Improvement Of Tinnitus Research Articles

Effectiveness of bisphosphonate for alleviating tinnitus associated with otosclerosis: a prospective case-control study.

To investigate the short-term efficacy of third-generation bisphosphonate in the management of tinnitus associated with otosclerosis. A prospective case-control study included 100 patients with otosclerosis-associated bothersome tinnitus. Patients were assigned to two groups: group A (control): 25 patients who planned to receive only complementary supplements, oral vitamin D plus calcium, and group B (case): 75 patients who planned to receive oral bisphosphonate plus routine vitamin D and calcium supplements. Group B was subdivided into B1: 25 patients without any previous intervention, B2: 25 patients with persistent tinnitus for more than 6months after a previous uncomplicated stapedotomy in the same ear, and B3: 25 patients with persistent tinnitus for more than 6months after hearing aid fitting. The outcome was tinnitus assessment both subjectively (tinnitus intensity, frequency, and questionnaire) and objectively (tinnitus intensity and frequency). The female-to-male ratio was 1.6:1 with ages ranging from 40 to 61years. The baseline revealed no statistically significant differences between the groups. After 6months, there were statistically significant differences, both objectively and subjectively. The tinnitus questionnaire median (IQR) for group B was 16 (30), whereas control group A had 52 (24). The tinnitus severity median (IQR) for group B was 20 (30), compared to group A's 52 (42). After 6months, 40% of the cases in group B demonstrated complete improvement, compared to 0% in control group A. We demonstrated significant tinnitus improvement in cases treated with bisphosphonate compared to the control group.

The Long-Term Effect of Cochlear Implantation on Tinnitus: A Systematic Review and Meta-Analysis.

This systematic review investigates the long-term effect of cochlear implantation (CI) on clinical outcomes in tinnitus patients with sensorineural hearing loss (SNHL). PubMed, Embase, and the Cochrane Library were searched from inception to 30 April 2024. Manual searches of reference lists supplemented these searches when necessary. Original studies included in the meta-analysis had to contain comparative pre- and postoperative data for SNHL patients who underwent CI. Outcomes measured were the Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS), and Tinnitus Questionnaire (TQ). A total of 28 studies comprising 853 patients showed significant tinnitus improvement after CI: THI mean difference (MD) -14.02 [95%CI -15.29 to -12.76, p < 0.001], TQ MD -15.85 [95%CI -18.97 to -12.74, p < 0.05], and VAS MD -3.12 [95%CI -3.49 to -2.76, p < 0.05]. Subgroup analysis indicated a significant difference between follow-up periods in THI (p < 0.0001) and VAS loudness (p = 0.02). Cochlear implantation substantially improves tinnitus in patients with hearing loss, though the effect may diminish over time. Further research is needed to confirm these findings.

AUDISTIM® Day/Night Alleviates Tinnitus-Related Handicap in Patients with Chronic Tinnitus: A Double-Blind Randomized Placebo-Controlled Trial.

The aim of this study is to evaluate the efficacy of taking a daily supplement based on active compounds (AUDISTIM® Day Night: A D/N) in alleviating tinnitus-related disability, as suggested by previous real-life studies. This double-blind randomized placebo-controlled study was conducted in adults with mild to severe tinnitus receiving a 3-month supplementation with A D/N (magnesium, vitamins, phytochemicals) or placebo (excipients without active ingredients). Tinnitus-related handicap (THI), psychological stress (MSP-9), and sleep quality (PSQI) were assessed at baseline and during intervention, perceived impression of tinnitus improvement at the end of the follow-up. The full set analysis included 114 patients (59 A D/N, 55 placebo) aged 53.8 ± 11.4 years, 58% women, with fluctuating (45%) or permanent (55%) tinnitus from 9.3 ± 9.4 years. A D/N supplementation led to greater changes in THI (-13.2 ± 16.0 vs. -6.2 ± 14.4, p = 0.0158,Cohen's d =0.44) at 3 months (primary outcome), especially with continuous tinnitus (-15.0 ± 16.3 vs. -4.6 ± 12.8, p = 0.0065), and, to a lesser extent, at 1 month (-9.8 ± 13.1 for A vs. -4.3 ± 12.1, p = 0.0213). PSQI significantly improved over time in both groups, but MSP-9 only with A D/N. In lines with previous observational studies, both clinical (THI score > 7 pts) and statistical (vs. placebo) improvement, more pronounced in permanent tinnitus, demonstrate the effectiveness of the combination of active compounds and support its use in the management of mild to severe tinnitus.

