Prognosis Of Tinnitus Research Articles

Predictive factors of tinnitus after vestibular schwannoma surgery: a case-control study

BackgroundTinnitus is very common in patients with vestibular schwannoma (VS). We analyzed the related factors of tinnitus after surgery.MethodsOne hundred seventy-three patients diagnosed with unilateral VS operated via the retrosigmoid approach were included in the study. All patients underwent relevant examinations and completed the THI scale before surgery and 6 months after surgery. The prognosis of tinnitus was evaluated according to the changes in THI.ResultsOf the 129 preoperative tinnitus patients, postoperative tinnitus resolved in 12.4%, improved in 29.5%, remained unchanged in 28.6%, and worsened in 29.5%. 18.2% of 44 patients without preoperative tinnitus appeared new-onset tinnitus postoperatively. Thirty-six patients never had tinnitus. Patients with smaller tumor sizes (≤ 3 cm) were more likely to experience preoperative tinnitus. Younger patients and those with serviceable hearing preoperatively were more likely to report their tinnitus unchanged or worsened. A new onset of postoperative tinnitus in the preoperative non-tinnitus group was found in better preoperative hearing function.ConclusionsIn this study, 70% of patients had persistent tinnitus after vestibular schwannoma resection. The prognosis of tinnitus was influenced by age and preoperative hearing function. Tinnitus is a bothersome symptom and is often underestimated by doctors. Assessment of tinnitus is mandatory during the management of vestibular schwannoma.

Prevalence and prognosis of tinnitus in post-COVID-19 patients: a cross-sectional survey.

Recent developments have indicated a potential association between tinnitus and COVID-19. The study aimed to understand tinnitus following COVID-19 by examining its severity, recovery prospects, and connection to other lasting COVID-19 effects. Involving 1331 former COVID-19 patients, the online survey assessed tinnitus severity, cognitive issues, and medical background. Of the participants, 27.9% reported tinnitus after infection. Findings showed that as tinnitus severity increased, the chances of natural recovery fell, with more individuals experiencing ongoing symptoms (p<0.001). Those with the Grade II mild tinnitus (OR=3.68; CI=1.89-7.32; p=0.002), Grade III tinnitus (OR=3.70; CI=1.94-7.22; p<0.001), Grade IV (OR=6.83; CI=3.73-12.91; p<0.001), and a history of tinnitus (OR=1.96; CI=1.08-3.64; p=0.03) had poorer recovery outcomes. Grade IV cases were most common (33.2%), and severe tinnitus was strongly associated with the risk of developing long-term hearing loss, anxiety, and emotional disorders (p<0.001). The study concludes that severe post-COVID tinnitus correlates with a worse prognosis and potential hearing loss, suggesting the need for attentive treatment and management of severe cases.

Multimodal quantitative magnetic resonance imaging of the thalamus in tinnitus patients with different outcomes after sound therapy.

This study systematically investigated structural and functional alterations in the thalamus and its subregions using multimodal magnetic resonance imaging (MRI) and examined its clinical relevance in tinnitus patients with different outcomes after sound therapy (narrowband noise). In total, 60 patients with persistent tinnitus and 57 healthy controls (HCs) were recruited. Based on treatment efficacy, 28 patients were categorized into the effective group and 32 into the ineffective group. Five MRI measurements of the thalamus and its seven subregions, including gray matter volume, fractional anisotropy, fractional amplitude of low-frequency fluctuation, and functional connectivity (FC), were obtained for each participant and compared between the groups. Patients in both the groups exhibited widespread functional and diffusion abnormalities in the whole thalamus and several subregions, with more obvious changes observed in the effective group. All tinnitus patients had abnormal FC compared with the HCs; FC differences between the two patient groups were only observed in the striatal network, auditory-related cortex, and the core area of the limbic system. We combined the multimodal quantitative thalamic alterations and used it as an imaging indicator to evaluate prognosis before sound therapy and achieved a sensitivity of 71.9% and a specificity of 85.7%. Similar patterns of thalamic alterations were identified in tinnitus patients with different outcomes, with more obvious changes observed in the effective group. Our findings support the tinnitus generation hypothesis of frontostriatal gating system dysfunction. A combination of multimodal quantitative thalamic properties may be used as indicators to predict tinnitus prognosis before sound therapy.

