Visual Snow Syndrome Prevalence Among Young Adults in the Russian Federation: a Research Perspective.

BACKGROUND: Visual snow syndrome (VSS) is a poorly understood neurological condition of unclear etiology, characterized by visual and non-visual symptoms that reduce quality of life. The objective of our study was to estimate the prevalence of young adults with visual snow in Russia. MATERIALS AND METHODS: We conducted an online survey among 1,177 respondents over the age of 18 residing in Russia. The questionnaire was based on MIDAS, HIT-6, ICHD-3, GAD-7, CES-D. RESULTS: A total of 1085 individuals, divided into three groups: 48 participants with Visual Snow Syndrome (VSS), 36 participants with visual snow symptoms (VS), and 1001 participants without visual snow (control group). Tinnitus (p<0.001) and paresthesia (p<0.001) were more common in participants with VSS compared to the control group. VSS group also reported mood disorders more frequently than those in the other groups (29.2% VSS, 13.9% VS, 7.0% control, p<0.001). Additionally, VSS group exhibited more elevated anxiety levels on the GAD-7 scale compared to the other groups (p=0.005), suggesting a weak association between anxiety and VSS. CONCLUSIONS: Diagnosed migraine, tinnitus, concentration problems, paresthesia, and verified psychiatric conditions were significantly more prevalent in the VSS group in our study. Tinnitus was significantly more frequent in the VS group. Diagnosed conditions across all ICD-10 classes were more frequently identified in the VSS group, with the strongest associations (moderate) found with ICD-10 codes: F80-F89 and F60-F69. Additionally ICD-10 codes F30-F39 were more frequently found in the VS group compared to the control group. Our study revealed that nearly all individuals with VSS in our sample (89.6%) had experienced symptoms for as long as they can remember. The prevalence of VS symptoms in Russia is 7.7% (6.2-9.3%) and VSS is 4.4% (3.2-5.7%).

Exploring the effects of naringenin on cell functioning and energy synthesis in the hippocampus of male Wistar rats with chronic tinnitus, by examining genetic indicators such as Bax, Bcl-2, Tfam, and Pgc-1α.

BACKGROUND: The pivotal factors, including neural plasticity, oxidative stress, neuronal inflammation, and apoptosis, play a significant role in the pathogenesis of tinnitus. The balance between Bax/Bcl-2 genes is an important factor in determining the rate of apoptosis. Pgc-1α and Tfam genes are fundamental regulators of mitochondrial biogenesis. Naringenin possesses significant antioxidant, neuroprotective, anti-inflammatory, anti-apoptotic, and antiviral properties, and its compounds are effective on cell signaling pathways. AIMS: In light of the aforementioned information, we endeavored to evaluate the impact of naringenin on the expression levels of Bax, Bcl-2, Pgc-1α, and Tfam genes in the hippocampus of male Wistar rats with chronic tinnitus. MATERIAL AND METHODS: To demonstrate the existence of tinnitus, all rats were instructed to complete an "active avoidance test" utilizing a conditioning box. The expression levels of genes mentioned above were assessed using real-time PCR. RESULTS: The sodium salicylate at a dosage of 350 mg/kg showed an upregulation in the expression level of Bax and a downregulation in the expression level of the Bcl-2 gene (p < 0.001). Furthermore, the sodium salicylate displayed significantly higher expression levels of Tfam and Pgc-1α (p < 0.001) genes. The naringenin, at a dose of 100 mg/kg, led to a decrease in Bax gene expression (p < 0.05) and an increase in Bcl-2 gene expression (p < 0.05). On the other hand, naringenin restored the expression level of both Tfam (p < 0.001) and Pgc-1α (p < 0.01) genes. CONCLUSIONS: Our research findings demonstrate that sodium salicylate-induced tinnitus leads to enhanced apoptosis and mitochondrial biogenesis within the hippocampus. Additionally, our evidence recommends that naringenin can reduce apoptosis effectively and maintain a balanced mitochondrial state.

