Incidence Of Tinnitus Research Articles

Retrospective evaluation of the association between climate and seasonal change with idiopathic tinnitus

ABSTRACT Tinnitus, affecting 10–15% of adults, is a multifactorial disorder with a challenging etiology. It is often associated with sex, age, obesity, smoking, and alcohol consumption. Current literature suggests that tinnitus could be associated with seasonal variability, exhibiting seasonal patterns. Although tinnitus is suggested to follow a seasonal trend conclusive evidence associating its onset to seasonality is lacking. This study aims to evaluate the impact of seasonal variability on the prevalence of tinnitus. Data was collected from MDClone platform regarding patients admitted to ‘Clalit medical services' in Israel's southern district due to the first emergence of tinnitus symptoms between the years 2005–2020. The comparison was relaying on difference in gender, age, known risk factors for tinnitus, and date of onset of tinnitus. A total of 56,315 patients were included in this cohort study. Winter is the most common season for first admissions due to tinnitus symptoms including 16,094 patients (29%). Summer (Beta = –3.037, p = 0.012) and autumn (Beta = –3.764, p < 0.001) show a negative effect on minimal mean temperature which suggest lower tinnitus incidence in a higher temperature. Humidity and maximal mean temperature did not show any statistical significance. Except for age (mean 51.73 ± 17.49), no statistical significance was found in the prevalence of risk factors related to tinnitus. In conclusion Our findings shows that tinnitus is associated with seasonality and its trends. The incidence of tinnitus is declining over the past two decades following a peak in the winter, with age being the only significant risk factor.

Otological manifestations of temporal bone fractures

Background: Temporal bone fractures are caused by high intensity trauma and can result in various facial and cochleovestibular sequelae, which can affect the quality of life. The aim was to study about the various otological manifestations of temporal bone fractures in head trauma patients. Methods: Descriptive study of 82 patients was conducted in the Department of Otorhinolaryngology, Government T D Medical College, Alappuzha from April 2019 to March 2021. All patients with radiological evidence of temporal bone fractures were taken for study and their symptoms and signs were compared among otic capsule sparing (OCS) and otic capsule violating (OCV) type fractures. Data was analysed statistically using SPSS version 22 and p value calculated using chi-square test. Results: Majority of the patients were in the 20–40-year age group. Male to female ratio was 8.1:1. The most common aetiology was road traffic accidents (RTAs) n=74 (90.24%). The incidence of tinnitus (p value=0.02), vertigo (p value=0.007), facial palsy (p value=0.0004), CSFO (p value=0.0002), nystagmus (p value=0.0065) and sensorineural hearing loss (SNHL) (p value=0.00001) were found to be more in OCV type fractures and their association was found to be statistically significant. The incidence of TM perforation (p value=0.01), conductive hearing loss (CHL) (p value=0.0008) and EAC laceration (p value=0.04) was more in OCS type fractures and was statistically significant. Conclusion: Rapid diagnosis of temporal bone fractures is crucial as it enables effective initial management aimed at avoiding the facial and cochleovestibular sequelae that can adversely affect the quality of life. Keywords: temporal bone; fracture; facial palsy; tinnitus; otological manifestation; sensorineural hearing loss

Comparative study of SSNHL with and without tinnitus: audiologic and hematologic differences

