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At least 19 recordsLinked to original sources
PubMed2003

Hearing impairment and tinnitus pitch in patients with unilateral tinnitus: comparison of sudden hearing loss and chronic tinnitus.

OBJECTIVES: The objectives were to analyze the results of pitch-matching and loudness-balance testing in patients with unilateral tinnitus and to evaluate the relationship between audiological findings based on the tinnitus-affected and tinnitus-unaffected threshold differences and tinnitus pitch by using linear interpolation methods. In addition, the effects of the duration of the tinnitus on this relationship were investigated. Sudden sensorineural hearing loss with tinnitus was selected for the "acute tinnitus" group, and unilateral tinnitus with unknown disease and a duration of more than 3 months was selected for the "chronic tinnitus" group. STUDY DESIGN: Retrospective study of the clinical records of patients. METHODS: One hundred thirty-two patients with unilateral tinnitus (comprising 68 female [51.5%] and 64 male [48.5%] patients) were investigated as subjects. Their mean age was 50.4 years (SD = 15.8 y). All patients underwent otoneurological testing, including the pure-tone audiogram and pitch-matching and loudness-balance tests. RESULTS: The mean difference in the hearing threshold between the tinnitus-affected ear and the tinnitus-unaffected ear was largest near the tinnitus pitch in both the acute and the chronic tinnitus groups. However, the relationship between hearing impairments and tinnitus pitch was somewhat different in the two groups: It exhibited a single smooth peak in the acute tinnitus group but a bimodal peak in the chronic tinnitus group. CONCLUSION: The results suggest that tinnitus is related to hearing impairment in the same frequency region in patients with sudden sensorineural hearing loss with tinnitus or in patients with chronic tinnitus, whereas some instances of chronic tinnitus are caused by reorganization in cortical cells.

Acute Disease↗
PubMed1995

[Tinnitus models for use in tinnitus counselling therapy of chronic tinnitus patients].

Tinnitus models are an integral part of tinnitus counselling. In cases with compensated tinnitus, counselling represents the only therapeutic measure necessary. In contrast, patients with uncompensated tinnitus require further therapy in the form of medication, tinnitus-maskers or psychotherapy. Sound processing along the peripheral and central auditory pathways is achieved by functional loops that direct mechanical, electrical or chemical information to various points in the pathway. Minor damage to a loop can cause destabilization of this finely balanced system and can induce tinnitus. Current peripheral tinnitus models are reviewed and discussed with respect to in vitro data from isolated outer hair cells of the guinea pig cochlea. Audiological findings of a patient with central tinnitus after brainstem surgery are discussed in view of central tinnitus models. Specific models for common hearing disorders, such as tinnitus with normal hearing, noise trauma, sudden hearing loss, toxic cochlear lesions, presbyacusis, acoustic neurinoma and Menière's disease are presented for the ENT-surgeon involved with tinnitus-counselling.

Adult↗
PubMed2001

Effects of tinnitus retraining therapy (TRT) for patients with tinnitus and subjective hearing loss versus tinnitus only.

The patients with tinnitus and/or hyperacusis undergoing an 18-24 month period of TRT are divided into five categories of treatment. Different types of counselling and sound therapy are used in each category. Selection of patients into a specific category depends on such factors as: hyperacusis, subjective hearing loss and long-lasting effect of noise on tinnitus. The 108 cases were evaluated After 1 year of treatment. The results of therapy of 40 patients with tinnitus and subjective hearing loss (category II) were compared with the results of therapy of patients with tinnitus only (categories 0 and I). A special questionnaire, answered before and during the treatment, was used to assess the results. Our data indicate significant improvement in about 70% of patients with tinnitus only and in about 90% of patients with tinnitus and subjective hearing loss after one year of therapy.

Female↗
PubMed1994

[The tinnitus questionnaire. A standard instrument for grading the degree of tinnitus. Results of a multicenter study with the tinnitus questionnaire].