Cochlear implant usage in single sided deafness and factors affecting usage.

OBJECTIVES: The primary objective was to examine duration of daily cochlear implant (CI) usage at 12 and 24 months post-operatively in single sided deafness (SSD). The secondary objective was to examine factors that could affect CI usage. METHODS: Retrospective cohort of patients with SSD who received CI from January 2015 to March 2020. CI usage was evaluated at 12 and 24 months. Hearing loss duration, tinnitus scores and signal-to-noise ratio (SNR) were correlated with CI usage at 12 months. RESULTS: Usage data was available for 54 patients at 12 months and 38 patients at 24 months. The mean usage was 8.2 h/day (SD 4.2) at 12 months, 7.0 h/day (SD 5.1) at 24 months. 5 out of 54 (9.3%) and 7 out of 38 patients (18.4%) were non-users at 12 and 24 months post-operatively. An improved mean SNR score from pre-operative 4.4 dB (SD 2.8) to - 0.70 dB (SD 4.2) at 12 months post-operative was positively correlated with CI usage at 12 and 24 months. Hearing loss duration and tinnitus scores were not associated with CI usage. CONCLUSIONS: 18.4% of our patients were non-users at 24 months. Mean usage at 24 months was 7.0 h/day. Improved hearing in noise at 12 months was correlated with better usage.

Can Residual Inhibition Predict the Success of Sound Enrichment Treatment for Tinnitus?

OBJECTIVES: The objective of this study was to investigate whether residual inhibition (RI), which provides information on the relationship between tinnitus and increased spontaneous activity in the auditory system, is a predictor for the success of sound enrichment treatment. DESIGN: Tinnitus patients were divided into two groups based on whether RI was achieved (RI+) or not (RI-). All participants underwent sound enrichment. Psychosomatic measures (for tinnitus severity, discomfort, attention deficit and sleep difficulties), Tinnitus Handicap Inventory (THI), minimum masking level (MML), and tinnitus loudness level (TLL) results were compared before and at 1, 3, and 6 months after treatment. STUDY SAMPLE: Sixty-seven chronic tinnitus patients were divided into two groups based on whether RI was achieved (RI+) or not (RI-). There were 38 patients in the RI+ group and 29 in the RI- group. RESULTS: There was a statistically significant difference between the groups in psychosomatic measures, THI, MML and TLL scores at the post-treatment 6 months after treatment (p <.05). There was a statistically significant decrease in psychosomatic measures, THI, MML and TLL scores during the treatment period in the RI+ group, but not in the RI- group. CONCLUSION: RI may predict the prognosis of tinnitus treatments used in clinics to reduce the spontaneous firing rate of neurons in the central auditory system, and that RI positivity may be a predictor of treatment success in sound enrichment.

Is Transcutaneous Electrical Nerve Stimulation Therapy the Answer for Tinnitus: A Prospective Study.

The study was aimed at determining the effectiveness of transcutaneous electrical nerve stimulation in treatment of tinnitus using Tinnitus handicap inventory (THI) and Visual analogue scale (VAS). 60 patients with bilateral, non-pulsatile, chronic subjective tinnitus; aged 18-65 years were subjected to 8 sessions (2 sessions/week) of TENS therapy given over a total period of 4 weeks. Pre-treatment and Post-treatment VAS, THI scores were compiled and analyzed statistically. A significant decrease in Tinnitus severity was seen after TENS Therapy (VAS: Loudness, Annoyance, Duration, Hampering of daily activities) (P value < 0.001). Moreover THI (Functional, Emotional & catastrophic) showed significant improvement (P value < 0.001). TENS is safe, effective, noninvasive therapeutic option for treatment of tinnitus.

Translation and Validation of Tinnitus Sample Case History Questionnaire in Tamil.