Venous sinus stenting for idiopathic intracranial hypertension: An updated Meta-analysis

BackgroundIdiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure and primarily affects obese women of reproductive age. Venous sinus stenting (VSS) is a surgical procedure used to treat IIH, but its safety and efficacy are still controversial. MethodsA systematic review and meta-analysis were conducted following PRISMA guidelines. Multiple databases were searched for studies evaluating the safety and efficacy of VSS in IIH patients and meta-analysis was performed to pool the data. ResultsA total of 36 studies involving 1066 patients who underwent VSS were included. After VSS, a significant reduction in trans-stenotic gradient pressure was observed. Patients also showed significantly lower cerebrospinal fluid (CSF) opening pressure. Clinical outcomes demonstrated improvement in tinnitus (95%), papilledema (89%), visual disturbances (88%), and headache (79%). However, 13.7% of patients experienced treatment failure or complications. The treatment failure rate was 8.35%, characterized by worsening symptoms and recurrence of IIH. The complications rate was 5.35%, including subdural hemorrhage, urinary tract infection, stent thrombus formation, and others. ConclusionVSS appears to be a safe and effective treatment option for IIH patients who are unresponsive to medical therapy or have significant visual symptoms. However, long-term outcomes and safety of the procedure require further investigation.

The impact of hearing-aid amplification and its integrated tinnitus feature on tinnitus management

Tinnitus is the potentially debilitating perception of phantom sound with no current cure. Although some management approaches are available, the benefits of hearing aid amplification and its added noiser are uncertain. This study assessed impacts of hearing-aid amplification, and amplification with an added noiser feature, on adults with hearing loss and chronic bothersome tinnitus. Thirty adults [42–75 (Mean = 61.1) years old; 18 males], with mild to moderate sensorineural hearing loss but no previous amplification exposure; and bothersome tinnitus [Tinnitus Functional Index (TFI) baseline scores of at least 20], were randomly assigned to one of two groups in a cross-over study to experience amplification-only, and amplification + noiser for one month each, following one month of no intervention. Study hearing aids were worn minimally for 5-h/day. TFI questionnaires evaluated tinnitus severity before and after each condition. A one-way repeated measures ANOVA with 30 participants revealed a significant effect on TFI across baseline, amplification-only, and amplification + noiser conditions (p = .023), suggesting tinnitus improvement across conditions. Further post-hoc tests indicated lower TFI scores in the amplification + noiser condition (p = 0.048), identifying its distinct benefit. Preliminary analysis suggests benefit of hearing aid amplification, with a prominent advantage of the noiser feature on tinnitus management.

Abstract 019: Effective Diagnostic Testing For Uncommon Etiologies Of Venous Pulsatile Tinnitus

