Intermittent Tinnitus Research Articles

Comparisons of Audiologic Characteristics in Patients with Continuous and Intermittent Tinnitus.

No studies to date have compared audiologic characteristics in patients with continuous and intermittent tinnitus. The present study classified tinnitus patients into continuous and intermittent groups based on tinnitus duration and compared their audiologic characteristics. This study enrolled 604 patients with tinnitus from January 2019 to December 2022. Clinical manifestations, PTA results, the frequency and loudness of tinnitus, ABR, DPOAE, and TEOAE tests were compared in patients with continuous and intermittent tinnitus. Of the 604 patients, 231 (38.2%) had continuous and 373 (61.8%) had intermittent tinnitus. There were no significant between-group differences in otologic symptoms, tinnitus onomatopoeia. PTA showed that hearing thresholds, except at 125 Hz, were significantly higher in patients with continuous rather than intermittent tinnitus. The loudness of tinnitus was significantly greater in patients with continuous rather than intermittent tinnitus. ABR tests showed that the absolute latency of wave V was significantly longer in continuous than in intermittent tinnitus. Signal-to-noise ratios on TEOAE tests were significantly lower in patients with continuous rather than intermittent tinnitus at all frequencies tested (1, 1.5, 2, 3, and 4 kHz). Response rates to sound stimuli at all frequencies, except for 1 kHz, were significantly lower on DPOAE tests in patients with continuous rather than intermittent tinnitus. Continuous tinnitus is more common in males, more persistent over time, and is associated with a higher rate of hearing loss. In contrast, intermittent tinnitus is more common in women, appears acutely, and is associated with a relatively lower rate of hearing loss. Based on the findings of the current paper, it seems that audiologic characteristics may differ between patients with continuous and intermittent tinnitus.

A Unique Case of Acute Deterioration in Visual Acuity: Vogt-Koyanagi-Harada Disease

Vogt-Koyanagi-Harada (VKH)disease is a chronic autoimmune inflammatorydisorderwithmultisystem involvement particularly involving the eye, skin, ear and brain. Our patient reported in the Ophthalmology OPD, CMH, Lahore, a 41-year-old female patient who presented with decreased visual acuity of 6/9 and 6/18 in her right and left eye respectively with intermittent tinnitus. Aslit lamp examination revealed bilateral paramacular choroiditis, more pronounced in the left eye. Fundoscopy showed the 'sunset glow fundus.' HerOCTshowedslightflattening ofthe foveal contourinthe left eye withgeneralized foveal thinning while the right eye had parafoveal thickening with a foveal lamellar hole. FFA showed a serous detachment in herleft eye.Adiagnosis of bilateral incomplete Vogt-Koyanagi-Harada syndrome was made as she tested negative for infectious diseases. She was started on an oral course of steroids initially but after persistent episodic exacerbations ciclosporin 75mg twice daily was started and regular 2 weekly follow-ups were advised. The mainstay of treatment for Vogt–Koyanagi–Harada disease is systemic corticosteroid therapy but the refractory cases get additional immunosuppressants like ciclosporin which was required in our patient as well. Keywords: Autoimmune, Fovea, Visual acuity.

Tinnitus Screener: Short-Term Test-Retest Reliability.

