Correlation between clinical characteristics and tinnitus severity in tinnitus patients of different sexes: an analytic retrospective study.

PURPOSE: This study aimed to explore whether sex is influences tinnitus severity and whether the risk factors for tinnitus severity are the same in tinnitus patients of different sexes. METHODS: This was a retrospective study of data from 1427 patients complaining of tinnitus in a local hospital otolaryngology clinic from November 2019 to January 2022. All patients were interviewed and assessed by otoscopy, pure-tone audiometry, tinnitus handicap inventory (THI), visual analogue scale (VAS), and tinnitus refinement test. RESULTS: THI values were higher in females than in males (P = 0.00). Types of tinnitus sounds (OR 0.667, P = 0.000) and degree of hearing loss (OR 1.318, P = 0.000) were risk factors for tinnitus severity in males. Types of tinnitus sounds (OR 0.789, P = 0.005), sensation level (OR 1.023, P = 0.037), tinnitus types (OR 1.163, P = 0.041), tinnitus location (OR 1.198, P = 0.026), and the degree of hearing loss (OR 1.303, P = 0.000) were risk factors for tinnitus severity in females. Sex was an influencing factor for tinnitus severity. There were different risk factors for the tinnitus severity in different sexes. CONCLUSION: The risk factors for tinnitus severity differed according to sex in tinnitus patients, and the risk factors for tinnitus severity were greater in women than in men. These findings add to the literature on sex differences in tinnitus and suggest that medical and psychological screening of affected individuals and customized tinnitus treatment for each individual with tinnitus are needed. TRIAL REGISTRATION NUMBER/DATE OF REGISTRATION: ChiCTR2200057958, 2022/3/24 (retrospectively registered trials).

Therapeutic effects of Rosa canina, Urtica dioica and Tanacetum vulgare herbal combination in treatment of tinnitus symptoms: A double-blind randomised clinical trial.

OBJECTIVE: To evaluate the effect of Neurotec® herbal capsule (100 mg twice a day for 3 months) on the tinnitus symptoms in comparison with the placebo. DESIGN: A double-blind randomised clinical trial. SETTING: Otolaryngology clinic of Baqiyatallah Hospital. PARTICIPANTS: Patients suffering from subjective tinnitus. MAIN OUTCOME MEASURES: Pure tone audiometry was measured at .5, 1, 2, 4 and 6 kHz frequencies before and after the third month of intervention. In addition, Tinnitus Handicap Inventory (THI) questionnaire as well as visual analogue scale (VAS) for tinnitus loudness, daily annoyance, daily life or sleep disturbance, daily perception and mood alteration were evaluated. RESULTS: Finally, 103 (69 males and 34 females) patients with a mean age of 51.33 ± 13.91 years were analysed. In contrast with control group, patients in intervention group showed a remarkable decrease in THI score after 3 months of treatment (p < .05). Although both groups had improvements in VAS scores, mood disturbance, daily tinnitus perception and daily life alteration scores were only improved in the intervention group. The mean pure tone air and bone conduction were not significantly different between the control and the intervention group at baseline and 3 months after the intervention at .5, 1, 2 and 4 kHz (p > .05). CONCLUSION: A 3-month treatment with Neurotec capsules in addition to patient education is of benefit for managing symptoms in patients with chronic tinnitus.

Transcutaneous Electric Nerve Stimulation in Chronic Subjective Tinnitus.