Clinical Factors Associated With Prognosis of Tinnitus and Aural Fullness After Sudden Sensorineural Hearing Loss.

We evaluated the long-term prognosis and risk factors associated with tinnitus and aural fullness, which occurred with sudden sensorineural hearing loss. Retrospective cross-sectional review. Tertiary referral center. Those who visited our clinic for sudden hearing loss from January 2016 to May 2020, diagnosed with sudden sensorineural hearing loss based on pure-tone audiometry, and underwent magnetic resonance imaging to rule out other cause of hearing loss. In total, 106 patients were enrolled in this study. All patients were treated with oral glucocorticoids. Salvage intratympanic dexamethasone injection therapy was performed for the patients whose hearing was not fully recovered. We scored the loudness of tinnitus and the intensity of aural fullness using the numerical rating scale. We used a mixed-effects model for repeatedly measured tinnitus and aural fullness scores. The time after the onset of sudden sensorineural hearing loss (SSNHL; β = -0.07; 95% confidence interval, -0.09 to -0.05; p < 0.001) and hearing outcome after treatment (overall p = 0.003) were significant factors associated with the prognosis of tinnitus. Concerning aural fullness, the time after the onset of SSNHL was a significant prognosis factor ( β = -0.08; 95% confidence interval, -0.09 to -0.06; p < 0.001), unlike hearing outcome (overall p = 0.261). Pretreatment pure-tone audiometry average threshold and mainly affected frequencies were not significant factors for tinnitus and aural fullness recovery, respectively. The persistence of tinnitus with SSNHL was significantly affected by hearing recovery after treatment, whereas aural fullness was not associated with hearing recovery. However, both symptoms were improved over time after SSNHL.

Long-Term Prognosis of Tinnitus Associated with Idiopathic Sudden Sensorineural Hearing Loss

Objective: To analyze the factors affecting the long-term prognosis of tinnitus accompanied by unilateral idiopathic sudden sensorineural hearing loss (SSNHL). Methods: A total of 161 patients with sudden hearing loss (HL) accompanied by tinnitus were enrolled. All patients had two separate telephone follow-ups and were asked about changes in tinnitus. The severity of tinnitus at admission and the outcome at discharge were assessed in terms of the patients’ sex, age, level of HL, type of audiogram, etc. Results: The prognosis of tinnitus after SSNHL had no relationship with grades of HL or hearing recovery. Initial tinnitus level was remarkably associated with tinnitus improvement at discharge and was an independent risk factor for the long-term prognosis of residual tinnitus after SSNHL (odds ratio 0.722, 95% confidence interval 0.550–0.949, p = 0.019), and the median recovery time was 23.00 ± 3.80 months. Conclusions: Residual tinnitus after SSNHL has a tendency of self-recovery. The short-term prognosis of tinnitus may be related to psychological changes caused by hearing recovery, while the long-term prognosis of residual tinnitus after SSNHL is related only to the initial tinnitus level, with a median recovery time of approximately 2 years.