The Tinnitus Screener was introduced in 2015 as a four-item algorithmic instrument to assess the temporal characteristics of a person's reported tinnitus. The Tinnitus Screener was then revised as a six-item version to include a new temporal category and to capture tinnitus duration (acute < 6 months vs. chronic ≥ 6 months). When contrasted with audiologist assessment, the four-item Tinnitus Screener was determined to be highly valid, but the short-term reliability of either version remained unknown. The present analysis focused on determining the test-retest reliability of the six-item Tinnitus Screener. Additionally, we sought to determine whether reliability differed by respondent age, sex, military status, and hearing loss. The Tinnitus Screener was administered to 190 military Service members and 250 military Veterans at two time points separated by 7-31 days. Our analysis focused on test-retest reliability of responses as measured by the kappa coefficient, overall and within subsamples. Percent agreement of tinnitus categorization (temporal categories) and classification (positive/negative) between the two time points was also evaluated. Constant or intermittent tinnitus was found in 31% of Service members and 53% of Veterans. Overall, kappa reliability coefficients were high, near .80, indicating substantial reliability. The majority (96%) of reliability coefficients for the Tinnitus Screener within subsamples were similarly high, ranging from .68 to .88. The updated version of the Tinnitus Screener is shown to be a reliable instrument. The Tinnitus Screener is recommended to inform clinical decision making by determining the temporal characteristics of tinnitus.

Tinnitus Prevalence and Associated Factors among Dental Clinicians in the United Arab Emirates.

Dental clinicians are at increased risk for developing tinnitus due to exposure to high levels of occupational noise. This study aimed to determine tinnitus prevalence and associated factors among dental clinicians. Interviews were conducted with 150 randomly selected dental clinicians using a questionnaire. Noise levels were measured at three points of time at the operating area. Tinnitus was reported in 19.33% of the participants. The average noise level was significantly higher among participants with tinnitus compared to those without the condition. More participants complained of intermittent tinnitus and the rest had the constant type, with the latter being significantly more bothersome. The weekly average time of using high-speed handpieces, suction and electric handpieces, age and experience had a significant effect on the presence of tinnitus. Only 2.7% of the participants reported the use of a hearing protection device. Tinnitus is a common finding among dental clinicians especially those with higher levels of occupational noise and more frequent use of noise-generating equipment. Knowledge of tinnitus prevalence aids in realizing the extent of its impact and making informed decisions. These results call for improved awareness of the negative impact of clinically-generated noise and emphasize the importance of preventive measures and periodic audiometry exams.

Refractory otitis media with effusion due to eustachian tube sialolipoma inform consistent with eustachian tube inflammatory polyp: rare case presentation and literature review

BackgroundUnilateral otitis media with effusion in adult patient is considered alarming finding needing a detailed examination of the nasopharynx. The lesions in this area ranged from benign to more destructive malignant pathologies. Lipoma as a cause of obstruction is an extremely rare entity. We are reporting a case of eustachian tube lipoma presented with refractory otitis media with effusion. This is an extremely rare location of such entity and to the best of our knowledge, this is the third case reported in the world literature of eustachian tube lipoma after 2 cases published in 2011 and 2016 respectively. However, this is the first case reported in the literature of eustachian tube sialolipoma.Case presentationWe are reporting a 27-year-old male who presented to our outpatient department with a complain of unilateral ear block, hearing loss, and intermittent tinnitus. Clinical evaluation revealed unilateral otitis media with effusion that was confirmed by pure tone audiogram and tympanometry. Computed tomography and magnetic resonance imaging were obtained showed a lesion originating in the eustachian tube area protruding in the nasopharynx. Surgical removal was successful with complete recovery.ConclusionsUnilateral otitis media with effusion necessitate nasal endoscopic examination to rule-out lesions at the nasopharynx. This is the first case of sialolipoma in eustachian tube in the literature. Endoscopic removal is usually successful with uneventful short recovery period.