Background and Objectives Tinnitus is one of the most common symptoms of sudden sensorineural hearing loss (SSNHL), with the incidence of tinnitus in patients with SSNHL ranging from 60% to 90%. Little is known, however, about the specific audiologic and hematologic factors that may be associated with the development of tinnitus. To better understand the relationship between tinnitus and SSNHL, the present study compared audiologic and hematologic factors in SSNHL patients with tinnitus and without tinnitus. Subjects and Method The present study compared 120 patients with SSNHL with tinnitus and 59 patients with SSNHL without tinnitus at their initial examination. Their audiology and hematologic test results were analyzed, and hearing recovery was determined by comparing the hearing thresholds before and after treatment. Results 120 patients with tinnitus showed longer III and V latency in auditory brainstem response (ABR) tests, lower signal-to-noise ratios (SNR) at 2 kHz in transient evoked otoacoustic emissions (TEOAE) tests, and lower response rates at 2 kHz in distortion product otoacoustic emissions (DPOAE) tests of the affected ear (p < 0.05 each) than the 59 patients without tinnitus. However, there were no significant between-group differences in the mean hearing threshold and hearing recovery rate of the affected ear. Patients with tinnitus had significantly worse mean hearing thresholds and hearing thresholds at 4 kHz in the nonaffected ear. The percentages of monocytes and large unstained cells (%LUCs) were higher in the group without tinnitus (p < 0.05), although there were no significant between-group differences in inflammatory markers, such as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR). Conclusion Tinnitus accompanying SSNHL may be associated with baseline hearing level, as well as being an indicator of damage to outer hair cells and auditory nerves. Additional studies are needed to evaluate hematologic data in SSNHL patients with and without tinnitus.

A Bibliometric Analysis of Publications on Tinnitus: A Study Based on Web of Science Data From 1980 to 2020.

The incidence of tinnitus has been increasing together with its patient impact and societal costs. Much research has been conducted in the field of tinnitus, especially on treatment modalities because there still is no cure. This study aims to analyze the evolutions and developments in the scientific output relating to tinnitus. We analyzed the Science Citation Index Expanded featured articles in the Web of Science Core Collection relating to tinnitus from 1980 to 2020. The publications were analyzed by characteristics such as the countries and institutions, journals, the most cited articles and references, and the most frequently used words in the abstracts and keywords. In total, 8282 articles relating to tinnitus were identified in the Web of Science. The number of publications has been significantly increasing after the 1990s. Of the 8282 articles, a major part originated from the American and European institutions. Most articles originated from high-impact journals, which consequently also covered the most cited papers. A major interest was seen in areas about treatment and pathogenic mechanisms. This bibliometric analysis here indicated an increasing trend in tinnitus research from 1980 to 2020, particularly with the increase in tinnitus burden and the societal costs by it. Specific interest has been seen in the specific tinnitus pathophysiological mechanisms and treatment. Individual researchers and institutions will gain a new perspective on their future studies based on the bibliometric data in our paper.

The Role of Diet in Tinnitus Onset: A Hospital-Based Case-Control Study from Italy.

Knowledge on the role of diet in tinnitus onset is mostly based on few cross-sectional studies. In 2016-2019 we conducted a hospital-based case-control study in northern Italy on 185 incident idiopathic tinnitus cases and 198 controls, providing data on dietary habits through a 37-item food-frequency questionnaire. Odds ratios (OR) for tinnitus risk were derived through unconditional multiple logistic regression models. Moderate-to-high vs. low intake of caffeine (OR, 0.49; 95% confidence interval (CI), 0.24-0.99) and butter (OR, 0.46; 95% CI, 0.23-0.93), and high vs. low intake of poultry (OR, 0.43; 95% CI, 0.23-0.81), prosciutto (OR, 0.44; 95% CI, 0.23-0.85), and legumes (OR, 0.50; 95% CI, 0.28-0.92) were inversely associated with tinnitus onset. Other food items, including cereals, red meat, fish, vegetables, and fruit did not show any statistically significant relationship. The variety of food consumed decreased the risk of tinnitus (OR for at least 20 vs. less than 16 different food items, 0.47; 95% CI, 0.24-0.90). Our findings highlight the importance of diet in tinnitus onset and confirm a potential inverse association of protein-rich food and caffeine on the incidence of tinnitus. Confirmation of our findings in longitudinal studies is necessary before proving any diet recommendations for tinnitus prevention.

