Tinnitus Handicap Inventory Scores Research Articles

Effectiveness of Intratympanic Dexamethasone with Lidocaine for Alleviation of Tinnitus

Objective: To determine the effectiveness of Intratympanic Dexamethasone with Lidocaine in control of idiopathic tinnitus.
 Study Design: Randomized control trial (Clinical Trials. gov Identifier: NCT04798391).
 Place and Duration of Study: ENT Department, PAF Hospital, Sargodha Pakistan, from Apr 2017 to Jul 2019.
 Methodology: 264 consenting patients with idiopathic unilateral tinnitus presenting at ENT Department PAF Hospital Sargodha were assessed for tinnitus severity using the modified tinnitus handicap inventory. The scores were recorded and subsequently administered intra-tympanicaly 2.0ml (milli-liter) of Dexamethasone and Lidocaine (1.5 ml Dexamethasone ± 0.5 ml 1% Lidocaine). The dose was repeated twice at weekly intervals. All the patients were reassessed on the modified tinnitus handicap inventory two weeks after the third Intra-tympanic administration, with patients divided into responsive and noresponsive groups depending on ten points or more improvement in tinnitus score.
 Results: Mean modified tinnitus handicap inventory score pre-therapy was 29.6 ± 5.68, and post-therapy was 17.1 ± 7.45. Independent-sample T-test applied showed a p-value of <0.001.
 Conclusion: Intratympanic Dexamethasone with lidocaine has a definitively positive outcome on tinnitus improvement.

Tinnitus characteristics and associated variables on Tinnitus Handicap Inventory among a Hungarian population

BackgroundTinnitus is a sound precepted without an external sound stimulus. Its background can be categorised into primary and secondary cases. The secondary cases include pathologies of the external, middle and inner ear. Tinnitus can be objective or subjective; the latter can only identified by the sufferer. Previous research results have shown that tinnitus significantly affects the quality of life and daily functioning. ObjectivesTo analyse the impact of tinnitus on the daily functioning and the possible influence of demographical data and tinnitus duration on it. Methods630 patients (265 males and 365 females, 25–85 years of age) suffering from primary tinnitus were enrolled. In the Hungarian language, these patients completed the Tinnitus Handicap Inventory (THI) questionnaire and underwent a complete otorhinolaryngological examination. IBM SPSS V24 software was used for data processing; correlation tests, the Mann-Whitney U and Kruskal-Wallis non-parametric tests were used. ResultsAccording to the THI questionnaires outcomes, most patients (62.5%) were presented with a mild handicap. Based on statistical analysis, no significant correlation was observed between the total THI points and the age of the patients, along with the duration and localisation of the symptoms. However, the total THI scores of male and female patients significantly differed, indicating higher THI values in the female group (p = 0.00052∗). ConclusionsThe tinnitus severity was not affected by the duration, localisation of the symptoms and age but by gender, indicating higher values in the case of females.

Tinnitus suppression with electrical stimulation in adults: long-term follow-up.

SUMMARYObjectivesTo investigate the long-term effects of cochlear implants as a treatment for patients with severe to profound neurosensory loss associated with severe tinnitus.MethodsProspective study in 17 adult patients with severe to profound sensorineural hearing loss associated with severe tinnitus, indicated with a Tinnitus Handicap Inventory (THI) score ≥ 58%, and hyperacusis. Measures were made on hearing, tinnitus, hyperacusis and quality of life up to 5 years after activation of the sound processor of the cochlear implant. It was evaluated by using the disyllabic test, THI, visual analogue scale and Glasgow Benefit Inventory questionnaire.Results60 months after cochlear implantation, improvements in loudness and discomfort of tinnitus, speech discrimination and hyperacusis were observed. Subjects perceive an important subjective benefit upon receiving the cochlear implant.ConclusionsCochlear implants can be used as treatment for patients with severe to profound sensorineural hearing loss associated with severe tinnitus and hyperacusis with long-term benefits on quality of life and lasting relief of tinnitus.

The Impact of Acute Tinnitus on Listening Effort: A Study Based on Clinical Observations of Sudden Sensorineural Hearing Loss Patients.

