Abstract
Human hearing loss (HL) and comorbidities like tinnitus pose serious problems for people’s daily life, which in most severe cases may lead to social isolation, depression, and suicide. Here, we investigate the relationship between hearing deficits and tinnitus. To this end, we conducted a retrospective study on anonymized pure tone and speech audiometric data from patients of the ENT hospital Erlangen in which we compare audiometric data between patients with and without tinnitus. Overall data from 37,661 patients with sensorineural (SHL) or conductive HL (CHL) with (T, 9.5%) or without (NT, 90.5%) a tinnitus percept in different age groups and with different tinnitus pitches were included in this study. The results of the pure tone audiometry comparisons showed significant differences in T patients compared to NT patients. In young patients, we generally found lower hearing thresholds in T compared to NT patients. In adult patients, differences were more heterogeneous: hearing thresholds in T patients were lower in low frequency ranges, while they were higher at high frequencies. Furthermore, lower thresholds were more often found in CHL patients and could rarely be detected in SHL patients. In speech audiometry, only CHL patients with high-pitched tinnitus showed lower thresholds compared to NT patients’ thresholds. The results of this study may point to a biologically plausible functional benefit on hearing thresholds in HL tinnitus patients. We hypothesize that the physiological mechanism of stochastic resonance counteracts HL by adding neuronal noise to the system. This neuronal noise may induce changes in the auditory pathway and finally—as a side effect of threshold improvement—lead to the development of a tinnitus percept. We propose a general model of changed hearing thresholds in T patients, being either decreased or increased compared to NT patients.
Highlights
Hearing is crucial for audio-verbal communication in humans and by that essential for social interactions
All frequencies except 4 and 6 kHz show significantly positive values indicating lower hearing thresholds in T compared to NT patients
We generally found that T patients’ thresholds in lower frequency ranges were lower compared to NT patients, while in other frequency ranges there was no difference or, especially above 2 kHz, those patients showed higher thresholds compared to NT patients: a detailed analysis revealed that for both groups, SHL (Figure 2A, upper panel) and conductive hearing loss (CHL) (Figure 2C, upper panel), hearing loss (HL) significantly increased from low to high frequencies
Summary
Hearing is crucial for audio-verbal communication in humans and by that essential for social interactions. Hearing impairment pose serious problems for the people’s daily life, which in most severe cases may lead to social isolation, depression, and suicide [1, 2]. The fact that our Audiometric Peculiarities in Tinnitus Patients western societies face increasing noise exposure in daily routine, work, and spare time adds to the problem and results in continuously increasing numbers of people suffering from hearing impairments. Factors leading to this high prevalence of hearing impairments are diverse. Patients can suffer from a combination of conductive and sensorineural hearing loss (HL), either with unilateral or bilateral impairments. The most common cause for sensorineural hearing impairments is noiseinduced HL (NIHL), which can lead to a number of secondary symptoms like tinnitus [for review, see Ref. As Cruickshanks and colleagues [10] demonstrated that the risk of HL is increased by almost 90% every 5 years, the demographic changes in most industrialized western countries will make age-dependent HL even more relevant in the future
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