Extended High-Frequency Hearing Loss Research Articles

Standard and Extend High-Frequency Audiometry in Sudden Sensorineural Hearing Loss: Impacts on Tinnitus and Mental Health.

To analyze the results of auditory assessment in standard (SA) and extended high-frequency (EHF) audiometry, associating the findings with sudden tinnitus and mental health of patients with unilateral sudden sensorineural hearing loss (SSNHL). Prospective, cohort study. Outpatient otology clinic in a tertiary care hospital. Patients experiencing unilateral SSNHL were evaluated with pure-tone audiometry performed at frequencies of 250 to16,000 Hz, tinnitus pitch and loudness matching tests, Tinnitus Handicap Inventory (THI), Analog and Visual Scale (AVS) for bothersome tinnitus, and the Hospital Anxiety and Depression Scale (HADS). Eighteen patients with unilateral SSNHL were assessed. After starting treatment, there was a significant improvement in the SA (71.1 dB to 50 dB; p < 0.001*) and EHF audiometry (64.5 dB to 54.4 dB; p < 0.001*) thresholds at 15 days, and this persisted at 30 days of follow-up. Significant improvements were seen for tinnitus in loudness, VAS, and THI and for mental health in the realms of anxiety and depression by HADS. Despite improvements in SA, persistent EHF hearing loss was accompanied by persistent tinnitus, but it was of diminished loudness. Despite improvement in pure-tone thresholds by SA, a subset of unilateral SSNHL patients did not experience hearing recovery in EHF thresholds and reported persistent tinnitus. We postulate that their diminished anxiety and better mental health may be related to both hearing improvement in standard audiometry and reduction in tinnitus loudness. This pilot prospective study investigates the utility of performing EHF audiometry to better understand outcomes in patients with SSNHL.

Clinical Features of Non-Lateralized Tinnitus.

We aimed to analyze and confirm the clinical features of patients with non-lateralized tinnitus and to identify clues that can be used in their management. Data from 469 patients who visited a university hospital complaining of tinnitus between March 2020 and December 2021 were reviewed. The patients' medical histories, Tinnitus Handicap Inventory, Beck Depression Inventory, and numerical rating scale scores on tinnitus awareness, annoyance, loudness, and effect on life, audiological profiles, and quantitative electroencephalography findings were documented. Forty-nine (10.4%) patients had non-lateralized tinnitus. They were older and had a shorter duration of symptoms (13.91 ± 34.16 months) than patients with bilateral tinnitus (duration: 39.15 ± 80.82 months) (P -lt; .05). The accompanying symptoms, Tinnitus Handicap Inventory scores, and numerical rating scale scores were not significantly different between the 2 groups (P -gt; .05). Patients with non-lateralized tinnitus had worse hearing at 12 kHz on the left side than those with unilateral tinnitus. Hearing asymmetry was least common in non-lateralized tinnitus (n=11/49, 10.4%), followed by bilateral tinnitus (n=54/198, 42.2%) and unilateral tinnitus (n=97/222, 47.3%) (P-lt; .001). Regarding quantitative electroencephalography, there were significant differences in the absolute power of the theta, alpha, beta, gamma, and total frequency bands based on tinnitus lateralization (P -lt; .001). Non-lateralized tinnitus can be perceived in elderly patients with symmetric and extended high-frequency hearing loss before habituation is achieved at an early stage of tinnitus. However, there was no difference in the questionnaire scores and accompanying symptoms; therefore, it may not be worth managing non-lateralized tinnitus separately from tinnitus in the ear.

Subcortical Auditory Processing and Speech Perception in Noise Among Individuals With and Without Extended High-Frequency Hearing Loss.