Introduction Pulsatile Tinnitus (PT) is a rhythmic sound in the ears. It can be incapacitating and is even associated with depression and suicidal ideationi. The etiology of PT can be grouped into vascular and non‐vascular causes. ii,iii While prominent venous structures may be believed to be the underlying cause of PT, interventions on these structures do not always result in symptom resolution. Successful treatment is contingent on correctly identifying culpable vascular targets. In this case series, we report 4 cases of pulsatile tinnitus that were successfully treated with endovascular intervention. Methods Retrospective chart review of patients who presented with symptoms of pulsatile tinnitus who were found to have symptoms that resolved on balloon‐occlusion‐testing of various cerebral veins. Results Case 1 A 42‐year‐old woman was referred for right‐sided PT which affected her sleep and quality of life. The initial venogram showed a right internal jugular (IJ) vein diverticulum, which was subsequently coiled. This resulted in a transient improvement in tinnitus. However, her symptoms returned within a few weeks and a repeat venogram showed an enlarged right MEV. She elected to undergo right MEV coil embolization. Two weeks post‐op she noted an improvement of her symptoms, with near resolution. On follow‐up exams, when she applied pressure on her right occipital groove, the tinnitus diminished. Under ultrasound guidance, her PT disappeared when the posterior auricular vein collapsed under applied pressure and returned when the pressure was released. For management she underwent coil embolization of the right occipital vein, as this was the vessel the posterior auricular vein was draining into. Following this intervention her tinnitus resolved. Case 2 A 73‐year‐old male was referred for bilateral pulsatile tinnitus. Initially, he underwent stent‐assisted coiling of a high‐riding jugular bulb with no change in symptoms. During a diagnostic venogram, a balloon‐occlusion test (BOT) of the right mastoid emissary vein (MEV) was performed. Following testing, he reported improved tinnitus. He underwent coil embolization of the right MEV which led to complete resolution of right‐sided PT. Case 3 A 50‐year‐old female was referred for evaluation of right‐sided PT. Catheter venography showed an enlarged right posterior condylar vein (PCV) and right IJ stenosis. Balloon occlusion test (BOT) of the PCV demonstrated improvement in PT. She underwent stent‐assisted coil embolization of the PCV and stenting of her IJ with resolution of her tinnitus. Case 4 A 56‐year‐old female was seen for left‐sided PT, ear fullness, and reduced hearing. A CT venogram revealed left IJ stenosis. Catheter venography showed minimal left IJ stenosis, but a dilated left MEV, measuring 7.31 mm in its widest dimension). BOT of the left MEV resulted in improvement in symptoms. She is scheduled for left MEV coil embolization. Conclusion In this report, we demonstrate 4 cases where abnormal venous structures were the suspected cause of tinnitus based on pre‐treatment occlusion testing. The 3 individuals who have undergone coil embolization of anomalous venous structures have experienced resolution of PT. Balloon occlusion is a useful diagnostic test for therapeutic targeting of abnormal venous etiologies of PT.

Effects of complex neck therapy – kinesiotherapy and interspinal muscles massage – on tinnitus

Introduction&lt;i&gt;&lt;/i&gt;Past studies have shown connections between the somatosensory system (the neck and temporomandibular joint region) and the auditory system. It is therefore likely that tinnitus patients might benefit from neck therapy. The aim of this study was to investigate the effects of physiotherapy of the neck, comprising cervical spine kinesiotherapy and interspinal muscles massage, on subjective tinnitus. We also investigated the effects of the therapy on the range of cervical spine motion and cervical muscles tension.Material and methodsThis was a non-randomised controlled trial. Adult patients with chronic subjective tinnitus (&lt;i&gt;n&lt;/i&gt; = 118) were enrolled in an intervention group and received 10 sessions, over 2 weeks, of neck therapy comprising active exercises, massage of the cervical interspinal muscles, and post-isometric relaxation exercises. There was also a control group (waiting list). The effects of the therapy on tinnitus were assessed at baseline, immediate post-treatment, and follow-up (2 weeks after the end of therapy) using the Polish Tinnitus Functional Index (TFI-Pl, primary outcome measure), a visual analogue scale (VAS) of tinnitus loudness, and the Polish Tinnitus Handicap Inventory (THIPl). Effects of therapy on neck were assessed using two measures: the range of cervical spine movement (cervical flexion, cervical rotation, and cervical side bending measured in cm using a tape measure); and muscle tension – assessed by palpation and graded using a scale of either 0 (normal) or 1 (increased).ResultsIn the intervention group, the mean TFI score was reduced significantly from baseline (mean = 52.6, SD = 20.4) to post treatment (mean = 40.9, SD = 19.0, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and at follow-up (mean = 40.4, SD = 21.1, linear mixed model). In the control group, mean TFI score did not change significantly from baseline (mean = 46.8, SD = 20.1) to post treatment (mean = 45.8, SD = 40.9) and follow-up (mean = 45.2, SD = 26.2, linear mixed model). Improvement in tinnitus in the intervention group was accompanied by a reduction in cervical muscles tension and improvement in the range of cervical spine motion.ConclusionsComplex neck therapy of the neck appears to be a promising intervention for tinnitus treatment. Further randomised studies are needed to confirm the positive effects of the therapy on tinnitus and explore the mechanisms leading to improvement.

