department of Cardiology, University Medical Center Mainz, 55131 Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, 55131 Mainz, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site RhineMain, 60549 Mainz, Germany
- Institute of Molecular Biology (IMB), 55128 Mainz, Germany
| | - Christoph Matthias
- Department of Otorhinolaryngology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Katharina Bahr-Hamm
- Department of Otorhinolaryngology, University Medical Center Mainz, 55131 Mainz, Germany
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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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10
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Carmody N, Eikelboom RH, Tegg-Quinn S. Seeking Help for Tinnitus and Satisfaction With Healthcare Providers Including Diagnosis, Clinical Services, and Treatment: A Scoping Review. Eval Health Prof 2023; 46:170-193. [PMID: 36853910 DOI: 10.1177/01632787231158402] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The objective of this scoping review was to describe the extent and type of evidence related to seeking help for tinnitus and satisfaction with healthcare providers including diagnosis, services and treatments along the clinical pathway. The selection criteria were adults aged 18 and over with tinnitus who sought help and where patient satisfaction with healthcare providers was reported. Online databases MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP) and CINAHL plus (EBSCO) were searched for original studies in English. The search had no date limit. Twenty-one records were eligible for data extraction. Studies reported that the most common healthcare providers seen were general practitioners, ear, nose and throat specialists and audiologists. Depression and tinnitus severity were related to an increase in the number of times help was sought and the type of healthcare provider seen may also impact patient satisfaction. The majority of participants were unlikely to receive a referral to a specialist at the initial GP consultation. Although there is limited research in this area, help-seekers for tinnitus were generally dissatisfied and reported negative interactions with healthcare providers. However, once in a specialised tinnitus clinical setting, studies reported that most help-seekers were satisfied and had positive interactions with healthcare providers.
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Affiliation(s)
- Natalie Carmody
- 104182Ear Science Institute Australia, Subiaco, WA, Australia.,Ear Sciences Centre, Medical School, 2720The University of Western Australia, Nedlands, WA, Australia
| | - Robert H Eikelboom
- 104182Ear Science Institute Australia, Subiaco, WA, Australia.,Ear Sciences Centre, Medical School, 2720The University of Western Australia, Nedlands, WA, Australia.,Department of Speech Language Pathology and Audiology, 56410University of Pretoria, Pretoria, South Africa.,Curtin Medical School, 1649Curtin University, Bentley, WA, Australia
| | - Susan Tegg-Quinn
- 104182Ear Science Institute Australia, Subiaco, WA, Australia.,Ear Sciences Centre, Medical School, 2720The University of Western Australia, Nedlands, WA, Australia
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11
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Nassar M, Islam MS, D’souza S, Praveen M, Al Masri MH, Sauro S, Jamleh A. Tinnitus Prevalence and Associated Factors among Dental Clinicians in the United Arab Emirates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1403. [PMID: 36674157 PMCID: PMC9859095 DOI: 10.3390/ijerph20021403] [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: 11/24/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
Dental clinicians are at increased risk for developing tinnitus due to exposure to high levels of occupational noise. This study aimed to determine tinnitus prevalence and associated factors among dental clinicians. Interviews were conducted with 150 randomly selected dental clinicians using a questionnaire. Noise levels were measured at three points of time at the operating area. Tinnitus was reported in 19.33% of the participants. The average noise level was significantly higher among participants with tinnitus compared to those without the condition. More participants complained of intermittent tinnitus and the rest had the constant type, with the latter being significantly more bothersome. The weekly average time of using high-speed handpieces, suction and electric handpieces, age and experience had a significant effect on the presence of tinnitus. Only 2.7% of the participants reported the use of a hearing protection device. Tinnitus is a common finding among dental clinicians especially those with higher levels of occupational noise and more frequent use of noise-generating equipment. Knowledge of tinnitus prevalence aids in realizing the extent of its impact and making informed decisions. These results call for improved awareness of the negative impact of clinically-generated noise and emphasize the importance of preventive measures and periodic audiometry exams.
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Affiliation(s)
- Mohannad Nassar
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Md Sofiqul Islam
- Ras Al Khaimah College of Dental Sciences, Ras Al Khaimah Medical and Health Science University, Ras Al Khaimah 11172, United Arab Emirates
| | - Stancey D’souza
- Ras Al Khaimah College of Dental Sciences, Ras Al Khaimah Medical and Health Science University, Ras Al Khaimah 11172, United Arab Emirates
| | - Milan Praveen
- Ras Al Khaimah College of Dental Sciences, Ras Al Khaimah Medical and Health Science University, Ras Al Khaimah 11172, United Arab Emirates
| | - Mohammad Hani Al Masri
- Ras Al Khaimah College of Dental Sciences, Ras Al Khaimah Medical and Health Science University, Ras Al Khaimah 11172, United Arab Emirates
| | - Salvatore Sauro
- Dental Biomaterials and Minimally Invasive Dentistry, Departamento de Odontología, Facultad de Ciencias de la Salud, Universidad CEU-Cardenal Herrera, C/Del Pozo ss/n, Alfara del Patriarca, 46115 Valencia, Spain
- Department of Therapeutic Dentistry, I. M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia
| | - Ahmed Jamleh
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh 11481, Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh 11481, Saudi Arabia
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12
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Prevalence and associated risk factors of tinnitus among adult Palestinians: a cross-sectional study. Sci Rep 2022; 12:20617. [PMID: 36450754 PMCID: PMC9712604 DOI: 10.1038/s41598-022-24015-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022] Open
Abstract
Tinnitus is a common complaint with potentially negative impact on quality of life. Prevalence of tinnitus ranges from 5 to 43% worldwide. This variation could be due to the heterogeneity of tinnitus assessment. This has limited the progress in understanding tinnitus. Therefore, we employed a standardized and a validated assessment method to determine the prevalence and related risk factors of tinnitus among Palestinians for the first time. This is a cross-sectional study in which we questioned a representative sample of 618 subjects in one-to-one interviews. The prevalence of any tinnitus was 30.6% among adult Palestinians. Participants from the oldest age group were almost five times more likely to have tinnitus. Moreover, participants with head and neck pain syndrome, severe hearing impairment, sleeping disorders or frequent complaints of vertigo were approximately two times more likely to have tinnitus. Our study provides novel information regarding tinnitus in Palestine and improves our understanding of tinnitus. This will improve the diagnosis and consequently will contribute in reducing the prevalence and perhaps in preventing tinnitus. As tinnitus still has no known cure, further investigations of modifiable risk factors and causes of tinnitus are crucial to prevent it in the future.
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Associations Between Physical Activity, Tinnitus, and Tinnitus Severity. Ear Hear 2022; 44:619-626. [PMID: 36404413 DOI: 10.1097/aud.0000000000001306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To examine the associations between physical activity and tinnitus development and physical activity and tinnitus severity in a large representative sample of US adults. DESIGN Data were obtained from 3826 eligible participants (20 to 69 years) in the National Health and Nutrition Examination Survey between 2015 and 2016. Physical activity was assessed using a Global Physical Activity Questionnaire. We used multivariable logistic regression to test the associations of physical activity (without physical activity, with physical activity) and amount of physical activity (min/week, in quartiles) with tinnitus symptoms. Adults with depressive symptoms were excluded, and the models were controlled for relevant sociodemographic, lifestyle, and health-related covariates. A restricted cubic spline was used to explore the dose-response relationship between the amount of physical activity and tinnitus. RESULTS Overall, 12.8% of the population who engaged in physical activity reported tinnitus, compared with 18.5% of the population who did not ( p = 0.005). Subgroup analysis based on the amount of physical activity showed that participants who performed physical activity (150 to 300, 310 to 540, and 550 to 4800 min/week) had lower risks of tinnitus than those with no physical activity (odds ratio = 0.72, 0.56, and 0.62, respectively), after adjusting for covariates. However, no correlation was observed between physical activity and tinnitus severity in the present study. The dose-response analysis showed a nonlinear relationship (P for nonlinearity = 0.04) between the amount of physical activity and the risk of tinnitus. CONCLUSIONS Physical activity may be associated with a reduced risk of tinnitus. Further research using a longitudinal design is required to confirm these findings and clarify the direction of causation.
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Holder JT, Holcomb MA, Snapp H, Labadie RF, Vroegop J, Rocca C, Elgandy MS, Dunn C, Gifford RH. Guidelines for Best Practice in the Audiological Management of Adults Using Bimodal Hearing Configurations. OTOLOGY & NEUROTOLOGY OPEN 2022; 2:e011. [PMID: 36274668 PMCID: PMC9581116 DOI: 10.1097/ono.0000000000000011] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Clinics are treating a growing number of patients with greater amounts of residual hearing. These patients often benefit from a bimodal hearing configuration in which acoustic input from a hearing aid on 1 ear is combined with electrical stimulation from a cochlear implant on the other ear. The current guidelines aim to review the literature and provide best practice recommendations for the evaluation and treatment of individuals with bilateral sensorineural hearing loss who may benefit from bimodal hearing configurations. Specifically, the guidelines review: benefits of bimodal listening, preoperative and postoperative cochlear implant evaluation and programming, bimodal hearing aid fitting, contralateral routing of signal considerations, bimodal treatment for tinnitus, and aural rehabilitation recommendations.
