Tinnitus Complaints Research Articles

Effect of Tinnitus Retraining Therapy in Normal Hearing Individual with Subjective Tinnitus: An Observational Study.

This study was done to study the effect of Tinnitus Retraining Therapy (TRT) in Bilateral Normal Hearing Individual with subjective tinnitus and to evaluate the success of simplified TRT with relation to duration of tinnitus, the patient's age and state of mind. As on date there is no definite cure available for tinnitus, so current TRT focuses on reducing the impact of tinnitus on the patient's quality of life. This study included total fifty (50) participants with bilateral normal hearing sensitivity, who had reported to the department of ENT with a complaint of tinnitus in one or both ears. All the participants are active serving military personnel and their dependents of Indian Armed Forces. All the participants had undergone basic audiological test batteries to assess the hearing acuity followed by TRT and its components (TRT counselling and sound therapy) in randomized manner. Audiological test batteries include pure tone audiometry to make sure that the participants have normal hearing acuity in both the ears and then tinnitus matching i.e. pitch and loudness match and measurement of Uncomfortable Level (UCL) followed by sound therapy and counselling. There was significant improvement reported in impact of tinnitus after completion of six (06) months of TRT schedule. Amongst the participants, 40% reported with complete relief from tinnitus, 30% reported with remarkable benefit but they can still perceive the tinnitus, 20% reported with no benefit with TRT and rest of the 10% were not able to tell whether they have got any benefit or not. Normal hearing individual with tinnitus can be benefitted with TRT accompanied with counselling and the improvement in impact of tinnitus severity that ensued over six months of TRT appear to be vigorous with significant clinical outcomes.

Hypnotic suggestion for the treatment of tinnitus

Aim of study. Considering the high spreading of tinnitus in population, the purpose of our research was to study the possibility and expediency of using hypnosuggestive therapy in treatment of tinnitus. Material and methods. The study included 55 people with tinnitus complaints. We divided three groups of patients depending on the severity of the manifestations, audiometry results, Tinnitus Handicap Inventory (THI) score according to this scale of severity, results of GAD-7 test and the PHQ-9 (Patient Health Questionnaire -9). Results. In the first group of patients, according to the tinnitus severity scale the score was up to 19 points and was considered as insignificant and mild. The score of the GAD-7 questionnaire was less than 8 points, PHQ-9 - up to 5 points. In the second group the severity of tinnitus was moderate and severe and counted more than 38 points. The GAD-7 questionnaire score was less than 8 points, PHQ-9 - up to 5 points. In the third group, 12 people complained of chronic tinnitus, sleep disturbances, nervousness, and reduced work capacity. The score of tinnitus severity in patients of this group was more than 58 points and was assessed as severe and catastrophic. According to the results of the GAD-7 and PHQ-9 questionnaires, all 12 people were diagnosed with anxiety disorders and depression, two parients even had suicidal thoughts. In the third group of patients with +++ hypnotability, after ten sessions of individual hypno-suggestive therapy, it was possible to reduce the severity of tinnitus to the third moderate degree in 7 people. 4 patients reported about complete regress of tinnitus. Conclusions. Tinnitus is a common problem and can negatively affect work, family and social life. It requires the individual approach and involvement of specialists of various profiles in the diagnostic process. The diagnostic algorithm for patients with tinnitus should include questionnaires to estimate the psychosomatic profile. The use of hypno-suggestive therapy can significantly reduce the severity of tinnitus and improve the quality of lives of patients.

