Effect of tinnitus on sound localization ability in patients with normal hearing

Abstract Objectives To determine whether tinnitus negatively impacts the accuracy of sound source localization in participants with normal hearing. Methods Seventy-five participants with tinnitus and 74 without tinnitus were enrolled in this study. The accuracy of sound source discrimination on the horizontal plane was compared between the two participant groups. The test equipment consisted of 37 loudspeakers arranged in a 180° arc facing forward with 5° intervals between them. The stimuli were pure tones of 0.25, 0.5, 1, 2, 4, and 8 kHz at 50 dB SPL. The stimuli were divided into three groups: low frequency (LF: 0.25, 0.5, and 1 kHz), 2 kHz, and high frequency (HF: 4 and 8 kHz) stimuli. Results The Root Mean Square Error (RMSE) score of all the stimuli in the tinnitus group was significantly higher than that in the control group (13.45 ± 3.34 vs. 11.44 ± 2.56, p = 4.115, t < 0.001). The RMSE scores at LF, 2 kHz, and HF were significantly higher in the tinnitus group than those in the control group (LF: 11.66 ± 3.62 vs. 10.04 ± 3.13, t = 2.918, p = 0.004; 2 kHz: 16.63 ± 5.45 vs. 14.43 ± 4.52, t = 2.690, p = 0.008; HF: 13.42 ± 4.74 vs. 11.14 ± 3.68, t = 3.292, p = 0.001). Thus, the accuracy of sound source discrimination in participants with tinnitus was significantly worse than that in those without tinnitus, despite the stimuli frequency. There was no difference in the ability to localize the sound of the matched frequency and other frequencies (12.86 ± 6.29 vs. 13.87 ± 3.14, t = 1.204, p = 0.236). Additionally, there was no correlation observed between the loudness of tinnitus and RMSE scores (r = 0.096, p = 0.434), and the Tinnitus Handicap Inventory (THI) and RMSE scores (r = −0.056, p = 0.648). Conclusions Our present data suggest that tinnitus negatively impacted sound source localization accuracy, even when participants had normal hearing. The matched pitch and loudness and the impact of tinnitus on patients' daily lives were not related to the sound source localization ability. Level of evidence 4.

Influential factors of the efficacy of tinnitus multivariate integrated sound therapy for the treatment of subjective tinnitus / 中国基层医药

Objective:To investigate the influential factors of the efficacy of tinnitus multivariate integrated sound therapy (T-MIST) in the treatment of subjective tinnitus.Methods:A total of 431 patients with subjective tinnitus who received treatment in The First Affiliated Hospital of Xiamen University from June 2019 to June 2020 were included in this study. A cross-sectional study method was used to conduct refined testing on tinnitus patients using the T-MIST matching platform. The severity of tinnitus patients was evaluated using the Tinnitus handicap inventory scale. SPSS software was used to analyze the factors affecting the effectiveness of the T-MIST for subjective tinnitus based on patients' basic characteristics.Results:Multivariate logistic regression analysis showed that compared with patients with short-term tinnitus, OR (95% CI) was 1.982 (1.033-3.804), P = 0.040, in patients with 3-12 months of disease duration, OR (95% CI) was 2.411 (1.322-4.396), P = 0.004 in patients with > 12 months of disease duration. With the increase in tinnitus handicap inventory score, the efficacy of T-MIST became better [ OR (95% CI) = 1.014 (1.004-1.024), P = 0.007]. The efficacy of T-MIST was better in the hearing compensation-effective patients [ OR (95% CI) = 0.133 (0.081-0.216), P < 0.001]. Conclusion:The course of the disease, tinnitus handicap inventory score, and effective hearing compensation are the influential factors of T-MIST. They can provide evidence for the treatment of subjective tinnitus.