Tinnitus is a subjective acoustic perception in the absence of any external source. Symptoms associated with tinnitus are insomnia, lack of concentration, depression, anxiety and elevated levels of stress. There were many questionnaires to evaluate the severity of tinnitus, one such questionnaire is the Tinnitus Sample Case History Questionnaire (TSCHQ). TSCHQ focuses on the tinnitus history and descriptive characteristics of tinnitus. As far as we know there have been no translation of TSCHQ in any Indian languages. This study aimed to translate TSCHQ into a Tamil version and validate it for use in clinics for the Tamil population. Rather than a direct translation, cross-cultural adaptation has been carried out. The steps involved in this process were forward translation, Synthesizing common translation, Backward translation, Expert committee review and pre-testing of the final version. Incorporating these procedures, the translated and validated TSCHQ questionnaire was made in Tamil. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04941-z.

Pulsatile Tinnitus Due to a Large Mastoid Emissary Vein: Successfully Managed with Percutaneous Embolization in a Novel Approach.

Tinnitus refers to the perception of sound without any external stimuli which can be pulsatile or non-pulsatile. Dilated mastoid emissary vein (MEV) can cause pulsatile tinnitus. Herein, we report a case of persistent pulsatile tinnitus with dilated MEV managed successfully with percutaneous coiling of MEV in a 36 years male.

A Comparative Analysis of the Efficacy of Ginkgo Biloba and Caroverine in the Management of Idiopathic Tinnitus.

Aim: The sound sensation that is experienced in the ears or brain and is unrelated to any external sources of stimulus is known as tinnitus. Tinnitus Functional Index (TFI) is used to establish the presence of the condition and determine symptom severity, its impact on the patient's quality of life, thus in this study, we aim to compare the efficacy of caroverine and Ginkgo Biloba in the management of idiopathic tinnitus using TFI. Methods: This clinical study was conducted in at a tertiary care hospital in North India, for a duration of one year, among patients with chronic tinnitus. The sample size for this study consisted of 60 patients in each of three groups (caroverine, gingko biloba, and multivitamin). Assessments of TFI and pure-tone audiometry were performed to evaluate the efficacy of the two medications. The information pertaining to the subjects was kept anonymous and confidential. During data analysis, an association was significant for p value < 0.05. Results: The patients in three groups were matched for the age, gender and duration of tinnitus. At 6 months of medication with Ginkgo Biloba, patients experienced a significant (p < 0.0001) decrease of 50.0% in tinnitus of moderate severity, and a complete resolution of severe tinnitus symptoms with a percentage change of -100.0%. Conclusion: In our study, Ginkgo Biloba Group has significantly improved the severity of idiopathic tinnitus. Tinnitus has diverse underlying mechanisms, can be a symptom of various underlying diseases, and is challenging to measure. Further research is warranted to validate and explore these treatment options further.

Single-Sided Deafness at a Tertiary Care Rehabilitation Centre: A Cross-Sectional Retrospective Study.

Aim: To estimate the Single-sided deafness (SSD) among sensorineural hearing loss (SNHL) in Tertiary Care Rehabilitation Centre. To determine the audiological characteristics, associated and medical problems, and rehabilitative approaches among SSD. Method: A retrospective study was conducted to report on demographic details, audiological evaluation, and hearing aid management among SSD clients. A total of 11,534 cases of SNHL were reported to the Audiology department at the tertiary care rehabilitative center at Mysuru between January 2014 and December 2017. Results: A total of 225 were diagnosed as having SSD, accounting for approximately two cases of SSD in a cohort of 100 SNHL cases (225/11,534*100). In addition, males are affected more than females. SSD is found to have more in the right ear than the left ear. Their major complaints were tinnitus and vertigo, apart from reduced hearing sensitivity from the affected ear. In the side of the ear with profound hearing loss among SSD clients showed normal middle ear status with absent acoustic reflexes, otoacoustic emissions, and auditory brainstem response. Only 54 individuals (24%) out of 225 SSD clients underwent a hearing aid trial. Twenty-one (9%) SSD clients purchased a hearing aid, and a minuscule seven (3%) of 225 SSD clients are using a hearing aid. The preference for hearing aid uptake was low because of the experience of vibratory sensation and having near-normal hearing in one ear. Conclusion: Two cases of SSD were observed among SNHL and they are less likely to get benefits from the hearing aid.

