A cross-sectional study on predictors of patients' tinnitus severity.

Objective: To identify factors that influence the severity of tinnitus via a hierarchical multiple linear regression model. Methods: The study was a retrospective cross-sectional analysis. The study included 331 patients experiencing tinnitus as their primary concern, who visited Shanghai Changzheng Hospital of the Navy Medical University between 2019 and 2021. Data on general health status and disease characteristics were collected from all patients. With their consent, participants underwent audiological evaluatons and completed questionnaires to analyze the characteristics of their tinnitus and the factors influencing its severity. Results: The correlation analysis showed a positive relationship between tinnitus frequency, tinnitus loudness, SAS scores, and PSQI scores with THI scores (P < 0.05) among nine examined variables (gender, handedness, employment status, age, BMI, tinnitus frequency, tinnitus loudness, SAS scores, and PSQI scores). The variables that were extracted from the multiple regression were; for the constant; ß = -51.797, t = -4.484, P < 0.001, variable is significant; for the tinnitus loudness; ß = 0.161, t = 2.604, P < 0.05, variable is significant; for the tinnitus frequency; ß = 0.000, t = 1.269, P = 0.206, variable is not significant; for the SAS scores; ß = 1.310, t = 7.685, P < 0.001, variable is significant; for the PSQI scores; ß = 1.680, t = 5.433, P < 0.001, variable is significant. Therefore, the most accurate model for predicting severity in tinnitus patients is a linear combination of the constant, tinnitus loudness, SAS scores, and PSQI scores, Y(Tinnitus severity) = ß 0 + ß 1 (Tinnitus loudness) + ß 2 (SAS scores) + ß 3 (PSQI scores). ß 0, ß 1, ß 2, and ß 3 are -51.797, 0.161, 1.310 and 1.680, respectively. Conclusion: Tinnitus severity is positively associated with loudness, anxiety levels, and sleep quality. To effectively manage tinnitus in patients, it is essential to promptly identify and address these accompanying factors and related symptoms.

Does tinnitus amplify the effects of healthy eating patterns and physical activity on the sleep disturbance or sleep insufficiency, based on the case study of NHANES survey in the United States.

Objective: Exploring whether the presence of tinnitus amplifies the effects of an individual's dietary patterns and physical activity on sleep disturbance or sleep insufficiency. Study design: This study extracted data from the five National Health and Nutrition Examination Surveys (NHANES) between 2009 and 2018, including individuals who had undergone complete questionnaires on tinnitus, dietary habits, physical activity, and sleep. Multivariate logistic regression, restricted cubic spline (RCS) and subgroup analyses were conducted to explore the associations of dietary habits, physical activity, and tinnitus with sleep disturbance and sleep insufficiency. Results: A total of 7,440 participants were enrolled in this study, of whom 1,795 participants were evaluated as sleep disturbance (24.13%), and 2,281 were sleep insufficiency (30.66%). With adjusting confounding factors of demographic and socioeconomic variables, among overall population, participants with tinnitus showed a significantly increased risk of sleep disturbance [adjusted odds ratio (aOR) = 2.08, 95% confidence interval (CI): 1.83-2.36), and sleep insufficiency (aOR = 1.31, 95% CI: 1.15-1.49). Poor dietary habits also increased the risk of sleep disturbance (aOR = 1.08, 95% CI: 1.04-1.12), as does lack of physical activity (aOR = 1.14, 95% CI: 1.03-1.27); but neither exposure factors significantly increased the risk of sleep insufficiency. The non-linear trend analyses of RCS found that the influence of exposure factors on sleep disturbance experiencing a steady or small decline trend after rising. In addition, the results of the subgroup analysis showed that in tinnitus patients, poor dietary habits and lack of physical activity both significantly increased the risk of sleep disturbance, and poor dietary habits also increased the risk of sleep insufficiency remarkable, but lack of physical activity did not. In healthy participants, poor dietary habits were only significantly associated the sleep disturbance, while lack of physical inactivity even had a protective effect against sleep insufficiency. Conclusion: Compared to the general population, tinnitus significantly amplified the effects of poor dietary patterns and physical inactivity on sleep disturbance and sleep insufficiency. For tinnitus patients, adjusting a healthy diet and increasing exercise could more effectively promote their sleep health.

Effectiveness of bisphosphonate for alleviating tinnitus associated with otosclerosis: a prospective case-control study.

