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Mi T, Qinxiu Z, Jie W. Music therapy for tinnitus: A systematic review and meta-analysis. Am J Otolaryngol 2024; 45:104362. [PMID: 38759414 DOI: 10.1016/j.amjoto.2024.104362] [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: 03/14/2024] [Accepted: 04/27/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVE To evaluate the clinical efficacy of music therapy in the treatment of tinnitus. METHODS Three English databases (PUBMED, Embase, Web of Science) and three Chinese databases (CNKI, VIP, and Wanfang) were searched, and eligible articles were selected according to the set inclusion criteria. Clinical efficacy was used as the primary outcome, and each score was used as the secondary outcome. Using RevMan5.3 software for statistical analysis. RESULTS A total of 14 studies involving 1239 tinnitus patients were included. The results of the meta-analysis showed that music therapy had a certain clinical efficacy in the treatment of tinnitus, but there was no significant difference compared with the control group (OR = 1.00, 95%CI =0.83-1.22; P = 1.00). However, music therapy significantly improved THI score (MD = -6.77, 95 % CI = -9.62 to -3.92; P < 0.00001), TSQ (MD = -2.80, 95 % CI = -3.23 to -2.36; P < 0.00001), tinnitus loudness (MD = -3.90, 95 % CI = -6.58 to -1.23; P = 0.004), VAS score (MD = -1.11, 95 % CI = -2.11 to -0.11; P = 0.03) and TQ score (MD = -8.36, 95 % CI = -11.10 to -5.62; P < 0.001). CONCLUSION Music therapy is an effective method for the treatment of tinnitus, which can improve the THI score, tinnitus severity, VAS score, and TQ score and reduce the loudness of tinnitus. Due to the low quality of the included literature, the current conclusions need to be further verified by more and higher-quality studies.
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Affiliation(s)
- Tang Mi
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China.
| | - Zhang Qinxiu
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China.
| | - Wang Jie
- Dujiangyan Hospital of Traditional Chinese Medicine, Chengdu, Sichuan 611830, China
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Meijers SM, de Ruijter JHJ, Stokroos RJ, Smit AL, Stegeman I. The Lifelines Cohort Study: Prevalence of Tinnitus Associated Suffering and Behavioral Outcomes in Children and Adolescents. Ear Hear 2024:00003446-990000000-00307. [PMID: 38982557 DOI: 10.1097/aud.0000000000001538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
OBJECTIVES Tinnitus in children and adolescents is relatively unexplored territory. The available literature is limited and the reported prevalence of tinnitus suffering varies widely due to the absence of a definition for pediatric tinnitus. The impact on daily life seems to be lower than in the adult population. It is unclear if children who suffer from tinnitus, like adults, also experience psychological distress like anxiety or depressive symptoms. A better understanding of tinnitus in children and its impact on daily life could provide more insight into the actual size of the problem and could give direction for future studies to investigate the cause of progression of tinnitus. DESIGN A cross-sectional study was performed using the Dutch Lifelines population-based cohort of people living in the north of the Netherlands. A total of 4964 children (4 to 12 years of age) and 2506 adolescents (13 to 17 years of age) were included. The presence of tinnitus suffering and behavioral outcomes were assessed with a single-item question and the Child Behavioral Checklist or the Youth Self Report questionnaire respectively. The associations of behavioral outcomes and tinnitus suffering were analyzed using univariate binary regressions. RESULTS The prevalence of tinnitus suffering in children was 3.3 and 12.8% in adolescents. Additionally, 0.3% of the children and 1.9% of the adolescents suffered a lot or extremely of their tinnitus. Externalizing and internalizing problems were associated with tinnitus in adolescents. Internalizing problems were associated with tinnitus in children. CONCLUSIONS The prevalence of tinnitus suffering in this sample of the general population is comparable to other population-based studies. A low percentage of children (0.3%) or adolescents (1.9%) suffered a lot or extremely of their tinnitus. Tinnitus suffering is associated with all behavioral outcome subscales in adolescents and with internalizing problems in children, although the effect sizes were very small. Future research should focus on achieving a consensus for the definition of pediatric tinnitus and on the development of a validated outcome measure.
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Affiliation(s)
- Sebastiaan M Meijers
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jessica H J de Ruijter
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Robert J Stokroos
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Adriana L Smit
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
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3
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Hoare DJ, Smith H, Kennedy V, Fackrell K. Tinnitus in Children. J Assoc Res Otolaryngol 2024; 25:239-247. [PMID: 38709437 PMCID: PMC11150219 DOI: 10.1007/s10162-024-00944-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/04/2024] [Indexed: 05/07/2024] Open
Abstract
This perspective reviews the current state of the art and literature on tinnitus in children, prevalence and risk factors, clinical management, and future priorities for healthcare provision and research. Most research in the field to date appears to be prevalence studies, which have reached dramatically different estimates; this reflects the lack of a standard language when asking about the presence of tinnitus, or how bothersome, distressing, or negatively impacting it is for the child. Estimates are also likely affected by a lack of awareness of tinnitus amongst children and parents. Children are less likely to spontaneously report tinnitus than adults, and parents are often unaware their child could even develop tinnitus, considering it a disease of older age for example. It is critical that children are asked and learn about tinnitus. In hearing clinics, clinicians should routinely ask about all children about tinnitus and offer tinnitus care and settings that are child- and family-friendly. As well as asking directly, clinicians should be alert to soft signs of tinnitus such as unexplained listening, speech perception, concentration difficulties, worry or anxiety, or difficulties completing hearing tests or using hearing aids. The recently developed impact of Tinnitus in Children Questionnaire (iTICQ) can then be used to assess problems that are most commonly core to children's experience of tinnitus. Clinical guidelines for tinnitus in children are few but provide recommendations for additional paediatric questionnaires and alternative assessments and for a range of treatment options. Of note, however, is the lack of clinical trials and, therefore, evidence of the effectiveness of any treatment for tinnitus in children. Significant and concerted work is therefore needed to raise awareness of tinnitus in children, understand the scale of clinical need, and standardise and evaluate clinical management options.