Global Prevalence and Incidence of Tinnitus

To date, no systematic review has taken a meta-analytic approach to estimating the prevalence and incidence of tinnitus in the general population. To provide frequency estimates of tinnitus worldwide. An umbrella review followed by a traditional systematic review was performed by searching PubMed-MEDLINE and Embase from inception through November 19, 2021. Research data from the general population were selected, and studies based on patients or on subgroups of the population with selected lifestyle habits were excluded. No restrictions were applied according to date, age, sex, and country. Relevant extracted information included type of study, time and location, end point, population characteristics, and tinnitus definition. The study followed the Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guideline. Pooled prevalence estimates of any tinnitus, severe tinnitus, chronic tinnitus, and diagnosed tinnitus as well as incidence of tinnitus were obtained using random-effects meta-analytic models; heterogeneity between studies was controlled using the χ2 test, and inconsistency was measured using the I2 statistic. Among 767 publications, 113 eligible articles published between 1972 and 2021 were identified, and prevalence estimates from 83 articles and incidence estimates from 12 articles were extracted. The pooled prevalence of any tinnitus among adults was 14.4% (95% CI, 12.6%-16.5%) and ranged from 4.1% (95% CI, 3.7%-4.4%) to 37.2% (95% CI, 34.6%-39.9%). Prevalence estimates did not significantly differ by sex (14.1% [95% CI, 11.6%-17.0%] among male individuals; 13.1% [95% CI, 10.5%-16.2%] among female individuals), but increased prevalence was associated with age (9.7% [95% CI, 7.4%-12.5%] among adults aged 18-44 years; 13.7% [95% CI, 11.0%-17.0%] among those aged 45-64 years; and 23.6% [95% CI, 19.4%-28.5%] among those aged ≥65 years; P < .001 among age groups). The pooled prevalence of severe tinnitus was 2.3% (95% CI, 1.7%-3.1%), ranging from 0.5% (95% CI, 0.3%-0.7%) to 12.6% (95% CI, 11.1%-14.1%). The pooled prevalence of chronic tinnitus was 9.8% (95% CI, 4.7%-19.3%) and the pooled prevalence of diagnosed tinnitus was 3.4% (95% CI, 2.1%-5.5%). The pooled incidence rate of any tinnitus was 1164 per 100 000 person-years (95% CI, 479-2828 per 100 000 person-years). Despite the substantial heterogeneity among studies, this comprehensive systematic review on the prevalence and incidence of tinnitus suggests that tinnitus affects more than 740 million adults globally and is perceived as a major problem by more than 120 million people, mostly aged 65 years or older. Health policy makers should consider the global burden of tinnitus, and greater effort should be devoted to boost research on tinnitus.

Hyperlipidemia and its relation with tinnitus: Cross-sectional approach.

Tinnitus is a common auditory complaint among individuals characterized by ringing, buzzing, hissing, chirping, whistling, or other sounds in the ear. Following a low-fat/low-cholesterol diet can help reduce the blood cholesterol and triglyceride levels, which aids improvement in tinnitus symptoms. High cholesterol and triglyceride levels in the bloodstream play a significant role in the development of tinnitus, hearing loss, and vertigo. This paper aims to test the association between hyperlipidemia and tinnitus among outpatients in King Khalid University (KKU) ENT clinic. A retrospective review of the medical records of patients who attended the ENT clinic at KKU was performed. An otological examination including pure tone audiometry, personal habits, and lipid profile was conducted. Patients were contacted by phone if there were any missing data. The study included 300 patients who were treated in the outpatient clinic during the study period. About 80% of the patients were of age >45 years and 60.3% were males. Half of the cases (150 cases) had tinnitus and 13% had hyperlipidemia. Patients with high lipid profile recorded doubled risk for tinnitus (P < 0.05). Other risk factors found to be significantly associated with tinnitus include vertigo, young age, and wearing an earpiece. In conclusion, there was a significant association between hyperlipidemia and the incidence of tinnitus even after adjusting for all other risk factors. More large-scale researches are needed to assess in detail the association between different lipid components such as low-density lipoprotein, high-density lipoprotein, triglycerides, and tinnitus epidemiology.

The Impact of COVID-19 Confinement on Tinnitus and Hearing Loss in Older Adults: Data From the LOST in Lombardia Study.

