Uncomfortable loudness levels among children and adolescents seeking help for tinnitus and/or hyperacusis

Objective: To assess the prevalence of hyperacusis and severe hyperacusis among children and adolescents seen at an audiology outpatient tinnitus and hyperacusis service.

Design: This was a retrospective study. Hyperacusis was considered as present if the average uncomfortable loudness level (ULL) at 0.25, 0.5, 1, 2, 4 and 8?kHz for the ear with the lower average ULL, which is denoted as ULLmin, was ≤77?dB HL. Severe hyperacusis was considered as present if the ULL was 30?dB HL or less for at least one of the measured frequencies for at least one ear.

Study sample: There were 62 young patients with an average age of 12?years (SD?=?4.1?years, range 4–18?years).

Results: Eighty-five percent of patients had hyperacusis and 17% had severe hyperacusis. On average, ULLs at 8?kHz were 9.3?dB lower than ULLs at 0.25?kHz. For 33% of patients, ULLs were at least 20?dB lower at 8 than at 0.25?kHz.

Conclusions: Among children and adolescents seen at an audiology outpatient clinic for tinnitus and hyperacusis, hyperacusis diagnosed on the basis of ULLs is very prevalent and it is often characterised by lower ULLs at 8 than at 0.25?kHz.     

Tinnitus patients lost to follow-up

Abstract

Tinnitus patients without hearing loss or hyperacusis often start tinnitus retraining therapy but do not return to the tinnitus clinic for follow-up visits. The aim of this study was to evaluate how these ‘missing patients’ feel and whether they still use their sound generators after they discontinue retraining therapy. We interviewed 269 tinnitus patients by phone who never returned to the clinic after receiving initial counseling and a generator for sound enrichment. Twenty-six percent did not have tinnitus anymore, 30.5% still used the sound generator to treat their tinnitus, and 43.5% did not use their sound generator but still suffered from tinnitus. This study suggests that therapists need to contact missing patients periodically to follow their improvement, encourage them, and decide on new therapeutic approaches as necessary.

Sumario

Los pacientes con acúfeno, sin hipoacusia ni hiperacusia, a menudo inician terapia de re-entrenamiento para el acúfeno pero no regresen a la clínica de acúfenos para citas de seguimiento. El objetivo de este estudio fue evaluar cómo se sienten estos “pacientes perdidos” de la consulta y si aún utilizan sus generadores de sonido luego de que suspenden la terapia de re-entrenamiento. Entrevistamos por teléfono a 269 pacientes que nunca retornaron a la clínica, luego de recibir una sesión de orientación inicial y un generador de enriquecimiento sonoro. Veintiséis por ciento no volvieron a tener acúfeno, 30.5% aún usaban el generador de sonido para tratar su acúfeno, y 43.5% no usaron su generador de sonido y aún sufren del acúfeno. Este estudio sugiere que los terapeutas necesitan contactar periódicamente a sus pacientes perdidos de la consulta, para dar seguimiento a su evolución, estimularlos, y para tomar decisiones sobre nuevos enfoques terapéuticos conforme sea necesario.     

Systematic review of evidence on the association between personality and tinnitus

IntroductionThe scientific literature demonstrates that personality traits are associated with the individual's adaptation to chronic diseases, and can be an important factor in the etiology and prognosis of physical illness. Some studies indicate that personality characteristics may influence the perception of tinnitus.ObjectiveTo assess the scientific evidence of the association between tinnitus and personality.MethodsA systematic review of the following databases: PubMed, SciELO, LILACS, and Web of Knowledge. Only studies of patients older than 18 years published in English, Portuguese, or Spanish that established an association between tinnitus and personality were selected.ResultsSeventeen of the 77 articles found were selected: 13 cross-sectional studies, two longitudinal studies, one validation study, and one birth cohort study. The samples ranged from 27 to 970 patients.ConclusionSome personality traits, especially neuroticism, psychasthenia, and schizoid aspects, may be associated with tinnitus perception and with the annoyance due to this symptom.     

42例耳鸣伴听觉过敏患者特征分析

目的 探讨耳鸣伴听觉过敏患者的临床、听力及心理声学特征以及对患者的影响。 方法 对2015年3月至2017年3月在广州医科大学附属第二医院耳鼻咽喉科门诊就诊的42例耳鸣合并听觉过敏患者进行纯音测听、耳鸣心理声学特征、响度不适阈(LDL)检测,并对耳鸣及听觉过敏严重程度进行评估。 结果 42例中,24例以耳鸣为第一主诉(A组),18例以听觉过敏为第一主诉(B组)。耳鸣主调以纯音为主,频率以高频为主,响度多数≤5 dB SL。患者听觉过敏表现为对正常环境声过分关注或刻意回避,伴烦躁、心悸、惊慌、恐惧,戴耳塞、不敢出门。分别检测0.125~8 kHz频率的LDL,两组在同一频率的LDL差异无统计学意义(P>0.05)。 结论 不能以响度不适阈判断听觉过敏的严重程度;临床上耳鸣与听觉过敏常相伴随,要重视其对患者工作、生活、睡眠与情绪的影响,应制定和使用适合中国国情的评估量表。     

110例耳鸣患者的神经内科临床治疗

目的：对该院110例耳鸣患者的神经内科临床治疗进行探究,对其治疗效果和治疗方法进行总结。方法随机选择2012年4月-2013年5月该院110例耳鸣患者作为研究对象,随机将其分成实验组和对照组,实验组50例,对照组60例。对照组患者给予常规的西比灵药物治疗,实验组患者在对照组患者治疗的基础上加用敏使朗药物,之后对两组患者的治疗效果和全血粘度性指标进行比较分析。结果实验组患者的治疗总有效率为94.00%,对照组患者的治疗总有效率是45.00%;实验组患者的血浆黏度、全血黏度低切值分别为(12.29±2.57)、(1.35±0.26);对照组患者的血浆黏度、全血黏度低切值分别为(14.93±3.54)、(1.61±0.45)。实验组患者的治疗总有效率、血浆黏度、全血黏度低切均优于对照组患者,差异有统计学意义(P<0.05)。结论西比灵联合敏使朗治疗耳鸣疾病具有积极的临床应用效果,值得实践和推广。     

Validation of a Korean Version of the Tinnitus Handicap Questionnaire

Objectives

The goal of the present study was to evaluate the reliability and validity of the Korean version of the tinnitus handicap questionnaire (THQ-K).