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Affiliation(s)
- Derek J Hoare
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.
- School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, T12 EK59, Republic of Ireland.
| | - Harriet Smith
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Psychology, University of Sheffield, Sheffield, UK
| | | | - Kathryn Fackrell
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- National Institute for Health and Care Research (NIHR) Coordinating Centre, School of Healthcare Enterprise and Innovation, University of Southampton, Southampton, UK
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Yu S, Wu J, Sun Y, Lyu J. Advances in acupuncture treatment for tinnitus. Am J Otolaryngol 2024; 45:104215. [PMID: 38218028 DOI: 10.1016/j.amjoto.2024.104215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/01/2024] [Indexed: 01/15/2024]
Abstract
Tinnitus is the abnormal perception of sound in the absence of a corresponding external acoustic stimulus, which seriously affects the patients' quality of life, physical and mental health, and the safety of life. There is almost no effective cure for tinnitus, primarily due to its complicated etiopathogenesis and unclear mechanisms. As a major and ancient physical therapy in Traditional Chinese Medicine, acupuncture has been widely used in tinnitus because of its simple operation, rapid effect, and low cost. This paper reviews the relevant literature on the treatment of different kinds of tinnitus by acupuncture, and summarizes the therapeutic efficacy and mechanism of acupuncture on tinnitus, which is expected to provide new ideas and research directions for the study of tinnitus treatment by acupuncture. Tinnitus is the abnormal perception of sound in the absence of a corresponding external acoustic stimulus, which seriously affects the patients' quality of life, physical and mental health, and the safety of life. There is almost no effective cure for tinnitus, primarily due to its complicated etiopathogenesis and unclear mechanisms. As a major and ancient physical therapy in Traditional Chinese Medicine, acupuncture has been widely used in tinnitus because of its simple operation, rapid effect, and low cost. This paper reviews the relevant literature on the treatment of different kinds of tinnitus by acupuncture, and summarizes the therapeutic efficacy and mechanism of acupuncture on tinnitus, which is expected to provide new ideas and research directions for the study of tinnitus treatment by acupuncture.
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Affiliation(s)
- Shencun Yu
- Department of Traditional Chinese Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, Shandong, 266035, China
| | - Jingfen Wu
- Qingdao Municipal Hospital, No.1 Jiaozhou Road, Qingdao, Shandong, 266011, China
| | - Yize Sun
- Department of Traditional Chinese Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, Shandong, 266035, China
| | - Jian Lyu
- Department of Traditional Chinese Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, Shandong, 266035, China.
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Choo OS, Kim H, Lee SJ, Kim SY, Lee KY, Lee HY, Moon IS, Seo JH, Rah YC, Song JJ, Nam EC, Park SN, Song JJ, Shim HJ. Consensus Statements on the Definition, Classification, and Diagnostic Tests for Tinnitus: A Delphi Study Conducted by the Korean Tinnitus Study Group. J Korean Med Sci 2024; 39:e49. [PMID: 38317449 PMCID: PMC10843967 DOI: 10.3346/jkms.2024.39.e49] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/06/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Tinnitus is a bothersome condition associated with various symptoms. However, the mechanisms of tinnitus are still uncertain, and a standardized assessment of the diagnostic criteria for tinnitus is required. We aimed to reach a consensus on diagnosing tinnitus with professional experts by conducting a Delphi study with systematic review of the literature. METHODS Twenty-six experts in managing tinnitus in Korea were recruited, and a two-round modified Delphi study was performed online. The experts evaluated the level of agreement of potential criteria for tinnitus using a scale of 1-9. After the survey, a consensus meeting was held to establish agreement on the results obtained from the Delphi process. Consensus was defined when over 70% of the participants scored 7-9 (agreement) and fewer than 15% scored 1-3 (disagreement). To analyze the responses of the Delphi survey, the content validity ratio and Kendall's coefficient of concordance were evaluated. RESULTS Consensus was reached for 22 of the 38 statements. For the definition of tinnitus, 10 out of 17 statements reached consensus, with three statements achieving complete agreement including; 1) Tinnitus is a conscious perception of an auditory sensation in the absence of a corresponding external stimulus, 2) Tinnitus can affect one's quality of life, and 3) Tinnitus can be associated with hearing disorders including sensorineural hearing loss, vestibular schwannoma, Meniere's disease, otosclerosis, and others. For the classification of tinnitus, 11 out of 18 statements reached consensus. The participants highly agreed with statements such as; 1) Vascular origin is expected in pulse-synchronous tinnitus, and 2) Tinnitus can be divided into acute or chronic tinnitus. Among three statements on the diagnostic tests for tinnitus only Statement 3, "There are no reliable biomarkers for sensory or emotional factors of tinnitus." reached consensus. All participants agreed to perform pure-tone audiometry and tinnitus questionnaires, including the Tinnitus Handicap Inventory and Tinnitus Questionnaire. CONCLUSION We used a modified Delphi method to establish a consensus-based definition, a classification, and diagnostic tests for tinnitus. The expert panel reached agreement for several statements, with a high level of consensus. This may provide practical information for clinicians in managing tinnitus.
