Research Article Tinnitus and Patterns of Hearing Loss

Journal of the Association for Research in Otolaryngology, 2013

Tinnitus is strongly linked with the presence of damaged hearing. However, it is not known why tinnitus afflicts only some, and not all, hearing-impaired listeners. One possibility is that tinnitus patients have specific inner ear damage that triggers tinnitus. In this study, differences in cochlear function inferred from psychophysical measures were measured between hearing-impaired listeners with tinnitus and hearing-impaired listeners without tinnitus. Despite having similar average hearing loss, tinnitus patients were observed to have better frequency selectivity and compression than those without tinnitus. The results suggest that the presence of subjective tinnitus may not be strongly associated to outer hair cell impairment, at least where hearing impairment is evident. The results also show a different average pattern of hearing impairment amongst the tinnitus patients, consistent with the suggestion that inner hair cell dysfunction with subsequent reduced auditory innervati...

European journal of therapeutics, 2023

Objective: In order to determine the pathophysiology of tinnitus and deciding on treatment, the function of peripheral hearing organs is very important. The aim of the study is to evaluate the cochlear functions in tinnitus patients with or without hearingloss (HL). Methods: Participants with tinnitus were divided into two groups; 16 participants with accompanying HL were included in the first study group (SG-I), and 15 participants without HL were included in the second group (SG-II). 21 normal-hearing subjects without tinnitus included as control group (CG). Tinnitus discomfort levels was determined with Tinnitus Handicap Inventory (THI). Besides pure-tone audiometry, Otoacoustic Emissions (OAE), to evaluate cochlear functions and to decide dead regions (DR), Threshold Equalizing Noise-(TEN) was used. Results: The threshold-shift was observed with TEN in subjects in SG-I and these levels were statistically different from SG-I and CG. There were both threshold-shift and DR in SG-I according to TEN. Transient Otoacoustic Emissions (TEOAE) did not differ between SG-I and CG. The Distortion Product Otoacoustic Emissions (DPOAE) results for SG-I showed significant decreases in emission amplitudes at 6 & 8 kHz. Conclusion: While Tinnitus patients with HL can be evaluated with conventional tests, evaluating patients with normal hearing tinnitus with additional tests such as OAE and TEN allows us to get more precise results on the functions of peripheral hearing organs.

Australian and New Zealand Journal of Audiology, 2007

European Archives of Oto-Rhino-Laryngology, 2014

Tinnitus is the phantom perception of sounds. No single theory explaining the cause of tinnitus enjoys universal acceptance, however, it is usually associated with hearing loss. The aim of this study was to investigate the relationship between tinnitus pitch and audiometry, minimum masking levels (MML), tinnitus loudness, and distortion product otoacoustic emissions (DPOAE). This was a retrospective analysis of participant's records from the University of Auckland Hearing and Tinnitus Clinic database. The sample consisted of 192 participants with chronic tinnitus (more than 18 months) who had comprehensive tinnitus assessment from March 2008 to January 2011. There were 116 males (mean = 56.5 years, SD = 12.96) and 76 females (mean = 58.7 years, SD = 13.88). Seventy-six percent of participants had a tinnitus pitch C8 kHz. Tinnitus pitch was most often matched to frequencies at which hearing threshold was 40-60 (T50) dBHL. There was a weak but statistically significant positive correlation between tinnitus pitch and T50 (r = 0.15 at p \ 0.05). No correlation was found between tinnitus pitch and DPOAEs, MML, audiometric edge and worst threshold. The strongest audiometric predictor for tinnitus pitch was the frequency at which threshold was approximately 50 dBHL. We postulate that this may be due to a change from primarily outer hair cell damage to lesions including inner hair cells at these levels of hearing loss.

Hearing Research, 2006

A broad consensus within the neuroscience of tinnitus holds that this audiologic condition is triggered by central deafferentation, mostly due to cochlear damage. The absence of audiometrically detectable hearing loss however poses a challenge to this rather generalizing assumption. The aim of this study was therefore to scrutinize cochlear functioning in a sample of tinnitus subjects audiometrically matched to a normal hearing control group. Two tests were applied: the Threshold Equalizing Noise (TEN) test and a pitch scaling task. To perform well on both tasks relatively normal functioning of inner hair cells is a requirement. In the TEN test the tinnitus group revealed a circumscribed increment of thresholds partially overlapping with the tinnitus spectrum. Abnormal slopes were observed in the pitch scaling task which indicated that tinnitus subjects, when presented with a high-frequency stimulus, relied heavily on input derived from lower-frequency inner hair cells (off-frequency listening). In total both results argue for the presence of a deafferentation also in tinnitus subjects with audiometrically normal thresholds and therefore favour the deafferentation assumption posed by most neuroscientific theories.