The prevalence of tinnitus in the Australian working population

To estimate the prevalence of tinnitus in Australian working people; to identify occupational and demographic factors associated with tinnitus. Cross-sectional national telephone survey of self-reported frequency and duration of tinnitus. Australian Workplace Exposure Survey (AWES) - Hearing; 4970 currently employed people aged 18-64 years, recruited by random digit dialling, representative by sex of the workforce population, 7 June 2016 - 20 March 2017. Prevalence of occasional, intermittent, and constant tinnitus, and of any tinnitus, by occupational group, sex, and other demographic characteristics; estimated numbers of working people with constant or any tinnitus, by occupational group and sex. Of 4970 respondents, 1317 reported experiencing tinnitus (26.5%): 713 people had occasional tinnitus (14.3%), 259 intermittent tinnitus (5.2%), and 345 constant tinnitus (6.9%). The sample prevalence of constant tinnitus was greater among men (7.5%; 95% CI, 6.2-8.7%) than women (3.3%; 95% CI, 2.3-4.3%), and was higher in older age groups. After rake weighting our survey responses, we estimated that 2.4 million workers (24.8%; 95% CI, 23.2-26.4%) experience tinnitus, including 529343 with constant tinnitus (5.5%; 95% CI, 4.6-6.3%). The estimated prevalence of constant tinnitus was highest for automotive workers (16.7%; 95% CI, 9.5-23.8%), drivers (13.0%; 95% CI, 7.3-18.6%), farmers (12.1%; 95% CI, 5.9-18.4%), and workers in other trades (10.4%; 95% CI, 4.6-16.2%). The prevalence of tinnitus in the Australian workforce is high, particularly in certain occupations. Workplace practices and conditions that increase the risk of tinnitus should be examined, and targeted workplace prevention strategies developed.

INTERMITTENT TINNITUS IN ADULTS: AN INSIGHT INTO COVERT HEARING LOSS

Objectives: Association of high frequency hearing loss/minor damage in peripheral auditory system in continuous chronic tinnitus with normal PTA is well established.The purpose of the study was to verify whether this finding is true for intermittent unilateral or bilateral tinnitus patients with normal PTA using EHF audiometry and conventional DPOAEs. Materials and method:This study was conducted on 45 normal hearing adults between the age ranges of 18-30 years. Among them 30 adults comprised of study group with intermittent tinnitus which varies in laterality.Tinnitus evaluation was done on these population followed by THI administration. DPOAE and EHF audiometry was completed on all subjects after conventional hearing assessment program. Result and Discussion:Kruskal Wallis H test &amp; Wilcoxon signed rank test was used to compare OAE amplitude &amp; EHF thresholds.Spearman's correlation was used to evaluate the correlation between DPOAE amplitude with EHF threshold. Reduced hearing sensitivity in the extended high frequency region may be early predictor of outer hair cell dysfunction in the most basal area.Findings of this study suggest that intermittent tinnitus may also lead to subtle lesion at the basal region of cochlea which would result in a significant hearing loss with continuous tinnitus in future. Conclusion:Intermittent tinnitus may increase the fragility of peripheral auditory system which may lead to permanent lesions and would be evident as elevated thresholds in conventional PTA.

Exposure to leisure noise and intermittent tinnitus among young adults in Bavaria: longitudinal data from a prospective cohort study

Objectives To investigate the association between total leisure noise exposure and intermittent tinnitus among young adults. Design Data were obtained from the Ohrkan study, an ongoing prospective cohort study conducted in South Germany since 2009. Information about exposure to impulse and leisure noise, tinnitus occurrences, sociodemographic variables, and self-rated hearing ability were analysed at four time points over a period of seven and a half years. Study sample Participants of the Ohrkan cohort study, who provided data about the occurrence of tinnitus for all surveys (n = 1028). Results Intermittent tinnitus was reported in the majority of the sample (60%). The risk for intermittent tinnitus increased with higher sound pressure levels from exposure to leisure noise (full model (Odds Ratio, 95%CI): 80–<85dB(A): 1.41 [1.13–1.78], 85–<90dB(A): 1.73 [1.38–2.16], >90dB(A): 2.04 [1.59–2.61]). Visiting nightclubs was a major contributor to this relationship. Of the considered covariables, self-rated hearing as “poor”, and growing up in a single-parent household were significantly associated with intermittent tinnitus. Conclusion Intermittent tinnitus is very frequent among young adults and is associated with high levels of leisure noise exposure. To prevent intermittent tinnitus, reduced sound pressure levels and the use of hearing protection are necessary.