The significance of extended high-frequency (EHF) hearing (> 8 kHz) is not well understood so far. In this study, we aimed to understand the relationship between EHF hearing loss (EHFHL) and speech perception in noise (SPIN) and the associated physiological signatures using the speech-evoked frequency-following response (sFFR). Sixteen young adults with EHFHL and 16 age- and sex-matched individuals with normal hearing participated in the study. SPIN performance in right speech-right noise, left speech-left noise, and binaural listening conditions was evaluated using the Turkish Matrix Test. Additionally, subcortical auditory processing was assessed by recording sFFRs elicited by 40-ms /da/ stimuli. Individuals with EHFHL demonstrated poorer SPIN performances in all listening conditions (p < .01). Longer latencies were observed in the V (onset) and O (offset) peaks in these individuals (p ≤ .01). However, only the V/A peak amplitude was found to be significantly reduced in individuals with EHFHL (p < .01). Our findings highlight the importance of EHF hearing and suggest that EHF hearing should be considered among the key elements in SPIN. Individuals with EHFHL show a tendency toward weaker subcortical auditory processing, which likely contributes to their poorer SPIN performance. Thus, routine assessment of EHF hearing should be implemented in clinical settings, alongside the evaluation of standard audiometric frequencies (0.25-8 kHz).

Magnitude of extended high frequency hearing loss associated with auditory related tinnitus distress, when controlling for magnitude of hearing loss at standard frequenciesa).

Impaired thresholds at extended high frequencies (EHF) are tightly linked to the prevalence of tinnitus, but little is known about how EHF status relates to tinnitus characteristics. In the present study, 93 individuals with tinnitus underwent standard (from 0.125 to 8 kHz) and EHF (from 10 to 16 kHz) audiometry and indicated their degree of tinnitus distress by completing the tinnitus functional index and their perceived tinnitus loudness by using a numeric rating scale. Partial correlation analyses indicated that the magnitude of EHF loss was significantly associated with degree of auditory related tinnitus distress (r = 0.343, p < 0.001) when controlling for pure tone average at standard frequencies and compensating for multiple testing. It is concluded that EHF status is related specifically to auditory related tinnitus distress, but not to intrusive-, sense of control-, cognitive-, sleep-, relaxation-, quality of life-, emotional-related tinnitus distress, total tinnitus distress, or perceived tinnitus loudness.

Suprathreshold auditory processes in listeners with normal audiograms but extended high-frequency hearing loss

Hearing loss in the extended high-frequency (EHF) range (>8 kHz) is widespread among young normal-hearing adults and could have perceptual consequences such as difficulty understanding speech in noise. However, it is unclear how EHF hearing loss might affect basic psychoacoustic processes. The hypothesis that EHF hearing loss is associated with poorer auditory resolution in the standard frequencies was tested. Temporal resolution was characterized by amplitude modulation detection thresholds (AMDTs), and spectral resolution was characterized by frequency change detection thresholds (FCDTs). AMDTs and FCDTs were measured in adults with or without EHF loss but with normal clinical audiograms. AMDTs were measured with 0.5- and 4-kHz carrier frequencies; similarly, FCDTs were measured for 0.5- and 4-kHz base frequencies. AMDTs were significantly higher with the 4 kHz than the 0.5 kHz carrier, but there was no significant effect of EHF loss. There was no significant effect of EHF loss on FCDTs at 0.5 kHz; however, FCDTs were significantly higher at 4 kHz for listeners with than without EHF loss. This suggests that some aspects of auditory resolution in the standard audiometric frequency range may be compromised in listeners with EHF hearing loss despite having a normal audiogram.

Audiological and psychological assessment of tinnitus patients with normal hearing.

This study was performed to assess identifiable abnormalities in tinnitus patients with normal hearing. The medical records of subjective non-pulsatile tinnitus patients with normal hearing confirmed by conventional pure-tone audiometry who visited our tinnitus clinic between March 2020 and May 2022 were reviewed. The loudness discomfort level (LDL), extended high-frequency hearing loss (EHFHL), summating potential (SP)/action potential (AP) ratio, distortion product otoacoustic emission (DPOAE), thresholds of auditory brainstem response (ABR) wave V, somatic modulation, and psychiatric symptoms, such as anxiety, depression, and stress were evaluated by questionnaires. Decreased LDL (n = 48, 59.8%) was the most frequent finding, followed by EHFHL (n = 29, 35.4%), increased SP/AP ratio (n = 27, 32.9%), psychiatric symptoms (n = 24, 29.3%), decreased DPOAE (n = 17, 20.7%), somatic modulation (n = 8, 9.8%), and increased ABR threshold (n = 3, 3.7%); 75.6% of patients had one or more of these findings. The presence of psychiatric symptoms was independently associated with the Tinnitus Handicap Inventory (THI) score. Tinnitus in patients with normal hearing may be accompanied by a combination of various subclinical abnormal audiological findings. However, the presence of psychiatric symptoms alone was independently associated with tinnitus distress.