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Affiliation(s)
- Oak-Sung Choo
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hantai Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon, Korea
| | - Seung Jae Lee
- Department of Otorhinolaryngology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Kyu-Yup Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ho Yun Lee
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Ewha Womans University, Seoul, Korea
| | - In Seok Moon
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Hyun Seo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoon Chan Rah
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jae-Jun Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Guro Hospital, Seoul, Korea
| | - Eui-Cheol Nam
- Department of Otorhinolaryngology, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Shi Nae Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Korea.
| | - Hyun Joon Shim
- Department of Otorhinolaryngology-Head and Neck Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
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Perez-Carpena P, Lopez-Escamez JA, Gallego-Martinez Á. A Systematic Review on the Genetic Contribution to Tinnitus. J Assoc Res Otolaryngol 2024; 25:13-33. [PMID: 38334885 PMCID: PMC10907330 DOI: 10.1007/s10162-024-00925-6] [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: 08/13/2023] [Accepted: 12/31/2023] [Indexed: 02/10/2024] Open
Abstract
PURPOSE To assess the available evidence to support a genetic contribution and define the role of common and rare variants in tinnitus. METHODS After a systematic search and quality assessment, 31 records including 383,063 patients were selected (14 epidemiological studies and 17 genetic association studies). General information on the sample size, age, sex, tinnitus prevalence, severe tinnitus distribution, and sensorineural hearing loss was retrieved. Studies that did not include data on hearing assessment were excluded. Relative frequencies were used for qualitative variables to compare different studies and to obtain average values. Genetic variants and genes were listed and clustered according to their potential role in tinnitus development. RESULTS The average prevalence of tinnitus estimated from population-based studies was 26.3% for any tinnitus, and 20% of patients with tinnitus reported it as an annoying symptom. One study has reported population-specific differences in the prevalence of tinnitus, the white ancestry being the population with a higher prevalence. Genome-wide association studies have identified and replicated two common variants in the Chinese population (rs2846071; rs4149577) in the intron of TNFRSF1A, associated with noise-induced tinnitus. Moreover, gene burden analyses in sequencing data from Spanish and Swede patients with severe tinnitus have identified and replicated ANK2, AKAP9, and TSC2 genes. CONCLUSIONS The genetic contribution to tinnitus is starting to be revealed and it shows population-specific effects in European and Asian populations. The common allelic variants associated with tinnitus that showed replication are associated with noise-induced tinnitus. Although severe tinnitus has been associated with rare variants with large effect, their role on hearing or hyperacusis has not been established.
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Affiliation(s)
- Patricia Perez-Carpena
- Otology and Neurotology Group CTS495, Division of Otolaryngology, Department of Surgery, Instituto de Investigación Biosanitaria, Ibs.GRANADA, Universidad de Granada, Granada, Spain.
- Sensorineural Pathology Programme, Centro de Investigación Biomédica en Red en Enfermedades Raras, CIBERER, Madrid, Spain.
- Department of Otolaryngology, Instituto de Investigación Biosanitaria Ibs.GRANADA, Hospital Universitario Virgen de Las Nieves, Granada, Spain.
| | - Jose A Lopez-Escamez
- Otology and Neurotology Group CTS495, Division of Otolaryngology, Department of Surgery, Instituto de Investigación Biosanitaria, Ibs.GRANADA, Universidad de Granada, Granada, Spain.
- Sensorineural Pathology Programme, Centro de Investigación Biomédica en Red en Enfermedades Raras, CIBERER, Madrid, Spain.
- Meniere's Disease Neuroscience Research Program, Faculty of Medicine & Health, School of Medical Sciences, The Kolling Institute, University of Sydney, Sydney, NSW, Australia.
| | - Álvaro Gallego-Martinez
- Otology and Neurotology Group CTS495, Division of Otolaryngology, Department of Surgery, Instituto de Investigación Biosanitaria, Ibs.GRANADA, Universidad de Granada, Granada, Spain
- Sensorineural Pathology Programme, Centro de Investigación Biomédica en Red en Enfermedades Raras, CIBERER, Madrid, Spain
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Sommerhalder N, Neff P, Bureš Z, Profant O, Kleinjung T, Meyer M. Deficient central mechanisms in tinnitus: Exploring the impact on speech comprehension and executive functions. Hear Res 2023; 440:108914. [PMID: 37979435 DOI: 10.1016/j.heares.2023.108914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/18/2023] [Accepted: 11/06/2023] [Indexed: 11/20/2023]
Abstract
Many individuals with chronic subjective tinnitus report significant problems in comprehending speech in adverse listening situations. A large body of studies has provided evidence to support the notion that deficits in speech-in-noise (SIN) are prevalent in the tinnitus population, while some studies have challenged these findings. Elemental auditory perception is usually only minimally or not impaired. In addition, deficits in cognitive functions, particularly executive functions, have also been observed in individuals with tinnitus. Given these previous findings, we theorize that deficient central mechanisms may be responsible for the reported speech comprehension problems in tinnitus. 25 participants suffering from chronic subjective tinnitus and 25 control participants, between 23 and 58 years of age, were examined in a cross-sectional design. The groups were case-matched for age, sex, education, and hearing loss. A large audiometric battery was used ranging from threshold and supra-threshold tasks to spoken sentence level speech tasks. Additionally, four cognitive tests were performed, primarily covering the area of executive functions. Tinnitometry and tinnitus-related questionnaires were applied to complement sample description and allow for secondary analyses. We hypothesized that tinnitus participants score lower in complex speech comprehension tasks and executive function tasks compared to healthy controls, while no group differences in elementary audiometric tasks were expected. As expected, individuals with chronic subjective tinnitus scored lower in the SIN and gated speech task, while there were no differences in the basic speech recognition threshold task and the other elementary auditory perception tasks. The cognitive tests revealed clear deficits in interference control in the Stroop task, but not in the Flanker task, in the tinnitus group. There were no differences in inhibition or working memory tasks. Our results clearly delineate differences between tinnitus individuals and control participants in two tests on speech intelligibility under adverse listening conditions. Further, the poorer performance in a task of interference control in individuals with tinnitus points towards an impaired central executive control in individuals with tinnitus. Taken together, our (partly) exploratory study provides novel evidence to the view that deficient central executive system in individuals with tinnitus probably account for impaired speech comprehension.