This study investigates the relationship between listening effort and acute tinnitus over the clinical course of sudden sensorineural hearing loss (SSNHL) before and after treatment. Thirty SSNHL patients with acute tinnitus were enrolled in this prospective study. Each patient was evaluated before treatment and after 1 and 3 months of follow-up. Listening effort was evaluated in the unaffected ears in two conditions (with and without background noise) using a dual-task paradigm, which included a primary (speech recognition) task and a secondary (visual reaction time) task. Tinnitus severity was assessed with the Tinnitus Handicap Inventory (THI). It was observed that background noise significantly increased listening effort in SSNHL patients with acute tinnitus before and after treatment. THI scores and listening effort in quiet conditions (** p = 0.009) were significantly decreased three months after treatment. In an analysis of the relation between tinnitus severity and listening effort, it was found that the THI total score was significantly correlated with listening effort in quiet (* p = 0.0388) and noisy conditions (* p = 0.044) before treatment. We concluded that SSNHL patients with acute tinnitus exerted greater listening effort in the presence of background noise than in quiet conditions. Furthermore, listening effort was reduced as tinnitus improved in SSNHL patients during the three months after treatment. Both before and after 3 months of treatment, patients who were more affected and emotionally distressed by tinnitus tended to exert more listening effort in both quiet and noisy environments.

The moderating effect of personality traits on acute tinnitus sensation in idiopathic sudden sensorineural hearing loss.

People may experience tinnitus after sudden hearing impairment. The details of the relationship between tinnitus improvement and hearing recovery are still unclear. Personality traits may play a role in the modulation of tinnitus sensation. We investigated the moderating effect of personality traits on pretreatment and posttreatment tinnitus sensation in patients with idiopathic sudden sensorineural hearing loss (ISSHL). This prospective longitudinal study enrolled 33 patients diagnosed with unilateral ISSHL and acute tinnitus in 2018-2019 at one institute. Clinical data were collected before and after treatment, including results of pure-tone audiometry (PTA), the Clinical Tinnitus Questionnaire (CTQ), the Tinnitus Handicap Inventory (THI), tinnitus loudness and annoyance (Visual Analog Scale; VAS), the Hospital Anxiety and Depression Scale (HADS), and the Big Five Inventory (BFI)-44. Eighteen men and 15 women with an average age of 48.3 ± 15.8 years were enrolled. The pretreatment hearing threshold and THI score were 58.0 ± 27.4 dB HL and 42.9 ± 26.2 (range: 0-88), respectively; the posttreatment values were 39.8 ± 22.4 dB HL and 20.7 ± 22.5 (range: 0-64), respectively. There were significant differences between pretreatment and posttreatment hearing thresholds as well as THI, VAS, and HADS scores (p < 0.001) but not BFI-44 results. Neuroticism and openness had significant positive and negative correlations, respectively, with acute tinnitus stress before treatment (r = 0.561, p = 0.001; r = -0.359, p = 0.040). After 3 months of follow-up, all patients were analyzed separately by dividing them into recovery (n = 16) and nonrecovery groups (n = 14) according to their hearing improvement status by Siegel's criteria. Neuroticism showed a significant moderating effect on acute tinnitus sensation in the ISSHL recovery group (p < 0.001) but not in the nonrecovery group (p = 0.106). Neuroticism and openness may affect acute tinnitus stress in ISSHL patients. Practitioners should consider personality traits when managing ISSHL patients with bothersome tinnitus.

Effects of the coronavirus disease 2019 pandemic on subjective tinnitus perception.

This study investigated the effects of the coronavirus disease 2019 pandemic on tinnitus severity and quality of life in individuals with subjective tinnitus. The study was carried out during the coronavirus disease 2019 pandemic. Sixty patients were evaluated with the Tinnitus Handicap Inventory and a visual analogue scale on resonance intensity and disturbance, together with questions assessing their emotional states. There was a significant difference between the visual analogue scale and the Tinnitus Handicap Inventory scores before the pandemic and during the pandemic. It was determined that tinnitus loudness and annoyance were significantly worse in the pandemic and, consequently, that the coronavirus disease 2019 pandemic negatively affected perceptions of tinnitus and quality of life. Psychological support can affect positively the perception of tinnitus and the change in moods experienced during the pandemic. Because personal contact and quotidian activities are severely limited during the pandemic, internet-based interventions should be prioritised in tinnitus therapy.

