Tinnitus Severity Research Articles

The correlation between earphone usage patterns with the incidence rate and severity of tinnitus

ABSTRACTBackground: Earphone nowadays is extensively used along with audiovisual technology development. The increased use of earphone can lead to tinnitus. Around 10- 20% of the adult population had experienced tinnitus during their life, and 0.5-2.5% affected their quality of life. Tinnitus in medical students could interfere in the teaching process which could can lead to decreased quality of medical students. Objective: To observe the correlation between the pattern of using earphone with the incidence of tinnitus, and to determine the severity of tinnitus among students of the Faculty of Medicine, Universitas Sumatera Utara, class 2017-2019 who used earphones. Method: This was an analytic study with cross-sectional design, using consecutive sampling technique. Result: Bivariate analysis between earphone use patterns and the incidence of tinnitus among the subjects obtained statistically significant results (p=0.017). Univariate analysis on 148 respondents showed a pattern of risky earphone use (64.2%) and 52 people with tinnitus (35.1%), and tinnitus severity with 52 participants based on Visual Analogue Scale was mild (55.8%) and based on Tinnitus Handicap Inventory Questionnaire was light (53.9%). In the pattern of earphone use, the results of the analysis of the frequency of using earphones for 3-4 days were (40.5%), the volume of earphone use was 60-80% (54.1%), the length of time using earphones >3 years was (65.5%), and the duration of using earphones <1 hour (38.5%). Conclusion: There was a correlation between the pattern of earphone use and the incidence of tinnitus among students at the Faculty of Medicine, Universitas Sumatera Utara, class 2017-2019.Keywords: earphone, tinnitus, Visual Analog Scale, Tinnitus Handicap Inventory QuestionnaireABSTRAKLatar belakang: Earphone saat ini sangat banyak digunakan seiring dengan perkembangan teknologi audiovisual. Prevalensi pengguna earphone pada remaja sekitar 83,6% dari 436 remaja. Penggunaan earphone yang berlebihan dapat menyebabkan tinitus. Statistik prevalensi dunia menunjukkan 30-40% populasi dewasa pernah mengalami tinnitus dalam hidupnya dan 0,5-2,5% kualitas hidupnya sangat terganggu oleh tinitus. Tinitus merupakan salah satu tanda penurunan fungsi pendengaran dan mampu menyebabkan penurunan performa kognitif. Tinitus pada mahasiswa kedokteran dapat mengganggu proses belajar mengajar sehingga dapat menurunkan kualitas mahasiswa kedokteran. Tujuan: Untuk mengetahui apakah terdapat hubungan pola penggunaan earphone dengan angka kejadian tinnitus serta tingkat keparahan tinitus pada mahasiswa Fakultas Kedokteran Universitas Sumatera Utara. Metode: Penelitian analitik dengan desain potong lintang dengan teknik pengambilan secara consecutive sampling. Pengukuran dilakukan dengan Visual Analog Scale (VAS) dan Tinitus Handicap Inventory Questionnaire (THI-Q). Hasil: Analisis bivariat antara pola penggunaan earphone dengan angka kejadian tinnitus pada mahasiswa Fakultas Kedokteran Universitas Sumatera Utara diperoleh hasil (p=0,017). Analisis univariat pada 148 responden menunjukkan pola penggunaan earphone berisiko sebanyak (64,2%) dan yang mengidap tinitus sebanyak 52 orang (35,1%), dan tingkat keparahan tinitus dengan jumlah responden 52 orang berdasarkan VAS adalah ringan (55,8%) dan berdasarkan THI-Q adalah ringan (53,9%). Pada pola penggunaan earphone diperoleh hasil analisis frekuensi penggunaan earphone 3-4 hari sebanyak (40,5%), volume penggunaan earphone 60-80% sebanyak (54,1%), lama penggunaan earphone >3 tahun sebanyak (65,5%), dan durasi penggunaan earphone <1 jam sebanyak (38,5%). Kesimpulan: Terdapat hubungan antara pola penggunaan earphone dengan angka kejadian tinitus pada mahasiswa Fakultas Kedokteran Universitas Sumatera Utara angkatan 2017-2019.Kata kunci: earphone, tinitus, Visual Analog Scale, Tinnitus Handicap Inventory Questionnaire

Tinnitus Evaluation in Type 1 Diabetes Mellitus at Tertiary Hospital Malaysia.