Effects of Anxiety Sensitivity and Hearing Loss on Tinnitus Symptom Severity

OBJECTIVE: The aim of the present study was to examine the relative role of anxiety sensitivity and hearing loss on the tinnitus symptoms severity in a large clinical sample of patients with tinnitus. METHODS: A total of 1,705 patients with tinnitus who visited the tinnitus clinic underwent the pure-tone audiometric testing and a battery of self-report questionnaires. Multiple linear regression analyses were performed to identify the relationship of anxiety sensitivity and hearing loss to tinnitus symptoms severity. RESULTS: Both anxiety sensitivity and hearing loss were a significant association with of annoyance (anxiety sensitivity β=0.11, p=0.010; hearing loss β=0.09, p=0.005) and THI score (anxiety sensitivity β=0.21, p < 0.001; hearing loss β=0.10, p < 0.001) after adjusting for confounding factors. Meanwhile, the awareness time (β=0.19, p < 0.001) and loudness (β=0.11, p < 0.001) of tinnitus was associated with only the hearing loss but not with anxiety sensitivity CONCLUSION: Our results indicate that both hearing loss and anxiety sensitivity were associated with increased tinnitus symptom severity. Furthermore, these associations could be different according to the characteristics of tinnitus symptoms.

Translation, Adaptation and Cross Language Validation of Tinnitus Handicap Inventory in Urdu

BACKGROUND AND OBJECTIVES: Tinnitus is characterized as a perception of numerous auditory sounds in absence of external stimulus. Tinnitus can have a considerable consequence on a person’s quality of life, and is considered to be very complicated to quantify. The aim of this study was to investigate the reliability and validity of Urdu translation of the Tinnitus Handicap Inventory (THI) in Pakistan. It was designed to assess the presence of various auditory sounds without the external stimulus. Scale consisted of 25 items having three subscales functional, emotional, and catastrophic. SUBJECTS AND METHODS: The study comprised into two stages, preliminary and main studies. The results of preliminary study revealed that the overall scale had high internal consistency [alpha coefficient of Urdu version of THI (THI-U)= 0.99, alpha coefficient of English version of THI=0.98]. The overall scale had test-retest correlation over a fifteen days period of interval (0.99). Main study was performed on 110 tinnitus patients. The results of main study showed that the internal consistency and reliability of Urdu version was (α=0.93). The THI-U and its subscales demonstrated good internal consistency reliability ( α =0.81 to 0.86). RESULTS: High to moderate correlations were noted between tinnitus symptom ratings. A confirmatory factor analysis was used to validate the three subscales of THI-U, and high inter-correlations were found between the subscales also results revealed that a three-factor model for the THI-U was most tenable. The results displayed that the confirmatory factor analysis confirmed to validate the three subscales of THI-U. CONCLUSION: THI-U might present important information about precise facets of tinnitus distress along with diagnostic interviews in clinical practice.

Analysis of clinical characteristics of subjective tinnitus in patients with perimenopausal syndrome / 中国耳鼻咽喉头颈外科

OBJECTIVE To observe and analyze the characteristics of tinnitus in perimenopausal women. METHODS To do sleep quality assessment, pure-tone test, tinnitus frequency and loudness match, tinnitus questionnaire investigation and FSH testfor 248 subjective tinnitus women with perimenopausal syndrome. RESULTS There was more single tinnitus than double tinnitus, the difference was statistically significant (P＜0. 05); The incidence of tinnitus on left and right ears was basically the same, the difference was not statistically significant;High frequency tinnitus accounted for 62. 73％, medium frequency was 2. 80％, low frequency was 34. 47％; There was no significant correlation between the frequency of tinnitus and hearing loss, There was no significant correlation between loudness and severity of tinnitus; Tinnitus THI loudness rating is mainly grade 2 and 3, accounting for 72. 18％, followed by gradel and grade 4, accounting for 24. 60％, grade 5 is very few, only 3. 22％; There was significant correlation between the FSH and severity of tinnitus, but there was no significant correlation between the FSH and loudness of tinnitus. The incidence of sleep disorders was 58. 06％. With the degree of tinnitus increased, the incidence of sleep disorders increased, and the degree of tinnitus was positively correlated with the quality of sleep. CONCLUSION The characteristics, etiology and pathogenesis of tinnitus in perimenopausal women are different from that of tinnitus happened in auditory system, mainly relate to FSH level. Otologists should pay attention to differential diagnosis, comprehensive analysis and treatment.