PURPOSE: To investigate the short-term efficacy of third-generation bisphosphonate in the management of tinnitus associated with otosclerosis. METHODS: A prospective case-control study included 100 patients with otosclerosis-associated bothersome tinnitus. Patients were assigned to two groups: group A (control): 25 patients who planned to receive only complementary supplements, oral vitamin D plus calcium, and group B (case): 75 patients who planned to receive oral bisphosphonate plus routine vitamin D and calcium supplements. Group B was subdivided into B1: 25 patients without any previous intervention, B2: 25 patients with persistent tinnitus for more than 6 months after a previous uncomplicated stapedotomy in the same ear, and B3: 25 patients with persistent tinnitus for more than 6 months after hearing aid fitting. The outcome was tinnitus assessment both subjectively (tinnitus intensity, frequency, and questionnaire) and objectively (tinnitus intensity and frequency). RESULTS: The female-to-male ratio was 1.6:1 with ages ranging from 40 to 61 years. The baseline revealed no statistically significant differences between the groups. After 6 months, there were statistically significant differences, both objectively and subjectively. The tinnitus questionnaire median (IQR) for group B was 16 (30), whereas control group A had 52 (24). The tinnitus severity median (IQR) for group B was 20 (30), compared to group A's 52 (42). After 6 months, 40% of the cases in group B demonstrated complete improvement, compared to 0% in control group A. CONCLUSION: We demonstrated significant tinnitus improvement in cases treated with bisphosphonate compared to the control group.

Validation and Transadaptation of Tinnitus Primary Function Questionnaire Into Central Kurdish Version (TPFQ-CK).

Background and Objectives: : Tinnitus affects individuals' quality of life, and multiple surveys have been conducted to assess this effect. One questionnaire used is the Tinnitus Primary Function Questionnaire. The aim of this study was to assess the reliability and validity of the Central Kurdish version of the Tinnitus Primary Function Questionnaire (TPFQ-CK). Subjects and Methods: : We obtained permission from the originator of the TPFQ to proceed with this study. The English version was translated into Central Kurdish, following guidelines for the cross-cultural adaptation of health-related quality-of-life measures. A total of 205 participants who self-reported having subjective tinnitus for more than 3 months were included in this study. The TPFQ-CK and Tinnitus Handicap Questionnaire (THQ) were administered to all participants. Additionally, pure-tone audiometry was conducted. Results: : Internal consistency of the TPFQ-CK was reflected in the total score (Cronbach's alpha=0.933), and excellent consistency was present in test-retest reliability (intraclass correlation coefficient=1.000). The concordance correlation coefficient (concordance correlation coefficient=0.999) of the total TPFQ-CK score revealed high concordance and correlation between the two evaluations. The good construct validity of the TPFQ-CK was evidenced by the strong correlation (r=0.895) between the TPFQ-CK and THQ scores. Conclusions: : The TPFQ-CK is a valid and reliable assessment tool for evaluating the influence of tinnitus on the quality of life of Central Kurdish speakers with tinnitus.

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.

Ginkgo biloba extract prescriptions are associated with less frequent repeat visits to ENT doctors due to tinnitus: a retrospective cohort study.

Objectives: We aimed to evaluate the drug utilization of Ginkgo biloba extract (Gbe), systemic corticosteroids (CSs), and pentoxifylline (PTXF) for the treatment of acute tinnitus by analyzing electronic patient health record data. In addition, we assessed whether the different drug treatments were associated with different frequencies of repeat visits to ear, nose, and throat (ENT) doctors. Methods: This retrospective cohort study used data from the IQVIA Disease Analyzer (DA) database. It included patients with an initial diagnosis of tinnitus between January 2005 and December 2021, treated by ENT specialists in Germany. Results: Of 111,629 patients meeting all selection criteria, 51,205 received prescriptions of Gbe, 34,817 of systemic CSs, and 25,607 of PTXF. Gbe prescription was associated with significantly lower odds of a repeat consultation due to tinnitus compared to systemic CSs [odds ratio (OR) 0.91; 95% confidence interval (CI): 0.88-0.95] as well as PTXF (OR 0.74; 95% CI: 0.72-0.77). This association was significant in both men and women and in some age groups. Conclusion: Gbe is the most frequently ENT specialist-prescribed drug for the treatment of acute tinnitus. It is associated with a reduced likelihood of patients consulting their ENT specialist for tinnitus again compared to systemic CSs and PTXF.

DNA Methylation Patterns Associated with Tinnitus in Young Adults-A Pilot Study.