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Affiliation(s)
| | | | | | | | | | - Christine Rocca
- Guy’s and St. Thomas’ Hearing Implant Centre, London, United Kingdom
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15
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Degeest S, Kestens K, Keppler H. Investigation of the Relation Between Tinnitus, Cognition, and the Amount of Listening Effort. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1988-2002. [PMID: 35377707 DOI: 10.1044/2022_jslhr-21-00347] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE This study aimed to investigate the effect of chronic tinnitus on measures of listening effort and cognitive performance, as well as the relation between cognitive performance and the amount of listening effort obtained by those measures. METHOD Thirteen normal-hearing young adults with chronic tinnitus were matched with a control group. First, behavioral listening effort was measured using a dual-task paradigm in various favorable and unfavorable listening conditions. Furthermore, verbal working memory, processing speed, selective attention, and cognitive flexibility and inhibition were evaluated. RESULTS A significant and nonsignificant trend toward more listening effort in the tinnitus group was, respectively, found for the quiet listening condition and the condition with a signal-to-noise ratio of +2 dB. No significant differences in cognitive performances were found between the groups, nor were there significant relationships between the cognitive factors and listening effort scores for either the control or tinnitus group. CONCLUSIONS Listening effort was increased in the tinnitus group. Although no clear differences in cognitive performance could be found between the tinnitus group and their controls, a trend could be seen whereby selective attention deficits in the subjects with tinnitus may be an important factor that affects the amount of listening effort.
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Affiliation(s)
- Sofie Degeest
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | - Katrien Kestens
- Department of Rehabilitation Sciences, Ghent University, Belgium
| | - Hannah Keppler
- Department of Rehabilitation Sciences, Ghent University, Belgium
- Department of Otorhinolaryngology, Ghent University Hospital, Belgium
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Are Electrocochleographic Changes an Early Sign of Cochlear Synaptopathy? A Prospective Study in Tinnitus Patients with Normal Hearing. Diagnostics (Basel) 2022; 12:diagnostics12040802. [PMID: 35453851 PMCID: PMC9027360 DOI: 10.3390/diagnostics12040802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 03/22/2022] [Accepted: 03/22/2022] [Indexed: 11/29/2022] Open
Abstract
The mechanism of tinnitus accompanied by a normal audiogram remains elusive. This study aimed to investigate evidence of primary neural degeneration, also known as cochlear synaptopathy, in tinnitus patients with normal hearing thresholds. We analyzed the differences in electrocochleography (ECochG) measurements between normal-hearing subjects with and without tinnitus. Forty-five subjects were enrolled in this study: 21 were in the tinnitus group, defined by chronic tinnitus of over two months’ duration with normal audiometric thresholds, and 24 were in the control group, defined by a lack of tinnitus complaints. Electrocochleograms were evoked by 1, 4, 6, and 8 kHz alternating-polarity tone bursts at sound pressure levels (SPLs) of 90−110 dB. The tinnitus group had smaller action potential (AP) amplitudes than the control group for 1, 4, 6, and 8 kHz tone bursts and showed significant amplitude reduction at 1 kHz 110 dB SPL (p < 0.01), 1 kHz 90 dB SPL (p < 0.05), and 4 kHz 110 dB SPL (p < 0.05). There were no significant differences in the summating potential/action potential (SP/AP) amplitude ratios across the four tested frequencies. A trend of reduced AP amplitudes was found in the tinnitus group, supporting the hypothesis that tinnitus might be associated with primary neural degeneration.
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17
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Da Cruz MJ. Clinical challenges in reducing the distress of tinnitus. Med J Aust 2022; 216:186-187. [DOI: 10.5694/mja2.51391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 11/17/2022]
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18
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Association of Primary Open Angle Glaucoma with Tinnitus. J Glaucoma 2022; 31:224-227. [DOI: 10.1097/ijg.0000000000002001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/03/2022] [Indexed: 11/26/2022]
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19
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Tang D, Tran Y, Lewis JR, Bondonno NP, Bondonno CP, Hodgson JM, Domingo D, McAlpine D, Burlutsky G, Mitchell P, Shekhawat GS, Gopinath B. Associations between intake of dietary flavonoids and the 10-year incidence of tinnitus in older adults. Eur J Nutr 2022; 61:1957-1964. [DOI: 10.1007/s00394-021-02784-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 12/13/2021] [Indexed: 12/25/2022]
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20
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Swain S. Tinnitus: A morbid clinical entity in COVID-19 patient. BLDE UNIVERSITY JOURNAL OF HEALTH SCIENCES 2022. [DOI: 10.4103/bjhs.bjhs_87_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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21
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Kok TE, Domingo D, Hassan J, Vuong A, Hordacre B, Clark C, Katrakazas P, Shekhawat GS. Resting-state Networks in Tinnitus : A Scoping Review. Clin Neuroradiol 2022; 32:903-922. [PMID: 35556148 PMCID: PMC9744700 DOI: 10.1007/s00062-022-01170-1] [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: 01/27/2022] [Accepted: 04/07/2022] [Indexed: 12/16/2022]
Abstract
Chronic subjective tinnitus is the constant perception of a sound that has no physical source. Brain imaging studies show alterations in tinnitus patients' resting-state networks (RSNs). This scoping review aims to provide an overview of resting-state fMRI studies in tinnitus, and to evaluate the evidence for changes in different RSNs. A total of 29 studies were included, 26 of which found alterations in networks such as the auditory network, default mode network, attention networks, and visual network; however, there is a lack of reproducibility in the field which can be attributed to the use of different regions of interest and analytical methods per study, and tinnitus heterogeneity. Future studies should focus on replication by using the same regions of interest in their analysis of resting-state data, and by controlling adequately for potential confounds. These efforts could potentially lead to the identification of a biomarker for tinnitus in the future.
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Affiliation(s)
- Tori Elyssa Kok
- grid.83440.3b0000000121901201Ear Institute, University College London, London, UK
| | - Deepti Domingo
- grid.1014.40000 0004 0367 2697College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Joshua Hassan
- grid.1014.40000 0004 0367 2697College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Alysha Vuong
- grid.1014.40000 0004 0367 2697College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Brenton Hordacre
- grid.1026.50000 0000 8994 5086Innovation, IMPlementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Chris Clark
- grid.83440.3b0000000121901201Great Ormond Street Institute of Child Health, Department of Developmental Imaging and Biophysics, University College London, London, UK
| | | | - Giriraj Singh Shekhawat
- grid.83440.3b0000000121901201Ear Institute, University College London, London, UK ,grid.1014.40000 0004 0367 2697College of Medicine and Public Health, Flinders University, Adelaide, Australia ,Tinnitus Research Initiative, Regensburg, Germany
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22
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Maxwell KS, Robinson JM, Hoffmann I, Hou HJ, Searchfield G, Baguley DM, McMurry G, Piu F, Anderson JJ. Intratympanic Administration of OTO-313 Reduces Tinnitus in Patients With Moderate to Severe, Persistent Tinnitus: A Phase 1/2 Study. Otol Neurotol 2021; 42:e1625-e1633. [PMID: 34629442 PMCID: PMC8584222 DOI: 10.1097/mao.0000000000003369] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the safety and exploratory efficacy of intratympanic administration of OTO-313 in patients with tinnitus. STUDY DESIGN Single intratympanic injection of OTO-313 evaluated in a randomized, double-blind, placebo-controlled Phase 1/2 clinical study. SETTING Tertiary referral centers. PATIENTS Patients with unilateral tinnitus (moderate-severe) with tinnitus duration 1 to 6 months. INTERVENTIONS Intratympanic OTO-313. MAIN OUTCOME MEASURES Safety and change from baseline in tinnitus functional index (TFI), daily ratings of tinnitus loudness and annoyance, and patient global impression of change (PGIC). RESULTS OTO-313 was well-tolerated with lower incidence of adverse events than placebo. Mean TFI reduction from baseline favored OTO-313 at Week 2, 4, and 8. A clinically meaningful, 13-point improvement on the TFI was observed in 43% (6/14) of OTO-313 patients at both Weeks 4 and 8 versus 13% (2/16) of placebo patients (ad hoc responder analysis, p-value < 0.05). Reductions in daily ratings of tinnitus loudness and annoyance favored OTO-313 compared with placebo. In OTO-313 responders, a strong correlation existed between change from baseline in TFI score and changes in tinnitus loudness, tinnitus annoyance, and PGIC. CONCLUSIONS OTO-313 was well-tolerated and demonstrated a higher proportion of responders than placebo across consecutive visits (Weeks 4 and 8) supporting further clinical development of OTO-313 for the treatment of tinnitus.
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Affiliation(s)
| | | | | | | | | | - David M. Baguley
- Mental Health and Clinical Neurosciences, School of Medicine
- National Institute for Health Research Biomedical Research Centre, University of Nottingham
- Nottingham Audiology Services, Nottingham University Hospitals, Nottingham, UK
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Han M, Yang X, Lv J. Efficacy of tinnitus retraining therapy in the treatment of tinnitus: A meta-analysis and systematic review. Am J Otolaryngol 2021; 42:103151. [PMID: 34303210 DOI: 10.1016/j.amjoto.2021.103151] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 06/16/2021] [Accepted: 06/19/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE To evaluate the efficacy of Tinnitus Retraining Therapy (TRT) in the treatment of tinnitus. MATERIALS AND METHOD Computer retrieval of PubMed, Embase, The Cochrane Library, Web of Science, China National Knowledge Internet (CNKI), Wanfang data, etc., were conducted. According to the inclusion and exclusion criteria, the literature's quality was evaluated, and useful data was extracted. All statistical analyses were performed by RevMan5.3 software. RESULTS 13 eligible RCTs with a total of 1345 patients were included in this meta-analysis. The meta-analysis results showed that the 1-month response rate, 3-month response rate, 6-month response rate, and overall response rate of TRT with drugs for tinnitus were higher than that of drugs only (P < 0.05). The results demonstrated that the THI scale after the treatment period of TRT with medications for tinnitus was lower than that of drugs only (P < 0.05). CONCLUSIONS Analysis of limited studies low-quality evidence with a high risk of bias showed that the TRT was an effective treatment for tinnitus, which could improve the response rate of tinnitus and reduce the THI scale. However, more multicenter RCTs with a large sample number and high quality should verify the conclusion mentioned above.