Tinnitus prevalence and associated risk factors among university students: A cross-sectional study.

Introduction: Tinnitus is a common medical condition that affects an individual's quality of life. It affects 5%-43% of the global population. Only a few research studies have been conducted in Palestine, so knowledge of tinnitus prevalence and risk factors is limited. The purpose of this study was to determine tinnitus prevalence and risk factors among young university students in Palestine. Methods: A cross-sectional study of Palestinian university students was done utilizing an online self-administered questionnaire. The questionnaire for the study was developed using the European School for Interdisciplinary Tinnitus Research-Screening Questionnaire. A logistic regression analysis of the associations between tinnitus and influencing factors was performed to determine the effects of various clinically relevant variables on the likelihood of experiencing tinnitus. Results: A total of 728 participants responded to the questionnaire aged 20.0 ± 2.0. The overall prevalence of tinnitus was 31%. Having a relative with tinnitus, gastroesophageal reflux, depression and anxiety, hearing difficulties, vertigo, tympanic membrane perforation, chronic otitis, acoustic trauma, head and neck radiotherapy, dental surgery, ear surgery, ear pain, headache, neck pain, temporomandibular joint pain, balance disorders, and nasal septal deviation were significantly associated with tinnitus. The logistic regression analysis showed that suffering from frequent vertigo (at least once per year), from slight hearing difficulty, temporomandibular joint pain, performing ear surgery, and having depression and anxiety is associated with an increased risk of having tinnitus. Conclusions: The current study concluded that tinnitus is common among Palestinian university students. Furthermore, the study identified several major risk factors for tinnitus. It is critical to explore the possibly modifiable risk factors for tinnitus in order to have a better understanding of the condition and eventually minimize its prevalence.

Effects of traditional Chinese medicine on symptoms of patients with spleen and stomach deficiency-related tinnitus.

BACKGROUND: Tinnitus affects 10%-30% of the population. Recent evidence suggests that tinnitus is associated with spleen deficiency. However, compared with kidney deficiency-related tinnitus, less research has been conducted on the impact of spleen deficiency-related tinnitus. AIM: To investigate the clinical efficacy of using Guipi Wan and dietary and lifestyle modification based on traditional Chinese medicine for treatment of patients with spleen and stomach deficiency-related tinnitus. METHODS: We enrolled 110 patients with spleen and stomach deficiency-related tinnitus who were distributed into treatment (58 cases) and control (52 cases) groups. Tinnitus severity, sleep quality and emotional state were assessed by questionnaires [Tinnitus Evaluation Questionnaire (TEQ); Pittsburgh Sleep Quality Index (PSQI); Depression-Anxiety-Stress Scale-21 (DASS-21)] that were used for analysis in the two groups during the initial and intervention and after. In the treatment group, patients were treated with oral administration of Guipi Wan and consulted for healthy dietary and lifestyle modification. In the control group, patients were only assessed and not treated. RESULTS: At the end of the 6-months, TEQ scores decreased significantly in the treatment group (P = 0.021) but not in the Control group. Significant effects in the treatment group were noted for PSQI total score (P = 0.043) and several PSQI component scores in the treatment group (P < 0.05). After treatment, the DASS-21 scores were significantly reduced in the treatment group (P < 0.05). CONCLUSION: Guipi Wan combined with dietary and lifestyle modification based on regulating the spleen and stomach can be considered core to the treatment of tinnitus related to spleen and stomach deficiency.

Gray matter volumetric changes in tinnitus: The impact of hearing loss and severity.

