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Kam ACS. Efficacy of Amplification for Tinnitus Relief in People With Mild Hearing Loss. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:606-617. [PMID: 38271299 DOI: 10.1044/2023_jslhr-23-00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
PURPOSE The study aimed to evaluate the efficacy of amplification with hearing aids for people with chronic subjective tinnitus and mild hearing loss. METHOD In this randomized, controlled, three-arm trial, 38 subjects with a primary complaint of tinnitus were randomly assigned to one of the three treatment groups. Twelve subjects received informational counselling (IC) only, 13 received IC with hearing aid fitting, and 13 subjects received IC with individualized music stimulation for 12 months. The primary efficacy analysis in tinnitus severity was based on the change from baseline to 12 months after the 1st day of the intervention. Secondary outcome measures included tinnitus impact, psychological and mental health effects, subjective ratings, and psychoacoustically measured tinnitus loudness. RESULTS A statistically significant treatment difference among the three groups in the Chinese Tinnitus Functional Index (TFI-CH) total score at the predefined end point in Month 12 was observed (F = 3.34, p = .04, partial η2 = .16). Reductions in the TFI-CH scores in both the hearing aid and the customized music group were more prominent than in the IC-only group. Only the hearing aid group showed a significantly greater treatment effect than the IC-only group. CONCLUSION Results from this study support that a combination of hearing aid use and IC can help improve tinnitus in people with mild hearing loss. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25015979.
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Affiliation(s)
- Anna Chi Shan Kam
- Department of Special Education and Counselling, The Education University of Hong Kong
- Integrated Centre for Wellbeing, The Education University of Hong Kong
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Boecking B, Brueggemann P, Rose M, Mazurek B. [Chronic tinnitus: An interplay between somatic and psychological factors]. HNO 2023; 71:719-730. [PMID: 37702794 DOI: 10.1007/s00106-023-01370-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2023] [Indexed: 09/14/2023]
Abstract
Chronic tinnitus is a common, sometimes highly distressing phenomenon that can be triggered and maintained by an interplay of physical and psychological factors. Partnering with clinical psychology and psychosomatic medicine, modern otolaryngology integrates both medical (e.g., hearing loss) and psychological influences (e.g., interactions between biographical experiences, personality traits, subjective evaluation of intrapsychic and interpersonal stimuli, emotional states, and intrapsychic or interpersonal emotion regulation strategies). Both groups of variables can influence the intensity and course of chronic tinnitus symptomatology both directly and indirectly, whereby the quality and relative degrees of psychological and physical components in a person's self-experience can fluctuate. With this in mind, the present article distinguishes between chronic tinnitus symptomatology with or without hearing loss-and strongly advocates for an integrated understanding of the symptomatology within a holistic psychological frame of reference. After a brief introduction to the principles of psychosomatic medicine and psychotherapy, the article discusses psychological case conceptualization using a vulnerability-stress-coping (VSC) model as an example, outlines clinical aspects and diagnostics of chronic tinnitus symptomatology, and concludes with a conceptualization of chronic tinnitus-related distress as a function of person-centered VSC interactions.
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Affiliation(s)
- Benjamin Boecking
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Luisenstraße 13, 10117, Berlin, Deutschland
| | - Petra Brueggemann
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Luisenstraße 13, 10117, Berlin, Deutschland
| | - Matthias Rose
- Medizinische Klinik mit Schwerpunkt für Psychosomatik und Psychotherapie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Birgit Mazurek
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Luisenstraße 13, 10117, Berlin, Deutschland.
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Sacchetto L, Monzani D, Apa E, Lovato A, Caragli V, Gherpelli C, Palma S, Genovese E, Nocini R. The Effect of Alpha-Lipoic Acid in the Treatment of Chronic Subjective Tinnitus through the Tinnitus Handicap Inventory Scores. Audiol Res 2023; 13:484-494. [PMID: 37489379 PMCID: PMC10366923 DOI: 10.3390/audiolres13040043] [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: 02/17/2023] [Revised: 06/26/2023] [Accepted: 07/03/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Tinnitus affects millions of adults. Many therapies, including complementary and alternative medicine and tinnitus retraining therapies, have been trialed, but an effective option, particularly for chronic subjective tinnitus (CTS), is still lacking. MATERIALS AND METHODS This study investigated the effects of alpha-lipoic acid (600 mg. per day for two months) on two groups of patients using a questionnaire. One group (A) was affected by tinnitus associated with likely cochlear dysfunction and metabolic syndrome, and the other (B) was composed of subjects with acoustic nerve lesions. All the patients were asked to complete the Italian version of the tinnitus handicap inventory (THI) to determine the overall degree of perceived annoyance at the beginning and end of therapy. Pure tone averages for speech frequencies and for high frequencies were computed, and psychoacoustic pitch and loudness matches were determined for each subject before and after treatment. RESULTS The pure tone audiometry, pitch, loudness, and THI scores of both groups were reported. In group A, statistically significant differences were observed for the "functional" and "emotional" subscales. The total score of THI and the loudness of tinnitus were also significantly reduced. No statistically significant differences were observed in group B. CONCLUSIONS These findings suggest a possible contribution of the antioxidant effect to the organ of Corti in subjects with metabolic syndrome and CST.