Auditory cortex hyperconnectivity before rTMS is correlated with tinnitus improvement

IntroductionRepetitive transcranial magnetic stimulation (rTMS) has been used as a potential treatment for tinnitus; however, its effectiveness is variable and unpredictable. We hypothesized that resting-state functional connectivity before rTMS may be correlated with rTMS treatment effectiveness. MethodsWe applied 1-Hz rTMS to the left primary auditory (A1) and dorsolateral prefrontal cortices (DLPFC) of 10 individuals with tinnitus and 10 age-matched controls. Resting-state functional magnetic resonance imaging (fMRI) studies were performed approximately one week before rTMS. Seed-based connectivity analyses were conducted for each individual, with seed regions as rTMS target areas. ResultsCompared to controls, the left superior temporal areas showed significantly increased positive connectivity with the left A1 and negative connectivity with the left DLPFC in the tinnitus group. The left frontoparietal and right cerebellar areas showed significantly increased negative connectivity with the left A1 and positive connectivity with the left DLPFC. Seed-based hyperconnectivity was correlated with tinnitus improvement (pre-rTMS vs. 2-week post-rTMS Tinnitus Handicap Inventory scores). Tinnitus improvement was significantly correlated with left A1 hyperconnectivity; however, no correlation was observed with left DLPFC connectivity. Positive rTMS outcomes were associated with significantly increased positive connectivity in bilateral superior temporal areas and significantly increased negative connectivity in bilateral frontal areas. ConclusionsOur results suggest that oversynchronisation of left A1 connectivity before rTMS of the left A1 and DLPFC is associated with treatment effectiveness.

The Effectiveness of a Smartphone Application for Tinnitus Relief.

There has been a growing interest in the provision of smartphone- or internet-based tinnitus management. Studies have shown a positive impact of the smartphone applications on tinnitus symptoms. However, research into a relatively long-term effect of these applications on tinnitus relief as well as sound preferences has been sparse. This study explored the potential benefit of a tinnitus application in tinnitus relief over a period of six months. Twenty-two participants with subjective tinnitus were enrolled in the study. Puretone audiometry, tinnitus pitch and loudness matching, stress assessment, and questionnaires were completed at the initial visit and three and six months after the first visit. The participants used the tinnitus application for six months. A significant reduction in subjective tinnitus loudness and annoyance and subjective stress level was observed. The Tinnitus Handicap Inventory scores were also significantly decreased after six months. The participants also reported high satisfaction with the application. Music and environmental sounds were the most preferred sound stimuli. The findings of this study demonstrate the potential benefit of the tinnitus application for tinnitus improvement.

The effect of cochlear implant and bimodal stimulation on tinnitus: a multinational survey

Background Tinnitus is a frequent symptom in cochlear implant (CI) patients. Many studies have shown that a CI leads to a significant change in the perception of tinnitus. Aims The aim of the present study was to evaluate the effect of CI on tinnitus in patients with Unilateral Cochlear Implant (UCI), Bilateral Cochlear Implant (BCI), and Bimodal Stimulation (BMS). Material and Methods A survey was administered online to CI patients. The Tinnitus Handicap Inventory (THI) score was calculated. Emotional, functional, and catastrophic subscales scores were calculated. The intensity and annoyance of tinnitus were graded using a scale from 1 to 10. Results 130 participants represented the study group; the Average THI score was 38.3 (SD: 26.3) in UCI, 32.4 (SD 25.8) in BCI users, and 42.5 (SD 28.2) in BMS: no significant difference was found among the three groups. CI users for less than 1 year showed significantly higher THI scores compared to CI users for more than 5 years (p = .0275). The intensity and annoyance of tinnitus significantly decreased with the CI on compared to the CI off condition. Conclusions and Significance Taken together, our findings support CI’s efficacy in reducing the perception of tinnitus. No significant differences were evident between unilateral and bilateral electrical stimulation in terms of tinnitus improvement.

Cochlear implantation in single-sided deafness: a single-center experience of 138 cases.