Correlations of Clinical and Audio-Vestibulometric Findings with Coexisting Anxiety and Depression in Ménière’s Disease Patients

Introduction: Ménière’s disease (MD) is an inner ear disorder, characterized by vertiginous attacks, fluctuating sensorineural hearing loss, tinnitus, and a feeling of ear fullness. Endolymphatic hydrops has been proven as the underlying pathology. Frequently, psychopathologies accompany the disease. The aim of this study was to investigate the correlation of anxiety and depression with demographic, clinical, and audio-vestibular findings in MD patients. Methods: The study included 40 consecutive unilateral MD patients. Demographic data (age, sex, education, employment, and marital status), clinical variables of drop attacks, the duration, frequency and severity of vertigo attacks, and tinnitus disturbance levels were recorded. Hearing threshold levels were graded between 1 and 4. Vestibulometric variables were taken as the presence of saccades and vestibulo-ocular reflex (VOR) gain deficits in the video head impulse tests (vHIT) and canal paresis in bithermal caloric tests. Becks’s depression and anxiety scales were used for psychometric evaluations and graded by 4 and 5 from normal to severe and normal to very severe, respectively. Results: The median age of the patients was 48.94 years, and the numbers of both sexes were almost equal (male/female = 19/21). All patients reported at least one vertigo attacks within the last year. The duration of attacks was most commonly (62.5%) 1–3 h, ranging from <1 h to 17 h. Most attacks were graded as mild (67.5%), and the frequency was 2–3 episodes per year in 22 (55%) patients. The number of attacks within the last year was 1–12. Three patients reported having drop attacks. Hearing loss in the affected ear was moderate/moderately severe in 20 (50%) patients. Thirty-seven (92.5%) patients had complaints of tinnitus. In vHIT, saccades and VOR gain deficits were found in 33 (82.5%) and 11 (27.5%) patients, respectively. Canal paresis was present in 18 (45%) patients. The depression and anxiety rates were 35% and 90%, respectively. Depression scores were correlated with education, marital status, and the presence of saccades. Anxiety was correlated only with tinnitus severity and VOR gain deficits. Depression and anxiety were also correlated. Conclusion: Vertigo appears to be more intrusive than the other MD symptoms, and a higher correlation with anxiety than depression was demonstrated in this cohort. However, depression was seen less among married and educated patients, suggesting the role of coping capability, and had more pronounced clinical/vestibulometric correlates. Overall, these results indicated that it is mainly the severity of organic/physiological pathology which determines the degree of depression and anxiety in MD rather than vice versa.

Estudo comparativo de zumbido e aptidão cardiorrespiratória entre pessoas pós-COVID-19

ABSTRACT Purpose To verify the relation between tinnitus and cardiorespiratory fitness among people after COVID-19. Methods Cross-sectional study with a sample of people post Covid-19 who responded to the Visual-Analog Scale for tinnitus and standardized questionnaire containing data on hospitalization and tinnitus. To evaluate cardiorespiratory fitness, it used the clinical assessment and Bruce test to measure oxygen consumption directly (via gas analyzer, using peak oxygen consumption - VO2peak). Results In total, 192 participants were assessed, with a mean age of 47.8 ± 12.6 years . The prevalence of self-reported tinnitus was 27.1% (n = 52). Of these 52 patients with tinnitus, 27 people started with the symptom during or after the diagnosis of COVID-19. There was a significant difference for the absolute VO2peak and the groups with and without tinnitus (p = 0.035): the tinnitus group showed the lowest values, the effect size was small. There was no correlation between the scores of the Visual-Analog Scale for tinnitus and the absolute and relative VO2peak (p &gt; 0.05). Conclusion There was a statistically significant difference between tinnitus complaints and the VO2peak among people post COVID-19, with the tinnitus group having a lower absolute VO2peak than the non-tinnitus group. In tinnitus patients, we also found lower absolute and relative VO2peak for women, in addition to lower relative VO2peak for hypertensive and obese patients.

Clinical Practice Guidelines for the Therapeutic Use of Repetitive Transcranial Magnetic Stimulation in Neuropsychiatric Disorders.

Clinical Practice Guidelines for the Therapeutic Use of Repetitive Transcranial Magnetic Stimulation in Neuropsychiatric Disorders.