Effect of Dry Needling on the Masseter Muscle in the Tinnitus Perception of Patients with Temporomandibular Disorder.

To evaluate the effect of dry needling on the masseter muscle in the perception of tinnitus in patients with temporomandibular disorder. Twenty-five patients with tinnitus and muscular temporomandibular disorders were randomly assigned to groups study (n = 13) and control (n = 12). Three sessions of dry needling (study) and sham (control) were performed. Follow-up was performed 30, 60 and 90days after the end of treatment. The Analog Visual Scale and Tinnitus Handicap Inventory (THI) were used to evaluate the treatment. In study group, 76.9% presented a reduction in the intensity and tinnitus discomfort and total THI. In control group, 66.7% presented a decrease in tinnitus intensity and total THI, and 58.3% reported a decrease in tinnitus discomfort. After 90days, in the study group, 84.6% maintained improvement in pain intensity and reduction in THI score and 69.2% reported improvement in both intensity and discomfort caused by tinnitus. In control group, 75% achieved improvement in pain intensity, 33.2% maintained improvement in tinnitus intensity, and 41.7% maintained improvement in discomfort caused by tinnitus and total THI. In the total THI score, the study group presented improvement (p = 0.041). Dry needling combined with counseling was associated with improvement in pain intensity and tinnitus, decrease in tinnitus discomfort and reduction in total THI score.

An Exploratory Investigation of Pupillometry As a Measure of Tinnitus Intrusiveness on a Test of Auditory Short-Term Memory.

The purpose of the current study was to investigate the potential of pupillometry to provide an objective measure of competition between tinnitus and external sounds during a test of auditory short-term memory. Twelve participants with chronic tinnitus and twelve control participants without tinnitus took part in the study. Pretest sessions used an adaptive method to estimate listeners' frequency discrimination threshold on a test of delayed pitch discrimination for pure tones. Target and probe tones were presented at 72 dB SPL and centered on 750 Hz±2 semitones with an additional jitter of 5 to 20 Hz. Test sessions recorded baseline pupil diameter and task-related pupillary responses (TEPRs) during three blocks of delayed pitch discrimination trials. The difference between target and probe tones was set to the individual's frequency detection threshold for 80% response-accuracy. Listeners with tinnitus also completed the Tinnitus Handicap Inventory (THI). Linear mixed effects procedures were applied to examine changes in baseline pupil diameter and TEPRs associated with group (tinnitus versus control), block (1 to 3) and their interaction. The association between THI scores and maximum TEPRs was assessed using simple linear regression. Patterns of baseline pupil dilation across trials diverged in listeners with tinnitus and controls. For controls, baseline pupil dilation remained constant across blocks. For listeners with tinnitus, baseline pupil dilation increased on blocks 2 and 3 compared with block 1. TEPR amplitudes were also larger in listeners with tinnitus than controls. Linear mixed effects models yielded a significant group by block interaction for baseline pupil diameter and a significant main effect of group on maximum TEPR amplitudes. Regression analyses yielded a significant association between THI scores and TEPR amplitude in listeners with tinnitus. Our data indicate measures of baseline pupil diameter, and TEPRs are sensitive to competition between tinnitus and external sounds during a test of auditory short-term memory. This result suggests pupillometry can provide an objective measure of intrusion in tinnitus. Future research will be required to establish whether our findings generalize to listeners across a full range of tinnitus severity.

Patient-Assessed Outcomes following Temporal Bone Fractures.

The long-term impact of neurotological symptoms after a temporal bone fracture (TBF), including facial nerve palsy (FP), hearing loss, tinnitus, and dizziness on the quality of life of patients is often underevaluated. Thus, we retrospectively assessed 30 patients with TBF (26 men and 4 women) in our university tertiary referral center. They participated from injury onset to the final follow-up, over an 18-month period. Quality of life was estimated using validated questionnaires, such as the Facial Disability Index (FDI: physical and social), Hearing Handicap Inventory (HHI), Tinnitus Handicap Inventory (THI), and Dizziness Handicap Inventory (DHI). The FDI score was significantly worse in patients with severe initial (for physical FDI) and final facial palsy (for both physical and social FDI), mainly with immediate onset. The HHI score was statistically worse in patients with mixed hearing loss compared to those with conductive or sensorineural hearing loss and in those with profound hearing loss vs. normal hearing. The mixed TBF and the severity of hearing loss (especially profound hearing loss) were correlated with HHI, THI and DHI score values. In the long-term period after a TBF, moderate or severe facial palsy, mainly with immediate onset, may cause psychological distress, more easily resulting in social disability than functional impairment. Mixed TBF and mixed or profound hearing loss may also negatively influence quality of life.