Assess the outcomes in patients who underwent cochlear implant (CI) for single-sided deafness (SSD). All patients affected by SSD who underwent CI at Gruppo Otologico, Piacenza, from October 2012 to May 2022 with at least 6months of follow-up were selected in the study group. The analysis included subjective and objective measures performed pre-operative and up to 24months after surgery. Hearing threshold on both sides was evaluated with a weighted four-frequency average (PTA [0.5kHz + 1kHz + 2kHz + 4kHz]/4) on pure tone audiometry and speech audiometry (Speech Discrimination Score, SDS). The Speech Spatial and Qualities of Hearing scale (SSQ Questionnaire) for binaural hearing benefits and sound localization, the Tinnitus Handicap Inventory Questionnaire (THI) and Dizziness Handicap Inventory Questionnaire (DHI) were used for subjective assessment. Data from 138 patients, 69 males and 69 females, (mean age 49years, range 17-77years) underwent CI for SSD were examined. Single-sided hearing deprivation average before undergoing CI surgery was 2.5years (range 3months-35years). There was a significant reduction of THI and DHI scores compared to pre-operative scores alongside a referred improvement in social, physical, and emotional well-being through the SSQ questionnaire. To the best of our knowledge, this paper descried the largest cohort of SSD who underwent CI in a single institution. According to our findings CI in patients affected by SSD represents a valuable tool for an overall improvement of tinnitus and dizziness but also quality of life, after at least 6months of follow-up. Further studies are desirable to improve rehabilitation pathways and possibly set new standards of care of this condition.

Tinnitus in COVID-19 Era – A Study on its Association with SARS-CoV-2 and its Outcome

Introduction Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) virus mainly affecting the respiratory and circulatory system. In many, neuro-otological changes have been noted – tinnitus being one of the leading clinical manifestations which has skipped the limelight due to the other deadly complications of the disease. The study aims to assess the relation between COVID-19 infection and tinnitus, its relation with vaccination against COVID-19 and to assess the change in intensity of tinnitus at the end of 10 weeks after medical treatment in the patients with and without a positive COVID-19 RTPCR (Reverse Transcription-Polymerase Chain Reaction) report. Materials and Methods An institution based prospective comparative study was done in a tertiary hospital in Kolkata, West Bengal between July 2021 to December 2021. All patients aged between 18 and 65 years, with recent onset of subjective tinnitus since March 2020 (COVID-19 1st wave), were included in this study. Intensity of tinnitus was assessed at the end of 10 weeks after medical treatment with the help of Tinnitus Handicap Inventory (THI). Results Among the 84 patients with tinnitus - 20 had a history of (H/O) COVID-19 infection, 64 didn’t. Among the 20 patients who developed tinnitus post-COVID-19 infection, 2(10%) had been vaccinated while 39 out of the 64(60.9%) patients without a had been vaccinated against COVID-19 disease. At the end of 10 weeks post-treatment, 6 out of 20(30%) patients with a H/O COVID-19 showed an improvement in THI score– of them, 2 were vaccinated while 33 out of 64(51.56%) patients without a H/O COVID-19 showed improvement in THI score – of them 28 were vaccinated against COVID-19. Conclusion Our study concludes that the chances of developing tinnitus is more in those who have not been vaccinated against COVID-19 and post-medication improvement of tinnitus in COVID-19 infected patients was much less than those without a history of COVID-19 infection.

A study of efficacy of Nigella sativa in treatment of Meniere's disease: A randomized, placebo controlled clinical trial

PurposeMeniere's disease (MD), first introduced by Prosper Meniere, is characterized mainly by vertigo, tinnitus, aural fullness and sensorineural hearing loss. Though the exact pathophysiology of MD is unknown, immunologic and inflammatory interactions are possible underlying mechanisms involved in MD. This study is aimed to investigate the immunomodulatory and anti-inflammatory effect of Nigella sativa on MD as a therapeutic agent. MethodsWe divided 40 patients with definite MD into two groups of 20 cases. The study group received 1 g of Nigella sativa oil daily for three months and the control group received a placebo. Changes in hearing, tinnitus and vertigo were estimated by pure tone audiometry, tinnitus handicap inventory questionnaire and dizziness handicap inventory questionnaire, respectively. ResultsAt the end of the study we did not observe any significant improvement in study's group hearing threshold, tinnitus and vertigo compared to the control group. ConclusionsIn this study, statistical analysis showed that Nigella sativa failed to improve signs and symptoms of MD. However, further investigations with a larger study population are needed to ascertain the current conclusion.