Cannabis use amongst tinnitus patients: consumption patterns and attitudes

BackgroundTinnitus has a significant impact on quality of life and causes considerable psychological distress. Cannabis is known to modulate neuron hyperexcitability, provide protection against auditory damage, and has been used for treatment for many diseases which have physiological similarities with tinnitus. The objective of this study was to survey patients presenting with tinnitus regarding their perspectives and usage patterns of cannabis.MethodsPatients with a primary presenting complaint of tinnitus in a tertiary neuro-otology clinic completed a 18-item questionnaire assessing perception, attitudes, and cannabis usage patterns.ResultsForty five patients completed the survey (mean age: 54.5 years, 31 females and 14 males). Overall, 96% of patients reported that they would consider cannabis as treatment for their tinnitus. Patients considered cannabis use for auditory symptoms (91%), and symptoms related to their tinnitus, such as emotional complaints (60%), sleep disturbances (64%), and functional disturbances (56%). 36% of patients had previously used cannabis and 22% of patients reported cannabis use at the time of the study. 80% of patients that were actively using cannabis reported that it helped with tinnitus-related symptoms, such as dizziness, anxiety, bodily pain, and sleep disturbances. Most patients would prefer to use edibles (62%), tablet (58%) and cream (47%) formulations of cannabis. Patients were concerned about the cost (29%), potential physical health implications (53%) and psychosocial side effects (60%) of cannabis. Over half of patients learned about cannabis from a friend or family member and only 22% of patients learned about cannabis from a physician or nurse.ConclusionCannabis use is common amongst patients with tinnitus and current users of cannabis reported that it helped with their symptoms. Most patients would consider its use as a potential treatment to alleviate their tinnitus-related symptoms and are interested in learning more regarding its use. By understanding how cannabis is perceived by tinnitus patients, healthcare providers can provide appropriate patient education.Graphical abstract

CHARACTERISTICS RELATIONSHIP OF WORKERS AND INTENSITY OF WORK ENVIRONMENT NOISE WITH TINNITUS COMPLAINTS IN GAS INDUSTRIAL WORKERS IN SIDOARJO

Introduction: Industrial progress is characterized by the increasing use of machinery in factory which has a negative impact on workers' health, one of which is tinnitus symptoms. Tinnitus is a hearing loss due to exposure to noise. The purpose of this study was to determine the relationship of worker characteristics and intensity of work environment noise with tinnitus symptoms in gas industry workers in Sidoarjo. Methods: Based on the study design, this study used analytic research, in terms of time including cross-sectional research. Research variables include age, years of service, noise intensity and tinnitus symptoms. Data are from observation, measurement, questionnaire filling and interview. Result: The results showed that there was a relationship between noise intensity and tinnitus symptoms (p = 0.033). There was no relationship between the age of workers and tinnitus symptoms (p = 1.000). There was no significant relationship between years of work (p = 0.505) with tinnitus symptoms suffered by workers at PT. X Sidoarjo Gas Industry. There was no association between exposure pattern and complaints of tinnitus (p=0.165). Conclusion: So as to reduce the risk of tinnitus complaints the company can apply the use of ear protector for workers and install silencers that can absorb sound with high noise intensity such as glasswool, rockwool, foam, cellulose fiber and acourete fiber carpets to reduce noise.

Pilot study on the role of somatic modulation in hyperacusis.

Hyperacusis is a reduced tolerance to sounds that often co-occurs with tinnitus. Both symptoms have convergent as well as divergent characteristics. Somatic modulation, changes in pitch or loudness during certain movements, is common in patients with a primary complaint of tinnitus. However, thus far, this is not documented in patients with hyperacusis. This study aimed to examine the influence of somatic manoeuvres on the perception of external sounds in patients with a primary complaint of hyperacusis. In this prospective cross-sectional pilot study, 18 patients with a primary complaint of hyperacusis were recruited at the Tinnitus Treatment and Research Center Antwerp (TINTRA). While patients listened to a 1kHz broadband noise of 30dB sensation level, six neck manoeuvres (flexion, extension, lateroflexion left/right, traction and compression), three jaw manoeuvres (protrusion, laterotrusion left/right) and one placebo manoeuvre (hand on head) were performed. The primary outcome measure was the change in the perception of the presented sound in terms of loudness and intrusiveness between baseline and each modulation measured by a visual analogue scale (VAS). No overall significant changes were found; however, individual results indicated that five patients presented a clinically relevant change of more than three points out of ten on VAS in terms of hyperacusis after at least one of the executed somatic manoeuvres. This pilot study did not demonstrate an overall significant change in hyperacusis after somatic manoeuvres but does not rule out the possibility of somatic modulation in some hyperacusis patients. The protocol of this prospective cross-sectional pilot study was registered on clinicaltrials.gov with registration number NCT04693819.