To determine the prevalence of tinnitus in Type 1 Diabetes Mellitus (T1DM) patients, to evaluate its severity and to correlate it with estimated Glomerular Filtration Rate (eGFR) as well as glycaemia control (HbA1c). We performed a questionnaire-based cross-sectional study at Hospital Canselor Tuanku Muhriz (HCTM) from a period of 15 months. A total of 133 T1DM patients who fulfilled our study's criteria were subjected to otoscopy examination, tuning fork test and free field voice test. The mini-Tinnitus Questionnaire (TQ) was used to assess the severity of tinnitus. We were careful to categorize the perceived duration of tinnitus. The prevalence of tinnitus among T1DM patients was 24.1% (32/133 patients). Out of 32 patients, approximately 78.1% (25 patients) had a compensated level of tinnitus distress and the remaining 21.9% (7/32) had moderate tinnitus. The duration of tinnitus ranged from 2 seconds to 2 minutes, whıch was ringing and intermittent in nature. The HbA1c and estimated Glomerular Filtration Rate (eGFR) were higher in tinnitus compared to the non-tinnitus group. There was no significant correlation between the severity of tinnitus and HbA1c level or eGFR. Our study concluded that tinnitus amongst T1DM patients was likely to be non-pathological in view of its short duration with minimal to no distress to the sufferers. An elevated HbA1c may increase the risk of developıng tinnitus.

Clinical efficacy and safety of Ethoxidol in cerebrovascular diseases

Evaluation of efficacy and clinical safety of ethylmethylhydroxypyridine malate (Ethoxidol) in cerebrovascular disease in out-patient, and in-patient setting. In the observational study was included of the 70 patients (aged 62.84±6.54 y.o) diagnosed with unspecified cerebrovascular disease, hypertensive encephalopathy, atherosclerosis of cerebral vessels. To access neurological deficit Montreal Scale (MoCA test) was used, MFI-20 test for asthenia. Berg balancing (BBS-test), tinnitus severity score (THI), and general clinical condition score also were recorded. Quality assurance was evaluated by VAS, and EQ-VAS Scores (European life quality gr). Interventions were identical, except treated received Ethoxidol 200 mg IV once/day, or 200 mg IM once/day and 200 mg per os (400 mg/day) during 7 days, follow up by oral administration of Ethoxidol 600 mg/day (200 mg TID) for the period of 53 days. The results of the observational study has shown of high clinical efficacy and tolerability of the Ethoxidol therapy. Statistical significance between baseline and treatment period was recorded on the 7th and 60th day of observation (p<0.001). Stabilization of the archived condition persisted on the 60th day. Ethoxidol administration reduced asthenia cognitive dysfunction, dizziness, balance disorders, and tinnitus. CGI Score revealed reduction of the severity of patient's condition and total of clinical improvement; EQ-VAS Score showed growth of quality of life. The majority of patients were satisfied with performed therapy, attending physicians highlight Ethoxidol safety. Serious adverse events weren't recorded. Ethoxidol was considered as efficient and safe medication for in-patient and out-patient treatment of patient with cerebrovascular diseases (chronic cerebral ischemia).

Effect of acupuncture on tinnitus severity index in the elderly with non-pulsating tinnitus

IntroductionIdiopathic subjective non-pulsating tinnitus (ISNPT) is a frustrating diagnosis to physicians owing to the limited effectiveness of traditional pharmacological approaches. This study aimed to investigate the effect of acupuncture on quality of life in elderly people with ISNPT.MethodsOverall, 40 patients of both sexes with ISNPT lasting for &gt; 3 consecutive months and aged 65 years participated in this study. They were assigned into the study and the control groups, 20 patients each. The study group received the prescribed medications in addition to manual acupuncture on the following acupoints: SJ 3, SJ 5, SJ 17, SJ 18, SJ 19, SJ 20, SJ 21, SJ 22, GB 2, GB 8, GB 20, LI 4, KI 3, and ST 36, for 30 minutes, 3 times/week for 4 weeks, while the control group received their prescribed medications only. All participants in both groups were assessed with the visual analogue score of tinnitus loudness (VASTL) and tinnitus severity index (TSI).ResultsNo statistically significant changes were reported in VASTL or TSI in the control group, while in the study group, VASTL showed a high statistically significant decrease from 8.27 ± 1.45 to 3.20 ± 1.36 (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) and TSI revealed a decrease from 44.30 ± 3.40 to 27.95 ± 4.18 (&lt;i&gt;p&lt;/i&gt; &lt; 0.001).ConclusionsAcupuncture is a good adjunctive complementary therapy to ISNPT in the elderly.