Noise Damage Accelerates Auditory Aging and Tinnitus: A Canadian Population-Based Study.

Age-related hearing loss (ARHL) is the third most challenging disability in older adults. Noise is a known modifiable risk factor of ARHL, which can drive adverse health effects. Few large-scale studies, however, have shown how chronic noise exposure (CNE) impacts the progression of ARHL and tinnitus. Retrospective large-scale study. Audiology clinical practice. In this study, 928 individuals aged 30-100 years without (n=497) or with the experience of CNE (n=431) were compared in their hearing assessments and tinnitus. In order to only investigate the impact of CNE on ARHL and tinnitus, people with other risk factors of hearing loss were excluded from the study. Diagnostic. Noise damage was associated with a greater ARHL per age decades (pure-tone average(PTA)0.5-4kHz alterations 19.6-70.8 dB vs. 8.0-63.2 dB, ≤0.001), an acceleration of developing a significant ARHL at least by two decades (PTA0.5-4kHz 33.4 dB at 50-59yr vs. 28.2 dB at 30-39yr, ≤0.001), and an increased loss of word recognition scores (total average 84.7% vs. 80.0%, ≤0.001). Significant noise-associated growth in the prevalence of tinnitus also was shown, including more than a triple prevalence for constant tinnitus (28.10% vs. 8.85%, ≤0.001) and near to a double prevalence for intermittent tinnitus (19.10% vs. 11.10%, ≤0.001). Noise also resulted in the elevation of the static compliance of the tympanic membrane throughout age (total average 0.61 vs. 0.85 mmho, ≤0.001). Our findings emphasize the significant contribution of CNE in auditory aging and the precipitation of both ARHL and tinnitus.

How effect is educational counseling prior to middle ear surgery for patients with both middle ear diseases and consistent tinnitus?

Background: The management of patients with tinnitus who receive middle ear surgery has not been established.Aims: The aim of this study is (1) how many patients who receive middle ear surgery have tinnitus and (2) how educational counselling and middle ear surgery is effective with consistent tinnitus.Subjects and methods: Twenty four cases out of 90 cases accounted for 26.7% of the middle ear diseases scheduled for surgery in the past two years. Of the 42 patients with hearing loss in the second year, 14 had consistent and intermittent tinnitus. Among them we have 6 patients complaining consistent tinnitus and we examined the change in the Tinnitus Handicap Inventory (THI) for patients with tinnitus before and after surgery.Results: Ten out of 13 cases (about 76.9%) reported that postoperative tinnitus improved. THI score in two cases showed worse.Conclusions and significance: Two cases showed worse THI in both mixed hearing loss cases with a small hearing improvement. The mechanism of improvement is similar to tinnitus retraining therapy including hearing aid because the increase in external sound input through hearing restoration after surgery to avoid silence.

Profiling intermittent tinnitus: a retrospective review

Objective: We conducted a retrospective review of medical records of tinnitus patients at a tertiary ENT clinic in Groningen, Netherlands. Our goal was to identify factors that differentiated the intermittent subgroup from the larger continuous group with chronic tinnitus.Design: Tinnitus-related factors such as hearing loss, emotional aspects, and demographics were used to advance our understanding of the subgroups. We analysed the data using descriptive statistics and binomial logistic regression, supplemented by random forests classification.Study sample: Patients presenting with tinnitus visiting the tinnitus clinic. We examined 1575 medical intake records obtained at a tertiary ENT hospital.Results: Duration, total Tinnitus Handicap Inventory (THI), and THI Functional subscale scores differed significantly between the two groups. Increasing age and higher THI Emotional subscale scores were associated with an increased likelihood of intermittent tinnitus. Increases in duration, depressive scores and THI Functional and Catastrophic subscale scores, decreased the likelihood of intermittent tinnitus.Conclusions: Results from this study dissociate the factors affecting those with intermittent and those with continuous tinnitus and point to potentially different mechanisms underlying the two conditions.