The Influence of Cognitive Distress on the Degree of Tinnitus / 听力学及言语疾病杂志

Objective To study the correlation between cognitive distress and tinnitus related handicaps.Methods One hundred and ninety-two primary tinnitus subjects ninety-nine males and ninety-three females were included in this study.The average age was 45±15.52 years old.The average durations of tinnitus for male and female were 25.67±37.71 months and 27.12±45.42 months, respectively.The patients were asked to fill the Mandarin tinnitus questionnaire (MTQ) and Mandarin (Chinese) tinnitus handicap inventory (THI-CM).The correlation between cognitive distress (CD) and tinnitus related handicap was studied.Results The average score of MTQ was 36.95±20.06.The average score of CD (Q17,18,23,41, and 42)was 2.61.The average score of question 17,18, 23,41, and 42 of MTQ was 2.81,2.63,2.59,2.40, and 2.41,respectively.The average score of THI-CM was 23.89±20.06.The correlation between CD and THI-CM was 0.64(P0.01),respectively.The correlations between CD and THI-CM among the nondisabled, mild, moderate and severe groups according to the scores of THI-CM were 0.30(P0.01),-0.12(P>0.01), and 0.23(P>0.01),respectively.Conclusion No strong correlation was demonstrated between the CD and the THI-CM.The same results were shown for males and female.No correlation was demonstrated between ages and cognitive distress.Correlation coefficient of cognitive distress was increased with age.The tinnitus handicaps of patients might be vulnerable to cognitive distress with ageing.

An Analysis of Anxiety in Tinnitus Population / 听力学及言语疾病杂志

Objective We undertook this study to analyze anxiety in tinnitus patients .Methods The partici‐pants were recruited from patients seeking treatment for primary tinnitus and were asked to complete self rating anx‐iety scale(SAS)and Chinese (Mandarin) tinnitus handicap inventory(THI -CM) .Results A total of 224 tinnitus patients were included in the study .The mean score of SAS was 46 ± 2 .55 .The average SAS score among different degrees of anxiety (no ,mild ,moderate ,severe) participants were 65 .63% ,20 .54% ,8 .04% ,5 .80% .The average SAS score for male and female were 46 .35 ± 12 .81 ,46 .28 ± 12 .40 ,respectively .No statistic differences were ob‐served among different genders whenever the degrees of anxiety and different ages (p>0 .01) .The mean SAS scores among young ,middle ,old age groups were 47 .72 ± 12 .80 ,44 .56 ± 12 .83 ,40 .28 ± 7 .24 ,respectively .The pearson correlation between tinnitus duration and the score of SAS was 0 .36(P=0 .594) .The pearson correlation between the scores of THI-CM and SAS was 0 .548(P<0 .01) .Conclusion Most tinnitus participants had mild or didn't have anxiety .Only 13 .84% participants have moderate or severe anxiety .Tinnitus handicap degree increased with the increase of anxiety .No anxiety difference was observed among different sex ,tinnitus duration and age groups . The anxiety of young age group was more severe than that of old groups .

Comparison of the safety and efficacy of caroverine and betahistine in patients of subjective tinnitus.