Clinical Findings That Differentiate Co-Occurrence of Hyperacusis and Tinnitus from Tinnitus Alone.

We aimed to assess the characteristics of patients with concurrent tinnitus and hyperacusis, determine the best audiological criteria for predicting hyperacusis, and confirm whether objective evidence of changes in the brain exists. The medical records of patients with tinnitus who visited the hospital between March 2020 and December 2021 were reviewed. Data on accompanying hyperacusis, audiological profiles, and questionnaires including the Tinnitus Handicap Inventory (THI), Beck Depression Inventory, and numerical rating scale were analyzed. Resting-state quantitative electroencephalography (qEEG) using power spectral density (PSD) and event-related spectral perturbation (ERSP) were performed to objectively quantify changes in the brain. A total of 194 patients were analyzed. Among them, 51 (26.3%) reported combined subjective hyperacusis with tinnitus. However, the proportions widely varied from 7.4% to 68.4% based on three audiological criteria for assessment. A higher score on the THI questionnaire was independently associated with the co-occurrence of tinnitus and hyperacusis. Fair agreement was observed between subjective hyperacusis and the audiological criterion based on a loudness discomfort level (LDL) of ≤90 dB at two or more frequencies for the diagnosis of hyperacusis. An increased beta-PSD and decreased levels of gamma-PSD, all-ERSP, and delta-ERSP were observed in patients with hyperacusis (p<0.05). Patients with co-occurring tinnitus and hyperacusis had more severe tinnitus distress. An LDL of ≤90 dB at two or more frequencies may be applicable to predict accompanying hyperacusis in subjects with tinnitus, and qEEG also provides more objective information.

ANXIETY AND DEPRESSION IN PATIENTS WITH TINNITUS

Objective: To determine the presence and severity of depression and anxiety in patients with tinnitus.&#x0D; Study Design: Cross sectional study.&#x0D; Place and Duration of Study: This study was conducted at department of Psychiatry, Combined Military Hospital Multan in collaboration with ENT department, Combined Military Hospital Multan, from Sep 2019 to Mar 2020.&#x0D; Methodology: All diagnosed cases of tinnitus in ENT out-patient department Tinnitus Handicap inventory (THI) was applied to assess the severity of tinnitus. Diagnosis of depression and Anxiety was done based on diagnostic criteria of ICD10 of WHO and symptom severity was assessed using Beck Depressive Inventory (BDI) for depression and Beck Anxiety Inventory (BAI) for Anxiety.&#x0D; Results: A total of 88 participants were included in this study. Fifty-three (60.2%) were male, 35 (39.7%) were females. Twentythree (20.2%) ranged between 18-40 years of age, 65 (57.2%) participants ranged between 41-60 years of age. Seven (12.5%) participants scored less than 38 on tinnitus handicap inventory showing mild severity of tinnitus, 3 (5.3%) individuals scored moderate while 19 (33.9%) had severe level of tinnitus. Thirty-three (37%) participants had depression 55 (62%) out of total 88 participants had anxiety.&#x0D; Conclusion: Studies show presence of anxiety and depression in patients with tinnitus so it seems prudent to screen all patients of tinnitus for psychiatric co morbidity. A multidisciplinary approach is required for the treatment of patients with tinnitus so that physical as well as psychiatric/psychological management of these patients is provided well in time.

Combined Amplification and Sound Therapy for Individuals With Tinnitus and Coexisting Hearing Loss: A Retrospective Cohort Study.