Combined Arterial and Venous Phase Computed Tomographic Imaging of the Skull Base in Pulsatile Tinnitus.

To describe the demographic, clinical, and radiologic findings in a consecutive series of patients presenting with a chief complaint of pulsatile tinnitus (PT). Retrospective review of 157 patients undergoing a combined arterial/venous phase computed tomographic (CT) imaging study. Tertiary referral center. Adult patients referred to neurotology faculty for evaluation of PT between 2016 and 2020. Triple phase high-resolution arteriography/venography/temporal bone CT. Prevalence of osseous, venous, and/or arterial pathology, clinicodemographic characteristics. One hundred fifty-seven adults (mean age, 52 years; 79.6% female) were evaluated. A history of migraine headaches was common (19.7%). The average body mass index was 30.0 (standard deviation, 6.8), and 17.2% of subjects had a diagnosis of obstructive sleep apnea. Idiopathic intracranial hypertension was diagnosed by elevated opening pressure on lumbar puncture in 13.4%. Comorbid depression and anxiety were common (25.5% and 26.1%, respectively). Overall, abnormalities were found in 79.0% of scans, with bilateral transverse sinus stenosis (TSS) seen in 38.9% and unilateral TSS found in 20.4%. Fifteen subjects (9.6%) had evidence of osseous etiologies, including superior canal dehiscence or thinning in 8.9% and sigmoid sinus dehiscence in one subject. There were 3 dural arteriovenous fistulae identified. Unilateral PT was ipsilateral to the side of TSS in 84.4% of subjects with unilateral TSS. In a large consecutive series of patients with PT referred for CT venography/arteriography, transverse sinus stenosis was the most common finding at 59%. Venous etiologies for PT should be suspected when patients are referred to neurotologists for evaluation.

An Evaluation of Thrombocyte Functions in Patients with Idiopathic Subjective Tinnitus

Objective: The aim of this study was to investigate the thrombocyte agggregation levels which are triggered by adenosine diphosphate (ADP) and collagen in patients with idiopathic subjective tinnitus.&#x0D; Material and Methods: The study included 33 patients who presented at the clinic with complaints of idiopathic subjective tinnitus that had been ongoing for at least 1 year and a control group of 33 subjects with no complaints of tinnitus. The Tinnitus Handicap Index (THI) was completed by all the patients to&#x0D; measure tinnitus severity. Thrombocyte count, prothrombin time (PT), and partial thromboplastin time (aPTT) were examined in blood samples taken from the patients. Adenosine diphosphate (ADP) collagenase and epinephrine collagenase were measured in the blood.&#x0D; Results: According to the THI, 4 (12.1%) patients were grade 1, 8 (24.2%) patients were grade 2, 10 (30.3%) patients were grade 3, 7 (21.2%) were grade 4 and 4 (12.1%) patients were grade 5. Mean aggregation triggered by ADP was determined as 83.85±16.80%in the tinnitus patients and 91.88±20.67% in the&#x0D; control group, with no statistically significant difference determined (p&gt;0.05). The mean thrombocyte aggregation triggered by collagen was determined as 119.24±24.76% in the tinnitus patients and 130.79±38.73% in the control group, with no statistically significant difference determined (p&gt;0.05).&#x0D; Conclusion: The thrombocyte functions were evaluated as normal in patients with idiopathic subjective tinnitus. However, as the measured values were lower than those of the control group, there was determined to be a tendency for thrombocyte aggregation.