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Tailor BV, Thompson RE, Nunney I, Agius M, Phillips JS. Suicidal ideation in people with tinnitus: a systematic review and meta-analysis. J Laryngol Otol 2021; 135:1-9. [PMID: 34689843 DOI: 10.1017/s0022215121003066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Tinnitus is associated with a variety of cognitive, psychosocial and psychiatric disorders, and may contribute to suicidality. However, the prevalence of suicidal ideation (SI) in tinnitus populations has not previously been systematically reviewed. METHOD Medline, Embase and PsychInfo were searched in August 2020 to identify studies that assessed suicidal ideation in people aged 16 years and above with subjective tinnitus. RESULTS Six cross-sectional studies were included, representing 7192 tinnitus sufferers across 4 countries. The pooled prevalence of suicidal ideation in tinnitus populations was 20.6 per cent (95 per cent confidence interval, 10.8-30.3 per cent; I2 = 88 per cent). Two studies included a control population, in which the prevalence of suicidal ideation was significantly lower. The quality of included studies was variable. CONCLUSION It is not possible to arrive at any reasonable conclusion given the lack of quality studies, meaning the pooled prevalence should be interpreted very cautiously. Suicidal ideation may be more prevalent in tinnitus populations. Further large-scale epidemiological research investigating this relationship is needed, which may help psychiatric risk stratification.
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Affiliation(s)
- B V Tailor
- Department of Otolaryngology, Norfolk and Norwich University Hospital National Health Service Foundation Trust, Norwich
| | - R E Thompson
- School of Clinical Medicine, University of Cambridge
| | - I Nunney
- Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia
| | - M Agius
- Center for Mental Health Research in Association with the University of Cambridge, Cambridge, UK
| | - J S Phillips
- Department of Otolaryngology, Norfolk and Norwich University Hospital National Health Service Foundation Trust, Norwich
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Schubert NMA, Rosmalen JGM, van Dijk P, Pyott SJ. A retrospective cross-sectional study on tinnitus prevalence and disease associations in the Dutch population-based cohort Lifelines. Hear Res 2021; 411:108355. [PMID: 34607212 DOI: 10.1016/j.heares.2021.108355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 09/14/2021] [Accepted: 09/20/2021] [Indexed: 10/20/2022]
Abstract
Tinnitus is a highly prevalent disorder with heterogenous presentation and limited treatment options. Better understanding of its prevalence and disease and lifestyle risk factor associations in the general population is necessary to identify the underlying mechanisms. To this end, we quantified the prevalence of tinnitus and identified disease and lifestyle risk factors associated with tinnitus within a general population cohort. For this study, we used the Lifelines population-based cohort study to perform a retrospective cross-sectional study. Lifelines is a large, multi-generational, prospective cohort study that includes over 167,000 participants (or 10% of the population) from the northern Netherlands. For this study, conducted between 2018 and 2021, data from the Lifelines population-based cohort study was used to perform a cross-sectional study. Adult participants (age ≥ 18 years) with data on tinnitus perception (collected once between 2011 and 2015) were included in this study. An elastic-net regression analysis was performed with tinnitus as the dependent variable and parameters of diseases and lifestyle risk factors (collected once between 2006 and 2014)-including hearing problems, cardiovascular disease, metabolic disorders, psychiatric disorders, thyroid disease, inflammatory disease, and functional somatic syndromes-as the independent variables. Among 124,609 participants, N = 8,011 (6.4%) reported perceiving tinnitus constantly (CT: constant tinnitus) and N = 39,625 (31.8%) reported perceiving tinnitus constantly or occasionally (AT: any tinnitus). Our analysis identified 38 parameters that were associated with AT and 48 parameters that were associated with CT. Our study identified established disease associates with tinnitus, including problems with hearing (OR 8.570 with CT), arrythmia (OR 1.742 with CT), transient ischemic attack (OR 1.284 with AT), diabetes mellitus (OR 1.014 with AT) and psychiatric disorders, including major depressive disorder (OR 1.506 with CT). Factors related to lifestyle associated with tinnitus included waist-hip ratio (OR 1.061 with CT) and smoking (OR 1.028 with AT). Novel disease associates with CT were identified for inflammatory diseases, including rheumatoid arthritis (OR 1.297) and ulcerative colitis (OR 1.588), thyroid disease (as evidenced by the use of thyroid medication) (OR 1.298), and functional somatic syndromes, including chronic fatigue syndrome (OR 1.568). In addition to validating established disease associates in a general population cohort, this study identified novel associations with tinnitus and several disease categories, including functional somatic syndromes, inflammatory diseases, and thyroid disease. Future work will be necessary to identify whether (common) mechanisms underly tinnitus and these associated disorders. Lifelines is an important new resource available for future studies investigating tinnitus in the general population.
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Affiliation(s)
- Nick M A Schubert
- University of Groningen, University Medical Center Groningen, Dept. of Otorhinolaryngology / Head and Neck Surgery, the Netherlands; Graduate School of Medical Sciences Research School of Behavioral and Cognitive Neurosciences, University of Groningen, the Netherlands
| | - Judith G M Rosmalen
- University of Groningen, University Medical Center Groningen, Dept. of Internal Medicine, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Dept. of Psychiatry, Groningen, the Netherlands
| | - Pim van Dijk
- University of Groningen, University Medical Center Groningen, Dept. of Otorhinolaryngology / Head and Neck Surgery, the Netherlands; Graduate School of Medical Sciences Research School of Behavioral and Cognitive Neurosciences, University of Groningen, the Netherlands
| | - Sonja J Pyott
- University of Groningen, University Medical Center Groningen, Dept. of Otorhinolaryngology / Head and Neck Surgery, the Netherlands; Graduate School of Medical Sciences Research School of Behavioral and Cognitive Neurosciences, University of Groningen, the Netherlands.
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Tegg-Quinn S, Eikelboom RH, Brennan-Jones CG, Barabash S, Mulders WHAM, Bennett RJ. Reflections on How Tinnitus Impacts the Lives of Children and Adolescents. Am J Audiol 2021; 30:544-556. [PMID: 34139128 DOI: 10.1044/2021_aja-20-00178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objectives The aim of this study was to generate a conceptual framework describing which aspects of children and adolescents' lives are affected by chronic tinnitus. Design Views and experiences of 32 participants from two participant groups informed this study: (a) a tinnitus group, consisting of adults who had experienced tinnitus during childhood and/or adolescence and primary carers of children/adolescents with tinnitus, and (b) a clinicians' group, consisting of clinicians who provided care for children/adolescents with tinnitus. Participants produced statements describing aspects of children/adolescents' lives that may be affected by chronic tinnitus. Key concepts were identified through the processes of sorting the statements and rating them for degree of associated impact. Result Participants identified 118 unique aspects of the lives of children/adolescents who may be affected by chronic tinnitus. These were clustered into four concepts: (a) emotional well-being, (b) academic performances, (c) social/relationa, and (d) auditory/cognitive processing. At a group level, participants rated the impact of tinnitus as above a slight degree but below a moderate degree of impact. However, individual participant's ratings indicated a range of perceived impact for each statement. Conclusions The experience of chronic tinnitus during childhood and adolescence extends beyond the mere perception of sound. The perception of tinnitus may impact a child's emotional well-being, academic performances, social/relational, and auditory/cognitive processing. The impact of tinnitus in one aspect of a child's life may influence other aspects of their life. While at a group level, participants regarded the impact of tinnitus as "somewhat more than mild" to "less than moderate"; individual participant's ratings indicate that the impact from chronic tinnitus may be highly individual and highlighted the importance of individual assessment and management. Clinically, tinnitus management during childhood and adolescence may be improved if clinicians consider the impact and manifestation of tinnitus within each child's daily life and tailor tinnitus education and management strategies accordingly.