Background: The heterogeneity of tinnitus perception and its impact necessitates a tailor-made management approach in everyone. The current study examined the effects of residual inhibition in combined amplification and sound therapy in individuals with tinnitus and coexisting hearing loss.Methods: A retrospective analysis was performed on patients with tinnitus and coexisting hearing loss between 2016 and 2019. A total of 72 patients provided with combined amplification and sound therapy were divided into 3 groups based on residual inhibition: (i) complete residual inhibition, (ii) partial residual inhibition, and (iii) negative residual inhibition. Tinnitus severity was measured using the Tinnitus Functional Index before treatment and 1 and 6 months after the intervention. A multilevel mixed-effects model was used to examine the treatment effects including both the main and interaction effects of time and residual inhibition on the tinnitus severity.Results: Of the 72 participants, 55 (76%) and 61 (85%) had clinically significant changes (13 points in Tinnitus Functional Index) at 1-month and 6-month postintervention, respectively. In the complete, partial, and negative residual inhibition groups, the reduction in tinnitus impact was 100%, 78%, and 74%, respectively. A multilevel mixed model analysis showed that the main effects of time and residual inhibition along with their interaction were significant.Conclusions: The study results suggest that combined amplification and sound therapy is beneficial in individuals with tinnitus and coexisting hearing loss in reducing their tinnitus severity, and this benefit was more in individuals with complete residual inhibition. However, these results need to be further confirmed by controlled trials.

Association between tinnitus and depressive symptoms in the South Korean population.

In this study, we aimed to examine the association between tinnitus and depressive symptoms in middle-aged and elderly South Korean population. The participants were selected from among those who participated in the 2014, 2016, and 2018 Korea National Health and Nutrition Examination Surveys. The incidence and severity of tinnitus was assessed using a self-reported questionnaire, while depressive symptoms were evaluated using self-reported Patient Health Questionnaire-9. Multiple logistic regression was performed to examine the association between tinnitus and depressive symptoms. Overall, 10 979 (4821 men and 6158 women) participants were enrolled in the study. Regardless of sex, individuals who reported having tinnitus were more likely to have depressive symptoms than those without tinnitus (men: odds ratio 1.53, 95% confidence interval 1.01–2.32; women: odds ratio 1.78, 95% confidence interval 1.35–2.35). In severe cases of tinnitus, women were more likely to have depressive symptoms (odds ratio 7.18, 95% confidence interval 3.71–13.87) compared to men. This study revealed a significant association between tinnitus and depressive symptoms among the middle-aged and elderly South Korean population.

ROLE OF GINKGO BILOBA IN TINNITUS BASED ON TINNITUS HANDICAP INVENTORY

ABSTRACT AIMS AND OBJECTIVES To evaluate whether there is role of Ginkgo biloba in treatment of tinnitus or not, using Tinnitus Handicap Inventory MATERIAL METHODS: The present prospective study, after approval by Institutional Ethics Committee, was conducted in Department of ENT, GMC Jammu from January 2019 to January 2020 on 90 patients with primary complaint of tinnitus. Inclusion criteria- Age: 20 years or above, Duration of tinnitus &gt; 3 months. Informed consent was taken and all patients were asked to complete the THI-Tinnitus Handicap Inventory. All patients were given 50mg of Ginkgo biloba standardized extract LI 1370 (containing 25% flavonoids, 3% ginkgolides and 5% bilobalides). Patients were advised to take three tablets daily for 12 weeks. RESULTS The mean pre-treatment THI score was 43.6 and mean post-treatment THI score (at 12 weeks) was 39.4; the mean change in THI score was 4.2, the result being statistically insignificant (p-value= 0.43). Out of 90 patients, 51 reported unchanged severity of tinnitus, 27 patients reported improvement in severity of tinnitus and 12 patients reported worsening of condition. CONCLUSION According to our study, Ginkgo biloba has no significant therapeutic role in tinnitus. However, the aetiology of tinnitus is multifactorial and Ginkgo biloba could benefit patients with ischemic aetiology. KEYWORDS Ginkgo, biloba, handicap, inventory, tinnitus

The DizzyQuest: relation between self-reported hearing loss, tinnitus and objective hearing thresholds in patients with Meniere’s disease