Hearing Aid Effects and Satisfaction in Patients with Tinnitus.

This study aimed to evaluate the effectiveness of and satisfaction with hearing aids as a treatment option for tinnitus with hearing loss. Methods: This retrospective study used the tinnitus handicap inventory (THI), the satisfaction with amplification in daily life (SADL) questionnaire, and a medical chart review. A total of 116 patients treated between August 2018 and December 2020 were included. All patients with tinnitus and hearing loss underwent the same counseling sessions. Sixty patients chose to have hearing aids fitted (aided group), whereas 56 patients chose not to (non-aided group). Both the groups had similar audiometric configurations, durations of tinnitus, and ages. Structured interviews were performed, with various measures evaluated using the visual analog scale (VAS) and the THI questionnaire, before and six months after fitting the hearing aids. The SADL questionnaire was administered 6 months after fitting the hearing aids. Results: The patients’ THI scores reduced 6 months after the counseling, but the improvement in the THI scores was only significant in the group that received hearing aids. There were significant differences between the VAS scores of the two groups, and the changes in the VAS scores in the groups were statistically different. Subjective satisfaction with a hearing aid increased with improvements to tinnitus-related discomfort. Conclusion: The study’s results indicated that patients with hearing loss and tinnitus can be treated with hearing aids and counseling.

Electrical stimulation of the cochlea for treatment of chronic disabling tinnitus: an open-label trial towards the development of an implantable device

BackgroundChronic tinnitus affects millions of people globally and constitutes the most commonly compensated disability among military service members in the United States. Existing treatment options largely surround helping patients cope with their disease as opposed to directly suppressing tinnitus perception. The current study investigated the efficacy of electrical stimulation of the cochlea on chronic disabling tinnitus.MethodsIn this single-arm, open-label clinical trial, 22 adult subjects with severe-range asymmetric or unilateral non-pulsatile tinnitus underwent electrical stimulation of the cochlea through use of an extra-cochlear electrode positioned on the cochlear promontory. Each subject underwent 3 stimulation treatments over 3 weeks at 7-day intervals. Tinnitus severity was determined by Tinnitus Handicap Inventory (THI), Tinnitus Functional Index (TFI), and Tinnitus Visual Analog Scale (VAS). Inclusion criteria required subjects have no worse than moderate sensorineural hearing loss determined by pre-enrollment audiometric testing. The primary outcome was nadir post-treatment THI scores, obtained at seven timepoints following electrical stimulation, with clinically significant improvement defined as a decrease of ≥ 7.ResultsAll 22 (100%) subjects experienced clinically significant improvement in the THI during the study period with a mean decrease in scores of − 31 (95% CI − 38 to − 25) from a baseline of 48. Twenty (91%) experienced clinically significant improvement detectable on at least two of the three tinnitus survey instruments and 17 (77%) experienced clinically significant improvement detectable on all three survey instruments (i.e., THI, TFI, and VAS). Eight (36%) subjects reported either complete (THI of 0; n = 3) or near-complete (THI 1–4; n = 5) suppression of their tinnitus following a stimulation session. Thirteen (59%) subjects reported a nadir following stimulation at or below the threshold for “no or slight handicap” on the THI (≤ 16). No adverse events were observed.ConclusionsThese findings establish the foundation for the development of an extra-cochlear implantable device that delivers electrical stimulation to the cochlea for the treatment of disabling tinnitus. For patients considering device implantation, trans-tympanic cochlear promontory stimulation can facilitate patient selection.Trial Registration ClinicalTrials.gov Identifier: NCT03759834. URL: https://clinicaltrials.gov/ct2/show/NCT03759834

Enlarged Vertebral Venous Plexus Alleviated Intracranial Hypertension-Related Symptoms in Patients with Bilateral Transverse Sinus Stenosis