Intermittent tinnitus-an empirical description.

Tinnitus is often classified into acute or chronic persistent forms. However, epidemiologic studies have shown that intermittent tinnitus (IT), which does not clearly belong to either category, is the most common form. The aim of this study was to further characterize IT empirically. We conducted an exploratory cross-sectional interview study among 320 subjects with tinnitus. Sociodemographic and tinnitus characteristics, concomitant complaints, perceived triggers, and help-seeking behavior were assessed. Subjects were classified into continuous (CT), IT, or single-episode tinnitus (SET) if they had experienced tinnitus "continuously," "temporarily time and again," or "only once but for several days," respectively, during the past 12months. Of the sample, 62% reported IT, 23% SET, and 16% CT. Mean time since onset was 36(CT), 28(IT), and 19months (SET), respectively. Most subjects with IT experienced episodes lasting afew days, whereas in 25%, episodes lasted 1-4weeks. Mean duration was 1.6weeks. The frequency of IT episodes ranged from every few days to half-yearly; mean frequency was every 7weeks. Leading triggers were occupational and private stress. Asthenia, depression, social isolation, psychiatric disorders, and inner ear disorders were more prevalent among CT than IT subjects. Help-seeking behavior was comparable between CT and IT. IT is associated with emotional reactions and situational impairment severe enough to trigger multiple treatment attempts, but usually does not result in severe impairment. Inner ear disorders and psychological changes are less frequent than in CT; therefore, treatment response and prognosis might be better. We suggest classification of tinnitus into acute single-episode (<3months), intermittent, or chronic persistent (>3months) forms.

Intermittent tinnitus-an empirical description. German version

Tinnitus is often classified into acute or chronic persistent forms. However, epidemiologic studies have shown that intermittent tinnitus (IT), which does not clearly belong to either category, is the most common form. The aim of this study was to further characterize IT empirically. We conducted an exploratory cross-sectional interview study among 320 subjects with tinnitus. Sociodemographic and tinnitus characteristics, concomitant complaints, perceived triggers, and help-seeking behavior were assessed. Subjects were classified into continuous (CT), IT, or single-episode tinnitus (SET) if they had experienced tinnitus "continuously," "temporarily time and again," or "only once but for several days," respectively, during the past 12months. Of the sample, 62% reported IT, 23% SET, and 16% CT. Mean time since onset was 36(CT), 28(IT), and 19months (SET), respectively. Most subjects with IT experienced episodes lasting afew days, whereas in 25%, episodes lasted 1-4weeks. Mean duration was 1.6weeks. The frequency of IT episodes ranged from every few days to half-yearly; mean frequency was every 7weeks. Leading triggers were occupational and private stress. Asthenia, depression, social isolation, psychiatric disorders, and inner ear disorders were more prevalent among CT than IT subjects. Help-seeking behavior was comparable between CT and IT. IT is associated with emotional reactions and situational impairment severe enough to trigger multiple treatment attempts, but usually does not result in severe impairment. Inner ear disorders and psychological changes are less frequent than in CT; therefore, treatment response and prognosis might be better. We suggest classification of tinnitus into acute single-episode (<3months), intermittent, or chronic persistent (>3months) forms.

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.

Awareness of Musicians on Ear Protection and Tinnitus: A Preliminary Study

Music induced hearing loss (MIHL) is linked to chronic, extended exposure, and progress at a rate proportionate to exposure conditions. The aim was to document hearing deterioration; awareness of ear protection devices (EPDs); presence of tinnitus, measurement of temporary threshold shift. Thirty-four musicians filled a questionnaire regarding: years of experience, instrument/splayed, hours of music exposure per week with/without amplification, through earphones and speakers, use of EPDs and tinnitus. Hearing screening in five subjects was done before and after one hour and ten minutes of practice session. Among the participants, 8.8% reported hearing deterioration subjectively and 38.2% reported unilateral intermittent tinnitus, 79.4% lacked awareness about EPDs and 21.6 % were aware but never used them. Mean for temporary threshold shift at 500 Hz and 1 KHz was 5dB HL and 10dBHL at 2 KHz. Musicians are at risk for hearing problems, but the awareness on auditory damage is limited, hence conservative measures must be taken for their well being.