The clinical examination of patients with severe and chronic tinnitus must include associated psychological disturbances. The present paper describes traditional diagnostic methods of ENT practice as well as the Tinnitus Questionnaire (TQ) which has been evaluated in a number of studies. This instrument differentiates between emotional and cognitive distress, auditory perceptual difficulties and self-experienced intrusiveness produced by the tinnitus. The results of a German multicenter study are presented which show that the TQ can be used to demonstrate differences of tinnitus distress under different clinical conditions (e.g., ENT clinic vs psychosomatic clinic and in- vs out-patient care). The TQ can be employed for comparative studies in different tinnitus-related institutions and for the evaluation of the relative effects of different treatment approaches.

Adaptation, Psychological↗
PubMed1987

Can tinnitus be masked by band erased filtered masker? Masking tinnitus with sounds not covering the tinnitus frequency.

In this study, the effectiveness of masking sound not covering the tinnitus frequency was tested against that of conventional masking sound in 117 subjects. Successful masking was observed in 72% of the former and 70% of the latter. There was no remarkable difference between the two maskers regarding the acceptability and intensity. The duration of residual inhibition, however, was smaller in the masker not covering the tinnitus frequency. The masking sound tested could be useful as an alternative when the conventional one is not accepted.

Adolescent↗
PubMed1993

Tinnitus characteristics in tinnitus complainers and noncomplainers.

The aim of this study was to describe the characteristics of tinnitus in 87 patients (mean age = 53.7 years); 43 patients seeking professional help (complainers) and 44 patients who do not seek help for their tinnitus (noncomplainers). 'Left-sided or mostly left-sided' tinnitus was reported by 42% of complainers and 30% of noncomplainers, whereas 'right-sided or mostly right-sided' tinnitus was equally prevalent in the two groups (26 v. 25%); the differences between groups were not significant. Tinnitus 'in the head' was reported by 14% of the complainers and 6% of the noncomplainers, a nonsignificant difference, whereas noncomplainers perceived tinnitus in 'both ears equally' significantly more frequently than complainers. Complainers had significantly more often 'combined' (tonal plus buzzing) tinnitus sounds (51 v. 30%) and 'non-fluctuating tinnitus' (49 v. 25%) than had noncomplainers, whereas 'tonal' tinnitus was significantly more frequent in noncomplainers than in complainers (43 v. 16%). Further, noncomplainers had worse hearing than complainers: pure-tone averages over vocal as well as high frequencies were significantly higher. Complainers scored significantly higher than noncomplainers on the psychological variables concentration difficulties, irritability and sleep disturbance. Patients with 'combined' tinnitus sounds scored significantly higher on irritability and sleep disturbance than subjects with 'tonal' tinnitus. Patients with 'non-fluctuating tinnitus' scored significantly higher on the three psychological variables than patients with 'fluctuating tinnitus'. A conclusion to be drawn is that 'combined' tinnitus sounds and 'non-fluctuating tinnitus' might be determinants of psychological problems.

Adaptation, Psychological↗
PubMed1990

Characterization of tinnitus by tinnitus patients.

A questionnaire was administered to 528 tinnitus patients to obtain data on their reactions to tinnitus. Results include a discussion of: (a) population characteristics, (b) perceptual characteristics, (c) the impact of tinnitus on daily life, and (d) etiology. Significant gender differences are also discussed. Tinnitus was not an occasional phenomenon, but was present for more than 26 days per month in 74% of the patients. Other important findings about tinnitus include: (a) Hearing levels at 1000 and 4000 Hz were less than or equal to 25 dB HL for 18% of the tinnitus patients, which suggests that some patients had normal hearing or mild hearing losses; (b) the prevalence of tinnitus in patients with noise-induced hearing loss (NIHL) was 30% for males and only 3% for females; (c) about 25% of the patients reported tinnitus severity had increased since tinnitus onset; (d) the effects of tinnitus were more severe in patients who reported tinnitus as their primary complaint and in patients diagnosed as having Ménière's syndrome tinnitus; and (e) some patients reported that noise exacerbated their tinnitus, whereas others reported that a quiet background exacerbated their tinnitus.

Adolescent↗
PubMed1997

Managing tinnitus: a comparison of different approaches to tinnitus management training.