Background: Enlarged vertebral venous plexus (EVVP) was often observed in patients with bilateral transverse sinus stenosis (BTSS). The purpose of this study was to investigate the physiological role of EVVP in BTSS patients. Methods: Forty-five BTSS patients and 92 normal controls were prospectively recruited from January 2014 to December 2019. The index of transverse sinus stenosis (ITSS) was used for the assessment of BTSS severity. Subjects underwent a standard lumbar puncture to measure the intracranial pressure (ICP). Papilledema and tinnitus were evaluated by using Frisén’s grade and questionnaires for Tinnitus Handicap Inventory (THI), respectively. The intensity and impact of headache were assessed by using 10-point Numeric Pain Rating Scale and six-item Headache Impact Test, respectively. Results: The BTSS group had more subjects with intracranial hypertension (IH) and less subjects with normal ICP than normal controls (p < 0.01; p < 0.01). BTSS patients had higher ICP than normal controls (p < 0.01). ICP was significantly lower in BTSS patients with EVVP than in those without EVVP (p < 0.01). No significant difference in ICP was found between normal controls with EVVP and those without EVVP (p = 0.99). A similar incidence of EVVP in BTSS patients and normal controls was found (p = 0.86). BTSS patients with IH exhibited a lower incidence of EVVP than those with normal ICP and overlapping ICP (p < 0.01; p < 0.01). The incidence of EVVP was not correlated with ITSS (p = 0.81). EVVP, rather than ITSS, correlated with ICP (p = 0.01). Furthermore, EVVP alleviated papilledema evaluated by Frisén’s grade and tinnitus evaluated by the THI score in BTSS patients (p = 004; p = 0.02). Conclusions: EVVP in normal controls is a congenital phenomenon that exerts no impact on ICP. However, the presence of EVVP reduces ICP and alleviates IH-related papilledema and tinnitus in BTSS patients.

Altered Neurovascular Coupling in Unilateral Pulsatile Tinnitus.

ObjectiveAltered cerebral blood flow (CBF) and regional homogeneity (ReHo) have been reported in pulsatile tinnitus (PT) patients. We aimed to explore regional neurovascular coupling changes in PT patients.Materials and MethodsTwenty-four right PT patients and 25 sex- and age-matched normal controls were included in this study. All subjects received arterial spin labeling imaging to measure CBF and functional MRI to compute ReHo. CBF/ReHo ratio was used to assess regional neurovascular coupling between the two groups. We also analyzed the correlation between CBF/ReHo ratio and clinical data from the PT patients.ResultsPT patients exhibited increased CBF/ReHo ratio in left middle temporal gyrus and right angular gyrus than normal controls, and no decreased CBF/ReHo ratio was found. CBF/ReHo ratio in the left middle temporal gyrus of PT patients was positively correlated with Tinnitus Handicap Inventory score (r = 0.433, p = 0.035).ConclusionThese findings indicated that patients with PT exhibit abnormal neurovascular coupling, which provides new information for understanding the neuropathological mechanisms underlying PT.

Effect of tinnitus distress on auditory steady-state response amplitudes in chronic tinnitus sufferers

Tinnitus is a bothersome disorder of primarily unknown etiology that affects a large number of people worldwide. Tinnitus distress is the most common clinical complaint by tinnitus sufferers because it strongly affects their personal and social life. Many studies have been carried out to determine the relation between tinnitus pathophysiology and electrophysiological findings such as the auditory steady-state response (ASSR). The results of such studies have been contradictory. The current study aimed to detect a possible relation between tinnitus distress and ASSR amplitudes. The tinnitus participants were divided into high and low distress subgroups according to their tinnitus handicap inventory (THI) scores. The ASSR stimuli were carrier frequencies with low (500 Hz), mid (2000 Hz), and high (4000 Hz) amplitude-modulated tones. ASSR amplitudes were calculated in anterio-frontal (F3, Fz, F4), centro-frontal (FC3, FCz, FC4), left auditory (T3, C5, C3) and right auditory (C4, T4, C6) regions of interest (ROI). Twenty-four right-handed subjects with non-pulsatile chronic tinnitus and 23 normal matched participants participated in this study. For recording ASSR amplitudes were used from 32-electrode EEG recording. Two-way repeated-measurement ANOVA was used to compare the ASSR amplitudes. The findings showed that the ASSR amplitudes in the tinnitus group with low distress were higher (better) than in the group with high distress (p < 0.001). This finding was seen in anterio-frontal and right auditory regions and at all carrier frequencies. The results indicated that there is a relation between the ASSR amplitude and the degree of tinnitus distress as measured by the THI questionnaire.