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Affiliation(s)
- Susan Tegg-Quinn
- Ear Science Institute Australia, Subiaco, Western Australia, Australia
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia
- School of Human Sciences, The University of Western Australia, Nedlands, Australia
| | - Robert H. Eikelboom
- Ear Science Institute Australia, Subiaco, Western Australia, Australia
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | - Christopher G. Brennan-Jones
- Ear Health Group, Telethon Kids Institute, The University of Western Australia, Nedlands, Australia
- Division of Paediatrics, School of Medicine, The University of Western Australia, Nedlands, Australia
- Department of Audiology, Perth Children's Hospital, Western Australia, Australia
| | | | | | - Rebecca J. Bennett
- Ear Science Institute Australia, Subiaco, Western Australia, Australia
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia
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Cost Effectiveness of Cognitive Behavioral Therapy for the Treatment of Subjective Tinnitus in Australia. Ear Hear 2021; 43:507-518. [PMID: 34456302 DOI: 10.1097/aud.0000000000001112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to conduct an economic evaluation for the treatment of subjective tinnitus using different modalities of cognitive behavioral therapy (CBT) in Australia. DESIGN A decision tree model was used to conduct a cost-utility analysis for CBT to determine the cost effectiveness for tinnitus treatments, in terms of cost per responder and cost per quality-adjusted life-year (QALY), from a health system perspective using a 2-year time horizon. Meta-analysis was used to differentiate the levels of effectiveness between three delivery methods for CBT: individual face-to-face care (fCBT), group sessions (gCBT), and a supported internet program (iCBT). One-way sensitivity analysis and probabilistic sensitivity analysis (PSA) explored the uncertainty surrounding model inputs and outcomes. Results were presented as incremental cost-effectiveness ratios compared with no treatment, and as net monetary benefit at a $50,000 willingness-to-pay threshold. RESULTS Compared with no treatment, the incremental cost per responder was $700 for gCBT, $871 for iCBT, and $1380 for fCBT. The base case incremental cost-effectiveness ratio was $35,363 per QALY for fCBT, $17,935 per QALY for gCBT, and $22,321 per QALY for iCBT compared with no treatment, although there was substantial uncertainty around the QALY gain for responders. Net monetary benefit was $356 (fCBT), $555 (gCBT), and $487 (iCBT), indicating the treatments were cost effective compared with no treatment. One-way sensitivity analysis revealed the results were most sensitive to the probability of a positive response to treatment and treatment length. The PSA found the probability of being cost effective compared with no treatment for gCBT was 99.8%, iCBT 98.4%, and fCBT 71.5% at a willingness-to-pay of $50,000 per QALY, although QALY gain remained at a fixed value in the PSA. CONCLUSIONS CBT for tinnitus was likely to be cost effective compared with no treatment regardless of treatment modality, assuming they are not mutually exclusive. Of the interventions, gCBT was the lowest cost per responder and lowest cost per QALY. Internet CBT obtained comparable economic outcomes due to similar treatment effectiveness and cost. Group CBT and iCBT warrant greater adoption in clinical practice for the treatment of subjective tinnitus. Further research on preference-based utility measures for varying levels of tinnitus severity and the durability of treatment effect is required to enhance the quality of economic evaluation in this field.
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Fetoni AR, Di Cesare T, Settimi S, Sergi B, Rossi G, Malesci R, Marra C, Paludetti G, De Corso E. The evaluation of global cognitive and emotional status of older patients with chronic tinnitus. Brain Behav 2021; 11:e02074. [PMID: 34288570 PMCID: PMC8413806 DOI: 10.1002/brb3.2074] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/26/2021] [Accepted: 02/05/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Tinnitus is a common symptom largely impactful on quality of life, especially in the elderly. Our aim was to evaluate the efficacy of self-administered screening tests to correlate the severity of subjective perception of tinnitus with emotional disorders and the overall cognitive status. METHODS Patients aged ≥ 55 years with chronic tinnitus were recruited and submitted to a complete audiological evaluation; Tinnitus Handicap inventory (THI); Hospital Anxiety and Depression Scale (HADS-A and HADS-D) and Mini-Mental State Examination (MMSE). Demographic and audiological features of patients with and without cognitive impairment (MMSE score cut-off of 24/30) were analyzed in order to reveal the relationship among tinnitus, emotional disorders, and cognitive dysfunction. RESULTS 102 patients were recruited (mean age: 70.4 ± 9.6). THI score was directly related to HADS-A score (r = .63) HADS-D score (r = .66), whereas there was no relationship between tinnitus severity and MMSE (r = .13). CI and n-CI groups did not differ in the characteristics of tinnitus (p > .05), however, hearing threshold (p = .049) and anxious depressive traits measured with HADS-A (p = .044) and HADS-D (p = .016) were significantly higher in the group with cognitive impairment. Furthermore, age ≥ 75 years (p = .002, OR = 13.8), female sex (p = .032; OR = 6.5), severe hearing loss (p = .036; OR = 2.3), and anxiety (p = .029; OR = 9.2) resulted risk factors for CI. Therefore, in CI group MMSE score was inversely related to age (r = -.84). CONCLUSIONS Cognitive impairment and psychiatric discomfort should be considered in tinnitus patients, related to increasing age, female sex, and severe hearing loss. Thus, self-administered questionnaires can be useful in addressing clinical approach.
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Affiliation(s)
- Anna Rita Fetoni
- Institute of Otolaryngology, Fondazione Policlinico Agostino Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | - Bruno Sergi
- Institute of Otolaryngology, Fondazione Policlinico Agostino Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Rita Malesci
- Audiology and Vestibology Unit, Neuroscience Department, Federico II University Naples, Naples, Italy
| | - Camillo Marra
- Università Cattolica del Sacro Cuore, Rome, Italy.,Memory Clinic, Fondazione Policlinico Agostino Gemelli, IRCCS, Rome, Italy
| | - Gaetano Paludetti
- Institute of Otolaryngology, Fondazione Policlinico Agostino Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eugenio De Corso
- Institute of Otolaryngology, Fondazione Policlinico Agostino Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
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Kok TE, Varley R, Shekhawat GS. Survey of tinnitus patients' acceptance of high-definition transcranial direct current stimulation as a management option. Int J Audiol 2021; 61:507-514. [PMID: 34120554 DOI: 10.1080/14992027.2021.1933622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To investigate acceptance of high-definition transcranial direct current stimulation (HD-tDCS) as a management option for tinnitus. DESIGN Participants completed an online version of the Tinnitus Functional Index (TFI), after which they recorded their satisfaction ratings with different hypothetical intervention outcomes on a 10-point rating scale using Opinio survey software. STUDY SAMPLE Data from 272 tinnitus sufferers from English-speaking regions worldwide were collected, of which the majority had moderate to severe tinnitus as per TFI. RESULTS The survey showed that HD-tDCS was considered an acceptable form of tinnitus management, and that the satisfaction rating depended significantly on a number of factors: (1) the strength of the tinnitus reduction following the intervention (p < 0.001); 2) the duration of the intervention (p < 0.001); and (3) the effects of the intervention on either tinnitus loudness or tinnitus-related distress (p < 0.001). Respondents rated their satisfaction with the intervention 10/10 only if it completely eliminated tinnitus loudness, although reductions of 50-80% were also rated highly acceptable. No association was found between tinnitus severity and acceptability ratings. CONCLUSIONS These findings are important for future HD-tDCS trials for tinnitus, as they demonstrate the need to optimise stimulation protocols to increase effect sizes and decrease time spent on the treatment.
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Affiliation(s)
| | - Rosemary Varley
- Psychology and Language Sciences, University College London, London, UK
| | - Giriraj Singh Shekhawat
- Ear Institute, University College London, London, UK.,College of Nursing & Health Sciences, Flinders University, Adelaide, Australia.,Public Relations Manager, Tinnitus Research Initiative, Germany
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Biswas R, Lugo A, Genitsaridi E, Trpchevska N, Akeroyd MA, Cederroth CR, Liu X, Schlee W, Garavello W, Gallus S, Hall DA. Modifiable lifestyle-related risk factors for tinnitus in the general population: An overview of smoking, alcohol, body mass index and caffeine intake. PROGRESS IN BRAIN RESEARCH 2021; 263:1-24. [PMID: 34243884 DOI: 10.1016/bs.pbr.2021.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Tinnitus is a symptom and not a disease in its own right. A number of medical conditions are known to increase the risk of developing tinnitus. Most known risk factors are otological or neurological, but general health and lifestyle can also precipitate the condition. Understanding these modifiable risk factors can help to identify vulnerable groups and can inform preventive actions to reduce likelihood of developing tinnitus. Smoking, alcohol consumption, body mass index (BMI) and caffeine intake are all lifestyle risk factors hypothesized to be related to tinnitus. Nonetheless, research findings in support of those relationships are somewhat mixed. METHODS A systematic review was conducted to identify all relevant studies on the specific risk factors. Findings were summarized using a narrative synthesis and meta-analysis, where possible. RESULTS Overall 384 studies were included, mostly using cross-sectional designs. Findings indicated significantly increased risk of tinnitus among current (based on 26 studies) and ever smokers (based on 16 studies) and among obese people (based on seven studies), but no effect of alcohol consumption (based on 11 studies). With respect to caffeine intake or coffee drinking, only three studies examined this risk factor and so we were unable to draw conclusions. CONCLUSION Our results contribute to quantifying the relationship between tinnitus and specific lifestyle-related risk factors, and we highlight some of the gaps and inconsistencies across published studies.