Tinnitus is a phantom auditory sensation that commonly co-occurs with hearing loss. Both tinnitus and hearing loss can impact the quality of life, emotional well-being, and cognitive functioning of the affected individuals. While previous studies have highlighted structural alterations in hearing loss and/or tinnitus, the fundamental neural mechanisms underpinning tinnitus severity remain poorly understood. In this study, we conducted a voxel-based morphometry to investigate gray matter (GM) volume differences among groups of participants with varying tinnitus severity and hearing status, and controls within a large sample. We observed reduced GM volume in the left anterior insula and right planum polare in participants with hearing loss, regardless of their tinnitus status, compared to normal hearing controls. We noted decreased GM volume in the bilateral anterior and posterior insula for those with tinnitus and normal hearing compared to a normal hearing control group. Further, the tinnitus with hearing loss group showed decreased GM volume in the left planum polare, left inferior temporal gyrus, bilateral anterior temporal gyri, and right superior frontal gyrus compared to the normal hearing control group, suggesting a combined effect of hearing loss and tinnitus. While tinnitus severity did not show a significant overall effect, there was a significant positive correlation between tinnitus distress and GM volume in bilateral planum polare. Our findings enhance the understanding of structural brain changes related to hearing loss and tinnitus, and advance the overall knowledge of tinnitus pathophysiology, which can contribute to the development of more effective treatments for tinnitus.

Stress-Induced Tinnitus in a Rat Model: Transcriptomics of the Prefrontal Cortex and Hippocampus.

OBJECTIVES: The molecular mechanisms by which stress leads to the development of tinnitus are not yet well understood. This study aimed to identify brain changes in a stress-induced tinnitus (ST) animal model through transcriptome analysis of the prefrontal lobe and hippocampus. METHODS: Twenty Sprague-Dawley rats were subjected to restraint stress for 2 h. Following the gap prepulse inhibition of the acoustic startle (GPIAS) reflex test to assess tinnitus development, the prefrontal lobes and hippocampi of the brains were harvested from 15 rats: five with evident tinnitus (ST), five with noticeable non-tinnitus (stress-induced non-tinnitus; SNT), and five without stress (control group). Comparative RNA-seq analysis was conducted to examine gene expression profiles. RESULTS: In comparison to the control group, the ST group exhibited 971 and 463 differentially expressed genes (DEGs) in the prefrontal lobe and hippocampus, respectively (FDR < 0.05). The SNT group showed a largely similar gene expression to the control group. Enrichment analysis of the prefrontal lobe revealed the downregulation of gene sets associated with neurotransmitter and synapse-related functions and the upregulation of cell cycle-related gene sets in the ST group. In the hippocampus, there were significantly downregulated gene sets associated with steroid production and upregulated gene sets related to the extracellular matrix in the ST group. Immune-related gene sets were upregulated in both the prefrontal lobe and hippocampus. CONCLUSION: Our research presents evidence that differences in genetic expression in the prefrontal lobe and hippocampus after exposure to stress play a significant role in the development of tinnitus. LEVEL OF EVIDENCE: NA Laryngoscope, 2024.

Glymphatic system dysfunction associated with cognitive impairment in chronic tinnitus patients.