BackgroundCombining a mobile application-based vestibular diary called the DizzyQuest and an iPad-based hearing test enables evaluation of the relationship between experienced neuro-otological symptoms and hearing thresholds in daily life setting. The aim was to investigate the relationship between self-reported hearing symptoms and hearing thresholds in patients with Meniere’s disease (MD), using the DizzyQuest and the iPad-based hearing test simultaneously.MethodsThe DizzyQuest was administered for 3 weeks in 21 patients. Using the experience-sampling-method (ESM), it assessed hearing loss and tinnitus severity for both ears separately. Each day after the DizzyQuest, an iPad-based hearing test was used to measure hearing thresholds. A mixed model regression analysis was performed to investigate relationships between hearing thresholds and self-reported hearing loss and tinnitus severity.ResultsFifteen patients were included. Overall, pure-tone averages (PTAs) were not correlated with self-reported hearing loss severity and tinnitus. Individual differences in PTA results between both ears did not significantly influence the difference in self-reported hearing loss severity between both ears. Self-reported hearing loss and tinnitus scores were significantly higher in ears that corresponded with audiometric criteria of MD (p < 0.001). Self-reported tinnitus severity significantly increased with self-reported hearing loss severity in affected (p = 0.011) and unaffected ears (p < 0.001).ConclusionCombining the DizzyQuest and iPad-based hearing test, facilitated assessment of self-reported hearing loss and tinnitus severity and their relationship with hearing thresholds, in a daily life setting. This study illustrated the importance of investigating neuro-otological symptoms at an individual level, using multiple measurements. ESM strategies like the DizzyQuest should therefore be considered in neuro-otological research.

The Use of Virtual Reality for Managing Chronic Tinnitus

The Use of Virtual Reality for Managing Chronic Tinnitus

Risk factors of decompensated tinnitus and the interaction effect of anxiety and poor sleep on decompensated tinnitus: a multicenter study

Background Decompensated tinnitus substantially degrades quality of life. Anxiety and poor sleep are comorbidities in decompensated tinnitus. Objective This multicenter study was designed to investigate the risk factors of decompensated tinnitus and to analyze the interaction effect of anxiety and poor sleep on decompensated tinnitus by conducting a multicenter study. Material and Methods We retrospectively analyzed patients with subjective chronic tinnitus who presented to five Chinese hospitals in China from September 2019 to November 2020. Demographic characteristics, pure tone audiometry, tinnitus-related tests, psychometric and sleep questionnaires were applied. Results A total of 338 patients were included, and 99 (29.3%) patients were in the decompensated group. Poor sleep and anxiety were possible risk factors of decompensated tinnitus by a forced-entry binary logistic analysis. Sleep disturbances and anxiety had an additive interaction that accounted for 87% of the decompensated tinnitus cases in our study population (RERI = 10.96, S = 18.22, AP = 0.87). Conclusions and Significance Anxiety and sleep disturbances are possible risk factors of decompensated tinnitus. The combination of poor sleep and anxiety exerts a greater impact on tinnitus severity than either risk factor alone.

Tinnitus prevalence in Europe: a multi-country cross-sectional population study.

SummaryBackgroundTinnitus prevalence studies report large variability across countries that might be due to inconsistent research methods. Our study aimed to report a single Pan-European estimate for tinnitus prevalence and investigate the effect of individual and country-level characteristics on prevalence. We explored the relationships of healthcare resource use and hearing difficulty with tinnitus symptoms.MethodsBetween 2017-2018, a cross-sectional European Tinnitus Survey (ETS) was conducted in 12 European Union nations (Bulgaria, England, France, Germany, Greece, Ireland, Italy, Latvia, Poland, Portugal, Romania, and Spain), using a standardised set of tinnitus-related questions and response options in country-specific languages. We recruited 11,427 adults aged ≥18 years.FindingsPrevalence of any tinnitus was 14·7% (14·0% in men and 15·2% in women), ranging from 8·7% in Ireland to 28·3% in Bulgaria. Severe tinnitus was found in 1·2% participants (1·0% in men and 1·4% in women), ranging from 0·6% in Ireland to 4·2% in Romania. Tinnitus prevalence significantly increased with increasing age and worsening of hearing status. Healthcare resource use for tinnitus increased with increasing tinnitus symptom severity.InterpretationThis is the first multinational report of Pan-European tinnitus prevalence using standardised questions. The overall prevalence estimates refine previous findings, although widespread inter-country heterogeneity was noted. The results indicate that more than 1 in 7 adults in the EU have tinnitus. Extrapolating to the overall population, approximately 65 million adults in EU28 have tinnitus, 26 million have bothersome tinnitus and 4 million have severe tinnitus.FundingNational Institute for Health Research, European Union's Horizon 2020, Medical Research Council, and GENDER-Net Co-Plus Fund.