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Affiliation(s)
- Roshni Biswas
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom; Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Eleni Genitsaridi
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom; National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Natalia Trpchevska
- Experimental Audiology, Department of Physiology and Pharmacology, Biomedicum, Karolinska Institutet, Stockholm, Sweden
| | - Michael A Akeroyd
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Christopher R Cederroth
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom; National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, United Kingdom; Experimental Audiology, Department of Physiology and Pharmacology, Biomedicum, Karolinska Institutet, Stockholm, Sweden
| | - Xiaoqiu Liu
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Werner Garavello
- Department of Otorhinolaryngology, School of Medicine and Surgery, Università degli Studi di Milano-Bicocca, Monza, Italy
| | - Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
| | - Deborah A Hall
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom; National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, United Kingdom; Nottingham University Hospitals NHS Trust, Queens Medical Centre, Nottingham, United Kingdom; Heriot-Watt University Malaysia, Putrajaya, Wilayah Persekutuan Putrajaya, Malaysia
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Malesci R, Brigato F, Di Cesare T, Del Vecchio V, Laria C, De Corso E, Fetoni AR. Tinnitus and Neuropsychological Dysfunction in the Elderly: A Systematic Review on Possible Links. J Clin Med 2021; 10:1881. [PMID: 33925344 PMCID: PMC8123622 DOI: 10.3390/jcm10091881] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/14/2021] [Accepted: 04/22/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Tinnitus is a common and disabling symptom often associated with hearing loss. While clinical practice frequently shows that a certain degree of psychological discomfort often characterizes tinnitus suffers, it has been recently suggested in adults as a determining factor for cognitive decline affecting attention and memory domains. The aim of our systematic review was to provide evidence for a link between tinnitus, psychological distress, and cognitive dysfunction in older patients and to focus on putative mechanisms of this relationship. METHODS We performed a systematic review, finally including 192 articles that were screened. This resulted in 12 manuscripts of which the full texts were included in a qualitative analysis. RESULTS The association between tinnitus and psychological distress, mainly depression, has been demonstrated in older patients, although only few studies addressed the aged population. Limited studies on cognitive dysfunction in aged patients affected by chronic tinnitus are hardly comparable, as they use different methods to validate cognitive impairment. Actual evidence does not allow us with certainty to establish if tinnitus matters as an independent risk factor for cognitive impairment or evolution to dementia. CONCLUSION Tinnitus, which is usually associated with age-related hearing loss, might negatively affect emotional wellbeing and cognitive capacities in older people, but further studies are required to improve the evidence.
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Affiliation(s)
- Rita Malesci
- Audiology Section, Neuroscience, Reproductive Sciences and Dentistry Department, “Federico II” University, via Pansini 5, 80131 Naples, Italy; (R.M.); (V.D.V.); (C.L.)
| | - Francesca Brigato
- Department of Otolaryngology Head & Neck Surgery, School of Medicine, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy; (F.B.); (T.D.C.); (E.D.C.)
| | - Tiziana Di Cesare
- Department of Otolaryngology Head & Neck Surgery, School of Medicine, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy; (F.B.); (T.D.C.); (E.D.C.)
| | - Valeria Del Vecchio
- Audiology Section, Neuroscience, Reproductive Sciences and Dentistry Department, “Federico II” University, via Pansini 5, 80131 Naples, Italy; (R.M.); (V.D.V.); (C.L.)
| | - Carla Laria
- Audiology Section, Neuroscience, Reproductive Sciences and Dentistry Department, “Federico II” University, via Pansini 5, 80131 Naples, Italy; (R.M.); (V.D.V.); (C.L.)
| | - Eugenio De Corso
- Department of Otolaryngology Head & Neck Surgery, School of Medicine, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy; (F.B.); (T.D.C.); (E.D.C.)
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Anna Rita Fetoni
- Department of Otolaryngology Head & Neck Surgery, School of Medicine, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy; (F.B.); (T.D.C.); (E.D.C.)
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
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Noise Damage Accelerates Auditory Aging and Tinnitus: A Canadian Population-Based Study. Otol Neurotol 2021; 41:1316-1326. [PMID: 32810017 DOI: 10.1097/mao.0000000000002848] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Age-related hearing loss (ARHL) is the third most challenging disability in older adults. Noise is a known modifiable risk factor of ARHL, which can drive adverse health effects. Few large-scale studies, however, have shown how chronic noise exposure (CNE) impacts the progression of ARHL and tinnitus. STUDY DESIGN Retrospective large-scale study. SETTING Audiology clinical practice. PATIENTS In this study, 928 individuals aged 30-100 years without (n=497) or with the experience of CNE (n=431) were compared in their hearing assessments and tinnitus. In order to only investigate the impact of CNE on ARHL and tinnitus, people with other risk factors of hearing loss were excluded from the study. INTERVENTION Diagnostic. MAIN OUTCOME MEASURES Noise damage was associated with a greater ARHL per age decades (pure-tone average(PTA)0.5-4kHz alterations 19.6-70.8 dB vs. 8.0-63.2 dB, ≤0.001), an acceleration of developing a significant ARHL at least by two decades (PTA0.5-4kHz 33.4 dB at 50-59yr vs. 28.2 dB at 30-39yr, ≤0.001), and an increased loss of word recognition scores (total average 84.7% vs. 80.0%, ≤0.001). Significant noise-associated growth in the prevalence of tinnitus also was shown, including more than a triple prevalence for constant tinnitus (28.10% vs. 8.85%, ≤0.001) and near to a double prevalence for intermittent tinnitus (19.10% vs. 11.10%, ≤0.001). Noise also resulted in the elevation of the static compliance of the tympanic membrane throughout age (total average 0.61 vs. 0.85 mmho, ≤0.001). CONCLUSIONS Our findings emphasize the significant contribution of CNE in auditory aging and the precipitation of both ARHL and tinnitus.
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Ausland JHL, Engdahl B, Oftedal B, Steingrímsdóttir ÓA, Nielsen CS, Hopstock LA, Johnsen M, Friborg O, Rosenvinge JH, Eggen AE, Krog NH. Tinnitus and associations with chronic pain: The population-based Tromsø Study (2015-2016). PLoS One 2021; 16:e0247880. [PMID: 33651844 PMCID: PMC7924755 DOI: 10.1371/journal.pone.0247880] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/16/2021] [Indexed: 11/18/2022] Open
Abstract
Tinnitus and pain have many similarities. Both are subjective sensations that may turn chronic, they are often accompanied by hypersensitivity in their respective sensory system, and overlapping brain changes have been observed. Since no population study has examined the empirical association between chronic pain and tinnitus, the present study aimed to explore the relationship in a general adult population. We used data from the seventh survey of the Tromsø Study (2015–2016). Participants (aged ≥40) responded to questions about pain and tinnitus. Using multiple logistic regression, we analysed the adjusted relationship between chronic pain and tinnitus in the full sample (n = 19,039), using several tinnitus definitions ranging from tinnitus >5 minutes within the past 12 months (broadest definition) to at least weekly and highly bothersome tinnitus (strictest definition). We also analysed relationships between number of body regions with pain, pain intensity and bothering, and tinnitus >5 minutes, among participants with chronic pain (n = 11,589). We found an association between chronic pain and tinnitus that was present irrespective of tinnitus definition, but was stronger with more bothersome tinnitus. With chronic pain, the odds of tinnitus >5 minutes was 64% higher, while odds of at least weekly, highly bothersome tinnitus was 144% higher than without chronic pain. Among participants with chronic pain, the number of pain regions was the pain variable most strongly associated with tinnitus >5 minutes (OR = 1.17 (95% CI: 1.14–1.20) for an increase of one region), whereas the other pain variables (intensity and bothering) showed weaker associations. All chronic pain variables had significant interactions with age, with the strongest associations for the youngest individuals (40–54 years). Our findings support the existence of an association between chronic pain and tinnitus and emphasises the importance of examining for comorbid pain in tinnitus patients to provide a more comprehensive treatment of tinnitus.
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Affiliation(s)
- Jannike H-L Ausland
- Department of Environmental Health, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
- * E-mail:
| | - Bo Engdahl
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
| | - Bente Oftedal
- Department of Environmental Health, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
| | - Ólöf A. Steingrímsdóttir
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
| | - Christopher S. Nielsen
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Nydalen, Oslo, Norway
| | - Laila A. Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Magnar Johnsen
- Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Oddgeir Friborg
- Department of Psychology, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Jan H. Rosenvinge
- Department of Psychology, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Anne E. Eggen
- Department of Community Medicine, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Norun H. Krog
- Department of Environmental Health, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
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孙 慧, 冯 国, 高 志. [Clinical application of sound therapy in chronic subjective tinnitus]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2021; 35:282-285. [PMID: 33794620 PMCID: PMC10128241 DOI: 10.13201/j.issn.2096-7993.2021.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Indexed: 06/12/2023]
Abstract
Chronic subjective tinnitus is an auditory phantom phenomenon perceived by patients only, with no external sound source. It's a common disease and it lacks effective treatments. Sound therapy is an optional treatment which proved to reduce the tinnitus loudness and the negative effects on life. After decades of development, a wide variety of acoustic therapies have been produced, but seldom are likely to thoroughly cure tinnitus. In recent years, some new acoustic treatments based on the hypothesis of mechanisms of tinnitus, are expected to alleviate or even eliminate tinnitus.