Extended High-frequency Hearing Loss in Chronic Suppurative Otitis Media Patients Complaining of Tinnitus but with Normal Cochlear Function on Conventional Pure-tone Audiometry

Objective: The aim of the study is to find the incidence of extended high-frequency hearing loss (EHFHL) in chronic suppurative otitis media (CSOM) patients complaining of tinnitus but with normal cochlear function on conventional pure-tone audiometry (PTA). CSOM often results in conductive hearing loss, but recent studies have shown sensorineural hearing loss, thus indicating inner ear damage. Study Design: The stud design was a prospective study. Setting: The study was conducted at a tertiary care hospital. Methods: In a prospective observational study, a total of 141 patients with CSOM were reviewed. Seventy-four CSOM patients presented with tinnitus, and the mean age of presentation was 31.4 ± 6.82 years. Only those with normal cochlear function based on PTA (250 Hz to 8 kHz) were included. They were further tested at extended frequencies of up to 12 kHz. The severity of tinnitus was assessed using the Tinnitus Handicap Index Questionnaire. Results: The prevalence of EHFHL in the normal cochlear function CSOM patients with tinnitus was 68.9%, whereas the prevalence in the tinnitus negative group was 22.38%. EHFHL and tinnitus in CSOM patients show statistically significant association (P &lt; 0.05). Furthermore, there was a significant association between the severity of tinnitus and EHFHL. Conclusion: The findings demonstrate that the patients of CSOM with tinnitus and normal hearing in conventional PTA have EHFHL that indicates damage has occurred in the inner ear. The severity of the tinnitus can be predicted by the degree of higher frequency hearing loss.

Functional consequences of extended high frequency hearing impairment: Evidence from the speech, spatial, and qualities of hearing scale.

Hearing loss in the extended high frequencies, despite a normal audiogram, could affect speech-in-noise recognition. However, it is not known if extended high frequency (EHF) hearing loss is associated with everyday listening and communication deficits. The present study aimed to determine the functional effects of impaired EHF hearing among adults using the Speech, Spatial, and Qualities of Hearing Scale (SSQ). A secondary objective was to evaluate the relationship between objective (speech-in-noise recognition) and subjective (SSQ) measures of hearing function. Listeners with EHF hearing loss provided lower SSQ ratings compared with their EHF-normal counterparts. The lower ratings could not be attributed to the age or standard audiogram of the listeners. Ratings from more than 50% of EHF-impaired listeners were below the 2 SD cutoff point obtained from EHF-normal listeners. The mean speech recognition threshold was poorer for EHF-impaired listeners, and a poorer speech recognition threshold was associated with lower SSQ ratings, i.e., poorer self-reported hearing ability. For some listeners, EHF hearing loss could be the missing link between self-reported hearing difficulty in the presence of a normal audiogram. These findings provide evidence for the functional deficits associated with EHF hearing loss and invoke the need for future investigations into the management of EHF loss.

Associations between medical conditions and auditory dysfunction in US Veterans

Objective To examine associations between non-otologic medical conditions and auditory dysfunction. Design Cross-sectional analysis of baseline data from the Noise Outcomes in Service members Epidemiology (NOISE) study. Logistic regression was used to estimate the association between medical conditions (0, 1, and 2 or more conditions) and auditory dysfunction (hearing loss pure tone average ≥20 dB HL and tinnitus), adjusting for key confounders including noise exposure. Secondarily, the association between specific medical conditions and auditory dysfunction was examined. All variables were self-reported. Study sample United States military Veterans (n = 580) with mean age 34.1 years (standard deviation = 9.2), who were within approximately 2.5 years of separation from service. Results Compared to Veterans reporting no medical conditions, Veterans reporting two or more had increased odds on low-frequency hearing loss and on tinnitus but not on high or extended-high frequency hearing loss. Furthermore, specific conditions sleep disorder and arthritis were associated with auditory dysfunction. Conclusions Non-otologic medical conditions were associated with low-frequency hearing loss and tinnitus in this sample of young Veterans. This suggests medical conditions may play a role in Veterans’ hearing health. Whether management of medical conditions earlier in life reduces the risk of hearing loss and tinnitus requires further study.