BackgroundAlthough a direct relationship between tinnitus or hearing difficulties and COVID-19 has been suggested, current literature provides inconsistent results, and no research has been undertaken in older adults.MethodsIn November 2020, we conducted the LOST in Lombardia survey, a telephone-based cross-sectional study on a sample of 4,400 individuals representative of the general population aged ≥65 years from Lombardy region, Northern Italy. Individuals with diagnosed tinnitus and/or hearing loss were asked whether their conditions had improved or deteriorated in 2020 compared to 2019.ResultsOverall, 8.1% of older adults reported a diagnosis of tinnitus and 10.5% of hearing loss. In 2020 compared to 2019, among individuals with tinnitus, those with increasing severity (5.0%) were similar to those decreasing it (5.3%). Among individuals with hearing loss, more people reported an increase (13.6%) than a decrease (3.2%) in their disease severity. No individual with a diagnosis in 2020 of tinnitus (n = 6) or hearing loss (n = 13) had COVID-19. The incidence of tinnitus was lower in 2020 (rate: 14.8 per 10,000 person-years) than in previous years (rate in 1990–2019: 36.0 per 10,000 person-years; p = 0.026). There was no change in the incidence of hearing loss (p = 0.134).ConclusionsIn this large representative sample of older adults, on average neither COVID-19 confinement nor SARS-CoV-2 infection appeared to increase the severity or incidence of tinnitus. The increased severity of hearing difficulties may totally or partially be explained by physiologic deterioration of the condition, or by a misperception due to the use of face-masks.

Hypothyroidism and related comorbidities on the risks of developing tinnitus

This is a retrospective longitudinal study that uses data from the National Health Insurance Research Database (NHIRD) of Taiwan of which hypothyroid patients who received a diagnosis between 2000 and 2010 were selected and followed up until 2011. The primary outcome of this study was the occurrence of tinnitus (ICD-9-CM code 388.3). The relevant comorbidities were selected as potential confounders according to the literature, which included vertigo (ICD-9-CM code 386), insomnia (ICD-9-CM code 780), anxiety (ICD-9-CM code 300.00), and hearing loss (ICD-9-CM code 388–389). The overall incidence of tinnitus was significantly higher in the hypothyroidism cohort than in the non-hypothyroidism cohort (9.49 vs. 6.03 per 1000 person-years), with an adjusted HR of 1.35 (95% CI 1.18–1.54) after adjusting potential confounders. The incidences of tinnitus, as stratified by gender, age, comorbidity, and follow-up time, were all significantly higher in the hypothyroidism cohort than those in the non-hypothyroidism cohort. The incidence of tinnitus significantly increased with age (aHR = 1.01, 95% CI 1.01–1.02). In conclusion, we report the relationship between hypothyroidism and the increased risk for tinnitus. We also found that hypothyroidism patients are at increased risk of developing tinnitus when associated with comorbidities including vertigo, hearing loss, and insomnia.

Awareness and Experience of Tinnitus in Nepalese Young Adult Population

Abstract Introduction The prevalence of tinnitus is increasing in younger adult rapidly. It is increasing mainly because of increased daily noise levels due to the unrestrained usage of recreational devices like mobile phones, MP3s, iPods, and other personal stereos. The aim of this study is to describe awareness and experience of tinnitus among younger adult with respect to the existence, cause, effects, and management. Methods A descriptive cross-sectional study was conducted in 205 young adult Nepalese population between the age ranges between 20 and 40 years through online survey mode. Statistical analyses were carried out using SPSS 25.0 software. Data were analyzed using the descriptive statistics. Results Result showed more than half of the participants (59.2%) were aware about the existence of tinnitus; however, only 16.1% of participants were aware about the effect of tinnitus. The incidence of tinnitus was found to be high (11.71%) in Nepalese population. Conclusion Even though most of the participants were found to be aware about existence of tinnitus, most of them were not aware about the effect of tinnitus and its cause. This result has implications for audiologist who are involved in hearing health care program across the various age groups. As per this study, since most of the participants pointed to the Internet as their source of awareness, that could be further tapped on to provide awareness in these age groups.