Tinnitus in elderly rural population of Salem district Tamilnadu

Background: Most patients with both tinnitus and hearing loss report that the frequency of the tinnitus correlates with the severity and frequency characteristics of their hearing loss, and that the intensity of the tinnitus is usually less than 10 dB above the patient's hearing threshold at that frequency. Some patients who have central auditory processing disorders and have difficulties understanding speech in noise report experiencing tinnitus even though their pure-tone audiometric thresholds are normal. Less prevalent forms of tinnitus, such as those involving well-known musical tunes or voices without understandable speech, occur among older people with hearing loss and are believed to represent a central type of tinnitus involving reverberatory activity within neural loops at a high level of processing in the auditory cortex. Methodology: Present study is a longitudinal study conducted at ENT OPD, VMKV MEDICAL COLLEGE AND HOSPITAL, SALEM among 500 patients attending ENT OPD for complaints of tinnitus for a period of 2 years. Data entry and analysis: Data collected was entered in Microsoft excel and analyzed using SPSS version 20.0.Qualitative variables were expressed in percentage and Quantitative variables were expressed in mean and standard deviation.

Long-Term Effects of COVID-19 and the Pandemic on Tinnitus Patients.

This study aimed to explore the effect of COVID-19 and the pandemic period on the tinnitus-related complaints of patients with chronic tinnitus. Ninety-six patients who were diagnosed with chronic tinnitus before the pandemic were enrolled in this study. Before the pandemic and in January 2022, all patients used the Visual Analog Scale (VAS) to assess tinnitus loudness, annoyance, and effect on everyday life, sleep, and concentration. Additionally, patients filled the Tinnitus Handicap Inventory (THI) and the Hyperacusis Questionnaire (HQ). In the entire cohort, tinnitus loudness, annoyance, and tinnitus-induced difficulties with concentration as well as THI and HQ scores increased significantly during the two pandemic years. Thirty-seven tinnitus patients contracted COVID-19 between March 2020 and January 2022. These patients were asked to list leading COVID-19 symptoms, changes in tinnitus complaints during and after the disease, and whether their hearing abilities were affected. Three patients in the COVID-19 group confirmed worsening their hearing abilities. There was no decrease in the tinnitus complaint during COVID-19, 24.3% of the infected patients reported exacerbation of tinnitus, and 75.7% said tinnitus remained the same. In the COVID-19-negative group, 13.5% reported tinnitus decrease during the pandemic, 57.6% said it remained the same, and 28.8% reported exacerbation of tinnitus. When split into infected and non-infected groups, a significant increase in tinnitus loudness, tinnitus effect on concentration, and THI scores were seen only in patients who contracted COVID-19, while hyperacusis worsened significantly (p < 0.05) only in COVID-19-negative tinnitus patients. Despite significant differences within the groups, there were no differences found between the groups. This study points to possible different effects of the infection with SARS-CoV-2 and the pandemic period on patients with chronic tinnitus. It also provides evidence for deterioration of preexisting tinnitus as a possible long-term effect of COVID-19.