Background: Owing to lack of any established treatment and handicap assessment methods, subjective tinnitus can be a debilitating disorder. This study was carried out to compare the safety and efficacy of caroverine and betahistine in patients of subjective tinnitus. Methods: A total of 60 patients of subjective tinnitus were randomized into two groups and followed-up for 12 weeks using tinnitus handicap inventory (THI) questionnaire. One group received 8 mg betahistine tablet TDS for a month whereas the other group was given supervised intravenous (IV) infusion of 160 mg of caroverine dihydrochloride. Data for the safety were also recorded. Results: Both the drugs showed significant improvement in severity of symptoms at 1 week, 4 weeks and 12 weeks individually as assessed by the THI scores. The response to caroverine was significant up to 4 weeks, but it was not significant at 12 weeks; whereas the response to betahistine was significant up to 12 weeks. A total of 28 adverse drug reactions (ADRs) were reported (53.6% with caroverine, 46.4% with betahistine). 24 ADRs were mild and 4 were moderate in intensity. There was no serious adverse event. Conclusions: Both the drugs are safe and efficacious in reducing the handicap of subjective tinnitus. A single IV infusion of caroverine may suffice for 4-6 weeks, so it may be repeated after 6 weeks to maintain the relief.

Development of Simplified Version of Korean-Type Tinnitus Handicap Inventory / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The Tinnitus Handicap Inventory (THI) is a useful measure to evaluate the tinnitus and to quantify the functional and psychosocial consequences of tinnitus. However, it can be difficult for patients to understand the items of questionnaire and may take 10 to 15 minutes for them to complete the questionnaire, which can be problematic. The objective of this study is to develop a simplified version of the Korean type Tinnitus Handicap Inventory (THIS). SUBJECTS AND METHOD: A retrospective clinical study was conducted to analyze the THI-S cutoff score used for referral purpose and the level of predictability between the THI and the THIS. 100 patients participated. The subject samples were drawn from outpatients who reported tinnitus as their primary complaints at the time of the initial audiology and otolaryngology evaluations. The 10-item THI-S, selected by using Cronbach's alpha coefficient, showed a high correlation with the scores of the THI. Based on their clinical experiences, the four otologists developed their own screening versions of THI, which were designated as THI-A, B, C and D. The Pearson product-moment correlation was used to assess the comparability of the scores between the THI and the THI-S, A, B, C and D. RESULTS: The results showed that there is a higher correlation between the THIS and the THI-S. A high comparability was shown in the comparison between the THI and the THI-S. CONCLUSION: Further studies will be needed if the THI-S can be applied for clinical use.

Reliability and Validity of a Korean Adaptation of the Tinnitus Handicap Inventory / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Several self-report measures had been developed to assess the handicap due to tinnitus, although they lacked reliability and validity. Well-validated instruments, however, are essential for evaluation and treatment. Newman et al. developed the Tinnitus Handicap Inventory (THI) and researches have examined its reliability and validity. The objective of this study was to determine the reliability and validity of a Korean adaptation of the THI. MATERIALS AND METHOD: The Korean adaptation of THI was administered to 111 patients with tinnitus, who visited the Otorhinolaryngology-Head and Neck Surgery department of Samsung Medical Center from March to August of 2001. Convergent validity was assessed using Tinnitus Handicap Questionnaire (THQ), and construct validity was examined using the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI-S), the somatization subscale of SCL-90-R (SOM) and etc. RESULTS: 1) The Korean adaptation of THI and its subsclaes showed good internal consistency (Cronbach's alpha=.95-.79) comparable to those of the original version. 2) THI and its subscales demonstrated high test-retest reliabilities (r=.91-.73) comparable to those of the original. 3) High correlation was observed between THI and THQ (r=.83). 4) Moderate correlations were observed among THI, BDI (r=.40-.51), STAI-S (r=.43-.68), SOM (r=.49-.59), the perceived loudness of tinnitus (r=.33-.46), and the perceived handicap of tinnitus (r=.44-.64). 5) A confirmatory factor analysis partly supported 3 factors of THI. CONCLUSION: We found THI and its subscales to have valuable internal consistency, test-retest reliability, convergent and construct validity. The results suggest that the Korean adaptation of THI, especially the total score it generates, is a reliable and valid measure of general distress related tinnitus.