The Effectiveness of Mindfulness-Based Cognitive Therapy in the Management of Tinnitus.

Mindfulness-based cognitive therapy (MBCT) has been suggested as an effective modality in reducing the effects of tinnitus and improving quality of life. This article aimed to compare the effectiveness of MBCT with that of standard treatment in the management of tinnitus in Thai patients. All participants were voluntarily divided into experimental MBCT and control groups depending on their availability. In addition to educational sessions and standard treatment, the MBCT group completed four weekly 120-minute sessions of mindfulness practicing skills. The Thai version of the Tinnitus Handicap Inventory (THI-T) and Hospital Anxiety and Depression Scale (HADs-T) were administered at baseline, 4th week, and 12th week. Tinnitus intensity (dB) was measured at baseline and 12th week. All data were compared between the different time points, within each group, and between the two groups. A total of 45 patients were enrolled, 24 in the MBCT group and 21 in the control group. When comparing baseline to post-treatment measurements, statistically significant improvements were observed in all outcomes except tinnitus intensity in both groups. The THI-T and HADs-T scores in the MBCT group were significantly lower than those in the control group at the 12th week. The reduction in the THI-T scores, HADs-T scores, and tinnitus intensity tended to be greater in the MBCT group after the 4-week course and at the 3-month follow-up assessment. The MBCT showed benefits in the management of tinnitus in terms of improved THI-T and HADs-T scores, and overall quality of life.

Long-Term Effects of Metal-on-Metal Cobalt-Chromium-Containing Prostheses Used in Total Knee Arthroplasty on Hearing and Tinnitus.

ObjectivesWe aimed to determine the long-term effects of metal-on-metal (MoM) cobalt (Co)-chromium-containing prostheses used in total knee arthroplasty (TKA) on hearing and tinnitus.MethodsA total of 88 patients with the normal otoscopic examination and normal blood B12 levels, consisting of 44 patients who had been using MoM Co-chromium-containing total knee prosthesis for more than 5 years, and 44 non-implanted patients with similar demographic characteristics, were randomly selected and included in the study. Patients with previous ear surgery, chronic middle ear disease, or conductive hearing loss were excluded from the study. All participants were evaluated with pure-tone audiometry (PTA), distortion product otoacoustic emission (DPOAE), tinnitus handicap inventory (THI), and tinnitus reaction questionnaire (TRQ).ResultsThe mean age of the 88 patients was 67.22±10.4 years. The mean age of 44 patients who underwent TKA at least 5 years ago was 72.89±7.18 years, 75% of these patients had bilateral prostheses, and the mean prosthesis duration was 11.00±5.08 years (range 5–25). The two groups were compared statistically using PTA, DPOAE, THI, and TRQ scores. When the patient groups with and without prostheses were compared in terms of hearing and tinnitus, we did not find a significant difference between the two groups (p>0.05).ConclusionIn our study, we observed that the long-term use of MoM Co-chromium total knee prostheses did not have an ototoxic effect, contrary to what was believed. We also found that prolonged prosthesis duration or undergoing bilateral surgery did not worsen hearing and tinnitus.

Characteristics of tinnitus and factors influencing its severity.