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Affiliation(s)
- 慧颖 孙
- 中国医学科学院北京协和医学院 北京协和医院耳鼻咽喉头颈外科(北京,100730)
| | - 国栋 冯
- 中国医学科学院北京协和医学院 北京协和医院耳鼻咽喉头颈外科(北京,100730)
| | - 志强 高
- 中国医学科学院北京协和医学院 北京协和医院耳鼻咽喉头颈外科(北京,100730)
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James CJ, Graham PL, Betances Reinoso FA, Breuning SN, Durko M, Huarte Irujo A, Royo López J, Müller L, Perenyi A, Jaramillo Saffon R, Salinas Garcia S, Schüssler M, Schwarz Langer MJ, Skarzynski PH, Mecklenburg DJ. The Listening Network and Cochlear Implant Benefits in Hearing-Impaired Adults. Front Aging Neurosci 2021; 13:589296. [PMID: 33716706 PMCID: PMC7947658 DOI: 10.3389/fnagi.2021.589296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/28/2021] [Indexed: 01/10/2023] Open
Abstract
Older adults with mild or no hearing loss make more errors and expend more effort listening to speech. Cochlear implants (CI) restore hearing to deaf patients but with limited fidelity. We hypothesized that patient-reported hearing and health-related quality of life in CI patients may similarly vary according to age. Speech Spatial Qualities (SSQ) of hearing scale and Health Utilities Index Mark III (HUI) questionnaires were administered to 543 unilaterally implanted adults across Europe, South Africa, and South America. Data were acquired before surgery and at 1, 2, and 3 years post-surgery. Data were analyzed using linear mixed models with visit, age group (18–34, 35–44, 45–54, 55–64, and 65+), and side of implant as main factors and adjusted for other covariates. Tinnitus and dizziness prevalence did not vary with age, but older groups had more preoperative hearing. Preoperatively and postoperatively, SSQ scores were significantly higher (Δ0.75–0.82) for those aged <45 compared with those 55+. However, gains in SSQ scores were equivalent across age groups, although postoperative SSQ scores were higher in right-ear implanted subjects. All age groups benefited equally in terms of HUI gain (0.18), with no decrease in scores with age. Overall, younger adults appeared to cope better with a degraded hearing before and after CI, leading to better subjective hearing performance.
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Affiliation(s)
| | - Petra L Graham
- Department of Mathematics and Statistics, Macquarie University, North Ryde, NSW, Australia
| | | | | | - Marcin Durko
- Department of Otolaryngology, Head and Neck Oncology, Medical University of Lodz, Lodz, Poland
| | - Alicia Huarte Irujo
- Department of Otorhinolaryngology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Juan Royo López
- Servicio de Otorrinolaringología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Lida Müller
- Tygerberg Hospital-Stellenbosch University Cochlear Implant Unit, Tygerberg, South Africa
| | - Adam Perenyi
- Department of Otolaryngology and Head Neck Surgery, Albert Szent Györgyi Medical Center, University of Szeged, Szeged, Hungary
| | | | - Sandra Salinas Garcia
- Servicio de Otorrinolaringología y Patología Cérvico-Facial, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Mark Schüssler
- Deutsches HörZentrum Hannover der HNO-Klinik, Medizische Hochschule Hannover, Hannover, Germany
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Wang S, Chen Z, Dai J, Yu F, Kang H. Evaluation of the therapeutic effect of acoustic therapy combined with acupuncture on idiopathic tinnitus: A randomized controlled trial protocol. Medicine (Baltimore) 2021; 100:e23883. [PMID: 33545954 PMCID: PMC7837873 DOI: 10.1097/md.0000000000023883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 11/24/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND: There is no effective treatment for idiopathic tinnitus. Both acoustic therapy and acupuncture have been used in the treatment of idiopathic tinnitus, but the clinical efficacy is quite different. For there is no clinical study combining the 2, the purpose of this randomized controlled trial is to evaluate the effectiveness and safety of acoustic therapy combined with acupuncture in the treatment of idiopathic tinnitus. METHODS: This is a prospective randomized controlled trial to study the effectiveness and safety of acoustic therapy combined with acupuncture in the treatment of idiopathic tinnitus, and is approved by the clinical research ethics committee of our hospital. The patients are randomly divided into one of 2 treatment options: (A) acoustic therapy combined with acupuncture group and (B) simple acupuncture group. Patients, doctors, nurses, and data collection assistants are blinded to group allocation. Observation indicators include: 1. Tinnitus Disability Scale; 2. Loudness visual analog scale; 3. Adverse reactions. Data is analyzed using the statistical software package SPSS version 25.0 (Chicago, IL). DISCUSSION: This protocol will evaluate the efficacy and safety of acoustic therapy combined with acupuncture in the treatment of idiopathic tinnitus. The results of this experiment will provide clinical evidence for the use of acoustic therapy combined with acupuncture in the treatment of idiopathic tinnitus. TRIAL REGISTRATION: This study protocol is registered in ETHICS AND DISSEMINATION: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/87VFB.
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Wang ML, Song Y, Liu JX, Du YL, Xiong S, Fan X, Wang J, Zhang ZD, Mao LQ, Ma FR. Role of the caudate-putamen nucleus in sensory gating in induced tinnitus in rats. Neural Regen Res 2021; 16:2250-2256. [PMID: 33818509 PMCID: PMC8354105 DOI: 10.4103/1673-5374.310692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Tinnitus can be described as the conscious perception of sound without external stimulation, and it is often accompanied by anxiety, depression, and insomnia. Current clinical treatments for tinnitus are ineffective. Although recent studies have indicated that the caudate-putamen nucleus may be a sensory gating area involved in noise elimination in tinnitus, the underlying mechanisms of this disorder are yet to be determined. To investigate the potential role of the caudate-putamen nucleus in experimentally induced tinnitus, we created a rat model of tinnitus induced by intraperitoneal administration of 350 mg/kg sodium salicylate. Our results revealed that the mean spontaneous firing rate of the caudate-putamen nucleus was increased by sodium salicylate treatment, while dopamine levels were decreased. In addition, electrical stimulation of the caudate-putamen nucleus markedly reduced the spontaneous firing rate of neurons in the primary auditory cortex. These findings suggest that the caudate-putamen nucleus plays a sensory gating role in sodium salicylate-induced tinnitus. This study was approved by the Institutional Animal Care and Use Committee of Peking University Health Science Center (approval No. A2010031) on December 6, 2017.
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Affiliation(s)
- Meng-Lin Wang
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, China
| | - Yu Song
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, China
| | - Jun-Xiu Liu
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, China
| | - Ya-Li Du
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, China
| | - Shan Xiong
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, China
| | - Xin Fan
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, China
| | - Jiang Wang
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, China
| | - Zhi-Di Zhang
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, China
| | - Lan-Qun Mao
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Analytical Chemistry for Living Biosystems, Institute of Chemistry, the Chinese Academy of Sciences, Beijing, China
| | - Fu-Rong Ma
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, China
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Clinical trials in otology: Examining trends and framework for prioritization. J Otol 2020; 16:95-98. [PMID: 33777122 PMCID: PMC7985013 DOI: 10.1016/j.joto.2020.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/25/2020] [Accepted: 11/25/2020] [Indexed: 11/23/2022] Open
Abstract
Objective To characterize otologic clinical trials and examine otologic clinical trial trends from 2008 to 2018 using the clinicaltrials.gov database. Methods Data was collected from clinicaltrials.gov and included all clinical trials that focused on otology from 2008 to 2018. Outcome measures include status of trials, funding sources, details regarding otologic conditions studied, and trends in clinical trials. Results There were 992 otology clinical trials from 2008 to 2018.457 (46.1%) were completed and 94 (9.5%) were discontinued. Industry remained the highest (76.5%) contributor to otology clinical trials. The otologic conditions studied, from most common to least common, include hearing loss (40.6%), vestibulopathy (18.8%), tinnitus (18.8%), and otitis media (15.1%). The number of otology clinical trials increased by an average of 12.0 trials per year from 2008 to 2018 (p < 0.001). The number of otology clinical trials focusing on hearing loss and vestibulopathy significantly increased over the studied period (p < 0.001), while those focusing on tinnitus and otitis media did not (p = 0.09 and p = 0.20, respectively). The majority of clinical trials on each of these four conditions focused on treatment options. Conclusion Our study describes trends in otology clinical trials registered on clinicaltrials.gov from 2008 through 2018. The total number of clinical trials over this time period increased significantly, driven by trials investigating hearing loss and vestibulopathy. Furthermore, most clinical trials were industry-sponsored and focused on treatment modalities. Our study provides an outline of otology clinical trials registered in a US web-based database, which may be of use for the development of future clinical trials.
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Park HM, Jung J, Kim JK, Lee YJ. Tinnitus and Its Association With Mental Health and Health-Related Quality of Life in an Older Population: A Nationwide Cross-Sectional Study. J Appl Gerontol 2020; 41:181-186. [PMID: 33090056 DOI: 10.1177/0733464820966512] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
This study investigated the relationship of tinnitus with mental health and health-related quality of life (QoL) in older people. Data source included 5,129 community-dwelling men and women ≥60 years old from the Korean National Health and Nutrition Examination Survey. Tinnitus was categorized into three groups: normal, tolerable tinnitus, and annoying tinnitus. Mental health and health-related QoL were assessed according to three dimensions (depressive mood, psychological distress, and suicidal ideation) and five domains (impaired mobility, impaired self-care, impaired usual activities, pain/discomfort, and anxiety/depression). The odds ratios (ORs) and 95% confidence intervals (CIs) of mental health and health-related QoL were calculated using multiple logistic regression analyses. Annoying tinnitus was positively and independently associated with deteriorated mental health and health-related QoL, suggesting comprehensive care is needed in older people with annoying tinnitus.