Professor Xiaoyan Wang’s Experience in Treating Tinnitus with Qi Vacuity Pattern by Using Qi Monism

Tinnitus refers to the abnormal sound hallucinations in the ear or inside the skull when the patient lacks outside sound. In recent years, the incidence of tinnitus is increasing gradually, which seriously affects the quality of life of patients. Reducing tinnitus symptoms is one of the main purposes of clinical treatment. Professor Xiaoyan Wang applied the monism of Qi, combined with the dialectics of the six channels and the therapeutic effect was remarkable.

An electroencephalogram-based study of resting-state spectrogram and attention in tinnitus patients

The incidence of tinnitus is very high, which can affect the patient's attention, emotion and sleep, and even cause serious psychological distress and suicidal tendency. Currently, there is no uniform and objective method for tinnitus detection and therapy, and the mechanism of tinnitus is still unclear. In this study, we first collected the resting state electroencephalogram (EEG) data of tinnitus patients and healthy subjects. Then the power spectrum topology diagrams were compared of in the band of δ (0.5-3 Hz), θ (4-7 Hz), α (8-13 Hz), β (14-30 Hz) and γ (31-50 Hz) to explore the central mechanism of tinnitus. A total of 16 tinnitus patients and 16 healthy subjects were recruited to participate in the experiment. The results of resting state EEG experiments found that the spectrum power value of tinnitus patients was higher than that of healthy subjects in all concerned frequency bands. The t-test results showed that the significant difference areas were mainly concentrated in the right temporal lobe of the θ and α band, and the temporal lobe, parietal lobe and forehead area of the β and γ band. In addition, we designed an attention-related task experiment to further study the relationship between tinnitus and attention. The results showed that the classification accuracy of tinnitus patients was significantly lower than that of healthy subjects, and the highest classification accuracies were 80.21% and 88.75%, respectively. The experimental results indicate that tinnitus may cause the decrease of patients' attention.

The Impact of the COVID-19 Pandemic on Tinnitus

The Impact of the COVID-19 Pandemic on Tinnitus

Does Caffeine Intake Increase the Incidence of Tinnitus? A Systematic Review.

Introduction Excessive caffeine intake has been thought to be a contributory factor for tinnitus. However, there has been no systematic review to elucidate the causal relationship between caffeine intake and the incidence of tinnitus. Objectives We performed the current review aiming at evaluating the evidence from the current literature for the relationship between caffeine intake and the incidence of tinnitus. Data Synthesis Databases including PubMed, Scopus, and Google scholar were searched for relevant articles. A total of 142 studies were screened for eligibility, of which four articles met our inclusion criteria: two were prospective cohorts and two were cross-sectional studies. Although one study found no association between caffeine consumption and the incidence of tinnitus, an inverse relationship was reported by two population-based studies. Concerning patients with preexisting tinnitus, reduction of caffeine intake in a subset who consumed 150 ml to 300 ml/day of coffee yielded a favorable outcome in tinnitus severity. However, those with higher dose intake were less prone to have improvement in the severity of tinnitus. Conclusion Although the current review was inconclusive, it appears that the incidence of tinnitus in previously unaffected individuals might be prevented by a high dose of caffeine intake. However, in preexisting tinnitus, a high dose of caffeine may adversely interfere with the efficacy of caffeine reduction.

Increased risk of tinnitus in patients with early-onset cataracts: a nationwide population-based case-control study