Tinnitus

Tinnitus is a highly prevalent symptom and a common reason for seeing an otolaryngologist. Since tinnitus can go hand in hand with hearing loss, the step-by-step clarification of hearing loss is one of the essential ENT examinations for tinnitus sufferers. The anamnesis and medical history are relevant, since a multidimensional interaction with the tinnitus can be important for the treatment, especially in the case of a psychological comorbidity. In the vast majority of patients, no causal factor can be found. In the absence of external stimuli, phantom perceptions of tones or noises are held responsible for subjective tinnitus, which probably arises from pathological changes of the auditory pathway, but also in non-auditory cortical structures. In the case of acute tinnitus, a comprehensive audiological assessment is needed, and if the hearing threshold is normal, counseling is the priority. The patient must be informed about the nature of these benign symptoms. So far, there is no acute therapy that has been proven to increase the probability of healing, i.e. the disappearance of the acute tinnitus. Only if the hearing threshold descended, for instance in case of sudden idiopathic hearing loss, therapy of the underlying disease can also lead to improvement or healing of the acute tinnitus. Counseling for chronic tinnitus with high burden is also about reducing exaggerated expectations of healing that cannot be fulfilled. The training of habituation strategies is important. The standard of therapy for chronic tinnitus with psychological strain represents cognitive behavioral therapy for dealing with the tinnitus in a beneficial way. Tinnitus is a symptom of a very heterogeneous group of patients. In the future, it is to be hoped that digital applications and interventions in particular will be evaluated in quality-controlled clinical studies in order to be able to further personalize patient therapy.

Intratympanic Botulinum Toxin Injection as a New Therapeutic Modality for Middle Ear Myoclonic Tinnitus.

Middle ear myoclonic tinnitus (MEMT) is a disease caused by myoclonus or abnormal contractive movement of middle ear muscles (MEMs). This translational study was conducted to propose intratympanic botulinum toxin (IT-BTX) injection as a new therapeutic modality to treat MEMT. Animal experiment and nonrandomized controlled clinical trial. Laboratory and medical center of an academic tertiary medical institution. For the animal study, male Sprague-Dawley rats were divided into 4 subgroups according to the sacrificing day after IT-BTX injection. After initial hearing tests, randomly assigned experimental ears were intratympanically injected with 1 unit/100 μL of BTX-A, whereas control ears were injected with normal saline. Changes in the hearing thresholds, morphometry of the cochleae, electron microscopy study, and immunofluorescence analysis of MEMs were evaluated. For the human study, 10 intractable MEMT patients were enrolled. The hearing thresholds and the degree of tinnitus distress were observed for changes after IT-BTX injection. All patients were followed up for 3 months. As for the animal study, there were no significant changes in hearing thresholds and cochlear morphologies in all 4 subgroups of the rats. Significant MEM degenerations and immuno-detection of cleaved synaptosome-associated protein of 25 kDa (cSNAP-25) indicated the efficacy of IT-BTX. MEMT patients enrolled for the pilot clinical trial showed statistically significant improvement in tinnitus after IT-BTX injection. No major complications were noted. The new therapeutic modality of IT-BTX injection for the treatment of MEMT seems highly promising with an excellent result.

Zilver stent versus Carotid Wallstent for endovascular treatment of idiopathic intracranial hypertension

BackgroundVenous sinus stenting (VSS) is a promising treatment option for medically refractory idiopathic intracranial hypertension (IIH). There are no published studies comparing the performance of different types of stents employed...