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Affiliation(s)
- Hye-Min Park
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jinsei Jung
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong-Koo Kim
- Yonsei University Wonju College of Medicine, Republic of Korea
| | - Yong-Jae Lee
- Yonsei University College of Medicine, Seoul, Republic of Korea
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Oosterloo BC, Croll PH, de Jong RJB, Ikram MK, Goedegebure A. Prevalence of Tinnitus in an Aging Population and Its Relation to Age and Hearing Loss. Otolaryngol Head Neck Surg 2020; 164:859-868. [PMID: 32988263 PMCID: PMC8027937 DOI: 10.1177/0194599820957296] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objectives Tinnitus is a common hearing-related disorder, which may have a large impact on daily life. With aging populations worldwide, it is important to gain insight in the occurrence of tinnitus at older ages and to understand its relationship with age-related hearing loss. We investigated the prevalence of tinnitus among a general aging population, across age strata and hearing status. Study Design Cross-sectional. Setting The population-based Rotterdam Study. Methods A total of 6098 participants underwent tinnitus assessment, and 4805 had additional hearing assessment. We determined tinnitus prevalence per 5-year age groups. Hearing impairment was defined as ≥25–dB HL worse ear pure tone average (0.5, 1, 2, 4 kHz). We investigated with multivariable logistic regression the association between hearing impairment and tinnitus. Tinnitus handicap was assessed in 663 participants with daily tinnitus via the Tinnitus Handicap Inventory–screening version (THI-s). Results Tinnitus was prevalent in 21.4% (n = 1304). Prevalent tinnitus was evenly distributed over 5-year age groups. Participants with hearing impairment were more likely to have tinnitus (odds ratio, 2.27; 95% CI, 1.92-2.69) as compared with those without hearing impairment. The median THI-s score was 4 (interquartile range, 0-10), indicating a slight handicap, and 14.6% of the participants reported a moderate or severe handicap (THI-s ≥16). Conclusions In a general elderly population, 1 in 5 persons has tinnitus. Of those with tinnitus, for 1 per 10 persons, the presence of tinnitus interfered with daily life. Participants with hearing impairment were twice as likely to have tinnitus. Despite the age-dependent occurrence of hearing impairment, no such age dependency was found for tinnitus.
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Affiliation(s)
- Berthe C Oosterloo
- Department of Otorhinolaryngology-Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Pauline H Croll
- Department of Otorhinolaryngology-Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Robert J Baatenburg de Jong
- Department of Otorhinolaryngology-Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology-Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
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Differences in Clinical Characteristics and Brain Activity between Patients with Low- and High-Frequency Tinnitus. Neural Plast 2020; 2020:5285362. [PMID: 32774356 PMCID: PMC7399790 DOI: 10.1155/2020/5285362] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/23/2020] [Indexed: 11/17/2022] Open
Abstract
This study was aimed at delineating and comparing differences in clinical characteristics and brain activity between patients with low- and high-frequency tinnitus (LFT and HFT, respectively) using high-density electroencephalography (EEG). This study enrolled 3217 patients with subjective tinnitus who were divided into LFT (frequency < 4000 Hz) and HFT (≥4000 Hz) groups. Data regarding medical history, Tinnitus Handicap Inventory, tinnitus matching, and hearing threshold were collected from all patients. Twenty tinnitus patients and 20 volunteers were subjected to 256-channel EEG, and neurophysiological differences were evaluated using standardized low-resolution brain electromagnetic tomography (sLORETA) source-localized EEG recordings. Significant differences in sex (p < 0.001), age (p = 0.022), laterality (p < 0.001), intensity (p < 0.001), tinnitus type (p < 0.001), persistent tinnitus (p = 0.04), average threshold (p < 0.001), and hearing loss (p = 0.028) were observed between LFT and HFT groups. The tinnitus pitch only appeared to be correlated with the threshold of the worst hearing loss in the HFT group. Compared with the controls, the LFT group exhibited increased gamma power (p < 0.05), predominantly in the posterior cingulate cortex (PCC, BA31), whereas the HFT group had significantly decreased alpha1 power (p < 0.05) in the angular gyrus (BA39) and auditory association cortex (BA22). Higher gamma linear connectivity between right BA39 and right BA41 was observed in the HFT group relative to controls (t = 3.637, p = 0.027). Significant changes associated with increased gamma in the LFT group and decreased alpha1 in the HFT group indicate that tinnitus pitch is crucial for matching between the tinnitus and control groups. Differences of band frequency energy in brain activity levels may contribute to the clinical characteristics and internal tinnitus “spectrum” differences.
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Lugo A, Edvall NK, Lazar A, Mehraei G, Lopez-Escamez JA, Bulla J, Uhlen I, Canlon B, Gallus S, Cederroth CR. Relationship between headaches and tinnitus in a Swedish study. Sci Rep 2020; 10:8494. [PMID: 32444677 PMCID: PMC7244494 DOI: 10.1038/s41598-020-65395-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/04/2020] [Indexed: 12/17/2022] Open
Abstract
The heterogeneity of tinnitus is likely accounting for the lack of effective treatment approaches. Headaches have been related to tinnitus, yet little is known on how headaches impact tinnitus. We use cross-sectional data from the Swedish Tinnitus Outreach Project to i) evaluate the association between headaches and tinnitus (n = 1,984 cases and 1,661 controls) and ii) investigate the phenotypic characteristics of tinnitus subjects with tinnitus (n = 660) or without (n = 1,879) headaches. In a multivariable logistic regression model, headache was significantly associated with any tinnitus (odds ratio, OR = 2.61) and more so with tinnitus as a big problem (as measured by the tinnitus functional index, TFI ≥ 48; OR = 5.63) or severe tinnitus (using the tinnitus handicap inventory, THI ≥ 58; OR = 4.99). When focusing on subjects with tinnitus, the prevalence of headaches was 26% and reached 40% in subjects with severe tinnitus. A large number of socioeconomic, phenotypic and psychological characteristics differed between headache and non-headache subjects with any tinnitus. With increasing tinnitus severity, fewer differences were found, the major ones being vertigo, neck pain and other pain syndromes, as well as stress and anxiety. Our study suggests that headaches could contribute to tinnitus distress and potentially its severity.
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Affiliation(s)
- Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Niklas K Edvall
- Laboratory of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Andra Lazar
- Hörsel och balansmottagningen, Karolinska Universitetssjukhuset, Stockholm, Sweden
| | | | - Jose-Antonio Lopez-Escamez
- Otology & Neurotology Group, Department of Genomic Medicine, Pfizer - Universidad de Granada - Junta de Andalucía Centro de Genómica e Investigación Oncológica (GENYO), PTS, Avenida de la Ilustración 114, 18016, Granada, Spain
- Department of Otolaryngology, Hospital Universitario Virgen de las Nieves, Instituto de Investigacion Biosanitaria ibs.GRANADA, Granada, Spain
| | - Jan Bulla
- University of Bergen, Bergen, Norway
- University of Regensburg, Regensburg, Germany
| | - Inger Uhlen
- Hörsel och balansmottagningen, Karolinska Universitetssjukhuset, Stockholm, Sweden
| | - Barbara Canlon
- Laboratory of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Christopher R Cederroth
- Laboratory of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, 171 77, Stockholm, Sweden.
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Choi JS, Yu AJ, Voelker CCJ, Doherty JK, Oghalai JS, Fisher LM. Prevalence of Tinnitus and Associated Factors Among Asian Americans: Results From a National Sample. Laryngoscope 2020; 130:E933-E940. [DOI: 10.1002/lary.28535] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 12/18/2019] [Accepted: 01/07/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Janet S. Choi
- Rick and Tina Caruso Department of Otolaryngology–Head and Neck Surgery Keck School of Medicine of the University of Southern California Los Angeles California U.S.A
| | - Alison J. Yu
- Keck School of Medicine of the University of Southern California Los Angeles California U.S.A
| | - Courtney C. J. Voelker
- Rick and Tina Caruso Department of Otolaryngology–Head and Neck Surgery Keck School of Medicine of the University of Southern California Los Angeles California U.S.A
| | - Joni K. Doherty
- Rick and Tina Caruso Department of Otolaryngology–Head and Neck Surgery Keck School of Medicine of the University of Southern California Los Angeles California U.S.A
| | - John S. Oghalai
- Rick and Tina Caruso Department of Otolaryngology–Head and Neck Surgery Keck School of Medicine of the University of Southern California Los Angeles California U.S.A
| | - Laurel M. Fisher
- Rick and Tina Caruso Department of Otolaryngology–Head and Neck Surgery Keck School of Medicine of the University of Southern California Los Angeles California U.S.A
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Abstract
How many people are affected by tinnitus? Is the risk of developing tinnitus on the rise or has it been declining over time? What modifiable lifestyle factors could help to prevent tinnitus? These population-based questions can be addressed through epidemiological research. Epidemiology refers to the underlying and basic science of public health. It describes the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the control of health problems. There are two key concepts in epidemiology: (1) measures of frequency and (2) measures of effect. In this chapter, we introduce the two main measures of frequency, prevalence and incidence. We also introduce the notion of risk factors, critical for understanding measures of effect concerning the risk of developing a health condition. In both sections, we provide illustrative examples from the published literature on tinnitus. We end by offering a critical evaluation of the current status of epidemiological research on tinnitus and point to some promising future directions.