Personal Audio Systems Unsafe At Any Sound

Personal Audio Systems Unsafe At Any Sound

Extended high frequency hearing loss in tinnitus-positive chronic suppurative otitis media patient.

ObjectivesTo determine the association between extended high frequency hearing loss and tinnitus in normal cochlear function based on a conventional audiometry chronic suppurative otitis media (CSOM) patient.Design and methodsA cross‐sectional study was conducted on 220 ears diagnosed as having CSOM with an equal number of tinnitus and without tinnitus groups. Only those with normal cochlear function based on conventional pure tone audiometry (250 Hz to 8 kHz) were included. They were further tested for hearing at extended high frequencies of up to 16 kHz. The severity of tinnitus was tested using a tinnitus questionnaire.ResultsThe prevalence of extended high frequency hearing loss in the normal cochlear function CSOM patients with tinnitus was 81.8% (95% CI 74.5%, 89.1%), whereas the prevalence in the tinnitus negative group was 30.0% (95% CI 21.3%, 38.7%). There was a significant association between extended high frequency hearing loss and tinnitus in CSOM patients (P < .001). The average thresholds were significantly higher in the tinnitus group at all extended high frequencies tested with an increasing trend of significance toward the higher frequencies. However, this study did not observe any association between the severity of tinnitus and extended high frequency hearing loss.ConclusionThe development of tinnitus among normal cochlear function CSOM patients indicates that the damage has occurred at a higher frequency level. However, the severity of tinnitus does not predict the degree of higher frequency hearing loss. Therefore, the presence of tinnitus warrants more aggressive monitoring and treatment to prevent sensorineural hearing loss from developing into the speech frequencies.Level of Evidence4.

Functional Impacts of Aminoglycoside Treatment on Speech Perception and Extended High-Frequency Hearing Loss in a Pediatric Cystic Fibrosis Cohort.

Purpose The purpose of this study is to better understand the prevalence of ototoxicity-related hearing loss and its functional impact on communication in a pediatric and young adult cohort with cystic fibrosis (CF) and individuals without CF (controls). Method We did an observational, cross-sectional investigation of hearing function in children, teens, and young adults with CF (n = 57, M = 15.0 years) who received intravenous aminoglycoside antibiotics and age- and gender-matched controls (n = 61, M = 14.6 years). Participants completed standard and extended high-frequency audiometry, middle ear measures, speech perception tests, and a hearing and balance questionnaire. Results Individuals with CF were 3-4 times more likely to report issues with hearing, balance, and tinnitus and performed significantly poorer on speech perception tasks compared to controls. A higher prevalence of hearing loss was observed in individuals with CF (57%) compared to controls (37%). CF and control groups had similar proportions of slight and mild hearing losses; however, individuals with CF were 7.6 times more likely to have moderate and greater degrees of hearing loss. Older participants displayed higher average extended high-frequency thresholds, with no effect of age on average standard frequency thresholds. Although middle ear dysfunction has not previously been reported to be more prevalent in CF, this study showed that 16% had conductive or mixed hearing loss and higher rates of previous otitis media and pressure equalization tube surgeries compared to controls. Conclusions Individuals with CF have a higher prevalence of conductive, mixed, and sensorineural hearing loss; poorer speech-in-noise performance; and higher rates of multiple symptoms associated with otologic disorders (tinnitus, hearing difficulty, dizziness, imbalance, and otitis media) compared to controls. Accordingly, children with CF should be asked about these symptoms and receive baseline hearing assessment(s) prior to treatment with potentially ototoxic medications and at regular intervals thereafter in order to provide otologic and audiologic treatment for hearing- and ear-related problems to improve communication functioning.

Tinnitus Is Associated With Extended High-frequency Hearing Loss and Hidden High-frequency Damage in Young Patients.