Long-term evaluation and physical and mental effects of residual tinnitus following treatment of sudden hearing loss

Objective: To clarify the long-term characteristics of tinnitus following treatment of sudden deafness and its long-term physical and mental effects on patients. Methods: A retrospective analysis was performed on 88 patients (46 males and 42 females; Age from 11 to 89 years) with sudden deafness treated in Department of Otoscope Surgery of Peoples's Libration Army General Hospital in Beijing from April 2020 to January 2021, and the occurrence of tinnitus and treatment effect of all patients were analyzed. Follow-up was conducted for patients with residual tinnitus after treatment for more than 1 year by the investigation and filling in the survey information collection form, Tinnitus Evaluation Questionnaire (TEQ) and Tinnitus Handicap Inventory (THI). Descriptive statistics and SPSS 22.0 software were used for statistical data analysis. Results: In this study, 93.2% (82/88) of patients with sudden deafness were accompanied by tinnitus at the onset, and the proportion of long-term tinnitus after treatment was 90.2% (74/82). After 1 year of treatment for sudden deafness, the improvement of tinnitus was significant in low-frequency sudden deafness compared with those of high-frequency, flat and total deafness sudden deafness (χ2 value was 6.801, 4.568 and 4.038, all P<0.05). In patients with residual tinnitus, 9 (12.2%) patients felt minimal loudness or even no loudness, 34 (46.0%) patients felt slight loudness, 28 (37.8%) patients felt tinnitus was relatively loud, and 3 (4.1%) patients felt tinnitus was loud or noisy. Nine (12.2%) patients's sleep was often affected, 41 (55.4%) patients's sleep was sometimes affected, 9 (12.2%) patients's sleep was rarely affected, 15 (20.3%) patients's sleep was almost not affected. Twenty-eight (37.8%) patients basically completely adapted to tinnitus and 46 (62.2%) patients did not completely adapted to residual tinnitus. Eight (10.8%) patients had no impact on life, 39 (52.7%) patients had slight impact, 22 (29.7%) patients had moderate impact, and the other 5 (6.8%) patients had greater impact. According to tinnitus evaluation questionnaire(TEQ), there were 12 cases (16.2%) of grade Ⅰ, 26 cases (35.1%) of grade Ⅱ, 28 cases (37.8%) of grade Ⅲ, 7 cases (9.5%) of grade Ⅳ and 1 case (1.4%) of grade Ⅴ. According to tinnitus handicap inventory(THI), tinnitus disability was classified into grade Ⅰ, 22 cases (29.7%), grade Ⅱ, 14 cases (18.9%), Grade Ⅲ, 27 cases (36.5%) and grade Ⅳ, 11 cases (14.9%). Conclusion: The rate of residual tinnitus following treatment of sudden deafness is high. Some of the patients can completely adapt residual tinnitus after one year, but some of them will be affected when sleep, work and study. Residual tinnitus can lead to tinnitus disability in different degrees.

Endolymphatic sac decompression effect on secondary symptoms of Meniere's disease

ObjectiveTo evaluate if endolymphatic sac decompression (ESD) significantly improves secondary symptoms of Meniere's disease including tinnitus and aural fullness. Study designSurvey study with retrospective chart review. SettingTertiary care center. MethodsSurvey of adult patients with Meniere's disease that underwent primary ESD surgery from 2015 to 2020. Subjective reporting of pre- and postoperative aural fullness and tinnitus based on postoperative survey. Survey results and audiologic data of the patients that reported were compared pre- and postoperatively. ResultsStatistical analysis was performed using weighted kappa statistics to examine the level of agreement. There was a value of 0.12 for pre- and postoperative aural fullness, indicating a difference in the two groups with 77 % having improvement and only 4 % having worsening. There was a value of 0.21 for pre- and postoperative tinnitus, demonstrating a lack of agreement with 58 % having improvement and 4 % having worsening. Overall, there was significant improvement in both tinnitus and aural fullness postoperatively. There was no significant difference in word recognition score, speech reception threshold, or pure tone average between the pre- and postoperative group based on paired t-test. ConclusionsThere is a significant improvement in both aural fullness and tinnitus for patients undergoing ESD with no negative effect on audiologic status. ESD is a viable option for treatment of Meniere's disease with vertigo, aural fullness, and tinnitus relief. Future prospective studies are needed to further improve the evidence of ESD's effect on secondary symptoms of Meniere's disease.