OBJECTIVE: It is aimed to determine the therapeutic role of transcutaneous electrical nerve stimulation (TENS) on chronic subjective tinnitus with a randomized and comparative analysis. METHOD: 46 individuals with normal hearing, chronic subjective tinnitus, aged 20-65; randomly divided into the study (TENS therapy) and tje control groups. The control group (n = 23) was informed only about tinnitus, while the study group (n = 23) received TENS therapy (20 sessions in 4 weeks). Before TENS therapy, tinnitus-related evaluations of all participants [tinnitus frequency, loudness, minimum masking level (MMS), residual inhibition (RI)] were made and Tinnitus Handicap Inventory (THI), Visual Analogue Scale (VAS), Short Form 36 (SF-36), and The Quality of Life Scale were applied to the participants. These evaluations and questionnaires were repeated after 4 weeks of the therapy. RESULTS: There was a significant decrease in the tinnitus severity after TENS therapy in the study group (p = 0.003). Moreover, it was found that VAS (loudness and annoyance), THI (functional, emotional and total score), SF-36 (physical function, physical role, pain, general health, vitality, emotional role and social function) values improved compared to before TENS therapy and the difference was significant (p < 0.05). There was no significant difference between the first and last evaluations of the control group (p > 0.05). CONCLUSION: TENS is an effective, practical and reliable therapy method in reducing severity, loudness, and annoyance of tinnitus, and increasing the quality of life in individuals with chronic subjective tinnitus.

Auditory brainstem response in unilateral tinnitus patients: does symmetrical hearing thresholds and within-subject comparison affect responses?

OBJECTIVE: In recent studies, cochlear synaptopathy has been suggested as a potential pathophysiology mechanism for tinnitus, which occurs in individuals with normal hearing thresholds. Auditory Brainstem Response (ABR) is a noninvasive method frequently used in the literature to evaluate cochlear synaptopathy in tinnitus patients. However, possible factors such as high-frequency pure-tone hearing thresholds, age, gender, and head characteristics that may affect ABR were not considered sufficiently in previous studies. Therefore, the present study aims to evaluate tinnitus ears and non-tinnitus ears with ABR in unilateral chronic tinnitus patients with symmetrical hearing. METHODS: Twenty unilateral chronic tinnitus patients having normal pure-tone average with symmetrical hearing thresholds was included in the study. Subjects were evaluated with 0.25-16 kHz pure-tone audiometry, Tinnitus Handicap Inventory (THI) and ABR were administered. All ears were evaluated monaurally using click stimuli at 80 dB nHL, alternating polarity (21.1 rate/s, 2000 sweeps). RESULTS: Wave I amplitude of the ABR and the ratio of III/I, V/I, and V/III wave amplitudes from tinnitus ears was higher than non-tinnitus ears. At the same time, there was a positive correlation between THI and V-I and V-III interpeak latency range, and a negative correlation between V/III wave amplitude ratio. CONCLUSION: ABR can be used as an evaluation method to provide evidence that the neural organizations of individuals with chronic tinnitus differ in certain regions in their auditory pathways. The correlation between THI and ABR findings suggests that there may be a connection between tinnitus distress and the neural organization of the auditory system.

Psychometric properties of the Norwegian translation of the Tinnitus Handicap Inventory (THI-NOR).

OBJECTIVE: To assess the psychometric properties of a Norwegian translation of the Tinnitus Handicap Inventory (THI-NOR). DESIGN: A survey was sent by post to patients referred with tinnitus as their main complaint to an audiology department. Patients completed a Norwegian version of the Tinnitus Handicap Inventory (THI-NOR), a Norwegian translation of two revised subscales of the Abbreviated profile of hearing aid benefit (APHAB), the General Health Questionnaire (GHQ-12) as well as questionnaires measuring coping expectancies (TOMCATS) and neuroticism (EPI). STUDY SAMPLE: Ninety-nine persons with tinnitus. RESULTS: No associations were found between THI-scores or pure-tone audiometry, gender or age. The proposed subscales of the original THI were not formed by responses from responders. The total scale shows good psychometric properties. Significant correlations were found between distress as measured by the GHQ-12, coping expectancies as measured by TOMCATS and neuroticism as measured by EPI and THI scores. CONCLUSIONS: THI-NOR has psychometric properties similar to those of the Danish translation (THI-DK), from which it was adapted, and to the original THI. THI-NOR seems to be a valid measure of the impact of tinnitus on a person's everyday life. Findings show that the suggested subscales of the questionnaire should be interpreted with caution.