Background and Objectives:There is a wealth of information regarding the treatment methods for tinnitus; however, the treatment available is unsatisfactory because of the following reasons: first, tinnitus has various etiologies and second, it has distinct heterogeneity among different individuals. Numerous studies have focused on understanding the causes of tinnitus severity, but the conclusions have been inconsistent. The purpose of the present study was to define factors that differentially influence subjectively perceived tinnitus severity.Methods:Clinical data of patients with chronic tinnitus who visited our outpatient clinic from April 2020 to April 2021 were collected. Tinnitus Handicap Inventory (THI) and Tinnitus Evaluation Questionnaire (TEQ) were used to evaluate tinnitus severity among patients, and the independent factors influencing the severity of tinnitus were investigated by performing univariate and multivariate stepwise regression analyses.Results:Eleven variables were associated with THI and TEQ scores, of which nine were identical. Multiple regression analyses results revealed that five variables had a significantly unique predictive effect on tinnitus severity based on THI and the TEQ scores. Three factors including Self-Rating Scale of Sleep (SRSS), change in loudness, and Self-Rating Anxiety Scale (SAS) were identical.Conclusion:Sleep status, anxiety level, and change in loudness in patients with chronic tinnitus were significantly correlated with severity of tinnitus. Follow-up studies should investigate the causal relationship between these factors and tinnitus severity.

Efficacy of Intratympanic Dexamethasone Injection in Subjective Idiopathic Tinnitus- An Interventional Study

Introduction: Tinnitus is a common and annoying symptom characterised by the perception of sound without any corresponding external stimulus. Subjective idiopathic tinnitus is a subjective form of tinnitus where the perceived sound originates from the auditory nervous system, without both aberrant aetiology and external stimuli. Intratympanic injection of steroid (Dexamethasone) is used for the treatment of subjective idiopathic tinnitus by introducing the drug through the tympanic membrane, resulting in reduced systemic toxicity and a higher perilymph steroid level. Aim: To evaluate the efficacy of intratympanic dexamethasone injection in the treatment of subjective idiopathic tinnitus. Materials and Methods: This prospective interventional study was carried out at Madurai Medical College, Madurai, Tamil Nadu, India, from March 2021 to March 2022. A total of 30 patients with subjective idiopathic tinnitus were subjected to intratympanic dexamethasone injection, once per week for three weeks. Improvement in the symptom of tinnitus was assessed by means of subjective evaluation with the help of Tinnitus Handicap Inventory (THI) before and after one week, one month and three months of last injection. Data were statistically analysed using Student’s paired t-test. Results: The results of this study shows that, 53.33% of the population belonged to the age group of 31-40 years. There was 16 females and 14 males. There was a significant reduction in the mean grade of THI at one month and three months after the treatment. The mean THI score was significantly reduced from 50.067 before treatment to 35.733 in one month and 26.933 in three months after the treatment. Conclusion: The intratympanic injection of dexamethasone was found to be effective in the treatment of subjective idiopathic tinnitus. Intratympanic treatment was demonstrated to improve tinnitus scores in the study population.

Association of Tinnitus with Anxiety and Depression among Active-Duty Army Personnel and Veterans at Hospital Angkatan Tentera Tuanku Mizan, Malaysia

To study the prevalence of tinnitus, its characteristic and its association with anxiety and depression among active-duty army personnel and veterans. This study also wants to determine the correlation of Tinnitus Handicap Inventory (THI) with Hospital Anxiety Depression Scale (HADS) among active-duty army personnel and veterans at Hospital Angkatan Tentera Tuanku Mizan. A cross-sectional study was conducted at the Otorhinolaryngology Head and Neck Surgery Department of Hospital Angkatan Tentera Tuanku Mizan from January 2020 until June 2021, involving active-duty army personnel and veterans with at least 3 years of service. Those patients who fulfilled inclusion and exclusion criteria were recruited. Their feedback was recorded based on Malay version of Tinnitus Handicap Inventory (THI) and Malay version of Hospital Anxiety Depression Scale (HADS). 106 subjects responded to our questionnaires, (51 active-duty army personnel and 55 veterans) in which 4.7% (n=5) reported to have anxiety and none had depression. Overall mean score for Total THI was 27.66, suggesting that majority of our subjects only felt mild handicap due to their tinnitus. Individual THI subdomain mean scores shows that the functional subdomain (17.79) affects subjects the most as compared to the emotional (5.7) and catastrophic scores (4.21). Tinnitus can occur in all degrees of hearing loss, and it is associated with poor functional THI scores. Tinnitus is associated with anxiety but not depression among army personnel. These findings suggest that tinnitus should be addressed by healthcare providers in the military in order to maximise function and Quality of Life (QOL) among the nation's military personnel.

The Use of Virtual Reality for Managing Chronic Tinnitus

The Use of Virtual Reality for Managing Chronic Tinnitus