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Affiliation(s)
- Nick Sommerhalder
- Evolutionary Neuroscience of Language, Department of Comparative Language Science, University of Zurich, Zurich, Switzerland.
| | - Patrick Neff
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Zurich, University of Zurich, Zurich, Switzerland; Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Zbyněk Bureš
- Department of Cognitive Systems and Neurosciences, Czech Institute of Informatics, Robotics and Cybernetics, Czech Technical University in Prague, Prague, Czech Republic; Department of Otorhinolaryngology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Oliver Profant
- Department of Otorhinolaryngology, Third Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Auditory Neuroscience, Institute of Experimental Medicine, Czech Academy of Sciences, Prague, Czech Republic
| | - Tobias Kleinjung
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Martin Meyer
- Evolutionary Neuroscience of Language, Department of Comparative Language Science, University of Zurich, Zurich, Switzerland; Center for the Interdisciplinary Study of Language Evolution, University of Zurich, Zurich, Switzerland; Cognitive Psychology Unit, Alpen-Adria University of Klagenfurt, Klagenfurt, Austria
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Park KW, Kullar P, Malhotra C, Stankovic KM. Current and Emerging Therapies for Chronic Subjective Tinnitus. J Clin Med 2023; 12:6555. [PMID: 37892692 PMCID: PMC10607630 DOI: 10.3390/jcm12206555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/13/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
IMPORTANCE Chronic subjective tinnitus, the perception of sound without an external source for longer than six months, may be a greatly debilitating condition for some people, and is associated with psychiatric comorbidities and high healthcare costs. Current treatments are not beneficial for all patients and there is a large need for new therapies for tinnitus. OBSERVATIONS Unlike rarer cases of objective tinnitus, chronic subjective tinnitus often has no obvious etiology and a diverse pathophysiology. In the absence of objective testing, diagnosis is heavily based on clinical assessment. Management strategies include hearing aids, sound masking, tinnitus retraining therapy, cognitive behavioral therapy, and emerging therapies including transcranial magnetic stimulation and electrical stimulation. CONCLUSIONS AND RELEVANCE Although current treatments are limited, emerging diagnostics and treatments provide promising avenues for the management of tinnitus symptoms.
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Affiliation(s)
- Ki Wan Park
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd., Palo Alto, CA 94305, USA
| | - Peter Kullar
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd., Palo Alto, CA 94305, USA
| | - Charvi Malhotra
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd., Palo Alto, CA 94305, USA
| | - Konstantina M. Stankovic
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd., Palo Alto, CA 94305, USA
- Department of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd., Palo Alto, CA 94305, USA
- Wu Tsai Neurosciences Institute, Stanford University, 290 Jane Stanford Way, Stanford, CA 94305, USA
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Dullaart MJ, Kip M, Smit AL, Stegeman I. Treatment of Tinnitus in Children-A Systematic Review. Front Neurol 2021; 12:726803. [PMID: 34566871 PMCID: PMC8460757 DOI: 10.3389/fneur.2021.726803] [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: 06/17/2021] [Accepted: 08/09/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives: To systematically review studies on the effect of treatment of subjective tinnitus in children. Data Sources: We searched for studies in MEDLINE and EMBASE databases, after which additional studies were hand searched using Scopus databases. The methods are described in the study protocol, which has been registered in the PROSPERO register. PRISMA guidelines were followed in the reporting of this study. Eligibility Criteria: We considered for inclusion randomized controlled trials (RCTs), observational studies, case reports, and case series, with tinnitus as primary outcome in children (0–18 years old) with acute or chronic subjective tinnitus. We excluded studies in which both children and adults participated but outcomes were not specifically reported for children, as well as animal studies, studies with a non-original study design and studies about children with pulsatile or objective tinnitus. Data Selection: Two reviewers independently assessed studies for eligibility and quality, collected and extracted data. Statistical analyses were performed in case of homogeneous outcomes. Results: The search yielded a total of 4,447 studies. Of these, 147 eligible studies were selected. One case report and five observational studies met the eligibility criteria. Three studies applied counseling and (simplified-)TRT and reported improvement in tinnitus outcome in 68 out of 82 children after 3–6 months of treatment. Two studies used pharmacological treatments and reported improvement in 74 out of 86 patients after 10 days to 3 months of treatment. One study reported the outcome of biofeedback therapy, describing an improvement in tinnitus loudness and annoyance after 2 months of treatment. Conclusion: Due to the high risk of bias of the included studies, we cannot determine the effectiveness of the treatment of subjective tinnitus in children. Also, owing to brief follow-up periods, it is not possible to draw conclusions regarding long-term effects. Randomized controlled trials with longer follow-up periods are necessary to provide substantial evidence of the effects of therapies for children affected by tinnitus. https://www.crd.york.ac.uk/prospero/ Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier [CRD42020178134].