Identification of factors associated with tinnitus outcomes following the microsurgical treatment of vestibular schwannoma patients

Background Tinnitus is common in vestibular schwannoma patients, but the postoperative tinnitus status of these patients and related factors remain unclear. Aims To identify preoperative and operative factors associated with postoperative tinnitus status. Materials and methods Postoperative outcomes were retrospectively assessed in 237 vestibular schwannomas (VS) patients with preoperative tinnitus and 90 VS patients without tinnitus. Results When evaluating patients with preoperative tinnitus, there were significant differences in rates of improvement, no change, and worsening of tinnitus for the translabyrinthine (TL) and retrosigmoid (RS) approaches. Of patients without preoperative tinnitus, there was a significant difference in rates of not developing tinnitus and new-onset tinnitus. Similar results were observed with respect to preoperative hearing. Least-squares analyses revealed that surgical approach and preoperative hearing were independent predictors of postoperative tinnitus. Preoperative pure tone averages for TL group patients that did not develop postoperative tinnitus were 85.8 dB, whereas in patients that developed new-onset tinnitus they were significantly lower (54.9 dB). Conclusions and significance Tinnitus prognosis in VS patients is better following TL microsurgery relative to RS microsurgery and is also better in patients with worse preoperative hearing. New-onset tinnitus was more likely to occur in patients with better preoperative hearing that underwent tumor removal via a TL approach.

Increased Serum Lipid Levels in Patients with Subjective Tinnitus.

Introduction:The aim was to investigate the link between tinnitus and serum levels of total cholesterol (TC), triglyceride (TRG), low-density (LDL) and high-density lipoprotein (HDL) in the central anatolian Turkish population.Materials and Methods:The retrospective and case-control study included a total of 91 patients with subjective tinnitus and a control group of age- and sex-matched 65 healthy volunteers. A detailed otolaryngologic examination followed by pure tone audiometry, serum lipid values, and magnetic resonance imaging of the temporal bone was performed. The clinical characteristics of tinnitus were registered for all patients. The serum levels of TC, TRG, LDL and HDL were compared between the two groups.Results:Mean TC level was 200.57±41.06 mg/dL in the patient group and 179.0±39.03 mg/dL in the control group (P=0.001). Mean TRG level was 177.76±86.94 mg/dL in the patient group and 124.43±61.44 mg/dL in the control group (P=0.000). Mean LDL level was 115.88±32.56 mg/dL in the patient group and 101.31±34.42 mg/dL in the control group (P=0.008). Mean HDL level was 50.25±13.60 mg/dL in the patient group and 53.46±12.66 mg/dL in the control group (P=0.137). Among all the serum lipids, TC, TRG and LDL established a significant difference between the two groups.Conclusion:The results indicated that TC, TRG and LDL levels were significantly higher in tinnitus group and this increase implicates the potential role of hyperlipidemia associated with altered lipid metabolism in the etiology of tinnitus. We suggest that serum lipid levels could be useful and conducive in the diagnosis and prognosis of tinnitus.

Systematic review of sound stimulation to elicit tinnitus residual inhibition.

Residual Inhibition is considered as tinnitus alteration immediately after exposure to sound. Its clinical significance and correlation with the pathophysiology and treatment prognosis of tinnitus remain enigmatic. The objective of this review is to critically appraise scientific evidence regarding the residual inhibition prevalence and how it is correlated with different sound stimuli. A systematic review of tinnitus Residual Inhibition (RI) studies was performed, focusing on prevalence, methods used, stimuli presented and responses obtained. A literature search (PubMed, Cochrane Central Register of Controlled Trials, Scopus, MEDLINE) was conducted. Seventeen studies involving 1066 patients fulfilled the inclusion criteria. Sound stimulation was performed using pure tones, customized sounds, narrow- and broadband noises, and modulated sounds. Sound stimuli exposure produced complete RI of tinnitus in 34.5% of patients (range 5.6-72%), with higher RI rates after stimulation with pure tones and narrowband noise centered to the tinnitus perceived pitch. RI duration tends to increase when stimuli duration increases. RI is frequent and can be induced by narrow-band noise (NBN), broadband noise (BBN), pure tones, customized sounds and modulated sounds. Adequate evidence to support the use of RI as a tool for tinnitus phenotyping or as a management option is pending. Further clinical research exploring the profile of patients with RI and its potential use as prognostic factor should be conducted.