COVID-19 and tinnitus—a tertiary care Centre experience

BackgroundCOVID-19 outbreak was declared a global pandemic in March 2020 by WHO. Due to person-to-person transmission of this infection, majority of countries of world introduced lockdown to ensure people stay at home. A complex bidirectional interaction exists between tinnitus and emotional distress, as they can exacerbate one another. Also, COVID-19 infection can cause damage to outer hair cells. The aim of this study is to find out relationship between COVID-19 and initiation or exacerbation of tinnitus.MethodsThe present retrospective study, after approval by Institutional Ethics Committee, was conducted in Department of ENT, GMC Jammu, from June 2020 to March 2021 on 90 patients with primary complaint of tinnitus. All 90 patients were asked to complete the Tinnitus Handicap Inventory. Also, all patients were asked COVID-19-related questions (history of contracting virus/history of grief/anxiety/depression/stress/nervousness/financial status/ physical exercise/sleep routine/ social interactions).ResultsOut of 90 patients, 72 patients (80%) had chronic longstanding tinnitus and 18 patients (20%) experienced tinnitus during pandemic. Out of 72 patients who gave history of longstanding tinnitus, 41 patients (56.9%) reported tinnitus to be stable during COVID-19 pandemic, 26 patients (36.1%) reported it to become more bothersome and 5 patients (6.9%) reported that tinnitus was improved. Out of 90 patients, 21 patients (23.3%) were diagnosed as COVID-19 positive. Of these 21 patients experiencing COVID-19 symptoms, 16 patients (76.2%) gave history of exacerbation of tinnitus, 4 patients (19%) gave history of tinnitus remaining stable and 1 patient (4.7%) said that tinnitus was improved. Out of 90 patients, history of negative psychological impact due to COVID-19 restrictions was seen in 65 patients (72.2%).ConclusionWith our study, we concluded that ENT specialists should be fully aware that not only pre-existing tinnitus may be exaggerated due to COVID-19 infection, but also, there can be development of new-onset tinnitus due to COVID-19 infection and the negative psychological impact due to COVID-19 pandemic.

Are Electrocochleographic Changes an Early Sign of Cochlear Synaptopathy? A Prospective Study in Tinnitus Patients with Normal Hearing.

The mechanism of tinnitus accompanied by a normal audiogram remains elusive. This study aimed to investigate evidence of primary neural degeneration, also known as cochlear synaptopathy, in tinnitus patients with normal hearing thresholds. We analyzed the differences in electrocochleography (ECochG) measurements between normal-hearing subjects with and without tinnitus. Forty-five subjects were enrolled in this study: 21 were in the tinnitus group, defined by chronic tinnitus of over two months’ duration with normal audiometric thresholds, and 24 were in the control group, defined by a lack of tinnitus complaints. Electrocochleograms were evoked by 1, 4, 6, and 8 kHz alternating-polarity tone bursts at sound pressure levels (SPLs) of 90–110 dB. The tinnitus group had smaller action potential (AP) amplitudes than the control group for 1, 4, 6, and 8 kHz tone bursts and showed significant amplitude reduction at 1 kHz 110 dB SPL (p < 0.01), 1 kHz 90 dB SPL (p < 0.05), and 4 kHz 110 dB SPL (p < 0.05). There were no significant differences in the summating potential/action potential (SP/AP) amplitude ratios across the four tested frequencies. A trend of reduced AP amplitudes was found in the tinnitus group, supporting the hypothesis that tinnitus might be associated with primary neural degeneration.

Transient otoacoustic emissions with contralateral suppression findings in COVID-19 patients

ObjectiveThe virus called SARS-CoV-2, which is known as the first epidemic of the twenty-first century, is known to affect the central and peripheral nervous system. In the literature, complaints of sudden hearing loss, tinnitus, and vertigo have been reported in the patients.The aim of this study is to objectively reveal the effect of the coronavirus disease 2019 on the efferent auditory system.MethodsTwenty-three participants, who had the coronavirus disease 2019, were included in the study group, while 20 healthy participants were included in the control group. The test of transient otoacoustic emissions with contralateral suppression was applied to individuals who had normal audiological and immitansmetric evaluations findings.ResultsIn audiological evaluation, a significant difference was observed between the groups in the 125–500 Hz low frequency range and 4 kHz–12.5 kHz high frequency range. In the test of TEOAE and TEOAE with contralateral suppression, a significant difference was observed between the groups at 4 kHz.ConclusionThe effect of the coronavirus disease 2019 on the peripheral hearing system has been shown. Its effect on the efferent hearing system in the high frequency region has been revealed.

Hyperacusis: demographic, audiological, and clinical characteristics of patients at the ENT department.