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Affiliation(s)
- Max J Dullaart
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Marijn Kip
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Adriana L Smit
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands.,University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands.,Epidemiology and Data Science, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands.,University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
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A Cross-Sectional Study of the Prevalence and Factors Associated With Tinnitus and/or Hyperacusis in Children. Ear Hear 2021; 41:344-355. [PMID: 31365354 PMCID: PMC7664713 DOI: 10.1097/aud.0000000000000759] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objectives: The aim of this study was to determine the prevalence of tinnitus and/or hyperacusis in Danish children aged 10 to 16 years, and to assess associations between tinnitus or hyperacusis and other relevant factors. Design: A cross-sectional study based on a previously established child cohort. A total of 501 children were enrolled in the project. The study was performed in eight mainstream schools and data were collected during an 8-week period from October 27, 2014 to December 16, 2014. Results: Using broad tinnitus research questions, the prevalence of any tinnitus was 66.9%; of noise-induced tinnitus (NIT) was 35.7%; and of spontaneous tinnitus (ST) was 53.7%. Bothersome tinnitus was reported by 34.6% of the children with any tinnitus, 23.2% of the whole population. Few children were severely bothered (2.4%, 1.6%, respectively). It was significantly more common for children with NIT to report tinnitus episodes lasting for minutes or longer than for children with ST (p = 0.01). Girls were more likely than boys to be bothered by tinnitus [Odds ratio (OR) = 2.96; 95% confidence interval (CI) 1.34 to 6.51; p = 0.01]. 14.6% of the children reported hyperacusis, and 72.6% of those reporting hyperacusis were bothered by it, 10.6% of the whole population. The odds of having hyperacusis were 4.73 (1.57, 14.21) times higher among those with ST compared with those without ST. Furthermore, hyperacusis was associated with sound avoidance behaviors such as experience of sound-induced pain in the ear (OR = 2.95, 95% CI 1.65 to 5.27; p < 0.001), withdrawal from places or activities (OR = 3.33; 95% CI 1.44 to 7.69; p = 0.01), or concerns about sound could damage the hearing (OR = 1.85, 95% CI 1.06 to 3.31; p = 0.03). Conclusions: Tinnitus and hyperacusis are common in children but prevalence is dependent on tinnitus definitions. Only a few children are severely bothered by tinnitus. In the case of hyperacusis, children may exhibit sound avoidance behavior.
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Weilnhammer V, Gerstner D, Huß J, Schreiber F, Alvarez C, Steffens T, Herr C, Heinze S. Exposure to leisure noise and intermittent tinnitus among young adults in Bavaria: longitudinal data from a prospective cohort study. Int J Audiol 2021; 61:89-96. [PMID: 33787447 DOI: 10.1080/14992027.2021.1899312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To investigate the association between total leisure noise exposure and intermittent tinnitus among young adults. DESIGN Data were obtained from the Ohrkan study, an ongoing prospective cohort study conducted in South Germany since 2009. Information about exposure to impulse and leisure noise, tinnitus occurrences, sociodemographic variables, and self-rated hearing ability were analysed at four time points over a period of seven and a half years. STUDY SAMPLE Participants of the Ohrkan cohort study, who provided data about the occurrence of tinnitus for all surveys (n = 1028). RESULTS Intermittent tinnitus was reported in the majority of the sample (60%). The risk for intermittent tinnitus increased with higher sound pressure levels from exposure to leisure noise (full model (Odds Ratio, 95%CI): 80-<85dB(A): 1.41 [1.13-1.78], 85-<90dB(A): 1.73 [1.38-2.16], >90dB(A): 2.04 [1.59-2.61]). Visiting nightclubs was a major contributor to this relationship. Of the considered covariables, self-rated hearing as "poor", and growing up in a single-parent household were significantly associated with intermittent tinnitus. CONCLUSION Intermittent tinnitus is very frequent among young adults and is associated with high levels of leisure noise exposure. To prevent intermittent tinnitus, reduced sound pressure levels and the use of hearing protection are necessary.
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Affiliation(s)
- Veronika Weilnhammer
- Department of Occupational and Environmental Medicine, Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Doris Gerstner
- Department of Occupational and Environmental Medicine, Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Jonas Huß
- Department of Occupational and Environmental Medicine, Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Fabian Schreiber
- Department of Occupational and Environmental Medicine, Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Carmelo Alvarez
- Ear, Nose and Throat Department, University Hospital of Regensburg, Regensburg, Germany
| | - Thomas Steffens
- Ear, Nose and Throat Department, University Hospital of Regensburg, Regensburg, Germany
| | - Caroline Herr
- Department of Occupational and Environmental Medicine, Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany.,Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Centre of the Ludwig Maximilian University, Munich, Germany
| | - Stefanie Heinze
- Department of Occupational and Environmental Medicine, Epidemiology, Bavarian Health and Food Safety Authority, Munich, Germany.,Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Centre of the Ludwig Maximilian University, Munich, Germany
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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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13
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Huang K, Liang S, Chen L, Grellet A. Acupuncture for tinnitus: a systematic review and meta-analysis of randomized controlled trials. Acupunct Med 2020; 39:264-271. [PMID: 32772848 DOI: 10.1177/0964528420938380] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To evaluate the efficacy/effectiveness of acupuncture for the treatment of tinnitus. METHODS Four English and four Chinese databases were searched for randomized controlled trials (RCTs) of acupuncture for tinnitus published before 30 September 2018. RCTs applying acupuncture alone compared with conventional treatments, sham acupuncture, or no treatment, as well as acupuncture plus conventional treatments compared with conventional treatments alone, were included. The primary outcome was the visual analogue scale (VAS). Secondary outcomes included tinnitus handicap inventory (THI) and tinnitus severity index (TSI) scores. Meta-analysis was conducted using RevMan V5.3 software. The protocol was registered in the PROSPERO database (ref. CRD42018108692). RESULTS Eight studies involving 504 participants were included. Meta-analysis showed no significant differences in the VAS score (mean difference (MD) = -1.81, 95% confidence interval (CI) = -3.69 to 0.07; p = 0.06) between the acupuncture and control groups. However, favorable effects of acupuncture on changes in THI score (MD = -10.11, 95% CI = -12.74 to -7.48; p < 0.001) and TSI score (MD = -8.36, 95% CI = -8.87 to -7.86; p < 0.001) were found. CONCLUSION Acupuncture had no significant effect on the primary outcome of VAS score compared with control treatment; however, positive effects on secondary outcomes (THI and TSI score) were observed in acupuncture versus control groups. Due to the low quality and small sample size of the included trials, the level of evidence was insufficient to draw any definitive conclusions. Further rigorous and high-quality studies with larger sample sizes should be conducted to confirm the efficacy/effectiveness of acupuncture for tinnitus.