Exploratory Data Mining Techniques (Decision Tree Models) for Examining the Impact of Internet-Based Cognitive Behavioral Therapy for Tinnitus: Machine Learning Approach.

BackgroundThere is huge variability in the way that individuals with tinnitus respond to interventions. These experiential variations, together with a range of associated etiologies, contribute to tinnitus being a highly heterogeneous condition. Despite this heterogeneity, a “one size fits all” approach is taken when making management recommendations. Although there are various management approaches, not all are equally effective. Psychological approaches such as cognitive behavioral therapy have the most evidence base. Managing tinnitus is challenging due to the significant variations in tinnitus experiences and treatment successes. Tailored interventions based on individual tinnitus profiles may improve outcomes. Predictive models of treatment success are, however, lacking.ObjectiveThis study aimed to use exploratory data mining techniques (ie, decision tree models) to identify the variables associated with the treatment success of internet-based cognitive behavioral therapy (ICBT) for tinnitus.MethodsIndividuals (N=228) who underwent ICBT in 3 separate clinical trials were included in this analysis. The primary outcome variable was a reduction of 13 points in tinnitus severity, which was measured by using the Tinnitus Functional Index following the intervention. The predictor variables included demographic characteristics, tinnitus and hearing-related variables, and clinical factors (ie, anxiety, depression, insomnia, hyperacusis, hearing disability, cognitive function, and life satisfaction). Analyses were undertaken by using various exploratory machine learning algorithms to identify the most influencing variables. In total, 6 decision tree models were implemented, namely the classification and regression tree (CART), C5.0, GB, XGBoost, AdaBoost algorithm and random forest models. The Shapley additive explanations framework was applied to the two optimal decision tree models to determine relative predictor importance.ResultsAmong the six decision tree models, the CART (accuracy: mean 70.7%, SD 2.4%; sensitivity: mean 74%, SD 5.5%; specificity: mean 64%, SD 3.7%; area under the receiver operating characteristic curve [AUC]: mean 0.69, SD 0.001) and gradient boosting (accuracy: mean 71.8%, SD 1.5%; sensitivity: mean 78.3%, SD 2.8%; specificity: 58.7%, SD 4.2%; AUC: mean 0.68, SD 0.02) models were found to be the best predictive models. Although the other models had acceptable accuracy (range 56.3%-66.7%) and sensitivity (range 68.6%-77.9%), they all had relatively weak specificity (range 31.1%-50%) and AUCs (range 0.52-0.62). A higher education level was the most influencing factor for ICBT outcomes. The CART decision tree model identified 3 participant groups who had at least an 85% success probability following the undertaking of ICBT.ConclusionsDecision tree models, especially the CART and gradient boosting models, appeared to be promising in predicting ICBT outcomes. Their predictive power may be improved by using larger sample sizes and including a wider range of predictive factors in future studies.

Can the Tinnitus Magnitude Index Reflect the Depression and Anxiety of Tinnitus Sufferers?

Purpose: This study evaluates the relationship between tinnitus magnitude and depression and statetrait anxiety.Methods: A total of 65 subjects suffering from tinnitus participated. None reported any hearing problems. The participants filled in the Tinnitus Magnitude Index (TMI), the Korean version of the Beck depression inventory, and the Korean version of state-trait anxiety questionnaires with 61 out of 65 subjects completing all the questionnaires.Results: No significant relationships between tinnitus magnitude and depression or state-trait anxiety were found. However, items for the TMI were found to be significantly related (p &lt; 0.05), and depression and state-strait anxiety also had a significant relationship (p &lt; 0.05).Conclusion: We concluded that the TMI was not sensitive when used for assessing depression and anxiety in individuals who are suffering from tinnitus, which implying that the TMI questionnaire is useful for a quick assessment tool of the severity of tinnitus in individuals.