Background: The glymphatic system has been regarded as a pivotal factor in the pathogenesis of neurodegenerative diseases. Given the heightened risk of cognitive impairment in chronic tinnitus patients, the possible alterations of the glymphatic system in tinnitus patients remain elusive. This study was designed to evaluate glymphatic dysfunction in chronic tinnitus patients using the diffusion tensor imaging (DTI) along the perivascular space (DTI-ALPS) approach. Methods: Fifty chronic tinnitus patients and 50 age, sex, and education-matched healthy controls (HCs) with normal hearing thresholds were recruited. The DTI-ALPS was calculated from each group. We investigated the differences in the DTI-ALPS index between the tinnitus patients and HCs. The relationships between the DTI-ALPS index and specific cognitive performance were further assessed. Results: There were significant differences in the DTI-ALPS index between the two groups. The DTI-ALPS index was significantly lower in the tinnitus group than in HCs group (p < 0.01). In addition, the Dyyproj index was significantly higher in the tinnitus group than in the HC group (p < 0.01). In chronic tinnitus patients, the decreased DTI-ALPS index was negatively associated with worse TMT-B scores (r = -0.309, p = 0.039). Moreover, the increased Dyyproj index was negatively correlated with the reduced AVLT performances (r = -0.413, p = 0.005). Conclusion: In this current study, glymphatic system activity in chronic tinnitus was investigated for the first time using DTI-ALPS index. Significant decrease in glymphatic system function was detected in chronic tinnitus, which correlated well with the specific cognitive performance. The current study may provide pivotal imaging markers for chronic tinnitus with cognitive impairment.

Ayurvedic Management of Presbycusis (Project TOPMAC): Protocol for an Exploratory Randomized Controlled Trial.

BACKGROUND: Presbycusis is characterized by sensorineural hearing loss in both ears at high frequencies, which affects more than half of the older adults by the age of 75 years and is often accompanied by tinnitus and cognitive deterioration. Unfortunately, there are no treatments available to restore hearing loss. Treatment mainly focuses on improving the quality of life and communication with hearing aids. Traditional medicine like Ayurveda also explains ailments of a similar nature as Badhirya and advises using drugs with antiaging and neuroprotective activity for treatment. In Ayurveda, Badhirya and Karnanada (senile deafness with tinnitus) are due to vitiation of Vata Dosha. Treatments such as topical oil pooling (Karnapurana) are usually advised to counter Vata, improve hearing capacity, and reduce tinnitus. Kshirabala Taila, a medicated oil formulation prepared with Sida cordifolia Linnaeus, is one of the most preferred oils for topical oil pooling in such conditions, as it has a definitive indication for sensory dysfunctions. Drugs like Withania somnifera (L.) Dunal (Ashwagandha) are also used, as they ameliorate neurodegeneration and help to improve cognitive dysfunction. OBJECTIVE: We propose an exploratory randomized controlled trial study for evaluating the efficacy of TOPMAC (Topical Oil Pooling with Kshirabala Taila and Supplementation of Ashwagandha Churna) in tinnitus suppression and hearing and cognitive function protection in patients aged 60-75 years with mild to moderate presbycusis. METHODS: A parallel, 2-group, exploratory randomized controlled trial will be conducted in an Indian Ayurvedic research center at its outpatient service. Participants (N=60) with mild to moderate presbycusis will be recruited by screening. Participants will be randomized (computer-generated 1:1) to receive either basic treatment and health education (BTHE) or BTHE+TOPMAC for 24 weeks. The primary objective is to compare the efficacy of TOPMAC with that of BTHE in the protection of hearing function. The secondary objective is to compare the efficacy of TOPMAC with that of BTHE in tinnitus suppression and cognitive function protection. RESULTS: This project was funded in January 2023. The institutional ethics committees at National Ayurveda Research Institute for Panchakarma (3/1/2020/NARIP/Tech/2036) and Institute for Communicative and Cognitive Neuro Sciences (IEC006) approved this study. The first patient was enrolled in September 2023; 22 participants were enrolled as of August 2024. The data analysis is yet to start, and the results are expected to be published by January 2025. CONCLUSIONS: If this exploratory trial is proven effective, it will steer the setting of a definitive randomized controlled trial to test whether the TOPMAC intervention can be incorporated as a cost-effective integrative approach for managing presbycusis. The Indian government has already launched a National Program for Prevention and Control of Deafness to benefit the deaf population. TOPMAC may later be considered for integration with the national program. TRIAL REGISTRATION: Clinical Trials Registry India CTRI/2023/04/051485; https://tinyurl.com/2h2hry3n. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/55089.

Evaluation of the audiovestibular system before and after treatment in patients with Idiopathic intracranial hypertension.