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Affiliation(s)
- Kaiyu Huang
- Department of Acupuncture, Ningbo Municipal Hospital of TCM, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China
| | - Shuang Liang
- Department of Acupuncture, Ningbo Municipal Hospital of TCM, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China
| | - Lei Chen
- Department of Acupuncture, Ningbo Municipal Hospital of TCM, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China
| | - Antoine Grellet
- The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China
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14
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Beukes EW, Manchaiah V, Allen PM, Andersson G, Baguley DM. Exploring tinnitus heterogeneity. PROGRESS IN BRAIN RESEARCH 2020; 260:79-99. [PMID: 33637233 DOI: 10.1016/bs.pbr.2020.05.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Tinnitus experiences differ widely. A greater understanding of the core processes underlying these variations is needed. Moreover, meaningful definitions for different subgroups are required to better manage this heterogeneous population. The objective of the present research was to contribute toward the understanding of tinnitus heterogeneity by identifying factors that can predict tinnitus severity and to ascertain if distinct subgroups of tinnitus presentation can be identified. METHODS This cross-sectional study consisted of 326 adults subdivided into subgroups of those with mild tinnitus (n=32; 10%), significant tinnitus (n=99; 30%) and severe tinnitus (n=195; 60%) according to their scores from the Tinnitus Functional Index. Multiple regression was used to identify factors associated with tinnitus severity. These factors included personal traits, tinnitus-related traits, treatment modalities and clinical comorbidities. RESULTS Insomnia, hearing distress, and anxiety were the best predictors of tinnitus severity (explaining 53% of the variability). These comorbidities were stronger predictors than any demographical factors (that explained 11% of the variability). Distinct subgroups based on tinnitus severity (mild, significant, and severe) and anxiety levels were evident. Those with severe tinnitus had significantly more severe comorbidities compared with the mild and significant groups. CONCLUSIONS This study highlights that people with tinnitus could initially be grouped according to tinnitus severity to direct further management. Those with higher tinnitus severity should receive more immediate and intensive care. Due to the strong associations between tinnitus severity and tinnitus-related comorbidities (e.g., insomnia, hearing disability, and anxiety), tinnitus assessment and interventions should focus on these comorbidities.
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Affiliation(s)
- Eldré W Beukes
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, United States; Vision and Hearing Sciences Research Centre, School of Psychology and Sports Sciences, Anglia Ruskin University, Cambridge, United Kingdom.
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, United States; Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India
| | - Peter M Allen
- Vision and Hearing Sciences Research Centre, School of Psychology and Sports Sciences, Anglia Ruskin University, Cambridge, United Kingdom; Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, United Kingdom
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institute, Stockholm, Sweden
| | - David M Baguley
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Ropewalk House, Nottingham, United Kingdom; Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom; Nottingham Audiology Services, Nottingham University Hospitals, Nottingham, United Kingdom
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15
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Smith H, Fackrell K, Kennedy V, Barry JG, Broomhead E, Hoare DJ. An evaluation of paediatric tinnitus services in UK National Health Service audiology departments. BMC Health Serv Res 2020; 20:214. [PMID: 32171314 PMCID: PMC7071756 DOI: 10.1186/s12913-020-5040-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 02/26/2020] [Indexed: 01/25/2023] Open
Abstract
Background Whilst evidence indicates many children experience troublesome tinnitus, specialist services for children are far less established than those available for adults. To date, there is limited understanding of how paediatric tinnitus is managed in the UK, and to what extent current practice reflects what is recommended. This service evaluation aimed to 1) profile how tinnitus in children is managed in UK clinical practice, and assess to what extent care provided by services reflects advice included in the British Society of Audiology (BSA) Tinnitus in Children Practice Guidance, 2) collate clinician opinions on how services may be optimised, and 3) identify common problems experienced by children who present with bothersome tinnitus in clinic. Methods As part of a larger survey, eight questions regarding services for paediatric tinnitus were distributed to UK NHS audiology services via email and social media. Representatives from eighty-seven services responded between July and September 2017. Results Fifty-three percent of respondents reported that their department provided a paediatric tinnitus service. Among these services, there was widespread use of most BSA recommended assessments and treatments. Less widely used practices were the assessment of mental health (42%), and the use of psychological treatment approaches; cognitive behavioural therapy (CBT) (28%), mindfulness (28%), and narrative therapy (14%). There was varied use of measurement tools to assess tinnitus in children, and a minority of respondents reported using adult tinnitus questionnaires with children. Frequently reported tinnitus-related problems presented by children were sleep difficulties, concentration difficulties at school, situation-specific concentration difficulties, and emotional distress. Conclusions Approaches used to manage children with troublesome tinnitus in UK NHS services are largely consistent and reflective of the current practice guidance. However, findings from this study indicate specialist staff training, access to child-specific tools, and the treatment and referral of children with tinnitus-related psychological problems represent key areas in need of optimisation.
