Abstract
Little is known about the transition from acute tinnitus to chronic tinnitus. By means of this study, we are attempting to close this gap by presenting prospective pilot data of patients with acute tinnitus, followed by tracking their condition's trajectory over a period of 6 months. Forty-nine patients presenting with acute tinnitus (duration < 28 days) were recruited in two clinics. We recorded demographic and clinical tinnitus-related data as well as data on personality, health, treatments, and life-style, during patients' first appearance in the clinic and again three and 6 months thereafter. Standard audiograms were performed at the first and the second visit. Nine (18.4%) patients showed full remission of their tinnitus. These patients differed from patients with a chronic course of tinnitus by shorter tinnitus duration, lower fear-related hyperacusis, higher proportion of female gender, increased ear pressure, and lower levels of alcohol consumption. Among the patients with a chronification of tinnitus, there was no change in tinnitus characteristics. However, their tinnitus distress improved moderately over time. These preliminary data are in line with earlier studies that have shown that only a small proportion of those patients presenting in the clinic with acute tinnitus experience a full remission. The results of this study can be of service in deducing hypotheses for the transition from acute to chronic tinnitus and in developing designs for interventional studies.
Highlights
Subjective chronic tinnitus has a high prevalence, affecting 10–15% of adults worldwide [1, 2], and is responsible for high costs for health care systems [3]
Standardized ratings included the Tinnitus Sample Case History Questionnaire [18] for tinnitus characteristics, numeric ratings scales for different aspects of tinnitus [19], the Mini Tinnitus Questionnaire [20] for measurement of tinnitus distress, the Big-Five-Inventory-10 [21] for measurement of five personality traits, the Life Orientation Test (LOT-R) [22] for measurement of optimism and pessimism, and the Generalized Anxiety Disorder 7 (GAD-7) of the Patient Health Questionnaire (PHQ) [23]
Our main results are [1] that among patients who present with a tinnitus duration of
Summary
Subjective chronic tinnitus has a high prevalence, affecting 10–15% of adults worldwide [1, 2], and is responsible for high costs for health care systems [3]. Research on chronic tinnitus has been growing during the last decade. Several hypotheses about risk factors for developing chronic or decompensated tinnitus exist. Hearing impairment can be found in almost all patients with chronic tinnitus [4, 5]. Not every patient with hearing difficulty has tinnitus, meaning that hearing impairment may be a required but not sufficient risk factor. Tinnitus loudness decreased rapidly in cases of mild-moderate hearing loss and tinnitus had completely resolved in two-thirds of the patients after 3 months. When tinnitus is associated with severe-profound hearing loss, it improved significantly less [6]. Temporomandibular joint or neck pathologies are discussed as moderators for tinnitus [7]
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