BackgroundThis study aimed to investigate the association between early-onset cataract and tinnitus using a population-based database.MethodsRetrospective claims data from the Taiwan National Health Insurance Research Database were analysed. Study subjects comprised patients with early-onset cataract, aged 20–55 years and diagnosed between 2000 and 2010 (n = 2084) and a comparison cohort without the disease (n = 8336). Both cohorts were followed until 2010 to estimate the incidence of tinnitus. To calculate the risk of tinnitus in the case and control groups, Cox proportional hazards models were used and presented as hazard ratios (HRs), adjusted HRs (aHRs) and 95% confidence intervals (CIs).ResultsPatients with early-onset cataract had 1.53-fold increased risk (HR = 1.53, 95% CI = 1.17–2.01, p < 0.01) of developing tinnitus than controls. The number of patients with vertigo (p < 0.0001), insomnia (p < 0.0001), anxiety (p < 0.0001) and hearing loss (p < 0.0001) as comorbidities was also significantly higher in the case group. After adjusting for age, sex and all listed comorbidities, patients with increasing age (aHR = 1.04, 95% CI = 1.02–1.07), early-onset cataract (aHR = 1.32, 95% CI = 1.01–1.74), vertigo (aHR = 1.75, 95% CI = 1.15–2.67), insomnia (aHR = 1.48, 95% CI = 1.14–1.93) and hearing loss (aHR = 6.20, 95% CI = 3.58–10.70) had significantly higher risk of tinnitus.ConclusionsPatients with early-onset cataract are at an increased risk of developing tinnitus in subsequent years and should receive further evaluation for early diagnosis and management if any signs of tinnitus occur.

Does person-centred care improve outcomes for musicians fitted with hearing protectors?

Objective: To reduce the risk of hearing injury, musicians are often recommended custom-made musicians’ hearing protectors (MHP). Studies report benefits of use however, many still report challenges leading to relatively low uptake and inconsistent usage. Person-centred approaches to health have been shown to improve patient outcomes, and these principles may be translatable to musicians’ hearing care. The aim was to investigate if use of, and satisfaction with, MHP is influenced by the treatment delivered to musicians by audiologists.Design: Participants were randomly allocated to one of four conditions that varied in extent of person-centred care.Study sample: Forty-two musicians with an interest in purchasing MHP were recruited.Results: Satisfaction with MHP was high overall and users reported a reduction in incidence of tinnitus. Participants reported few issues related to sound quality, however insertion difficulty was the main problem reported. Only one musician self-identified the need for alterations to their MHP.Conclusions: Adoption of person-centred approaches to MHP was not found to increase likelihood of use, however, satisfaction was high across all conditions. Most often, the need for MHP alterations were clinician-identified during fitting appointments or follow-up contact, underscoring the importance of including these components when providing audiological services to musicians.

Increased risk of tinnitus following a trigeminal neuralgia diagnosis: a one-year follow-up study

BackgroundTinnitus due to hyperactivity across neuronal ensembles along the auditory pathway is reported. We hypothesized that trigeminal neuralgia patients may subsequently suffer from tinnitus. Using nationwide, population-based data and a retrospective cohort study design, we investigated the risk of tinnitus within 1 year following trigeminal neuralgia.MethodsWe used the Taiwan National Health Insurance Research Dataset, a claims database, to identify all patients diagnosed with trigeminal neuralgia from January 2001 to December 2014, 12,587 patients. From the remaining patients, we identified 12,587 comparison patients without trigeminal neuralgia by propensity score matching, using sex, age, monthly income, geographic region, residential urbanization level, and tinnitus-relevant comorbidities (hyperlipidemia, diabetes, coronary heart disease, hypertension, cervical spondylosis, temporomandibular joint disorders and injury to head and neck and index year). All study patients (n = 25,174) were tracked for a one-year period to identify those with a subsequent diagnosis of tinnitus over 1-year follow-up.ResultsAmong total 25,174 sample patients, the incidence of tinnitus was 18.21 per 100 person-years (95% CI = 17.66 ~ 18.77), the rate being 23.57 (95% CI = 22.68 ~ 24.49) among patients with trigeminal neuralgia and 13.17 (95% CI = 12.53 ~ 13.84) among comparison patients. Furthermore, the adjusted Cox proportional hazard ratio for tinnitus in the trigeminal neuralgia group was 1.68 (95% CI = 1.58 ~ 1.80) relative to the comparison cohort.ConclusionsWe found a significantly increased risk of tinnitus within 1 year of trigeminal neuralgia diagnosis compared to those without the diagnosis. Further studies in other countries and ethnicities are needed to explore the relationship between trigeminal neuralgia and subsequent tinnitus.