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Affiliation(s)
- Harriet Smith
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.
| | - Kathryn Fackrell
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre (NETSCC), University of Southampton, Southampton, UK
| | | | - Johanna G Barry
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Derek J Hoare
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
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16
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Raj-Koziak D, Bieńkowska K, Gos E, Włodarczyk E, Skarżyński H, Skarżyński PH. Audiological and psychological profiles of children with tinnitus. HEARING BALANCE AND COMMUNICATION 2019. [DOI: 10.1080/21695717.2019.1692590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Danuta Raj-Koziak
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Katarzyna Bieńkowska
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Elżbieta Gos
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Elżbieta Włodarczyk
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Henryk Skarżyński
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Piotr Henryk Skarżyński
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
- Heart Failure and Cardiac Rehabilitation Department, Medical University of Warsaw, Warsaw, Poland
- Institute of Sensory Organs, Warsaw/Kajetany, Poland
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17
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Smith H, Fackrell K, Kennedy V, Barry J, Partridge L, Hoare DJ. A scoping review to catalogue tinnitus problems in children. Int J Pediatr Otorhinolaryngol 2019; 122:141-151. [PMID: 31029948 DOI: 10.1016/j.ijporl.2019.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 04/09/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND The reported prevalence of tinnitus in children is similar to that in adults. However, unlike adults, there is relatively little understanding of the tinnitus-related problems children experience. Knowledge of the problems experienced by adults has led to the development of numerous clinical questionnaires used by health professionals in assessment and treatment practices; to date no child-specific questionnaire measure of tinnitus has been developed. To support development of a questionnaire measure of tinnitus in children, the aim of this scoping review was to catalogue the peer-reviewed and grey scientific literature according to 1) the methods used to identify problems experienced by children with tinnitus, 2) tinnitus-related problems observed in or reported by children, and 3) research recommendations suggested by investigators with regards to tinnitus in children. METHODS A scoping review was conducted following an established methodological framework. Records were included where a tinnitus-related problem was reported in a child 18 years or younger, and tinnitus was reported as the primary complaint. Tinnitus problems were extracted and categorised into problem themes. RESULTS Thirty-five records met the inclusion criteria for this review. Methods used to identify tinnitus-related problems in children, and the number and range of problems reported, varied across the records. Symptom impact was summarised according to six problem themes; Physical health, Cognitive health, Hearing and listening, Emotional health, Quality of life, and Feeling different/isolated. Identified research recommendations highlighted a demand for more standardised approaches. CONCLUSIONS The findings evidence the detrimental impact tinnitus can have on a child's quality of life and emotional wellbeing. The current British Society of Audiology Tinnitus in Children Practice Guidance recommends management practices to address the most broadly reported problems identified in this review; sleep difficulties, emotional difficulties, and concentration and hearing problems at school. Given the finding of this review, we suggest problems relating to the impact of tinnitus on quality of life and feelings of isolation are also important problem domains to consider when managing a child who has tinnitus. Current variability in the approach to identifying children's tinnitus problems underlines the importance of developing a standardised and dedicated measure of tinnitus in children.
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Affiliation(s)
- Harriet Smith
- NIHR Nottingham Biomedical Research Centre, Ropewalk House, 113 the Ropewalk, Nottingham, NG1 5DU, UK; Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.
| | - Kathryn Fackrell
- NIHR Nottingham Biomedical Research Centre, Ropewalk House, 113 the Ropewalk, Nottingham, NG1 5DU, UK; Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.
| | - Veronica Kennedy
- Bolton NHS Foundation Trust, Halliwell Health and Children's Centre, Bolton, BL1 3SQ, UK.
| | - Johanna Barry
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK; Nottingham University Hospitals NHS Trust, Queens Medical Centre, Derby Road, Nottingham, NG7 2UH, UK.
| | - Lucy Partridge
- Nuffield Hearing and Speech Centre, Royal National Throat Nose and Ear Hospital, 330 Gray's Inn Rd, London, WC1X 8DA, UK.
| | - Derek J Hoare
- NIHR Nottingham Biomedical Research Centre, Ropewalk House, 113 the Ropewalk, Nottingham, NG1 5DU, UK; Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.