A series of studies examining the interaction between the characteristics of individual tinnitus sufferers and the effectiveness of the methods used to assist them has been conducted. The first of these studies provided a baseline description of 96 people with tinnitus, according to a range of audiological and psychological variables. In the present paper four differing tinnitus management programmes are described and the related changes in tinnitus perception reported three months after tinnitus management training. For the majority of subjects, the tinnitus was less annoying and less distressing three months after attending tinnitus management training. However, the majority of subjects reported no change in tinnitus loudness, or tinnitus awareness and no change in their tinnitus coping ability. Subjects receiving low level white noise stimulation reported greater improvement in tinnitus coping ability than subjects who received information and relaxation training, although there was no associated improvement in tinnitus awareness. Subjects' beliefs about tinnitus and preferred coping style may have influenced the reported benefit or otherwise of the differing tinnitus management techniques.

Acoustic Stimulation↗
PubMed1999

The influence of training on tinnitus perception: an evaluation 12 months after tinnitus management training.

Sixty-five subjects were reviewed 12 months after tinnitus management training, which had been comprised variously of information, relaxation training and a therapeutic noise strategy. Seventy-four per cent of subjects reported increased habituation to tinnitus (n = 48), 65% reported reduced tinnitus annoyance (n = 42), and 52% reported an increased ability to cope with tinnitus (n = 34). Twenty-five per cent of subjects reported deterioration in coping ability (n = 16), 23% reported reduced habituation to tinnitus (n = 15) and 8% reported increased tinnitus-related annoyance (n = 5). None of the management strategies were found to be significantly more effective than others in facilitating improved coping or habituation to tinnitus. Subjects who reported reduced coping and habituation to tinnitus experienced greater levels of general life stress than subjects who reported increased habituation and coping ability. The use of relaxation therapies as applied in this study did not appear to influence the level of tinnitus distress or the level of life stress. Thirty-seven per cent of subjects given long-term low-level white noise (LTWN) stimulation reported benefit. However, LTWN stimulation did not significantly alter tinnitus awareness or the minimum masking level (MML) of tinnitus. Long-term low-level white noise stimulation appeared to influence cognitive reaction to tinnitus rather than its physical perception. Subjects who initially had low ability to cope with tinnitus and preferred a more active coping style reported significantly greater benefit from LTWN stimulation than subjects whose primary approach to coping was to regulate the emotional impact of tinnitus.

Adaptation, Psychological↗
PubMed2001

Assessing tinnitus and prospective tinnitus therapeutics using a psychophysical animal model.

Subjective tinnitus is a common and often debilitating disorder that is difficult to study because it is a perceptual state without an objective stimulus correlate. Studying tinnitus in humans is further complicated by the heterogeneity of tinnitus quality, severity, and associated hearing loss. As a consequence, the pathophysiology of tinnitus is poorly understood and treatments are often unsuccessful. In the present study, an animal psychophysical model was developed to reflect several features of tinnitus observed in humans. Chronic tinnitus was induced in rats by a single intense unilateral exposure to noise. The tinnitus was measured using a psychophysical procedure, which required the animals to discriminate between auditory test stimuli consisting of tones, noise, and 0 dB. Tinnitus was indicated by a frequency-specific shift in discrimination functions with respect to control subjects not exposed to noise. The psychophysical consequences of the noise exposure were best explained by a tinnitus hypothesis and could not be explained easily by other consequences of noise exposure such as hearing loss. The qualitative features of the tinnitus were determined and related to the duration of noise exposure and the associated cochlear trauma. The tinnitus was found to persist and intensify over 17 months of testing. Finally, the tinnitus was reversibly attenuated by treatment with gabapentin, a GABA agonist. It was concluded that this model reflected several features of human tinnitus, such as its tonality and persistence, and could be useful as a screen for potential therapeutics as well as a tool to help unravel the pathophysiology of the disorder of phantom auditory perception.

Acetates↗
PubMed1989

Investigation of tinnitus induced by sound and its relationship to ongoing tinnitus.

Tinnitus was temporarily induced by monaurally presented sound, and its level monitored using a dichotic loudness-matching task. The first experiment found no effect of varying the level, bandwidth, or center frequency of an inducing noise on the level or duration of the induced tinnitus; nor was there any difference when tones or different noises were used to induce tinnitus. The rated loudness of the tinnitus, however, increased with the level and decreased with the center frequency of the noise. The second experiment investigated tinnitus induced by a 1-kHz, 95-dB SPL tone in 53 subjects with thresholds in the normal range, but with varying degrees of ongoing tinnitus that ranged from no discernible sound sensation at all, through an apparently normal but usually inaudible noise or ringing, to constant or near-constant tinnitus. Individual differences in induced tinnitus were found that were related to differences in ongoing tinnitus; for example, the levels of induced and ongoing tinnitus were positively correlated. The results suggest that some kinds of ongoing tinnitus may arise from the auditory process responsible for induced tinnitus.