Effect of cochlear implantation on tinnitus and the prognosis mode analysis

Objective:To describe the effects of the possible related factors in unilateral cochlear implantation（CI） on tinnitus，and analysis the hearing and speech ability in different tinnitus prognosis mode. Method:The 70 post-lingual deafness CI patients（27.73±14.032 years old） in the clinical trial for LCI-20PI cochlear implant and LSP-20A sound processor project by a fast questionnaire about the tinnitus positive or negative respectively before the CI, 3rd, 6th, 9th and 12th months after the first mapping. 6 modes about tinnitus development were record: Type A（-to-）, no tinnitus before the CI and continued negative until the last follow-up; Type B（+ to-）, have tinnitus before CI and disappeared after the mapping; Type C（-to +）, no tinnitus before but appeared after the surgery; Type D（+ to-to +）, have tinnitus before the CI and disappeared during the continue follow-up, but finally the tinnitus show up again at last; Type E（-to + to-）, no tinnitus before and suffered from tinnitus after the CI surgery, but the noise disappeared at last; Type F（+ to +）, have the tinnitus in all the duration. Then we briefly analyzed the factors like age, gender, the duration of hearing loss, and the duration of hearing aids usage. Compare the characteristics in all the modes of tinnitus prognosis. Result:In this research CI treatment effect rate on tinnitus is 80%. The mean age of Type A （tinnitus from -to- ） group is （20.79 ±11.364） years old; Type B （tinnitus from + to-） group is （32.69±10.606） years old; Type C（tinnitus from-to +） group is （40.25±2.217） years old; Type D（tinnitus from + to-to +） group is （28.00±0） years old; Type E （tinnitus from-to + to-） group is （52.50±6.364） years old; Type F （tinnitus from + to +） group is （30.33±11.015） years old. And P<0.05 between the groups, while the severe-deaf-duration intergroup differences （P>0.05）. The mean speech discrimination rates are all elevate after 12 months and no statistical significance between the groups. But the E group has a lowst elevation in mean pure tone threshold （22.50±3.535 ） dB HL, when the F group has the best promotion （56.04±10.649 ） dB HL, and the difference between the groups is statistically significant. Conclusion:The cochlear implantation could eliminate tinnitus in 80% patients in this research. The better elevation of hearing and speech ability in the patients with persist tinnitus pre-and post-CI usage may related to amount and functions of the residual auditory nerves. Age may be an important factor in tinnitus generation, which may need more explanation and attention during the rehabilitation period.

Larger tumor size and female gender suggest better tinnitus prognosis after surgical treatment in vestibular schwannoma patients with tinnitus

Background: Tinnitus is a subjective auditory phantom phenomenon which can be highly distressing. About 63%–75% vestibular schwannoma (VS) had a symptom of tinnitus.Objectives: To investigate the tinnitus maintenance mechanism from the view of tinnitus change after surgical treatment in VS patients.Material and methods: We conducted a retrospective study of VS patients with tinnitus from August 2008 to February 2019 and did follow-ups on their changes of tinnitus after surgery.Results: Among 298 VS cases, 201 of them had tinnitus symptom (67.4%). No statistical difference in the surgical approach was found between the tinnitus poor outcome and good outcome groups (p = .14), and statistical difference was found in gender (p = .04) and tumor size (p = .01) between the two groups. Binary logistic regression analysis revealed that gender (odds ratio [OR], 2.12; 95% CI, 1.10–4.08 [p = .03]) and tumor size (OR, 2.22; 95% CI, 1.16–4.24 [p = .02]) emerged as a significant and independent factor associated with the good outcome of tinnitus.Conclusions and significance: The results of this study confirmed that the cochlear nucleus of the brainstem and above part of the brainstem may play an important role in the maintenance of tinnitus.