Clinical characteristics of subjective idiopathic tinnitus and preliminarily analyses for the effect of tinnitus multielement integration sound therapy.

OBJECTIVE: To study the psychoacoustic and audiological characteristics of patients with chronic subjective tinnitus and provide basis for the personalized diagnosis and treatment of tinnitus through a single tinnitus multielement integration sound therapy (T-MIST) and analysis of efficacy preliminarily. METHODS: 145 patients with tinnitus were assessed by systematic medical history collection, professional examination of otolaryngology, audiology examination, full precision test (FPT), residual inhibition test (RIT), tinnitus handicap inventory (THI) and visual analog scale (VAS) annoyance. The correlation among factors was performed. RESULTS: The frequency of tinnitus was correlated with the frequency of maximum hearing loss (P < 0.05). The loudness of tinnitus was correlated with the loudness of maximum hearing loss (P < 0.05). In this study, T-MIST was used to treat tinnitus. After treatment, tinnitus alleviated VAS annoyance (P < 0.05). The results of RIT were correlated with the effect of T-MIST (P < 0.05). CONCLUSION: There was a correlation between tinnitus and hearing loss. The RIT may indicate the effectiveness of acoustic therapy in patients. The FPT can find the hidden hearing loss without display on routine pure tone audiometry, so as to provide a clinical reference for the detection of early hearing loss in tinnitus patients.

Tinnitus related handicap in daily living among Pakistani population: A multicenter study.

OBJECTIVE: To determine the impact of tinnitus-related handicap on daily living of tinnitus sufferers and factors associated with tinnitus severity. METHODS: The cross-sectional study was conducted from November 2016 to April 2017at Al-Nafees Medical College Hospital, Islamabad, Capital Development Authority Hospital, Islamabad, Lahore General Hospital, Lahore, Bahawal Victoria Hospital, Bahawalpur; and Wassay Ear Nose Throat Clinic, Muzaffarabad, Pakistan. Tinnitus patients of either gender aged 15-75 years were included. Detailed history was taken and examination was conducted. Data was collected using the Tinnitus Handicap Inventory, and was analysed using SPSS 21. RESULTS: Of the 152 patients, 87(57.20%) were males. The overall mean age was 44.10±16.06 years. Tinnitus was severe in 53(34.87%), while catastrophic severity was noted in 26(17.10%). Cases with hearing loss and male gender suffered significantly more in daily life activities (p<0.05). Severity of tinnitus handicap was associated with the type of tinnitus sound (p<0.05). CONCLUSIONS: Gender, hearing loss and type of tinnitus sound were found to be associated with the severity of the condition.

Multiple Daily Rounds of Theta-Burst Stimulation for Tinnitus: Preliminary Results.

Background and Objectives: Tinnitus is a condition that negatively affects the quality of life and is difficult to treat. Theta burst stimulation (TBS), a new method of repetitive transcranial magnetic stimulation (rTMS), is a promising treatment approach because it shows stronger and more prolonged effects in a shorter time of stimulation than other rTMS protocols. However, the therapeutic effect of TBS for tinnitus was inconsistent. We hypothesized that more stimulation would be more effective. Therefore, this study aimed to explore the safety and effectiveness of multiple daily rounds of TBS over five consecutive days. Materials and Methods: The continuous TBS (cTBS) protocol is 300 pulses/day, but we applied 8 sessions of 300 pulses in a day (total 2400 pulses/day). A total of 15 patients with tinnitus were randomly assigned to treatment and sham groups. Outcome measurements were taken three times: before and after 5-day of stimulation; at a 1-3 month follow-up visit. Outcome measurements were the degree of annoyance due to ear fullness, duration of tinnitus, visual analog scales of tinnitus for annoyance, Tinnitus Handicap Inventory, pitch, loudness, minimum masking level, and residual inhibition. Results: Five-day cTBS was completed without adverse events. We did not find any significant therapeutic effect in the treatment group, but we needed to be cautious to interpret our result due to the small sample size. Conclusions: In conclusion, multiple rounds of cTBS in a day may be safe. Further research is needed in a larger sample size to determine the effectiveness and confirm the safety.