Methods

A total of 60 patients were included in this study. Patients responded to the THQ-K, the tinnitus handicap inventory (THI), Beck''s depression index (BDI), and the visual analogue scale (VAS) for loudness and pitch, loudness match, and minimum masking level (MML) test were performed.

Results

Internal consistency of the THQ-K was examined using Cronbach coefficient alpha. Cronbach alpha was 0.96. The THQ-K showed a significant correlation with THI, BDI, VAS for distress, and VAS for loudness, but no significant correlation with psychoacoustic measurement of tinnitus, such as loudness match, pitch match, and MML.

Conclusion

The THQ-K is a reliable and valid test for evaluating the degree of handicap due to tinnitus for both research and clinical use.     

“Distressed aging”: the differences in brain activity between early- and late-onset tinnitus

Recent findings regarding different characteristics according to the age of tinnitus onset prompted us to conduct a study on the differences in tinnitus-related neural correlates between late-onset tinnitus (LOT; mean onset age, 60.4 years) and early-onset tinnitus (EOT; mean onset age, 29.7 years) groups. Hence, we collected quantitative electroencephalography findings of 29 participants with LOT and 30 with EOT, and from 59 controls. We then compared the results between the 2 groups and between the tinnitus groups and age- and sex-matched control groups using resting state electroencephalography source-localized activity and connectivity analyses. Compared with the EOT and older control groups, the LOT group demonstrated increased localized activity and functional connectivity in components of previously described tinnitus distress networks, and the default mode and intrinsic alertness networks, such as the prefrontal cortices, dorsal anterior cingulate cortex, and insula. The current findings of intrinsic differences in tinnitus-related neural activity between the LOT and EOT groups might be applicable for planning individualized treatment modalities according to age of onset. Moreover, differences with regard to the age of tinnitus onset might be a milestone for future studies on onset-related differences in other similar pathologies, such as pain or depression.     

Transmastoid Approach for Resurfacing the Superior Semicircular Canal Dehiscence with a Dumpling Structure

Background:

Superior semicircular canal dehiscence (SSCD) is gradually recognized by otologists in recent years. The patients with SSCD have a syndrome comprising a series of vestibular symptoms and hearing function disorders which can be cured by the operation. In this study, we evaluated the characteristics of patients with SSCD and determined the effectiveness of treating this syndrome by resurfacing the canal via the transmastoid approach using a dumpling structure.

Methods:

Patients with SSCD, confirmed by high-resolution computed tomography and hospitalized at Beijing Tongren Hospital between November 2009 and October 2012, were included in the study. All of the patients underwent the unilateral transmastoid approach for resurfacing the canal, and received regular follow-up after surgery. Data from preoperative medical records and postoperative follow-up were comparatively analyzed to evaluate the effect of surgery.

Results:

In total, 10 patients and 13 ears (three left ears, four right ears, three bilateral ears) were evaluated in the study, which included 7 men and 3 women. Different symptoms and distinctive manifestations of vestibular evoked myogenic potential were found in these patients. After surgery, 4 patients had complete resolution, 5 had partial resolution, and 1 patient, with bilateral SSCD, had aggravation. None of the patients suffered from serious complications such as sensorineural hearing loss, facial paralysis, cerebrospinal fluid leakage, or intracranial hypertension.

Conclusions:

In patients with unilateral SSCD, resurfacing the canal via the transmastoid approach using a dumpling structure is an effective and safe technique. However, more consideration is needed for patients with bilateral SSCD.     

基于经筋理论刃针治疗颈源性耳鸣临床疗效的随机对照研究

背景　颈源性耳鸣处于耳鼻喉科和康复科交界区域,临床上易被忽视,或常被误诊为神经性耳鸣。制定行而有效的颈源性耳鸣治疗方法具有重要现实意义。针灸是常用的治疗方法,但临床上关于刃针治疗颈源性耳鸣的研究较少。目的　探讨经筋理论下刃针治疗颈源性耳鸣的临床疗效。方法　选取2017年7月-2018年7月广州中医药大学顺德医院收治的60例颈源性耳鸣患者为研究对象,采用随机数字表法分为对照组与观察组,各30例。对照组予普通针刺治疗,观察组给予刃针治疗,两组均治疗15 d。观察治疗前后两组患者的临床疗效、Northwick Park颈痛量表（NPQ）评分、耳鸣致残量表（THI）评分及耳鸣严重程度评估量表（TSIS）评分。结果　治疗后,对照组痊愈4例、显效7例、有效13例、无效6例,观察组痊愈7例、显效12例、有效9例、无效2例,观察组临床疗效优于对照组,差异有统计学意义（Z=-2.084,P=0.037）。治疗前,两组患者的NPQ评分、THI评分及TSIS评分比较,差异无统计学意义（P>0.05）;治疗后,观察组NPQ评分、THI评分及TSIS评分均低于对照组,差异有统计学意义（P<0.05）。结论　基于经筋理论的刃针疗法能缓解颈源性耳鸣患者的颈痛症状和耳鸣程度,疗效优于普通针刺疗法。