Characteristics of tinnitus found in anemia patients and analysis of population-based survey

ObjectiveThis study analyzed the characteristics of tinnitus identified in anemia patients with cohort- and population-based studies in a single institute and suggests a management algorithm. MethodsFifty patients who were treated for anemia and referred for tinnitus treatment were included in a single institute retrospective study. Characteristics of tinnitus were investigated in a correlation analysis with demographic and audiologic parameters. For the population-based study, data from the Korea National Health and Nutrition Examination Survey collected between 2010 and 2011 were analyzed. The study population consisted of 11,402 individuals aged 20–97 years with complete tinnitus-related data. The prevalence of tinnitus in anemia patients was investigated using the questionnaire, and associations between tinnitus and blood/urine parameters were evaluated by binary logistic regression analysis. ResultsIn a single-institute study, patients with non-pulsatile tinnitus were significantly older and their initial hemoglobin was higher than those with pulsatile tinnitus (p=0.001, 0.008, respectively). In pulsatile tinnitus, age and difference between initial and post-treatment hemoglobin were significantly associated with a subjective improvement in tinnitus (p=0.002, 0.016, respectively). There were no significant audiologic or hematologic parameters associated with the improvement of non-pulsatile tinnitus. In the population-based study, there was no significant correlation between anemia and tinnitus (p=0.064). In a multivariate analysis, age was the only parameter associated with tinnitus in participants with anemia. ConclusionThe therapeutic strategy and prognosis of tinnitus in anemia patients differ according to the characteristics of tinnitus and the severity of anemia.

Characteristics and Prognosis of Tinnitus after Treatment in Acute Low-Frequency Sensorineural Hearing Loss

급성 저주파수 난청(Acute Low-frequency sensorineural Hearing Loss, ALHL)의 정의는 아직 명확하게 확립되지 않아 다양한 진단 기준이 있다(Abe, 1982; Fuse et al., 2002; Junicho et al., 2008; Kitajiri et al., 2002). 1982년에 ALHL을 독립된 질 환으로 처음 보고한 Abe는 저주파수 대역 즉, 125, 250, 500 Hz에서 평균 35 dB 이상의 청력 손실이 있는 경우만을 ALHL 로 정의하였으나, 최근에는 2011년 일본 후생노동성이 제시한 정의가 보다 널리 사용되고 있다.

The Characteristic and Short-Term Prognosis of Tinnitus Associated with Sudden Sensorineural Hearing Loss.

Tinnitus is believed to result from the maladaptive plasticity of the auditory nervous system; reports regarding its severity and prognosis are conflicting. We evaluated the characteristic and short-term prognosis of tinnitus associated with sudden sensorineural hearing loss (SSNHL). A total of 230 cases were enrolled. The severity and 1-month prognosis of tinnitus (according to the Tinnitus Handicap Inventory (THI)) were assessed in terms of the patients' sex, age, level of hearing loss, type of audiogram results, and so on. According to our statistical analysis, the degree of handicap due to tinnitus was not related to sex, age, or level of hearing loss; the Tinnitus Handicap Inventory indicated that the low-frequency-audiogram group had a low tinnitus handicap (F = 7.516, P = 0.000). Furthermore, we found that the prognosis of tinnitus was not related to the type of audiogram or level of hearing loss. Recovery from a severe level of hearing loss was, however, found to be associated with a poor tinnitus prognosis (F = 5.203, P = 0.006). In summary, our study indicates that the association between tinnitus and SSNHL is extremely high. Tinnitus can be ameliorated by the successful treatment of hearing loss. The study was registered in the Chinese Clinical Trial Registry (ChiCTR1800014797).

The Persistence of Tinnitus after Acoustic Neuroma Surgery.