Adolescent↗
PubMed2003

Psychologic profile of tinnitus patients using the SCL-90-R and Tinnitus Handicap Inventory.

OBJECTIVE: To correlate the Tinnitus Handicap Inventory and the Symptom Checklist-90-R results on a group of tinnitus patients and to compare the average scores of the Tinnitus Handicap Inventory and SCL-90-R for help-seeking and non-help-seeking patients with tinnitus. STUDY DESIGN: A prospective study in which tinnitus patients were administered the Tinnitus Handicap Inventory and the Symptom Checklist-90-R. SETTING: Tertiary referral center. PATIENTS: Patients with tinnitus seeking audiological services. INTERVENTIONS: Rehabilitative. MAIN OUTCOME MEASURES: Results of Tinnitus Handicap Inventory and Symptom Checklist-90-R. RESULTS: Fifty-three consecutive patients having tinnitus were administered the Tinnitus Handicap Inventory and the Symptom Checklist-90-R. There was a significant correlation between the Symptom Checklist-90-R and the Tinnitus Handicap Inventory (rs = 0.43). Furthermore, 25% of these patients scored abnormally high on the Symptom Checklist-90-R, which is substantially more than the general medical population of patients. CONCLUSIONS: Based on this sample of 53 patients, the Symptom Checklist-90-R does seem to be a useful tool in identifying distress among tinnitus patients. The Global Severity Index of the Symptom Checklist-90-R has a defined cutoff score indicating significant distress levels, which makes it a useful screening tool for identifying those who would benefit from psychologic or psychiatric intervention.

Adult↗
PubMed1993

A randomized trial of nortriptyline for severe chronic tinnitus. Effects on depression, disability, and tinnitus symptoms.

OBJECTIVE: To determine whether the antidepressant, nortriptyline, is effective for treatment of depression, tinnitus-related disability, and tinnitus symptoms in patients with severe chronic tinnitus. DESIGN: A 12-week, double-blind, randomized controlled trial. SETTING: A university otolaryngology clinic. PATIENTS: Ninety-two subjects with severe chronic tinnitus: 38 with current major depression and 54 with depressive symptoms and significant tinnitus-related disability. INTERVENTION: Nortriptyline (maintained at 50 to 150 mg/mL for 6 weeks) or placebo. MAIN OUTCOME MEASURES: Hamilton Depression Rating Scale, Tinnitus Disability Measures, and Audiometric Measures. RESULTS: Nortriptyline was superior to placebo by multivariate analysis of covariance for depression (10.6 vs 14.3 final Hamilton Depression score), for tinnitus-related disability (1.8 vs 2.4 final MPI Tinnitus Interference), and tinnitus loudness (13.6 vs 20.0 dB final loudness match [in worst ear at tinnitus frequency]). When major depression and depressive symptoms groups were considered separately, nortriptyline was superior to placebo on these same measures but differences did not achieve statistical significance. CONCLUSIONS: The antidepressant nortriptyline decreases depression, functional disability, and tinnitus loudness associated with severe chronic tinnitus. What appears to be irreversible disability of otologic origin may, in part, be reversible disability of psychiatric origin.

Aged↗
PubMedDate not supplied

Psychoacoustic characterization of the tinnitus spectrum: implications for the underlying mechanisms of tinnitus.