BACKGROUND: Idiopathic intracranial hypertension (IIH) can affect both hearing and balance due to increased inner ear pressure. AIMS/OBJECTIVES: This study aimed to evaluate the impact of increased inner ear pressure on hearing and balance in patients with IIH using auditory and vestibular tests. MATERIAL AND METHODS: Twenty-four IIH patients and 28 healthy controls underwent oVEMP, pure tone audiometry, tympanometry, and acoustic reflex tests pre-lumbar punctures. IIH patients received acetazolamide. Pre- and post-treatment results, tinnitus, and vertigo scores were compared. Post-treatment oVEMP and audiometry results were compared between groups. RESULTS: Pre-treatment oVEMP showed a significant left N1 latency difference (p = 0.049). Post-treatment, left ear amplitude (p = 0.035) and both ear amplitude ratios (p = 0.044 and p = 0.047) increased significantly. Audiometry had no significant changes (p < 0.05). Tinnitus and vertigo scores decreased significantly (p ≤ 0.001). CONCLUSION: Prolonged oVEMP latency suggests IIH may impact the brain stem and vestibular nerve, while increased amplitude values indicate peripheral vestibular involvement. IIH affects hearing across all frequencies, especially at 4000 Hz, impacting both hearing and balance. SIGNIFICANCE: Understanding the effects of IIH on auditory and vestibular functions can guide effective treatments, improving quality of life for patients by addressing both hearing and balance issues.

Novel technique utilizing polymethylmethacrylate cement for the treatment of pulsatile tinnitus caused by different sigmoid sinus pathologies.

PURPOSE: Sigmoid sinus anomalies such as dehiscence or diverticula may present with pulsatile tinnitus (PT) and low-frequency hearing loss. Occasionally, these symptoms are severe, necessitating resurfacing of the affected area to restore a normal-appearing sinus wall. This study describes three cases wherein we managed PT attributed to sigmoid sinus anomalies using polymethylmethacrylate (PMMA) bone cement, a novel material. METHODS: Three patients with PT without any history of illnesses initially underwent cortical mastoidectomy to expose the affected area and resurface the sinus wall. Subsequently, PMMA bone cement was used to reconstruct any bony defects causing PT symptoms. Viscosity of the bone cement was altered based on specific characteristics and causes of the affected area. Additionally, we performed the water occlusion test (WOT), audiological assessment, the Tinnitus Handicap Inventory score (THI), and temporal computed tomography, both pre- and postoperatively, to assess the extent of PT. RESULTS: Preoperatively, all three patients had tinnitus that dissipated with pressure on the neck and the water occlusion test (WOT), with no reported vertigo, trauma, or ear infections. Moreover, all three cases had a severe handicap according to the THI. In contrast, all cases had reduced PT and a significantly decreased THI score postoperatively, as well as no recurrence or complications and no instances of increased intracranial hypertension at the 12-month follow-up. CONCLUSION: All cases showed promising results, emphasizing the sustained benefits of this novel intervention for the management of PT.

The Indirect Effect of an Internet-Based Intervention on Third-Party Disability for Significant Others of Individuals with Tinnitus.

BACKGROUND: This study aimed to investigate whether Internet-based cognitive behavioural therapy intervention (ICBT) for individuals with tinnitus had an indirect effect on the third-party disability noticed by significant others (SOs). METHODS: Significant Others Questionnaire (CTSOQ). Individuals with tinnitus completed standardized self-reported outcome measures for tinnitus severity, anxiety, depression, insomnia, hearing-related quality of life, tinnitus cognitions, hearing disability, and hyperacusis. RESULTS: In total, 194 pairs of individuals with tinnitus and their SOs participated. The impact of third-party disability experienced by SOs was significantly reduced after individuals with tinnitus undertook the ICBT intervention (d = 0.41). This reduced SOs with severe difficulties from 52% to 35%. The remaining impact was mild for 30% and moderate for 35%. SOs with higher baseline difficulties and SOs who were partners (e.g., spouses) were less likely to notice indirect benefits from intervention undertaken by their family members. There was a moderate positive correlation between the post-intervention CTSOQs and the clinical variables of tinnitus severity and depression. CONCLUSIONS: Third-party disability may be reduced as an indirect effect of individuals with tinnitus undertaking ICBT. Including SOs of individuals with tinnitus within the rehabilitation process may add additional benefits, and such involvement should be encouraged.