Objectives:To analyze the results of extended high-frequency (EHF) and high-frequency hearing tests in young patients with tinnitus who show normal response in conventional pure-tone audiometry (PTA), and to explore the correlation between tinnitus and hearing loss (HL).Study Design:A case–control study.Setting:A Tertiary Eye Ear Nose & Throat Hospital of China.Participants:Patients with tinnitus, aged 18 to 35 years old, and with normal conventional PTA (125 Hz–8 kHz) were enrolled in the tinnitus group. Volunteers without tinnitus of the same age were enrolled in the control group.Main Outcome Measures:The incidence of EHF-HL and the hearing thresholds at each frequency, as well as the distribution of maximum HL frequency and edge frequency in all participants were compared.Results:In total, 28 cases (43 ears) were enrolled in the tinnitus group and 34 cases (68 ears) in the control group. The incidence of EHF-HL, average hearing threshold of each frequency ranging from 4 to 16 kHz, and the maximum hearing threshold were significantly higher in the tinnitus group. The edge frequency in the tinnitus group was lower than that in the control group (10.4 ± 3.1 kHz versus 12.3 ± 2.5 kHz, p = 0.010). The dominant tinnitus pitch in cases whose EHF was impaired was positively correlated with the hearing-level loudness of tinnitus (r = 0.627, p < 0.001).Conclusion:Patients with tinnitus and normal hearing in conventional PTA showed signs of EHF-HL and hidden damage in the high-frequencies more easily. EHF hearing tests and the follow-up of HF hearing tests are recommended to facilitate early detection of hearing impairment for timely intervention.

Peripheral Auditory Involvement in Childhood Listening Difficulty.

This study tested the hypothesis that undetected peripheral hearing impairment occurs in children with idiopathic listening difficulties (LiDs), as reported by caregivers using the Evaluation of Children"s Listening and Processing Skills (ECLiPS) validated questionnaire, compared with children with typically developed (TD) listening abilities. Children with LiD aged 6-14 years old (n = 60, mean age = 9.9 yr) and 54 typical age matched children were recruited from audiology clinical records and from IRB-approved advertisements at hospital locations and in the local and regional areas. Both groups completed standard and extended high-frequency (EHF) pure-tone audiometry, wideband absorbance tympanometry and middle ear muscle reflexes, distortion product and chirp transient evoked otoacoustic emissions. Univariate and multivariate mixed models and multiple regression analysis were used to examine group differences and continuous performance, as well as the influence of demographic factors and pressure equalization (PE) tube history. There were no significant group differences between the LiD and TD groups for any of the auditory measures tested. However, analyses across all children showed that EHF hearing thresholds, wideband tympanometry, contralateral middle ear muscle reflexes, distortion product, and transient-evoked otoacoustic emissions were related to a history of PE tube surgery. The physiologic measures were also associated with EHF hearing loss, secondary to PE tube history. Overall, the results of this study in a sample of children with validated LiD compared with a TD group matched for age and sex showed no significant differences in peripheral function using highly sensitive auditory measures. Histories of PE tube surgery were significantly related to EHF hearing and to a range of physiologic measures in the combined sample.

Ecological cocktail party listening reveals the utility of extended high-frequency hearing

A fundamental principle of neuroscience is that each species' and individual's sensory systems are tailored to meet the demands placed upon them by their environments and experiences. What has driven the upper limit of the human frequency range of hearing? The traditional view is that sensitivity to the highest frequencies (i.e., beyond 8 kHz) facilitates localization of sounds in the environment. However, this has yet to be demonstrated for naturally occurring non-speech sounds. An alternative view is that, for social species such as humans, the biological relevance of conspecific vocalizations has driven the development and retention of auditory system features. Here, we provide evidence for the latter theory. We evaluated the contribution of extended high-frequency (EHF) hearing to common ecological speech perception tasks. We found that restricting access to EHFs reduced listeners' discrimination of talker head orientation by approximately 34%. Furthermore, access to EHFs significantly improved speech recognition under listening conditions in which the target talker's head was facing the listener while co-located background talkers faced away from the listener. Our findings raise the possibility that sensitivity to the highest audio frequencies fosters communication and socialization of the human species. These findings suggest that loss of sensitivity to the highest frequencies may lead to deficits in speech perception. Such EHF hearing loss typically goes undiagnosed, but is widespread among the middle-aged population.