Perception of Tinnitus Handicap And Stress Across Age Groups in Normal Hearing.

INTRODUCTION: This research was conducted to investigate the severity of tinnitus, its impact on subject's daily, personal and emotional life, which varies widely across the age groups. METHODOLOGY: Sample population of 60 unilateral tinnitus subjects with normal hearing between the age ranges of 15-55years were divided into four age groups. Tinnitus severity was measured using tinnitus severity index, impact of tinnitus on daily life was documented through tinnitus handicap inventory and the stress levels through perceived stress scale. RESULTS: A high frequency tinnitus was observed in age group of 56-65years, in contrast to noise like tinnitus in subjects aged 15-25years. The tinnitus was found to be most handicapping (38-56; moderate handicap) in Group 4(56-65years), the perceived stress levels were also falling in very high range (21 and over). Tinnitus severity index did not show any significant difference between the Group 1:15-25yrs, Group 2: 26-40yrs, Group 3:41-55yrs, and however group 4(56-65 yrs) did report with mild severity. The outcomes of present study demonstrated that elderly subjects certainly require modifications in the test protocols and referrals to address to their significant responses to tinnitus.

The Efficacy of Digital Hearing Aids in the Management of Tinnitus in Individuals with Sensorineural Hearing Loss.

Tinnitus is a condition which is often seen coexisting with hearing loss. In many persons with tinnitus, the use of amplification devices has been reported to show improvement in difficulties due to tinnitus. Though the underlying physiological mechanism is not clearly understood, hearing aids have proven beneficial. The aim of the study is to evaluate the benefit of the hearing aid in management of tinnitus. This study was conducted to assess whether such claims are true and, if so, what is the quantum of such benefit. In order to ascertain this, we studied the effects of three commonly used newer designs of digital programmable hearing aids namely, (i) Hearing aids with Basic programming, D-Basic (ii) those with tinnitus specific programming, DTS and (iii) those with in-built masking facility, DIM. In this study 108 subjects (65 males and 43 females), in the age range of 18 to 81 years were included. Each subject was fitted with one of the above mentioned three types of hearing aids, by qualified audiologists, purely on clinical grounds. All the subjects showed improvement in their hearing. The efficacy of the hearing aids, in mitigating the tinnitus, was assessed by employing the Tinnitus Handicap Inventory - THI. The THI has been developed by Newman et al in 1996 to study the effects of tinnitus, comprehensively under three domains viz. functional, emotional and catastrophic domains. A reduction in the THI scores indicates improvement. This tool is very popular and is acclaimed worldwide. It had been translated into several languages. In this study, the translated Telugu language version (THIT) of THI was used. The use of the local language (Telugu) afforded easy comprehension and better reliability. In each subject, we documented the THIT scores, before fitting of hearing aid and after two months of proper usage of the hearing aids. In the entire sample population of 108 subjects, across all the three different designtypes of hearing aids, we found a mean reduction of 42.6 points in the THIT scores. When the design of hearing aid was taken into reckoning, the mean post-fitting reduction of THIT scores in the subjects fitted with D-Basic, DTS, DIM hearing aids were 32.2, 43.5 and 51.9 respectively. In all the three designs, several subjects, those who were in a worse grade of tinnitus severity category of tinnitus severity before fitting, improved to a better grade after fitting. Further, we studied relief in the domain sub scales of the THIT viz. functional, emotional and the catastrophic domains. While all the three designs gave over-all relief of tinnitus, we found differences in the domain sub scales. However, designs with the In built maskers and tinnitus specific programming fared better. The conclusion drawn from our study is that, apart from the amplification benefit, all the three types of digital programmable hearing aids provided appreciable mitigation of tinnitus. Among the three design-types, hearing aids with inbuilt masker (DIM) were found to give the best benefit. Hearing aids with tinnitus specific programming (DTS) were the second best.