Medication Use Reported by Individuals With Tinnitus Who Are Seeking Internet-Based Psychological Interventions.

This study examined medication use by individuals with tinnitus who were seeking help for their tinnitus by means of a psychological intervention. This study used a cross-sectional survey design and included individuals with tinnitus enrolled in an Internet-based cognitive behavioral therapy trial (n = 439). Study participants provided demographic details, completed various structured questionnaires and provided details about the medications used. The self-reported medications were classified using the United States Pharmacopeial Medicare Model Guidelines v7.0. Current medication use was reported by 67% (n = 293) of the study participants. Those currently using medication were older; had consulted their primary care physician, had greater tinnitus severity, depression, anxiety, and insomnia when compared with those not reporting any current medication use. The top 10 medication used included cardiovascular agents (n = 162; 55.3%), antidepressants (n = 80; 27.3%), electrolytes/minerals/metals/vitamins (n = 70; 23.9%), respiratory tract/pulmonary agents (n = 62; 21.2%), anxiolytics (n = 59; 20.1%), hormonal agents/stimulant/replacement/modifying (thyroid; n = 45; 15.4%), gastrointestinal agents (n = 43; 14.7%), analgesics (n = 33; 11.3%), blood glucose regulators (n = 32; 10.9%), and anticonvulsants (n = 26; 8.87%). Some associations between type of medication used and demographic or tinnitus-related variables were noted especially for the cardiovascular agents, electrolytes/minerals/metals/vitamins, and anxiolytics. This exploratory study indicated a large percentage of patients using medication and a range of medications. Further studies are required to assess the effects of such medications on the tinnitus percept and concurrent medication moderate treatment effects.

Job satisfaction in a group of patients with tinnitus.

Tinnitus is an auditory impression without any external auditory stimulus. It may cause negative symptoms (anxiety, insomnia, depression) significantly affecting work performance and job satisfaction. To evaluate the job satisfaction in tinnitus sufferers. Cross-sectional study were conducted and 51 individuals (23-70 years) were recruited. Participants completed two questionnaires: Tinnitus Handicap Inventory and Job Satisfaction Scale. People affected by tinnitus report higher job satisfaction than healthy people. Job satisfaction was significantly related to age: r = 0.31; p < 0.05 in all tinnitus patients. There was a correlation between job satisfaction and tinnitus severity but only in people with normal hearing (-0.69; p < 0.05). The results show that job satisfaction is affected by the level of tinnitus annoyance (from both its emotional and functional aspects), but only in people with normal hearing. In future research it is recommended that additional factors be investigated, both work and non-work related, to thoroughly explore the impact of tinnitus on job satisfaction.

Age-Related Hearing Loss With Tinnitus and Physical Frailty Influence the Overall and Domain-Specific Quality of Life of Chinese Community-Dwelling Older Adults.