PURPOSE: Tinnitus, the perception of sound without any external sound source, is a prevalent hearing health concern. Mounting evidence suggests that a confluence of genetic, environmental, and lifestyle factors can influence the pathogenesis of tinnitus. We hypothesized that alteration in DNA methylation, an epigenetic modification that occurs at cytosines of cytosine-phosphate-guanine (CpG) dinucleotide sites, where a methyl group from S-adenyl methionine gets transferred to the fifth carbon of the cytosine, could contribute to tinnitus. DNA methylation patterns are tissue-specific, but the tissues involved in tinnitus are not easily accessible in humans. This pilot study used saliva as a surrogate tissue to identify differentially methylated CpG regions (DMRs) associated with tinnitus. The study was conducted on healthy young adults reporting bilateral continuous chronic tinnitus to limit the influence of age-related confounding factors and health-related comorbidities. METHODS: The present study evaluated the genome-wide methylation levels from saliva-derived DNA samples from 24 healthy young adults with bilateral continuous chronic tinnitus (> 1 year) and 24 age, sex, and ethnicity-matched controls with no tinnitus. Genome-wide DNA methylation was evaluated for > 850,000 CpG sites using the Infinium Human Methylation EPIC BeadChip. The association analysis used the Bumphunter algorithm on 23 cases and 20 controls meeting the quality control standards. The methylation level was expressed as the area under the curve of CpG sites within DMRs.The FDR-adjusted p-value threshold of 0.05 was used to identify statistically significant DMRs associated with tinnitus. RESULTS: We obtained 25 differentially methylated regions (DMRs) associated with tinnitus. Genes within or in the proximity of the hypermethylated DMRs related to tinnitus included LCLAT1, RUNX1, RUFY1, NUDT12, TTC23, SLC43A2, C4orf27 (STPG2), and EFCAB4B. Genes within or in the proximity of hypomethylated DMRs associated with tinnitus included HLA-DPB2, PM20D1, TMEM18, SNTG2, MUC4, MIR886, MIR596, TXNRD1, EID3, SDHAP3, HLA-DPB2, LASS3 (CERS3), C10orf11 (LRMDA), HLA-DQB1, NADK, SZRD1, MFAP2, NUP210L, TPM3, INTS9, and SLC2A14. The burden of genetic variation could explain the differences in the methylation levels for DMRs involving HLA-DPB2, HLA-DQB1, and MUC4, indicating the need for replication in large independent cohorts. CONCLUSION: Consistent with the literature on comorbidities associated with tinnitus, we identified genes within or close to DMRs involved in auditory functions, chemical dependency, cardiovascular diseases, psychiatric conditions, immune disorders, and metabolic syndromes. These results indicate that epigenetic mechanisms could influence tinnitus, and saliva can be a good surrogate for identifying the epigenetic underpinnings of tinnitus in humans. Further research with a larger sample size is needed to identify epigenetic biomarkers and investigate their influence on the phenotypic expression of tinnitus.

Reverse Correlation Characterizes More Complete Tinnitus Spectra in Patients.

Goal: We validate a recent reverse correlation approach to tinnitus characterization by applying it to individuals with clinically-diagnosed tinnitus. Methods: Two tinnitus patients assessed the subjective similarity of their non-tonal tinnitus percepts and random auditory stimuli. Regression of the responses onto the stimuli yielded reconstructions which were evaluated qualitatively by playing back resynthesized waveforms to the subjects and quantitatively by response prediction analysis. Results: Subject 1 preferred their resynthesis to white noise; subject 2 did not. Response prediction balanced accuracies were significantly higher than chance across subjects: subject 1: 0.5963, subject 2: 0.6922. Conclusion: Reverse correlation can provide the foundation for reconstructing accurate representations of complex, non-tonal tinnitus in clinically diagnosed subjects. Further refinements may yield highly similar waveforms to individualized tinnitus percepts.

Evaluation of the effectiveness of cognitive behavioral therapy on tinnitus.

OBJECTIVE: This research aims to examine the effects of Cognitive Behavioral Therapy (CBT) on tinnitus in individuals aged 18-60 years. METHODS: Thirty participants with subjective tinnitus for at least six months were included a randomized controlled trial was conducted with 15 participants in the experimental group and 15 in the control group, with pre-test and post-test measurements. The experimental group received eight CBT sessions for eight weeks. Data were collected using Tinnitus Handicap Inventory (THI) and Visual Analog Scale (VAS). The Mann-Whitney and Wilcoxon Signed Rank Test were used to compare scores between experimental and control groups before and after the intervention. RESULTS: A within-group difference was found between total scores on THI and VAS before and after CBT in the experimental (z = -3.241, P = 0.001), but not in the control group (z = -1.764, P = 0.078). Following the intervention, there was a significant between-group difference on the THI Emotional, Catastrophic, and Functional tinnitus subscale scores, favoring the experimental group. CONCLUSIONS: CBT significantly reduced tinnitus level, severity, duration, frequency, discomfort, tinnitus-related attention deficit, and sleep problems. Further studies are needed to replicate these results in other populations.

Effects of tinnitus retraining therapy on patients with tinnitus: a systematic review of randomized controlled trials.