Relationship between cognition and the severity of chronic tinnitus: Validation of the Japanese version of the Tinnitus Cognitions Questionnaire.

OBJECTIVE: The Tinnitus Cognitions Questionnaire (TCQ) is a scale designed to assess the positive and negative cognitions associated with tinnitus. The purpose of this study was to validate the Japanese version of the TCQ and to analyze the relationship between cognition and the severity of chronic tinnitus. METHODS: This was a cross-sectional, multicenter study. Patients with chronic tinnitus persisting for longer than 3 months were included. Participants completed the TCQ, the Tinnitus Handicap Inventory (THI), and the Hospital Anxiety and Depression Scale (HADS). They also completed the TCQ a second time 3-7 days later. The questionnaire was translated into Japanese. A factor analysis was performed and the convergent and discriminant validity, internal consistency, and test-retest reliability were evaluated. RESULTS: The total sample consisted of 75 participants. We obtained high Cronbach's α coefficients for the total score and subscales, ranging from 0.933 to 0.974. The total score and subscale interclass correlation coefficients for test-retest reliability ranged from 0.631 to 0.963. The factor analysis yielded a two-factor structure: negative and positive subscales. The convergent and discriminative validity was sufficiently clear. The negative subscale of the TCQ was strongly correlated with the THI and the HADS. CONCLUSION: The Japanese version of the TCQ was validated here. It also exhibited a two-factor structure that was well matched with previous data. And it was a highly consistent and reliable measure that can be used to evaluate cognitions in patients with chronic tinnitus. Negative cognition for tinnitus was greatly related to handicap and psychological state.

Treatment of patients with glomus jugulare tumours (GJT) and its subjective effect on quality of life (QoL) measures.

Cerebellopontine angle (CPA) tumours account for 6-10% of intracranial tumours. The most common CPA tumours are vestibular schwannomas (VS), also known as acoustic neuromas, benign tumours of the vestibulocochlear nerve. Less common but symptomatic skull base lesions are glomus jugulare tumours (GJT), of which approximately 40% are identified as CPA tumours. Initial symptoms for GJT may include hearing loss and tinnitus and progress to various cranial nerve dysfunctions. Three well-accepted treatment modalities for such tumours include surgical resection, radiotherapy and/or conservative management employing serial MR or CT imaging. Patients' quality of life may be impacted by different treatment methods, so treatment decisions should be client centered.

One-Year Results for Patients with Unilateral Hearing Loss and Accompanying Severe Tinnitus and Hyperacusis Treated with a Cochlear Implant.

OBJECTIVE: To show that patients with unilateral hearing loss (UHL), with one ear fulfilling cochlear implant (CI) indication criteria, and an additional severe tinnitus handicap can be treated effectively with a CI. METHOD: A prospective multi-centre study was conducted in five Spanish centres. Sixteen adult patients with UHL and a mean Tinnitus Handicap Inventory (THI) score of at least 58 were implanted. The study design included repeated within-subject measures of quality of life (Health Utility Index Mark 3 [HUI3]), tinnitus (THI, Visual Analogue Scale [VAS] on tinnitus loudness), hearing (Speech, Spatial, and Qualities of Hearing Scale- [SSQ]), and hyperacusis (Test de Hipersensibilidad al Sonido [THS]) up to 12 months after the initial CI fitting. RESULTS: Group data showed significant subjective benefit from CI treatment: the preoperative HUI3 total utility score of 0.45 went up to 0.57 at 6 months and 0.63 at 12 months; the preoperative THI total score of 75 decreased to 40 at 6 months and 35 at 12 months. The preoperative tinnitus loudness VAS score of 8.2 decreased to 2.4 at 6 months and 2.2 at 12 months with the implant "On" and to 6.7 at 6 months and 6.5 at 12 months with the implant "Off." The preoperative THS total score of 26 decreased to 17 at 12 months. The preoperative SSQ total score of 4.2 increased to 5.1 at 6 months and 6.3 at 12 months. No unanticipated adverse events were reported during the study period. At 12 months after CI activation all subjects (except 1 subject who used the device 6 days a week) wore their devices all day and every day. The primary reason for CI use was split evenly between tinnitus suppression (n = 6) and both hearing and tinnitus (n = 6). CONCLUSION: A CI should be considered as a treatment option in patients with UHL and a concomitant severe tinnitus handicap. However, appropriate counselling of candidates on the anticipated risks, benefits, and limitations that are inherent to cochlear implantation is imperative.