Patterns of Extended High-frequency Hearing Loss Following Stapes Surgery.

Thresholds in the extended high-frequency (EHF) range (> 8 kHz) often worsen after otherwise successful stapedectomy. The aims of this study were to document the prevalence of hearing loss from 0.25 to 16 kHz after stapedectomy and the relative rates of transient and permanent EHF hearing loss. Prospective, observational, longitudinal. Tertiary referral center. Thirty-nine patients who underwent 44 primary or revision stapes surgeries. Hearing thresholds were measured at 0.25 to 16 kHz preoperatively, and at approximately 1 week, 1, 3, 6, and 12 months postoperatively. Average threshold changes in bands of frequencies (0.25-1, 2-8, 9-11.2, 12.5-16 kHz) and the percentage of patients with a change in the highest frequency at which a hearing threshold could be measured were evaluated at each assessment. A mean hearing loss was documented in the EHF range at all postoperative assessments. There was a decrease in the highest frequency at which a hearing threshold was measureable in 77% of patients at the first postoperative assessment, and despite some improvement over time, in 50% of patients 12 months postoperatively. There is a significant incidence of EHF loss after stapedectomy. Although partial recovery often occurs, more than half of patients retain an EHF hearing loss 12 months postoperatively. As hearing loss in the EHF range is more common than loss at 4 kHz, EHF measurements may be a more sensitive model to compare surgical factors and evaluate pharmacologic interventions.

Benefits of Extended High-Frequency Audiometry for Everyone

Benefits of Extended High-Frequency Audiometry for Everyone

Distinguishing Between Conductive and Sensorineural Extended High-Frequency Hearing Loss Following Middle Ear Surgery

Distinguishing Between Conductive and Sensorineural Extended High-Frequency Hearing Loss Following Middle Ear Surgery

Extended High Frequency Audiometry in Polycystic Ovary Syndrome

Objective. Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder affecting 5–10% of women in reproductive age. Insulin resistance, dyslipidemia, glucose intolerance, hypertension, and obesity are metabolic disorders accompanying the syndrome. PCOS is a chronic proinflammatory state and the disease is associated with endothelial dysfunction. In diseases with endothelial damage, hearing in high frequencies are mostly effected in early stages. We evaluated extended high frequency hearing loss in PCOS patients. Material Methods. Forty women diagnosed as PCOS and 25 healthy controls were included in this study. Age and BMI of PCOS and control groups were comparable. Each subject was tested with low (250–2000 Hz), high (4000–8000 Hz), and extended high frequency audiometry (8000–20000). Hormonal and biochemical values including LH, LH/FSH, testosterone, fasting glucose, fasting insulin, HOMA-I, and CRP were calculated. Results. PCOS patients showed high levels of LH, LH/FSH, testosterone, fasting insulin, glucose, HOMA-I, and CRP levels. The hearing thresholds of the groups were similar at frequencies of 250, 500, 1000, 2000, and 4000 Hz; statistically significant difference was observed in 8000–14000 Hz in PCOS group compared to control group. Conclusion. PCOS patients have hearing impairment especially in extended high frequencies. Further studies are needed to help elucidate the mechanism behind hearing impairment in association with PCOS.