Tinnitus Prevalence, Associated Characteristics, and Treatment Patterns among Adults in Saudi Arabia.

Tinnitus affects millions of people around the world and causes significant negative impacts on their quality of life (QoL). Tinnitus is rarely examined in Saudi Arabia. This study aimed to estimate the prevalence of tinnitus among adults, explore their experience with tinnitus, investigate the impact of tinnitus on their QoL, and discover their tinnitus management methods. A descriptive cross-sectional study design was performed utilizing a non-probability purposive sampling technique and a face-to-face in-person administered questionnaire. Descriptive statistics and a chi-square test were used to assess the data and find any correlation between the variables. Out of 4860 adults, 320 (males: n = 172; females: n = 148; age range = 18-90 years) had tinnitus, mainly described as a daily, gradual, continuous, whistling, and ringing tinnitus in both ears. Tinnitus prevalence was estimated at 6.54% with a slight predominance in males (6.9%) compared with females (6.2%). Most of the participants were unaware of the cause of their tinnitus. The modal value of the severity of tinnitus signals was severe for both genders. The modal value of the impact of tinnitus on the QoL was moderate for males and severe for females. Sleep, social activities, quiet settings, and concentration were largely affected by tinnitus. Significant associations (p < 0.05) between the impact of tinnitus on the QoL and risk factors, such as gender, age, hearing loss, and hyperacusis were determined. Also, the impact of tinnitus on the QoL was significantly associated (p < 0.05) with the duration of complaints and the severity of tinnitus signals. Approximately, 61% of the participants did not use any tinnitus treatment, while the remaining participants usually used hearing aids, medications, and counseling to manage their tinnitus. By increasing awareness, establishing standard practice, developing guidelines for managing tinnitus, expanding access to suitable interventions, and carrying out additional research, adults living with tinnitus in Saudi Arabia will have better support and, ultimately, an enhancement of their overall well-being.

Network pharmacology and bioinformatics approach to unravel the mechanism of Xiao-chai-hu-tang herbal formula in tinnitus treatment.

Background: Tinnitus treatment remains a global challenge, and current therapeutic approaches are still controversial. This study aims to elucidate the potential mechanisms of Xiao-Chai-Hu-Tang (XCHT) in treating tinnitus through the analysis of network pharmacology, mendelian randomization and molecular docking, and molecular dynamics simulation analysis. We hope to contribute to the research on the target of action of traditional Chinese medicine and exploration of the mechanism of tinnitus. Methods: We utilized network pharmacology to screen potential targets of action of XCHT on tinnitus. Mendelian randomization was employed to determine the causal relationship between potential targets of action and tinnitus. Finally, molecular docking and molecular dynamics simulation with clear targets and the combination of the active ingredient in effectiveness. Results: Through network pharmacology, we identified 38 potential targets of action. Mendelian randomization analysis revealed that HIF1A (OR [95 % CI] = 0.78 [0.65, 0.94], P = 0.008) and CCND1 (OR [95 % CI] = 1.22 [1.00, 1.49], P = 0.04) exhibited significant results with tinnitus. Molecular docking and molecular dynamics simulation of HIF1A and active ingredients demonstrated good binding efficacy. Conclusion: HIF1A may play a key role in the treatment of tinnitus by XCHT, which may play a certain protective role in tinnitus patients and may inhibit the occurrence and development of tinnitus. However, the specific mechanism and effect need to be further studied and verified.