Tinnitus functional index: validation of the German version for Switzerland.

BACKGROUND: Different standardized questionnaires are used to assess tinnitus severity, making comparisons across studies difficult. These questionnaires are also used to measure treatment-related changes in tinnitus although they were not designed for this purpose. To solve these problems, a new questionnaire - the Tinnitus Functional Index (TFI) - has been established. The TFI is highly responsive to treatment-related change and promises to be the new gold standard in tinnitus evaluation. The aim of the current study was to validate a German version of the TFI for a German-speaking population in Switzerland. METHODS: At the ENT department of the University Hospital Zurich, 264 subjects completed an online survey including the German version for Switzerland of TFI, Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and sociodemographic variables. Internal consistency of the TFI was calculated with Cronbach's alpha coefficient. Pearson correlation coefficients were used for the test-retest reliability of the TFI and to investigate convergent and discriminant validity between the THI and the BDI and BAI, respectively. Factor analysis was assessed using a principal component analysis with oblique rotation. The different factors extracted were then compared with the original questionnaire. RESULTS: The German version of the TFI for Switzerland showed an excellent internal consistency (Cronbach's alpha of 0.97) and an excellent test-retest reliability of 0.91. The convergent validity with THI was high (r = 0.86). The discriminant validity with BAI and BDI showed moderate results (BAI: r = 0.60 and BDI: r = 0.65). In the factor analysis only five factors with one main factor could be extracted instead of eight factors as described in the original version. Nevertheless, relations to the original eight subscales could be demonstrated. CONCLUSION: The German version of the TFI for Switzerland is a suitable instrument for measuring the impact of tinnitus. The reliability and validity of this version are comparable with the original version of the TFI. Although this study showed only five factors in the factor analysis, relations to the original eight subscales were identified. Therefore, the German version of the TFI for Switzerland can deliver relevant information regarding the different tinnitus domains. TRIAL REGISTRATION: Clinical trial registration number on clinicaltrial.gov: NCT01837368 .

Validation of PRISM (Pictorial Representation of Illness and Self Measure) as a novel visual assessment tool for the burden of suffering in tinnitus patients.

BACKGROUND: Chronic subjective tinnitus is a frequent condition that affects the subject's quality of life. The lack of objective measures of tinnitus necessitates the use of self-reporting and often time-consuming questionnaires for evaluating tinnitus severity. The Pictorial Representation of Illness and Self Measure (PRISM) is a two dimensional pictorial method to assess the burden of suffering. Patients illustrate their burden of suffering by the distance from a "self" to an illness circle, whereby a shorter distance indicates a higher burden of suffering. The aim of this prospective observational study was to validate the burden of suffering measured with PRISM in tinnitus patients by comparing it with different standardized questionnaires currently used in tinnitus evaluation. METHODS: A total of 188 patients filled out an online-based survey including sociodemographic variables and the following questionnaires: Tinnitus Handicap Inventory (THI), Tinnitus Questionnaire (TQ), WHO Quality of Life-Questionnaire (WHOQOL-BREF), and the Beck Depression Inventory (BDI). The subtle differences in the burden of suffering were accessed by using PRISM as an iPad version. Based on PRISM performance patients could easily be assigned in three groups, these being mildly, moderately, or severely affected akin to the standard questionnaires. RESULTS: The burden of suffering measured with PRISM correlated with the tinnitus severity (THI and TQ), depressive symptoms (BDI), and health related quality of life (WHOQOL-BREF) (all p ≤ 0.001). In the three PRISM groups tinnitus severity (THI and TQ), and depressive symptoms (BDI) differed significantly (all p ≤ 0.01). CONCLUSION: PRISM is an easily understood and time saving method for the assessment of burden of suffering in tinnitus patients. In daily clinical practice PRISM can help to identify patients with decompensated tinnitus that require more intensive treatment.