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18
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Koops EA, Husain FT, van Dijk P. Profiling intermittent tinnitus: a retrospective review. Int J Audiol 2019; 58:434-440. [DOI: 10.1080/14992027.2019.1600058] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Elouise A Koops
- Department of Otorhinolaryngology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Graduate School of Medical Sciences, Cognitive Neurosciences Center, University of Groningen, Groningen, Netherlands
| | - Fatima T Husain
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA
- Beckman Institute of Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Pim van Dijk
- Department of Otorhinolaryngology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Graduate School of Medical Sciences, Cognitive Neurosciences Center, University of Groningen, Groningen, Netherlands
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19
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Lee DY, Kim YH. Risk factors of pediatric tinnitus: Systematic review and meta‐analysis. Laryngoscope 2017; 128:1462-1468. [DOI: 10.1002/lary.26924] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/21/2017] [Accepted: 08/28/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Doh Young Lee
- Department of Otorhinolaryngology–Head and Neck SurgeryKorea University Anam HospitalSeoul South Korea
| | - Young Ho Kim
- Department of Otorhinolaryngology–Head and Neck SurgerySeoul National University Boramae Medical Center, Seoul National University College of MedicineSeoul South Korea
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20
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Humphriss R, Hall A, Baguley D. Paediatric tinnitus: The unmet clinical need. Int J Audiol 2016; 55:599-600. [DOI: 10.1080/14992027.2016.1190467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rosing SN, Kapandais A, Schmidt JH, Baguley DM. Demographic data, referral patterns and interventions used for children and adolescents with tinnitus and hyperacusis in Denmark. Int J Pediatr Otorhinolaryngol 2016; 89:112-20. [PMID: 27619040 DOI: 10.1016/j.ijporl.2016.07.036] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 07/29/2016] [Accepted: 07/30/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To investigate whether children and adolescents with tinnitus and/or hyperacusis are seen in Ear-Nose-Throat (ENT) clinics and to report the clinical data, treatment and referral patterns of these children. To describe the population of children and adolescents with tinnitus and/or hyperacusis found in Educational- Psychological Advisory services (EPAs) and Centres for special Education for Adults (CEAs) and to identify the referral patterns and interventions used for the children in each of these settings. METHODS A prospective study within 15 ENT clinics was conducted from June 2014 to February 2015. All children with a primary complaint of tinnitus and/or hyperacusis was reported. No changes in daily practice regarding diagnostics, treatment or referral were made. A retrospective case review was undertaken during a five-year period from 01/01/2009 to 31/12/2013 in each Danish municipality and region. RESULTS In the prospective ENT study, 12 children were identified and in the retrospective CEA/EPA study 69 children were identified. The 12 children seen by ENT (8 females and 4 male) had an age range from 5.7 to 14 years. The majority of the 69 children seen by CEA/EPA (n = 50, 72.5%) had been diagnosed with tinnitus as a primary complaint. Hyperacusis was the primary complaint in 9 cases (12.8%), and both tinnitus and hyperacusis were reported in 11 cases (15.7%). The findings of this study indicate that a majority of children with tinnitus and/or hyperacusis are seen in settings designed for adult audiological rehabilitation. Counselling, including explanations and discussion of coping strategies was the most commonly reported intervention. Intervention methods corresponding with guidelines for tinnitus management in adults were used in 11 cases (15.9%). CONCLUSION Overall only a small number of children with tinnitus and/or hyperacusis were identified in this systems, suggesting that either the children are seen at general practitioner level or not being referred at all. It may also be the case that the incidence of troublesome tinnitus in childhood is lower than the epidemiological data proposes. Referral pathways indicate a general uncertainty about which services provide acquire sufficient intervention. This study indicates that clinicians working at tinnitus services for adults (CEAs) collectively have the skills to help older children, and that a service development focus should be on the younger children as this point.
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Affiliation(s)
- Susanne Nemholt Rosing
- Institute of Regional Health Service Research, University of Southern Denmark, Denmark; Kommunikationscentret, The Social Division in the Capital Region of Denmark, Denmark; Department of Audiology, Odense University Hospital, Odense, Denmark.
| | - Anestis Kapandais
- Department of Audiology, Odense University Hospital, Odense, Denmark; Department of Nordic Studies and Linguistics, Copenhagen University, Denmark
| | - Jesper Hvass Schmidt
- Department of Audiology, Odense University Hospital, Odense, Denmark; Department of ENT Head and Neck Surgery, Odense University Hospital, Denmark; Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - David M Baguley
- Audiology Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, UK
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22
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Hall AJ, Humphriss R, Baguley DM, Parker M, Steer CD. Prevalence and risk factors for reduced sound tolerance (hyperacusis) in children. Int J Audiol 2015; 55:135-41. [PMID: 26642866 DOI: 10.3109/14992027.2015.1092055] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To estimate the prevalence of reduced sound tolerance (hyperacusis) in a UK population of 11-year-old children and examine the association of early life and auditory risk factors with report of hyperacusis. DESIGN A prospective UK population-based study. STUDY SAMPLE A total of 7097 eleven-year-old children within the Avon longitudinal study of parents and children (ALSPAC) were asked about sound tolerance; hearing and middle-ear function was measured using audiometry, otoacoustic emissions, and tympanometry. Information on neonatal risk factors and socioeconomic factors were obtained through parental questionnaires. RESULTS 3.7% (95% CI 3.25, 4.14) children reported hyperacusis. Hyperacusis report was less likely in females (adj OR 0.64, 95% CI 0.49, 0.85), and was more likely with higher maternal education level (adj OR 1.72, 95% CI 1.08, 2.72) and with readmission to hospital in first four weeks (adj OR 1.98, 95% CI 1.20, 3.25). Report of hyperacusis was associated with larger amplitude otoacoustic emissions but with no other auditory factors. CONCLUSIONS The prevalence of hyperacusis in the population of 11-year-old UK children is estimated to be 3.7%. It is more common in boys.
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Affiliation(s)
- Amanda J Hall
- a Children's Hearing Centre , University Hospitals Bristol NHS Foundation Trust , Bristol , UK .,b Centre for Child and Adolescent Health , School of Social and Community Medicine, University of Bristol , UK
| | - Rachel Humphriss
- a Children's Hearing Centre , University Hospitals Bristol NHS Foundation Trust , Bristol , UK .,c School of Social and Community Medicine, University of Bristol , UK
| | - David M Baguley
- d Audiology Department , Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK .,e Department of Vision and Hearing Sciences , Anglia Ruskin University , Cambridge , UK , and
| | - Melanie Parker
- f Community Children's Health Partnership, North Bristol NHS Trust , Bristol , UK
| | - Colin D Steer
- b Centre for Child and Adolescent Health , School of Social and Community Medicine, University of Bristol , UK
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