Examine possible prognostic factors for the persistence of tinnitus after acoustic neuroma resection. Case series with chart review. Tertiary academic medical center. The records of 166 patients who underwent acoustic neuroma resection from 2009 to 2014 were reviewed. Patients were asked to complete a survey, including the Tinnitus Handicap Inventory, 1 to 6 years postoperatively. Of the 53 patients who completed the survey, 17% reported that their tinnitus resolved; 9% reported improvement; 23% reported no change; 43% reported that their tinnitus worsened; and 8% were unsure. Respondents ≥50 years old and those with nonserviceable hearing preoperatively were more likely to report that their tinnitus resolved or improved (P < .01 and P = .02, respectively). Respondents <50 years old and those with serviceable hearing preoperatively were more likely to report that their tinnitus was the same or worse (P < .001 and P = .036, respectively). Respondents with age <50 years, serviceable hearing preoperatively, and residual tumor had a higher average Tinnitus Handicap Inventory score (P = .016, P = .048, and P = .047, respectively). Sex, tumor size, surgical approach, hearing preservation, and cochlear nerve status did not correlate with the prognosis of tinnitus postoperatively. Respondents whose tinnitus resolved postoperatively were more likely to report being "very satisfied" with their care (P = .012). In this study, 83% of respondents had persistent tinnitus after acoustic neuroma resection. The prognosis of tinnitus was worse for younger respondents, those with serviceable hearing preoperatively, and those with residual tumor postoperatively. Respondents' satisfaction was higher if their tinnitus resolved.

Acute idiopathic sensorineural hearing impairment at frequency exceeding 8 kHz

Conclusions: Acute idiopathic sensorineural hearing impairment at a frequency exceeding 8 kHz (high-frequency range) was recognized in patients suffering from acute tinnitus without hearing loss. The cases in this study may contribute to clarifying the pathogenesis of tinnitus without hearing loss and evaluating its response to steroid therapy. Objectives: The aim of this study was to demonstrate the existence of acute idiopathic sensorineural hearing impairment only in the high-frequency range and to investigate its relation to tinnitus without hearing loss. Methods: Five patients aged 29 years or younger who consulted a hospital within a few days after the onset of unilateral tinnitus without hearing loss were studied. We conducted audiometry involving the high-frequency range on first medical examination and on improvement in tinnitus, and investigated the association between the hearing findings in the high-frequency range and a tinnitus prognosis. Results: All five patients showed abnormalities in the threshold in the high-frequency range on the affected side. In the three cases given prednisolone, tinnitus and the threshold abnormalities were reduced within 20 days. In contrast, tinnitus and the threshold abnormalities showed little change in two patients who were not treated.

A Clinical Study of the Efferent Auditory System in Patients With Normal Hearing Who Have Acute Tinnitus

Etiological diagnosis and treatment of tinnitus still remain challenging in clinical practice. The aim of this study was to determine the potential contribution of a defective cochlear efferent innervation to the onset of tinnitus in patients with normal hearing. Prospective randomized controlled study. Otorhinolaryngology department of a general hospital. The patient group consisted of 18 normal-hearing adults (7 men, 11 women) with acute tinnitus (bilateral in 3 patients). Tympanogram, stapedial muscle reflex, pure tone audiometry, tinnitus pitch matching, spontaneous otoacoustic emissions, and distortion product otoacoustic emissions (DPOAEs) in the absence and presence of contralateral suppression by white noise. DPOAEs suppression amplitudes recorded from tinnitus and nontinnitus ears of the patients' group were compared with each other and with a control group. The contralateral application of white noise induced the enhancement of DPOAE amplitudes in some patients. The suppression of DPOAE amplitudes by contralateral white noise did not reach statistically significant levels in either ear (with or without tinnitus). On the contrary, under the same conditions, our control group demonstrated statistically significant reduction of DPOAE amplitudes at all frequencies. Patients with normal hearing acuity who have acute tinnitus seem to have a less effective functioning of the cochlear efferent system because the application of contralateral noise enhanced the DPOAEs or suppressed them less intensely than it did in a control group. Further studies may establish the clinical applications for the diagnosis of changes in efferent function, in the subjective evaluation, patient etiological grouping, treatment, or prognosis of tinnitus.