New Diagnostic and Therapeutic Approaches in Otologic Diseases

Cochlear pathologies and vestibular disorders have been investigated in detail in the recent years. Recent advances in diagnostic and therapeutic methods have introduced new investigations about the cytologic degenerations and regenerations of cochlear cells. Knowledge and understanding of otologic diseases have led to the development of novel therapies, approaches, and/or tools. This special issue covers the important topics in the diagnosis and therapies of otologic diseases including chronic otitis media, tinnitus, ototoxicity, and hearing loss. Investigation of the Presence of Biofilms in Chronic Suppurative Otitis Media, Nonsuppurative Otitis Media, and Chronic Otitis Media with Cholesteatoma by Scanning Electron Microscopy. Biofilms have been shown to play a major role in the pathogenesis of otolaryngologic infections. However, very limited studies have been undertaken to demonstrate the presence of biofilms in tissues from patients with chronic otitis media (COM) with or without cholesteatoma. E. Kaya et al. found that their study supports the hypothesis that biofilms are involved in chronic suppurative otitis media, cholesteatoma, and to a lesser degree, chronic nonsuppurative otitis media. The presence of biofilms was significantly higher in the middle ear mucosa compared with the mastoid and ossicle samples. They emphasized that careful use of topical or systemic antimicrobials is essential and during surgery, hypertrophic tissue must be carefully removed from normal tissue. Is It Necessary to Do Temporal Bone Computed Tomography of the Internal Auditory Canal in Tinnitus with Normal Hearing? Tinnitus is the perception of sound without an external stimulus. The prevalence of tinnitus varies between 3–30% of all population. As we know very well, tinnitus can be seen due to the pressure of the acoustic neuromas, cerebellopontine angle tumors, and vascular lesions, such as vascular loop to the eight cranial nerve reported in the literature. The development of the tinnitus can be observed due to nerve edema, degeneration, and compression in the canal. Accordingly, the pathological conditions that affect the width of the canal can lead to tinnitus due to compression. T. L. Kumral et al. investigated the diameter of internal acoustic canal in physiologically impaired tinnitus patients as the etiology may be due to anatomical differences of the temporal bone. In conclusion they found that there were no anatomical differences in the etiology of tinnitus rather than physiological degeneration in the nerves. Efficacy of Low-Level Laser Therapy in the Management of Tinnitus due to Noise-Induced Hearing Loss: A Double-Blind Randomized Clinical. Several remedial modalities for the treatment of tinnitus have been proposed, but an effective standard treatment is still to be confirmed. In the present study, A. Mollasadeghi et al. investigate the effect of low-level laser therapy on tinnitus accompanied by noise-induced hearing loss. They found low-level laser therapy to be effective in alleviating tinnitus in patients with noise-induced hearing loss, although this effect has faded after 3 months of follow-up. The Role of Thiamine Pyrophosphate in Prevention of Cisplatin Ototoxicity in an Animal Model. Cisplatin ototoxicity has several characteristics. Inner ear toxicity is often a dose limiting side effect that hampers optimal cisplatin-based chemotherapy. It is normally manifested as a sensorineural hearing loss beginning in the high frequencies, successively progressing towards the speech frequency range. O. Kuduban et al. investigate the effectiveness of thiamine pyrophosphate against cisplatin-induced ototoxicity in guinea pigs. They found that systemic administration of thiamine pyrophosphate yielded statistically significant protection to the cochlea of guinea pigs from cisplatin toxicity. They emphasized that further experimental animal studies are essential to determine the appropriate indications and dosages of thiamine pyrophosphate before clinical use. Extended High Frequency Audiometry in Polycystic Ovary Syndrome. Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder affecting 5–10% of women in the reproductive age. Disease is characterized by oligo/amenorrhea, hyperandrogenism, and polycystic ovaries. PCOS is a chronic proinflammatory state. C. Kucur et al. evaluated extended high frequency hearing loss in PCOS patients. They concluded that PCOS patients have hearing impairment especially in extended high frequencies. Further studies are needed to help elucidate the mechanism behind hearing impairment in association with PCOS and to see whether the impairment of extended high frequency audiometry in these cases is progressive. Possible Protective Effect of Sertraline against Cisplatin-Induced Ototoxicity: An Experimental Study. Cisplatin is a widely used chemotherapeutic agent but its ototoxicity side effect can occur in the majority of patients. Lots of agents were tried to prevent this, but there is not a routine treatment modality yet. The aim of this study was to evaluate the otoprotective effect of sertraline, which is an antidepressant with neuroprotective effects, against cisplatin, in rats. M. Ozturk et al. showed that sertraline seems to have a protective effect on cisplatin ototoxicity, and could be used to prevent the ototoxicity and also to treat the depression that occurred in cancer patients together. Fatih Oghan Cemal Cingi Erkan Karatas Sebahattin Cureoglu