Impact of reduction of tinnitus intensity on patients' quality of life.

OBJECTIVE: Assess the impact of a reduction of tinnitus intensity achieved through sound stimulation during sleep on the improvement in the patients' quality of life. DESIGN: Acoustic stimuli consisted of a highly customized sound that reproduced the spectral and intensity characteristics of the tinnitus in each patient. This stimulus was uploaded into a portable electronic device and delivered through customized ear buds during sleep, every night for three months. STUDY SAMPLE: Twelve patients with subjective idiopathic chronic tinnitus were studied. RESULTS: Results were assessed through: (1) the measurement in dB SPL of tinnitus intensity reduction over time; (2) the results of three psychometric tests: Tinnitus handicap inventory (THI), Tinnitus reaction questionnaire (TRQ), Tinnitus functional index (TFI); and (3) a Visual analog scale (VAS) for tinnitus annoyance. After three months of treatment, we observed an average decrease in tinnitus intensity of 14.1 dB SPL (p < 0.001), implying a 62% reduction of the perceived sound. This improvement was followed by a statistically significant decrease of TRQ (78%), THI (65%), and TFI (77%). CONCLUSIONS: These results suggested that the intensity reduction achieved through the protocol used in this study had a direct impact on the improvement in the patients' quality of life.

Reliability and validity of the Lithuanian Tinnitus Handicap Inventory.

OBJECTIVE: The aim of this study was to determine the reliability and validity of the Lithuanian version of the Tinnitus Handicap Inventory (THI), a self-report measure of perceived tinnitus handicap. MATERIALS AND METHODS: A cross-sectional psychometric validation study was performed in the University Hospital. A total of 248 subjects reporting chronic tinnitus as their primary complaint or secondary to hearing loss were encluded in the study and filled in the Lithuanian version of THI. For assessment of construct validity a subgroup of 55 participants completed the Lithuanian version of the Hospital Anxiety and Depression Scale as a measure of self-perceived levels of anxiety and depression. Test-retest and internal consistency reliability as well as construct validity were calculated. RESULTS: The Lithuanian version of the THI and its subscales showed a robust internal consistency reliability (Cronbach's alpha=0.93) comparable to the original version. Statistically significant correlations were observed between the Lithuanian translation of the THI and the measures of self-perceived levels of anxiety and depression using HADS. Confirmatory factor analysis demonstrated that the three subscales of the THI Lithuanian version corresponded to three different factors, which strongly correlated between themselves. CONCLUSIONS: The results suggest that the Lithuanian version of THI maintains its original validity and may serve as reliable and valid measure of general tinnitus related distress that can be used in a clinical setting to quantify the impact of tinnitus on daily living.

Comparison of the outcomes of repetitive transcranial magnetic stimulation to the ipsilateral and contralateral auditory cortex in unilateral tinnitus.