Long-term efficacy of dexamethasone treatment via tympanic antrum catheterization for intractable Meniere's disease.

To explore the long-term efficacy and safety of dexamethasone treatment via tympanic antrum catheterization (TAC) in intractable Meniere's disease (MD). In this retrospective analysis, 60 unilateral intractable MD patients treated with TAC in our hospital from January 2020 to August 2020 were followed for 2 years. Fifty patients who underwent endolymphatic sac decompression (ESD) and 50 patients who accepted intratympanic steroids (ITS) were established as the control groups. Vertigo control, hearing level, tinnitus, aural fullness and functional level were assessed during the study. The effective vertigo control rate of intractable MD patients with TAC treatment was 76.7% (46/60) after 2 years follow-up, with a complete control rate of 58.3% (35/60) and a substantial control rate of 18.3% (11/60). The vertigo control rate of TAC was comparable to that of ESD (χ 2 = 0.313, p > 0.05), and significantly higher than that of ITS (χ 2 = 4.380, p < 0.05). The hearing loss rate of these patients was 10.8% (4/37), which was not significantly different from the control groups (χ 2 = 2.452, p > 0.05). The tinnitus improvement rate of patients with TAC was 56.7% (34/60), which was significantly higher than that of patients with ESD (χ 2 =11.962, p < 0.001) and ITS (χ 2 =15.278, p < 0.001). The aural fullness improvement rate in the TAC group was 56.7% (34/60), which was significantly higher than that in the ESD (χ 2 = 11.962, p < 0.001) and ITS groups (χ 2 = 5.635, p < 0.05). The functional level improvement rate in the TAC group was 71.7% (43/60), which was much higher than that in the ITS group (χ 2 = 17.256, p < 0.001), but there was no significant difference between TAC and ESD (χ 2 = 0.410, p > 0.05). No patients had complications or adverse reactions following TAC treatment. Dexamethasone treatment via TAC can effectively control vertigo attacks and improve related symptoms of intractable MD patients, providing valuable new insights into the treatment of MD.

Dural Venous Sinus Stenting in Idiopathic Intracranial Hypertension: A National Database Study of 541 Patients.

Dural venous sinus stenting (VSS) is an effective intervention for patients with idiopathic intracranial hypertension (IIH) refractory to medical treatment. Our goal was to evaluate the efficacy by utilizing a large multi-institutional sample. Five hundred forty-one patients >18years old who underwent VSS within 3years of IIH diagnosis were queried using Current Procedural Terminology and International Classification of Diseases, Tenth Revision codes from the TriNetX Analytics Network. Patient demographics, baseline symptoms, procedures, and clinical outcomes were evaluated within 1 year postoperatively. Outcomes examined were headache, tinnitus, blindness/low vision, optic nerve sheath fenestration (ONSF), cerebrospinal fluid (CSF) shunt, and use of medications (acetazolamide, methazolamide, furosemide, topiramate, tricyclic antidepressants, and valproate) for IIH. Prestent and poststent data were compared using Fisher exact test, and the odds ratios were computed using the Baptista-Pike method. The mean age at VSS was 36.7±10.6; 92% were female, 65% of patients were Caucasian, 25% were Black/African American, 1% were Asian, and 9% were of other/unknown race. Within the 1-year follow-up, acetazolamide and topiramate use were significantly reduced post-VSS (P < 0.0001∗; odds ratio, 0.45; confidence interval, 0.35-0.57 and P= 0.03∗; odds ratio, 0.71; confidence interval, 0.52-0.95, respectively). Also, headaches, visual disturbance, dizziness/giddiness, and tinnitus significantly improved post-VSS (P < 0.005∗). Finally, the number of CSF shunt procedures and ONSF procedures demonstrated no significant change post-VSS (P > 0.05). VSS is an effective and safe procedure resulting in significant improvement of headaches, visual impairment, dizziness, and tinnitus, acetazolamide and topiramate usage were lower after VSS in patients with IIH. The paucity of pre-VSS and post-VSS CSF shunt and ONSF procedure data does not provide enough evidence to establish significance.