In this study, an original psychometric procedure was used in order to characterize in more detail than in previous studies the different perceptual components of tinnitus, i.e. auditory sensations which are perceived in the absence of a corresponding external acoustic stimulus. Ten subjects with chronic tinnitus were asked to rate on a numeric scale the contribution of elementary pitch sensations evoked by isolated frequency components to their overall tinnitus sensation. The resulting 'internal tinnitus spectra', which represented the estimated perceptual contribution to the tinnitus sensation as a function of frequency over a large range of frequencies, were found to occupy a wide frequency range corresponding largely to that at which hearing thresholds were abnormally elevated. In most cases, they exhibited a broad peak falling within the hearing loss range. This pattern of result suggests that in subjects with high-frequency hearing loss, tinnitus sensations, when present, resemble those evoked by high-frequency noise bands with, in some cases, a superimposed tonal-like pitch. These results confirm and extend earlier results in the literature and agree with the patients' reports; their practical implications for the design of future studies on tinnitus and theoretical implications for the understanding of the neurophysiological mechanisms underlying tinnitus are discussed. The results of an additional experiment showed that the internal tinnitus spectrum could be altered by perceptual training in a fine frequency discrimination task with tones in the frequency range of the main peak of the tinnitus spectrum.

Adult↗
PubMed2000

Convergent validity of the tinnitus handicap inventory and the tinnitus questionnaire.

For research into tinnitus to be robust and credible, the use of well-validated instruments of self-perceived tinnitus handicap as outcome measures is essential. The tinnitus handicap inventory (THI) and the tinnitus questionnaire (TQ) are two such instruments which are in widespread use. Both questionnaires were administered by mail to 100 consecutive new patients of the Cambridge Tinnitus Clinic, and completed in randomized order. These patients had been referred by the otolaryngology team and had not undergone any tinnitus therapy. The response rate was 78 per cent, neither questionnaire being more acceptable to patients than the other. The convergent validity of the instruments was high, with total and subscale scores all being significantly correlated at the five per cent level (Spearman correlation coefficients). A number of subscale scores were not significantly correlated at the one per cent level however. In particular, the sleep disturbance element of the TQ was demonstrated to have some discriminant validity from the THI and from other elements of the TQ at the one per cent significance level. The THI and TQ have been demonstrated to have high convergent validity and are both suitable for tinnitus outcome studies involving the quantification of self-perceived tinnitus handicap. For research that aims to determine the specific effect of an intervention on tinnitus-related sleep disturbance, the TQ sleep subscale has potential utility. The hypothetical constructs of tinnitus handicap underlying the psychologist-developed TQ and the audiologist-developed THI have been shown to be convergent.

Adolescent↗
PubMed1995

Tinnitus Synthesis: Fluctuant and Stable Matches to the Pitch of Tinnitus.

Five subjects mimicked the sensation caused by their tinnitus with a complex sound pattern consisting of the sum of sine waves. The imitation tinnitus was generally broadband, spanning an average of 2.94 kHz. Measures of the pitch of the tinnitus were made using both a forced-choice double-staircase (FCDS) task and a method of adjustment (MOA) task. Even tinnitus portrayed as broadband was matched reliably using a FCDS task, presumably because all but one component of the tinnitus was ignored. With the MOA task, successive matches to the predominant tinnitus pitch were fluctuant, presumably because disparate components of the tinnitus were subsequently matched. Because tinnitus is a broad-band signal, clinical trials evaluating the effect of a treatment on tinnitus should involve assessing changes occurring at any location in tinnitus spectrum.

Journal Article↗
PubMed1996

[Direct loudness scaling in diagnosis of tinnitus. A contribution to loudness perception in tinnitus].

We used free-field audiometry to investigate the loudness perception of unilateral high-frequency tinnitus in 16 "normal-hearing" ears by comparing the results with loudness scaling in 20 normally hearing ears without any tinnitus. Narrow-band noise signals at four different frequencies from 500 to 4000 Hz were employed. The parameters used included the slope m of the loudness function and the level Lm (corresponding to the loudness perception of "medium loud") as well as the suitability of fit (delta FIT). The results showed that in subjects with tinnitus the slope of the mean loudness level tended to decrease at 4000 Hz. The dynamic range of ears affected by tinnitus was restricted for stimulation with noise signals at 1000, 2000 and 4000 Hz. The parameters of delta FIT fitted to the loudness functions were increased in the whole frequency range of 500-4000 Hz, indicating that loudness scaling was not as reliable for normal hearing ears when influenced by tinnitus. Tinnitus masking was based on the finding that external sound could change tinnitus loudness. Our results showed that the loudness perception of external sound was influenced by tinnitus. This change in loudness perception seemed to be not restricted to the frequency range of the tinnitus.

Adult↗