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Affiliation(s)
- Luca Sacchetto
- Otolaryngology-Head and Neck Surgery Department, University Hospital of Verona, 37126 Verona, Italy
| | - Daniele Monzani
- Otolaryngology-Head and Neck Surgery Department, University Hospital of Verona, 37126 Verona, Italy
| | - Enrico Apa
- Otolaryngology and Audiology Unit, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Andrea Lovato
- Otolaryngology Unit, Vicenza Hospital, 36100 Vicenza, Italy
| | - Valeria Caragli
- Otolaryngology and Audiology Unit, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Chiara Gherpelli
- Otolaryngology and Audiology Unit, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Silvia Palma
- Audiology, Primary Care Department, AUSL Modena, 41121 Modena, Italy
| | - Elisabetta Genovese
- Otolaryngology and Audiology Unit, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Riccardo Nocini
- Otolaryngology-Head and Neck Surgery Department, University Hospital of Verona, 37126 Verona, Italy
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Bulla J, Brueggemann P, Wrzosek M, Klasing S, Boecking B, Basso L, Nyamaa A, Psatha S, Rose M, Mazurek B. Limited Link of Common Blood Parameters with Tinnitus. J Clin Med 2023; 12:jcm12113814. [PMID: 37298009 DOI: 10.3390/jcm12113814] [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: 04/17/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Background: Tinnitus severity is generally assessed by psychometric and audiological instruments. However, no objective measure exists to evaluate the subjective discomfort and suffering caused by this hearing phenomenon. The objective of this work was to determine the possible blood parameters for diagnostics and therapy. Methods: We measured tinnitus distress by using the Tinnitus Questionnaire (TQ) and collected tinnitus-related audiological measures, namely the hearing threshold (HT), tinnitus loudness (TL), and sensation level (SL, i.e., the tinnitus loudness/hearing threshold at a tinnitus frequency). Blood samples were taken from 200 outpatients of the Tinnitus Centre of the Charité, and 46 routine blood count parameters were examined. The possible interactions were determined by (robust) linear models. Results: Tinnitus distress and audiological measurements were largely uncorrelated but could partly be predicted by selected blood parameters. First, the erythrocyte counts predicted tinnitus distress to a small extent. Second, the levels of vitamin D3 explained about 6% of tinnitus loudness and, age-dependently, the hearing threshold variability. Last, the levels of uric acid explained about 5% of the sensation level variability. Conclusions: Tinnitus is a multidimensional phenomenon. The marginal influences of blood markers suggest the possible roles of inflammation and oxidative stress produced by psychological or somatic burdens. Clinically, a vitamin D substitution (in older patients) might have a hearing-protective effect.
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Affiliation(s)
- Jan Bulla
- Department of Mathematics, University of Bergen, 5020 Bergen, Norway
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
| | - Petra Brueggemann
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Małgorzata Wrzosek
- Faculty of Psychology and Cognitive Science, Adam Mickiewicz University in Poznan, 60-568 Poznań, Poland
| | - Sven Klasing
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Benjamin Boecking
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Laura Basso
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Amarjargal Nyamaa
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Stamatina Psatha
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Matthias Rose
- Medical Department, Clinic of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Birgit Mazurek
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
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Hearing Aid Use Time Is Causally Influenced by Psychological Parameters in Mildly Distressed Patients with Chronic Tinnitus and Mild-to-Moderate Hearing Loss. J Clin Med 2022; 11:jcm11195869. [PMID: 36233736 PMCID: PMC9573609 DOI: 10.3390/jcm11195869] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Hearing aids (HAs) can improve tinnitus-related distress (TRD) and speech-comprehension (SC) in silence or at 55 dB level of noise-interference (SC_55 dB) in patients with chronic tinnitus and mild-to-moderate hearing loss. However, the role of HA use time in relation to psychological, audiological, or self-reported tinnitus characteristics is an under-investigated area. Methods: We examine 177 gender-stratified patients before (t1) and after an intervention comprising binaural DSLchild algorithm-based HA fitting and auditory training (t2) and at a 70-day follow up [t3]. HA use time was retrospectively retrieved (at t2) for the pre-post- and (at t3) post-follow up periods. General linear models investigated HA use time in relation to (1) general audiological, (2) tinnitus-related audiological, (3) tinnitus-related self-report, and (4) distress-related self-report indices before and after treatment, where applicable. Receiver operator characteristic analyses identified optimal HA use time for hereby-mediated treatment changes. Results: At t1 and t2, psychological, but not audiological indices causally influenced prospective HA use time—except for SC_55 dB at t1, which, however, correlated with patients’ anxiety, depressivity, and psychological distress levels. Correlations did not differ between patient subgroups defined by categorical tinnitus-related audiological or self-report indices. HA use time partly mediated treatment-related improvement in TRD, but not SC. Optimal use amounted to 9.5–10.5 h/day. Conclusions: An awareness of psychological influences may help clinicians facilitate HA use and, thereby, TRD improvement with hearing amplification.
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