Seasonal affective disorder in patients with chronic tinnitus.

To investigate the point prevalence of SAD, degrees of anxiety/depression/sleep disturbance, and characteristics of tinnitus in patients with chronic tinnitus. Cross-sectional survey study. From December 2012 to February 2014, 100 patients with chronic persistent or intermittent tinnitus (>3 months) were enrolled. Audiograms, tinnitograms, and Visual Analogue Scales (VAS) were used to assess tinnitus. Tinnitus Handicap Inventory (THI) assessment and questionnaires about anxiety/depression/sleep disturbance/SAD were administered. The male:female ratio was 48:52, and the mean age was 55.0 years. The numbers of patients with suspected SAD and subsyndromal SAD (S-SAD) were nine (9.0%) and 11 (11.0%), respectively. Winter was the most uncomfortable season. Nine patients had a catastrophic THI score >76 (11.1% in the SAD group, 27.3% in the S-SAD group, and 6.3% in the control group), suggesting a significant correlation between SAD/S-SAD and THI (P = .042). Audiogram, tinnitogram, VAS assessment, and sleep disturbance testing revealed no significant differences among the three groups. Anxiety tests yielded more abnormal findings in the SAD group than in the control group (State Anxiety Inventory score: 33.3% vs. 3.3%, respectively, P = .012; Trait Anxiety Inventory score: 22.2% vs. 1.3%, respectively, P = .002). Depression test scores were significantly higher in the SAD/S-SAD groups than in the control group (35.0% vs. 21.3%, respectively; P = .005). Suspected SAD and/or S-SAD in chronic tinnitus patients were correlated with THI, anxiety, and depression. Understanding SAD in tinnitus patients may be important to manage these patients effectively. 4.

Long-term outcome of patients with clinical stage I high-risk nonseminomatous germ-cell tumors 15 years after one adjuvant cycle of bleomycin, etoposide, and cisplatin chemotherapy

To report the long-term results of adjuvant treatment with one cycle of modified bleomycin, etoposide, and cisplatin (BEP) in patients with clinical stage I (CS I) nonseminomatous germ-cell tumors (NSGCT) at high risk of relapse. In a single-arm, phase II clinical trial, 40 patients with CS I NSGCT with vascular invasion and/or >50% embryonal cell carcinoma in the orchiectomy specimen received one cycle of adjuvant BEP (20 mg/m(2) bleomycin as a continuous infusion over 24 h, 120 mg/m(2) etoposide and 40 mg/m(2) cisplatin each on days 1-3). Primary end point was the relapse rate. Median follow-up was 186 months. One patient (2.5%) had a pulmonary relapse 13 months after one BEP and died after three additional cycles of BEP chemotherapy. Three patients (7.5%) presented with a contralateral metachronous testicular tumor, and three (7.5%) developed a secondary malignancy. Three patients (7.5%) reported intermittent tinnitus and one had grade 2 peripheral polyneuropathy (2.5%). Adjuvant chemotherapy with one cycle of modified-BEP is a feasible and safe treatment of patients with CS I NSGCT at high risk of relapse. In these patients, it appears to be an alternative to two cycles of BEP and to have a lower relapse rate than retroperitoneal lymph node dissection. If confirmed by other centers, 1 cycle of adjuvant BEP chemotherapy should become a first-line treatment option for this group of patients.