To document whether patients with and without hyperacusis differ from each other on demographic, audiological, and clinical characteristics. Based on the Hyperacusis Questionnaire's (HQ) cut-off (HQ > 28), a total of 2301 participants were divided into patients with and without hyperacusis. Demographic data, scores on self-reported questionnaires [Tinnitus Functional Index (TFI), Visual Analogue Scale of tinnitus loudness (VASloudness), Hospital Anxiety Depression Scale (HADS)], and audiological parameters were retrospectively analysed to determine differential factors between the two groups. In total, 10.9% of the patients was classified as hyperacusis patients (n = 251). They reported a significant, higher tinnitus severity (mean difference of 19 points on TFI) and mental distress (mean difference of 4 points on the HADS subscales) (p < 0.001) than patients without hyperacusis. Moreover, this group consisted of more women (45% % in hyperacusis group vs. 35% in non-hyperacusis group) and women scored significantly higher on the HQ (p < 0.001) and TFI (p < 0.01). Patients with hyperacusis have distinctive characteristics. The presence of hyperacusis in combination with tinnitus can indicate a higher need for psychoeducation. Patients that present themselves with hyperacusis without tinnitus complaints remain a minority, yet might be underdiagnosed. Hence, future studies should disentangle tinnitus from hyperacusis. In clinical practice, greater efforts are required to increase knowledge about hyperacusis as a primary or secondary complaint and to provide individualized treatment for these patients.

Geriatrik hastalarda objektif tinnitus

OBJECTIVE: This study aimed to investigate the distribution and possible causes of objective tinnitus in geriatric patients. METHODS: A total of 242 patients (101 males, 141 females; mean age: 71.5±13.3 years) over 65 years who were admitted to our outpatient clinic with the complaint of tinnitus between March 2021 and October 2021 were included in the retrospective study. The clinical history and the etiology of tinnitus were investigated. The pure tone audiometry tests were evaluated to determine whether there was a loss in any frequency. The associations between the presence of objective tinnitus, age, sex, hearing loss, and comorbid diseases were analyzed. RESULTS: The prevalence of objective tinnitus was 13.6% in geriatric patients. The relation between objective tinnitus with the male sex and lower age was statistically significant (p&lt;0.001 and p&lt;0.001, respectively). No association was found between objective tinnitus and hearing loss or other comorbid diseases (p=0.727 and p=0.658, respectively). CONCLUSION: Objective tinnitus may be less common than subjective tinnitus; however, a detailed medical history and physical examination is recommended, particularly in males and younger patients. The most common cause of objective tinnitus was vascular diseases.

Nutrimentum vascularum as pulsatile tinnitus

&lt;p&gt;Tinnitus is one of the most common otological symptoms encountered in otorhinolaryngology. In recent times our understanding of tinnitus has significantly progressed but nonetheless, it still constitutes a very incapacitating symptom which greatly affects the quality of life. Objective tinnitus accounts for only 5% and has various aetiologies both non-otological and otological which include both non vascular and vascular. Vascular malformations like dural arteriovenous fistulas (DAVFs) constitute about 10% of objective tinnitus and hence are of academic interest to an otolaryngologist due to their rarity. We present one such case. A 26-year-old female presented to the department of ENT with chief complaints of a left pulsatile tinnitus of 2 months duration. A detailed clinical examination revealed no abnormality. A pure tone audiometry (PTA) was then done which once again showed hearing within normal limits. Given the clinical persistence of the symptom which was affecting her daily activities, further investigation of magnetic resonance imaging (MRI) brain was done. A suspicion of a dural arterio-venous fistula in the transverse sinus further warranted an arteriography which showed a low grade DAVF at the level of the left sigmoid sinus. DAVFs, although infrequent, constitute a treatable cause of tinnitus and hence should be considered as a possible diagnosis in all patients with pulsatile tinnitus, especially if it is unilateral. We also carried out a review of the current medical and surgical management in an attempt to better understand this rare yet intriguing condition.&lt;/p&gt;&lt;p&gt;&lt;strong&gt; &lt;/strong&gt;&lt;/p&gt;