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Internet/smartphone-based applications for the treatment of tinnitus: a systematic review. Eur Arch Otorhinolaryngol 2019; 277:649-657. [PMID: 31807891 DOI: 10.1007/s00405-019-05743-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 11/24/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Most of the individuals suffering from tinnitus report of negative effects on their lives to the extent that clinical intervention is necessary. Although traditional tinnitus management has proven to be effective in treating tinnitus, there are a few drawbacks. The major drawback is the lack of professionals for the treatment of tinnitus, especially in remote areas. Considering the growing usage of the internet as a platform for availing treatment, there is a requirement for the development of applications in the health care sector. Recent search related to tinnitus treatment revealed that more than 200 applications are available online in the most popular platforms like Android and iOS. However, most of the applications for the treatment of tinnitus lack validation, and thus, there is a need for research on this ground. METHOD Five studies evaluating the efficacy of Internet/app delivered tinnitus treatments were identified. The treatment forms included were Tinnitus E-program, Mobile serious game, Tinnitus web-based sound therapy, and Tailor-made notch music therapy delivered through a smart phone. RESULTS Each study used a variety of standardized and validated questionnaires to measure the outcome of the treatment. The outcome measures were diverse, but both Internet/app-based and traditional methods like Tinnitus Retraining Therapy, Cognitive Behavioral Therapy, and Acceptance and Commitment Therapy had similar improvements in terms of tinnitus distress and quality of life. CONCLUSION It can be construed that the development of tinnitus treatment applications and web-based platforms will have a significant impact on the normal life of individuals with tinnitus.
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Jafari Z, Kolb BE, Mohajerani MH. Age-related hearing loss and tinnitus, dementia risk, and auditory amplification outcomes. Ageing Res Rev 2019; 56:100963. [PMID: 31557539 DOI: 10.1016/j.arr.2019.100963] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/20/2019] [Accepted: 09/18/2019] [Indexed: 01/07/2023]
Abstract
Age-related hearing loss (ARHL) or presbycusis, as the third leading cause of chronic disability in older adults, has been shown to be associated with predisposing cognitive impairment and dementia. Tinnitus is also a chronic auditory disorder demonstrating a growth rate with increasing age. Recent evidence stands for the link between bothersome tinnitus and impairments in various aspects of cognitive function. Both ARHL and age-related tinnitus affect mental health and contribute to developing anxiety, stress, and depression. The present review is a comprehensive multidisciplinary study on diverse interactions among ARHL, tinnitus, and cognitive decline in older adults. This review incorporates the latest evidence in prevalence and risk factors of ARHL and tinnitus, the neural substrates of tinnitus-related cognitive impairments, hypothesized mechanisms concerning the association between ARHL and increased risk of dementia, hearing amplification outcomes in cases with ARHL and cognitive decline, and preliminary findings on the link between ARHL and cognitive impairment in animal studies. Given extensive evidence that demonstrates advantages of using auditory amplification in the alleviation of hearing handicap, depression, and tinnitus, and the improvement of cognition, social communication, and quality of life, regular hearing screening programs for identification and management of midlife hearing loss and tinnitus is strongly recommended.
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Bazoni JA, Dias ACM, Meneses-Barriviera CL, Marchiori LLDM, Teixeira DDC. Possible Association between the Lack of Regular Physical Activity with Tinnitus and Headache: Cross-sectional Study. Int Arch Otorhinolaryngol 2019; 23:e375-e379. [PMID: 31649754 PMCID: PMC6805190 DOI: 10.1055/s-0039-1688469] [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: 03/28/2017] [Accepted: 03/18/2019] [Indexed: 11/24/2022] Open
Abstract
Introduction
Physical inactivity is an important risk factor for many aging-related symptoms. Studies suggest that physical activity may help to relieve tinnitus and headache.
Objective
To investigate the presence of tinnitus and headache in elderly individuals by associating it with the lack of regular physical activity.
Methods
A cross-sectional study including elderly individuals who live independently. The practice of physical activity and the complaints of headache and of tinnitus were checked by means of a questionnaire with objective questions. The statistical analysis was performed using the chi-squared test and relative risk, and a multiple logistic regression model was used to determine how well each factor predicted headache while controlling for each of the other factors.
Results
Based on a sample of 494 subjects, it was found that 213 (43.11%) complained of tinnitus. Among the complainants, 97 (45.53%) practiced physical activity regularly. We have confirmed associations between headache with lack of physical activity among elderly individuals with tinnitus (
p
= 0.0440). It was also observed that certain factors, such as male gender and tinnitus, are independent factors for the complaint of headache.
Conclusion
We have found that headache could be a symptom related to the lack of regular physical activity among elderly individuals with tinnitus.
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Affiliation(s)
- Jéssica Aparecida Bazoni
- Doctoral and Masters Programs in Rehabilitation Sciences, Universidade Estadual de Londrina, Unopar, Londrina, PA, Brazil
| | - Ana Carolina Marcotti Dias
- Doctoral and Masters Programs in Rehabilitation Sciences, Universidade Estadual de Londrina, Unopar, Londrina, PA, Brazil
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Stohler NA, Reinau D, Jick SS, Bodmer D, Meier CR. A study on the epidemiology of tinnitus in the United Kingdom. Clin Epidemiol 2019; 11:855-871. [PMID: 31572016 PMCID: PMC6750864 DOI: 10.2147/clep.s213136] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 07/10/2019] [Indexed: 01/10/2023] Open
Abstract
PURPOSE Subjective tinnitus is a common symptom with potentially negative impact on quality of life. More research is required to gain a deeper understanding of the disease and its clinical presentation. To estimate the incidence of tinnitus and to describe patient-related characteristics such as lifestyle factors and comorbidities. PATIENTS AND METHODS Using the Clinical Practice Research Datalink, we calculated incidence rates of first-time diagnosed tinnitus in an adult population between 2000 and 2016. We stratified incidence rates by sex, age, and year of diagnosis. Additionally, we performed a 1:1 matched case-control study comparing body mass index, lifestyle factors and selected comorbidities between patients with incident tinnitus and tinnitus-free controls. RESULTS We identified 109 783 adults with a first-time diagnosis of tinnitus between 2000 and 2016, yielding an overall age-standardized incidence rate of 25.0 new tinnitus cases per 10,000 person-years (95% CI: 24.6-25.5). There was a steady increase in tinnitus incidence throughout the study period. Approximately 80% of tinnitus cases were diagnosed at age 40 years or older. We observed the highest incidence rate in individuals aged 60-69 years (41.2 per 10,000 person-years, 95% CI: 40.7-41.7). Smokers and alcohol drinkers were at lower risk of being diagnosed with tinnitus compared with non-smokers and non-drinkers, respectively. The occurrence of tinnitus was strongly associated with a recent diagnosis of several otological and vestibular disorders as well as head and neck disorders. CONCLUSION The present observational study found an increasing incidence of tinnitus over time, emphasizing the continuously growing health burden. The findings on patient characteristics, lifestyle factors, and selected comorbidities contribute to a better understanding of risk factors for tinnitus.
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Affiliation(s)
- Nadja A Stohler
- Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
- Hospital Pharmacy, University Hospital Basel, Basel, Switzerland
| | - Daphne Reinau
- Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
- Hospital Pharmacy, University Hospital Basel, Basel, Switzerland
| | - Susan S Jick
- Boston Collaborative Drug Surveillance Program, Lexington, MA, USA
- Boston University School of Public Health, Boston, MA, USA
| | - Daniel Bodmer
- Department of Biomedicine and Clinic for Otorhinolaryngology, University Hospital Basel, Basel, Switzerland
| | - Christoph R Meier
- Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
- Hospital Pharmacy, University Hospital Basel, Basel, Switzerland
- Boston Collaborative Drug Surveillance Program, Lexington, MA, USA
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Salazar JW, Meisel K, Smith ER, Quiggle A, McCoy DB, Amans MR. Depression in Patients with Tinnitus: A Systematic Review. Otolaryngol Head Neck Surg 2019; 161:28-35. [PMID: 30909841 DOI: 10.1177/0194599819835178] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Tinnitus is a condition that causes distress and impairment across cognitive, functional, and psychiatric spectra. In the psychiatric realm, tinnitus has long been associated with depression. To better characterize the co-occurrence of depression and tinnitus, we performed a systematic review of the prevalence of depression among patients with tinnitus. DATA SOURCES We comprehensively examined original studies reporting the prevalence of depression in adult populations with tinnitus, as indexed in the PubMed and Web of Science databases and published from January 2006 to August 2016. REVIEW METHODS All identified articles were reviewed independently by 2 researchers, with a third reviewer for adjudication. Included studies were evaluated for threats to validity across 3 domains-representativeness, response rate, and ascertainment of outcome-on a 4-point modified Newcastle-Ottawa Quality Assessment Scale. RESULTS Twenty-eight studies were included, representing 15 countries and 9979 patients with tinnitus. Among the included studies, the median prevalence of depression was 33%, with an interquartile range of 19% to 49% and an overall range of 6% to 84%. Studies were high quality overall, with a mean score of 3.3 (SD = 0.76), and 89% utilized a validated tool to ascertain depression. CONCLUSIONS We conducted one of the largest contemporary comprehensive reviews, which suggests a 33% prevalence of depression among patients with tinnitus. Our review reaffirms that a substantial proportion of patients with tinnitus have depression, and we recommend that all who treat tinnitus should screen and treat their patients for depression, if present.
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Affiliation(s)
- James W Salazar
- 1 Department of Medicine, University of California, San Francisco, California, USA
| | - Karl Meisel
- 2 Department of Neurology, University of California, San Francisco, California, USA
| | - Eric R Smith
- 3 Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Aaron Quiggle
- 4 Department of Psychiatry, University of California, San Francisco, California, USA
| | - David B McCoy
- 5 Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Matthew R Amans
- 5 Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
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