Tinnitus prevalence in the city of São Paulo

IntroductionThe public and private health care in the city of São Paulo has no data on tinnitus prevalence. ObjectiveDetermine tinnitus prevalence in São Paulo city. Study designSeries study. MethodsCross-sectional study by field questionnaire with 1960 interviews. Predictor variables included gender, age, tinnitus. ResultsThe prevalence of tinnitus was 22%. It affects more women (26%) than men (17%) and increases with advancing age. Approximately one third of cases (32%) assert that they have constant tinnitus (i.e., “ringing”), while most describe intermittent tinnitus (68%). The majority (64%) reported feeling annoyed, while others (36%) denied any annoyance. Among women, the occurrence of an annoying tinnitus was significantly higher (73%) than among men (50%). The percentages were: mildly annoying (11%), moderately annoying (55%), and severely annoying (34%). Tinnitus interferes with daily activities in 18% of those reporting to be annoyed. ConclusionThe population in the city of São Paulo suffering from tinnitus was more prevalent than previously estimated. Generally, it affects more women and those without occupation, and increases significantly with age. Most respondents described the tinnitus as annoying, and this was more prevalent in females. The degree of discomfort measured by a Visual Analogue Scale showed moderate tinnitus, with responses averaging 6.3.

Transient Evoked Otoaocustic Emissions Before and After Alternate Stimulation in Elderly Group

The purpose of this study was to investigate Transient Evoked Otoacoustic Emissions (TEOAEs) with alternate stimulation for elderly group and suggest probability between tinnitus and efferent system. Twenty-eight subjects (56 ears) ranging from 65 to 86 years old were participated. The pure tone threshold average (0.5, 1, 2 kHz) of the right ear was 32.22±14.65 dB HL and the left was 28.83±11.64 dB HL. There were nineteen subjects without tinnitus and the others had various tinnitus. Four out of tinnitus group had spontaneous right unilateral type, two out of them had bilateral type, while the others had intermittent tinnitus in somewhere of head. Alternate stimulation for contralateral suppression of TEOAEs was broad band noise of 70 dB SPL. Contralateral suppressions of TEOAEs were recorded in almost all subjects used every frequency (1, 1.4, 2, 2.8, 4 kHz), and TEOAEs suppressions were shown significantly on left ears of all subjects (t = -2.06, p = .049). TEOAEs of female were lower than male's in almost frequencies except 4 kHz, but TEOAEs differences of suppression were not appeared significantly between male and female (p > .05). Alternate TEOAEs suppressions were investigated in all frequencies without tinnitus group and varied in each frequency with tinnitus group. These results were achieved using a small pool of subjects but exposed a possibility for clinical application of TEOAEs associated with the efferent system.

Tinnitus Prevalence in the City of São Paulo

Introduction: The public and private health care in the city of Sao Paulo has no data on tinnitus prevalence. Objective: Determine tinnitus prevalence in the city of Sao Paulo. Study Design: Clinical trial. Casuistic and Methods: Cross-sectional study by field questionnaire with 1,960 interviews. Predictor variables included gender, age, and tinnitus. Results: The prevalence of tinnitus was 22%. It affects women more (26%) than men (17%). Progressive prevalence spread with increasing age was also observed. Approximately one-third of cases (32%) claim to have constant tinnitus, while most states’ intermittent tinnitus (68%). The majority (64%) reported feeling annoyed, while others (36%) denied any bother. Among women annoying tinnitus was significantly higher (73%) than males (50%). The percentages were mildly annoying (11%), moderately annoying (55%), and severely annoying (34%). Tinnitus interferes with daily activities in 18% of those reporting to find it annoying. Conclusion: The tinnitus population in the city of Sao Paulo was more prevalent than previously estimated. It generally affects women more often, those without work, and increases significantly with advancing age. Most respondents referred annoying tinnitus, and this fact was more prevalent in females. The degree of discomfort measured by visual analogue scale showed moderate tinnitus, with average responses on 6.3.