Investigation of the relationship between tinnitus and temporomandibular disorders

Globally, tinnitus affects between 14 and 32% of the population, occurring at any age of both sexes and increasing with age. The most significant otologic symptoms such as ear pain, tinnitus, dizziness, and hearing loss in clinical practice are often associated with disorders of the nearby temporomandibular joint. Dental practice often has abnormalities of the temporomandibular joint, with an incidence of 18–27% in the population. These disorders may be associated with trauma, injury or dislocation in the disc of the temporomandibular joint, excessive strain on the jaw muscles (e.g., bruxism), arthritis or malocclusion. Symptoms include pain in the jaw and/or face, difficulty opening the jaw and chewing, and sounds when opening the mouth (for example, when talking or chewing). The incidence of tinnitus in subjects with temporomandibular disorders is up to 60%. This report traces the link between tinnitus and temporomandibular disorders.

Tinnitus and Self-Perceived Hearing Handicap in Firefighters: A Cross-Sectional Study.

Firefighters are susceptible to auditory dysfunction due to long-term exposure to noise from sirens, air horns, equipment, and tools used in forcible entry, ventilation, and extrication. In addition, they are exposed to ototoxic chemicals, particularly, during overhaul operations. Studies indicate that 40% of firefighters have hearing loss in the noise-sensitive frequencies of 4 and 6 kHz. Noise-induced hearing loss (NIHL) is often accompanied by tinnitus, which is characterized by ringing noise in the ears. The presence of phantom sounds can adversely affect the performance of firefighters. However, there has been limited research conducted on the prevalence of tinnitus in firefighters. We enrolled firefighters from Michigan, with at least 5 years of continuous service. The hearing handicap inventory for adults (HHIA) was used to determine the difficulty in hearing perceived by the firefighters and the tinnitus functional index (TFI) was used to determine the severity of tinnitus. Self-perceived hearing handicap was reported by 36% of the participants, while tinnitus was reported by 48% of the participants. The TFI survey indicated that 31% perceived tinnitus as a problem. More importantly, self-perceived hearing handicap was significantly associated with the incidence of tinnitus in firefighters, suggesting a potential link between occupational exposure to ototraumatic agents and tinnitus in firefighters.

Impact of TBI, PTSD, and Hearing Loss on Tinnitus Progression in a US Marine Cohort.

Mild TBI (TBI) is associated with up to a 75.7% incidence of tinnitus, and 33.0% of tinnitus patients at the US Veterans Administration carry a diagnosis of post-traumatic stress syndrome (PTSD). Yet factors contributing to new onset or exacerbation of tinnitus remain unclear. Here we measure intermittent and constant tinnitus at two time points to ascertain whether pre-existing or co-occurring traumatic brain injury (TBI), hearing loss, or post-traumatic stress disorder (PTSD) predicts new onset, lack of recovery and/or worsening of tinnitus in 2,600 United States Marines who were assessed before and after a combat deployment. Ordinal regression revealed that constant tinnitus before deployment was likely to continue after deployment (odds ratio [OR] = 28.62, 95% confidence interval [CI]: 9.84,83.26). Prior intermittent tinnitus increased risk of post-deployment constant tinnitus (OR = 4.95, CI: 2.97,8.27). Likelihood of tinnitus progression increased with partial PTSD (OR = 2.39, CI: 1.50,3.80) and TBI (OR = 1.59, CI: 1.13,2.23), particularly for blast TBI (OR = 2.01, CI: 1.27,3.12) and moderate to severe TBI (OR = 2.57, CI: 1.46,4.51). Tinnitus progression also increased with low frequency hearing loss (OR = 1.94, CI: 1.05,3.59), high frequency loss (OR = 3.01, CI: 1.91,4.76) and loss across both low and high frequency ranges (OR = 5.73, CI: 2.67,12.30). Screening for pre-existing or individual symptoms of PTSD, TBI, and hearing loss may allow for more focused treatment programs of comorbid disorders. Identification of those personnel vulnerable to tinnitus or its progression may direct increased acoustic protection for those at risk.