Auditory and Vestibular Complaints Among COVID-19 Patients: A Descriptive Survey of 300 Young Patients Over a 3-Month Follow-up Period

Introduction: COVID-19 is a pandemic disease caused by a novel coronavirus, presenting a wide range of symptoms. Most of the reported symptoms are commonly related to the respiratory system; however, over time, the disease has shown new diverse signs and symptoms. Recent studies have suggested that COVID-19 may affect the auditory and vestibular systems. Besides, little is known about symptoms that persist after the recovery. This study aimed to investigate the general characteristics and especially auditory and vestibular symptoms in young COVID-19 patients over a 3-month follow-up. Materials and Methods: A total of 300 participants aged 25-45 years took part in this cohort study. They were diagnosed with COVID-19, according to radiographical abnormalities on CT scan and or PCR test, and were in good health based on medical history. Patients who had a history of hearing loss, vertigo, tinnitus, or any disease associated with auditory and vestibular disorders and who were hospitalized and received drugs were excluded. We collected patients’ demographics, some common symptoms, and their complaints (acute phase), and 1 month and 3 months later (follow-up phases) using a checklist of symptoms. The participants were asked to describe their chief complaints and, in particular, whether they had any complaints of hearing problems, tinnitus, rotatory vertigo, and aural fullness, or even changes in these symptoms over these periods. Results: Auditory and vestibular symptoms were observed in a small percentage of COVID-19 patients and were not their chief complaints. Overall, among 300 patients, only about 5% of patients (15 cases) expressed rotatory vertigo, 4% (12 cases) aural fullness, 2.66% (8 cases) tinnitus, and 2.66% (8 cases) hearing problem in the acute phase. However, these symptoms disappeared almost in all participants in the follow-up phases (0 to 3 cases). In addition, none of these symptoms were the patients’ chief complaints. Conclusion: Only a small percentage of COVID-19 patients complained of auditory and vestibular symptoms. It needs to be determined whether these complaints are due to the effects of the virus itself, medications, or stress. The persistence of some symptoms, such as fatigue even after 3 months, indicates the long-term impact of the COVID-19 virus, which necessitates further studies.

Transtemporal Sigmoid Sinus Decompression: A Novel Surgical Procedure for the Treatment of Idiopathic Pulsatile Tinnitus.

Idiopathic pulsatile tinnitus (IPT) is associated with high patient morbidity although treatment methods remain unsatisfactory. In the present study, the transtemporal sigmoid sinus decompression is used in the treatment of idiopathic pulsatile tinnitus. Retrospective case study. Tertiary referral center. From 2005 to 2020, 287 patients presented with a complaint of pulsatile tinnitus. After exclusion criteria, 25 patients were diagnosed with IPT. Those patients underwent treatment and were included in a retrospective study. Following failed conservative therapies, the primary author performed a transtemporal sigmoid sinus decompression surgery on the patients under general anesthesia. Long-term resolution of IPT was measured using the Tinnitus Handicap Inventory (THI). Outcome measurements were taken preoperatively, immediately postoperatively, three months postoperatively, and the status of all 25 patients is known at the time of this study. Transtemporal sigmoid sinus decompression was performed on 25 patients (mean age: 51.7 years, 80.0% female). Out of the 25 patients, 23 (92.0%) patients experienced complete resolution of their IPT. Statistically significant differences based on preoperative THI (mean THI: 4.19) were evident immediately after surgery (mean THI: 1.31; p < 0.001), at 3 months postoperatively (mean THI: 1.19; p < 0.001), and over a mean follow-up time of 68.7 months (range, 3-168 months) (mean THI: 1.38; p < 0.001). Out of the two patients considered unsuccessful, Case 21 experienced a partial resolution. No major postoperative complications occurred. Transtemporal sigmoid sinus decompression is a safe and effective surgical procedure demonstrated to give near total resolution in properly selected patients and provides long-term relief for patients with IPT.