It is generally accepted that tinnitus severity is influenced by stress and depression (Folmer, Griest, Meikle, & Martin, 1999) while the contribution of hearing loss to tinnitus severity is unclear (Baskill & Coles, 1999). Functional imaging has suggested that the degree of cortical reorganisation following hearing loss contributes to tinnitus severity (Muhlnickel, Elbert, Taub, & Flor, 1998) while more severe tinnitus has also been associated with gently sloping audiograms (Weisz, Voss, Berg, & Elbert, 2004). This study related results for two self-report questionnaires, the Tinnitus Handicap Questionnaire (THQ) (Kuk, Tyler, Russell, & Jordan, 1990) and the Tinnitus Severity Index (TSI) (Meikle, Griest, Stewart, & Press, 1995) to audiometric results from 79 patients attending a tinnitus clinic. The TSI did not show a statistically significant correlation with any variables obtained from the audiogram. The Tinnitus Handicap Questionnaire score was correlated to aspects of the pure tone audiometry — in particular elevated low frequency thresholds were correlated with greater tinnitus handicap. The relationship between hearing loss and measures of tinnitus impact are discussed.

Auris Nasus Larynx, 2009

Objectives: This study was designed to investigate the possibility of underlying cochlear damage whether outer hair cells (OHCs) or inner hair cells (IHCs) in tinnitus suffering patients with normal hearing sensitivity, using transient evoked otoacoustic emission (TEOAEs) and threshold equalizing noise (TEN) test, if any. Methods: Twenty patients suffering from unilateral tinnitus with normal hearing sensitivity participated in this study. Their other ear acted as control ears. They were subjected to full history taking, otoscopy, basic audiologic evaluation, TEOAEs and TEN test. Results: TEOAEs were abnormal in 85% of the tinnitus ears compared to 20% in control ears; this difference was statistically significant. The abnormal TEOAEs frequency bands in the tinnitus ears were statistically significant above 2000 Hz when compared to the control ears and were more common for the 4000 and 5000 Hz. This suggests that OHCs dysfunction may be important in the generation of tinnitus. TEN test demonstrated dead regions in the cochlea in 15% of the tinnitus ears only. This might be attributed to increased resistance of IHCs to damage compared to OHCs vulnerability. The affected frequency location was at 500 Hz in 5%, 3000 and 4000 Hz in 10% of tinnitus ears. Conclusion: This work has shown a higher prevalence of OAE abnormalities in tinnitus patients with normal hearing in contrast to TEN test denoting the more vulnerability of OHCs to damage. #

The International Tinnitus Journal, 2015

Tinnitus is an auditory sensation whose source comes from external stimulus to the body. All studies that can help people with this disorder are very imperative. Objective: This study investigates the cochlear function in patients with tinnitus, using Distortion Products Otoacoustic Emissions (DPOAE). Material and Methods: Ears where the subjects referred to feel the tinnitus were considered for the study group while other ears without this sensation of tinnitus acted as a control group. Fifty subjects suffering from unilateral or bilateral tinnitus with normal hearing sensitivity or mild hearing loss were recruited. Results and conclusions: Where comparing the control and study group, the highest percentage of cases of DPOAE detected was in the control group, although these differences were not statistically significant. When the analyzed frequency is the same as the tinnitus frequency, the prevalence of detected DPOAE is in tinnitus ears (50.0 %). In ears where tinnitus was not perceived (73.5 %) a p value of 0.024 (< 0.05) was found, which means that the undetected DPOAE could be influenced by tinnitus. Based on the results, tinnitus might not be caused by changes in the outer hair cells but seems to be affected by that.

International Archives of Otorhinolaryngology, 2014

International Archives of Otorhinolaryngology

Introduction Tinnitus, which is considered the third worst symptom for humans, is a common complaint among people living with hearing loss and may negatively affect the quality of life of those who have it. Objective To analyze the perception of the handicap in patients with tinnitus and hearing loss as well as the possible associations between the variables hearing loss, loudness, onset, frequency and annoyance by tinnitus, and the correlation between the visual analogue scale (VAS) and the Tinnitus Handicap Inventory (THI). Methods A total of 30 patients with complaints of tinnitus and the presence of sensorineural hearing impairment were selected for this cross-sectional, observational, and descriptive study. The loudness of the tinnitus was measured by a VAS and classified as mild, moderate, or severe. The THI was classified as slight, mild, moderate, severe, and catastrophic. Data were submitted to statistical analysis using the Fisher exact test and Spearman correlation coeffi...