Objective: To investigate the impact of the severity of age-related hearing loss (ARHL) and tinnitus, presence of ARHL and/or tinnitus, and physical frailty on the health-related quality of life (HRQoL) and domain-specific HRQoL in Chinese community-dwelling older adults.Design: This was a cross-sectional study of a community-based cohort.Participants: We evaluated Chinese older adults (n = 429, 183 men and 246 women) aged ≥ 58years.Measurements: The severity of HL and tinnitus were measured using pure-tone audiometry and the Tinnitus Handicap Inventory (THI), respectively. Physical frailty was measured using the five-item Fried scale. HRQoL was assessed using the Assessment of Quality of Life-8-Dimension (AQoL-8D) multi-attribute utility instrument (35 HRQoL items and eight domain-specific HRQoL subcategories). Low HRQoL (HRQoL score or subscores in the highest quintile) was used as a dependent variable in logistic regression analyses adjusted for demographic (Model 1) and health-related (Model 2) and psychosocial (Model 3) confounders.Results: Age-related hearing loss severity was an independent determinant of senses in the physical dimension of HRQoL after adjusting for all covariates. Tinnitus severity was significantly associated with HRQoL and with independent living, senses, and pain in the physical dimension after adjusting for demographic and health-related covariates and was still associated with independent living and senses after adjusting for all covariates. The presence of ARHL and/or tinnitus was significantly associated with independent living and senses in the physical dimension after adjusting for all the covariates. Physical frailty was an independent determinant of HRQoL, independent living, and pain in the physical dimension and with mental health, happiness, and coping in the psychosocial dimension after adjusting for demographic and health-related covariates. The association with HRQoL, independent living, and pain in the physical dimension, and with happiness and coping in the psychosocial dimension remained significant after adjusting for the covariates. Depressive symptoms, social dysfunction, and a number of comorbidities were critical determinants of psychosocial HRQoL.Conclusion: Physical frailty has a stronger and more profound effect on HRQoL, particularly on independent living and pain in the physical dimension and on happiness and coping in the psychosocial dimension. Domain-specific HRQoL should be considered in the management of patients with ARHL with tinnitus and physical frailty.Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT2017K020.

A Study to Grade the Severity of Tinnitus and its Psychological Impact Using Tinnitus Functional Index (tfi).

Chronic tinnitus has a lot impact on the quality of life of person by affecting his/ her physical health, occupational health and social relations. It can lead to sleep interference, cognitive difficulties, lack of concentration, anxiety, frustration, anger and depression. The present study showed the severity and impact of tinnitus on quality of life of subjects with or without hearing loss using tinnitus functional index (TFI). Subjects with history of tinnitus with or without hearing loss including informed consent, otoscopy, pure tone audiometry (PTA) were done. Grading of tinnitus was done by using tinnitus functional index score. The mean age of participants were 50.20 ± 4.2years and male to female ratio were found to be 1.05:1. On PTA, 122 participants had hearing loss and 28 had no hearing loss. 49 patients had mild TFI score, 85 had moderate TFI score and 16 had severe hearing loss. The difference in the severity of tinnitus using TFI between normal hearing and sensorineural hearing loss individual was statistically significant. On the other hand, the severity of tinnitus and degree of hearing loss were also found to be statistically significant with p value < 0.0001 chi. Sq = 77.39. This shows that with increase in increase in hearing loss there is increase in TFI sore. Tinnitus has a negative impact on the quality of life like pshycological, emotional and physical effects. The effects of tinnitus is more in those with co-existing hearing loss.

Striatal networks for tinnitus treatment targeting.

Neuromodulation treatment effect size for bothersome tinnitus may be larger and more predictable by adopting a target selection approach guided by personalized striatal networks or functional connectivity maps. Several corticostriatal mechanisms are likely to play a role in tinnitus, including the dorsal/ventral striatum and the putamen. We examined whether significant tinnitus treatment response by deep brain stimulation (DBS) of the caudate nucleus may be related to striatal network increased functional connectivity with tinnitus networks that involve the auditory cortex or ventral cerebellum. The first study was a cross‐sectional 2‐by‐2 factorial design (tinnitus, no tinnitus; hearing loss, normal hearing, n = 68) to define cohort level abnormal functional connectivity maps using high‐field 7.0 T resting‐state fMRI. The second study was a pilot case–control series (n = 2) to examine whether tinnitus modulation response to caudate tail subdivision stimulation would be contingent on individual level striatal connectivity map relationships with tinnitus networks. Resting‐state fMRI identified five caudate subdivisions with abnormal cohort level functional connectivity maps. Of those, two connectivity maps exhibited increased connectivity with tinnitus networks—dorsal caudate head with Heschl's gyrus and caudate tail with the ventral cerebellum. DBS of the caudate tail in the case‐series responder resulted in dramatic reductions in tinnitus severity and loudness, in contrast to the nonresponder who showed no tinnitus modulation. The individual level connectivity map of the responder was in alignment with the cohort expectation connectivity map, where the caudate tail exhibited increased connectivity with tinnitus networks, whereas the nonresponder individual level connectivity map did not.