Transcranial magnetic stimulation (TMS) is a noninvasive method of activating or deactivating focal areas of the human brain. Repetitive TMS (rTMS) applied over the temporoparietal cortex has been reported to show therapeutic effects on tinnitus. We compared the effects of 1 Hz rTMS delivered either contralaterally or ipsilaterally to the symptomatic ear in patients with unilateral tinnitus. Forty patients with asymmetric hearing loss and non-pulsatile tinnitus localized to poorer ear of 6 months in duration or greater who were refractory to medication were enrolled in this study. Patients were assigned randomly to one of two treatment groups: with 1 Hz stimulation applied the temporoparietal junction either ipsilaterally (n = 21) or contralaterally (n = 19) to the symptomatic ear. The patients were given 600 pulses per session daily for 5 d. Changes in the tinnitus handicap inventory (THI) and self-rating visual analog scores (VAS) for loudness, awareness and annoyance were analyzed before, immediately after and 1 month after treatment. There was no significant difference in the rate of patients with marked improvement between ipsilateral and contralateral stimulation groups. In addition, there were no significant differences in the amount of decreases in THI scores and VAS between the two groups immediately or 1 month after rTMS. Finally, significant decreases in THI scores and most VAS were observed 1 month after rTMS in both groups compared to pretreatment. Daily treatment with 1 Hz rTMS ipsilaterally and contralaterally to the side of tinnitus both had significant beneficial effects. The laterality of stimulation with 1 Hz rTMS is not the decisive factor in relieving symptoms.

Predictive factors of tinnitus after vestibular schwannoma surgery: a case-control study.

BACKGROUND: Tinnitus is very common in patients with vestibular schwannoma (VS). We analyzed the related factors of tinnitus after surgery. METHODS: One hundred seventy-three patients diagnosed with unilateral VS operated via the retrosigmoid approach were included in the study. All patients underwent relevant examinations and completed the THI scale before surgery and 6 months after surgery. The prognosis of tinnitus was evaluated according to the changes in THI. RESULTS: Of the 129 preoperative tinnitus patients, postoperative tinnitus resolved in 12.4%, improved in 29.5%, remained unchanged in 28.6%, and worsened in 29.5%. 18.2% of 44 patients without preoperative tinnitus appeared new-onset tinnitus postoperatively. Thirty-six patients never had tinnitus. Patients with smaller tumor sizes (≤ 3 cm) were more likely to experience preoperative tinnitus. Younger patients and those with serviceable hearing preoperatively were more likely to report their tinnitus unchanged or worsened. A new onset of postoperative tinnitus in the preoperative non-tinnitus group was found in better preoperative hearing function. CONCLUSIONS: In this study, 70% of patients had persistent tinnitus after vestibular schwannoma resection. The prognosis of tinnitus was influenced by age and preoperative hearing function. Tinnitus is a bothersome symptom and is often underestimated by doctors. Assessment of tinnitus is mandatory during the management of vestibular schwannoma.

AUDISTIM® Day/Night Alleviates Tinnitus-Related Handicap in Patients with Chronic Tinnitus: A Double-Blind Randomized Placebo-Controlled Trial.

The aim of this study is to evaluate the efficacy of taking a daily supplement based on active compounds (AUDISTIM® Day Night: A D/N) in alleviating tinnitus-related disability, as suggested by previous real-life studies. This double-blind randomized placebo-controlled study was conducted in adults with mild to severe tinnitus receiving a 3-month supplementation with A D/N (magnesium, vitamins, phytochemicals) or placebo (excipients without active ingredients). Tinnitus-related handicap (THI), psychological stress (MSP-9), and sleep quality (PSQI) were assessed at baseline and during intervention, perceived impression of tinnitus improvement at the end of the follow-up. The full set analysis included 114 patients (59 A D/N, 55 placebo) aged 53.8 ± 11.4 years, 58% women, with fluctuating (45%) or permanent (55%) tinnitus from 9.3 ± 9.4 years. A D/N supplementation led to greater changes in THI (-13.2 ± 16.0 vs. -6.2 ± 14.4, p = 0.0158,Cohen's d =0.44) at 3 months (primary outcome), especially with continuous tinnitus (-15.0 ± 16.3 vs. -4.6 ± 12.8, p = 0.0065), and, to a lesser extent, at 1 month (-9.8 ± 13.1 for A vs. -4.3 ± 12.1, p = 0.0213). PSQI significantly improved over time in both groups, but MSP-9 only with A D/N. In lines with previous observational studies, both clinical (THI score > 7 pts) and statistical (vs. placebo) improvement, more pronounced in permanent tinnitus, demonstrate the effectiveness of the combination of active compounds and support its use in the management of mild to severe tinnitus.