PURPOSE: This review aims to explore the influences of tinnitus retraining therapy (TRT) on patients with tinnitus. METHODS: PubMed, MEDLINE, EMBASE, CINAHL, PEDro, SCOPUS, and Web of Science were screened for randomized controlled trials (RCTs) that explored the effects of TRT on patients with tinnitus from inception to June 30, 2024. The methodological quality of the included RCTs was evaluated using the physiotherapy evidence database (PEDro) scale. RESULTS: Fifteen studies met our eligibility criteria. A total of 2069 patients with tinnitus (mean age 52.93 years; 66% male) were involved in the present review. The quality of the selected studies ranged from 5 to 8 on the PEDro scale, with a median score of 7. TRT did not provide superior effects in treating patients with tinnitus compared to tinnitus masking (TM), tinnitus educational counselling (TED), TRT with open ear hearing aids, Tailor-made notched music training (TMNMT), partial TRT, usual care, and smart TRT. CONCLUSIONS: TRT intervention is considered a treatment option for patients with tinnitus. Combining TRT with other interventions, such as cognitive-behavioral therapy, pharmacotherapy, or tDS, may show even greater efficacy. Additional studies are strongly required to recognize the long-term effects of TRT on tinnitus, determine who most likely would benefit from the intervention regarding tinnitus type and severity, and identify the optimal treatment protocol.

Efficacy of tailor-made notched music training for primary tinnitus: A systematic review and meta-analysis.

OBJECTIVE: We systematically reviewed and meta-analyzed the efficacy of Tailor-Made Notched Music Training (TMNMT) for primary subjective tinnitus in adults. The main goal was to evaluate TMNMT's impact on tinnitus symptoms. METHODS: Following PRISMA guidelines, we included randomized and non-randomized trials. Studies considered involved adults with primary subjective tinnitus treated with TMNMT alone or combined with other therapies. Bias risk was assessed using the Cochrane RoB 2 and ROBINS-I tools. Comprehensive database searches were conducted, and relevant data were extracted and analyzed. RESULTS: Three studies (total: 99 TMNMT patients, 109 sound therapy) were meta-analyzed. Using THI scores, the Forest plot showed no significant difference in tinnitus distress between TMNMT and listening to music groups (p > 0.05), with low study heterogeneity (I2 = 0 %). CONCLUSION: While TMNMT offers a non-invasive approach with a potential to reduce tinnitus distress, it did not significantly outperform the only listening to music. More research is needed to optimize TMNMT for tinnitus management and to better document its safety profile.

Effectiveness of bimodal stimulation of the auditory-somatosensory system in the treatment of tonal tinnitus.

BACKGROUND AND OBJECTIVES: The dorsal cochlear nucleus (DCN) is the interaction site of auditory and somatosensory system inputs. According to the stochastic resonance theory, hearing loss increases the neural activity of the somatosensory system in the DCN and causes tinnitus. it is possible to modulate this neural hyperactivity by applying random noise through the auditory and somatosensory systems (bimodal stimulation). Therefore, this study aimed to investigate the effectiveness of the bimodal intervention based on the theory of stochastic resonance. METHODS: The study divided 34 participants into unimodal and bimodal groups with 17 subjects in each. The bimodal group received customized acoustic stimulation along with transcutaneous auricular vagus nerve stimulation (tAVNS) and the unimodal group received customized acoustic stimulation along with tAVNS as a sham. The treatment sessions in both groups were 6 sessions and each session lasted for 20 min. The participants were evaluated before, immediately after, and one month after the completion of the intervention sessions, using the Tinnitus Handicap Inventory (THI) questionnaire and the mismatch negativity (MMN) test. RESULTS: After the intervention sessions, the results indicated a statistically significant decrease in THI scores and a significant increase in the MMN amplitude in the bimodal group compared to the unimodal group. No significant changes in MMN latency were observed between the two groups. These changes were stable in the one-month follow-up visit. CONCLUSIONS: Our study showed that bimodal stimulation is a better intervention option compared to unimodal stimulation. Bimodal stimulation may be an effective intervention method for some subjects with tinnitus, especially people with hearing loss who have tonal tinnitus.

The tinnitus handicap inventory is a better indicator of the overall status of patients with tinnitus than the numerical rating scale.

OBJECTIVES: This study aimed to explore the electrophysiological characteristics of patients with chronic tinnitus through electrocochleography (ECochG) findings and determine if these findings correlate with specific audiological patterns that could differentiate tinnitus patients from those without this condition. MATERIALS AND METHODS: A retrospective analysis of medical records from patients who visited a tinnitus clinic at a tertiary university hospital between March 2020 and December 2023 was conducted. Inclusion criteria were non-pulsatile subjective tinnitus lasting over three months, and ECochG performed at initial evaluation. Audiological assessments and ECochG results were analyzed, with the SP/AP ratio being a focal point. RESULTS: Among 256 patients, an elevated SP/AP ratio was observed in 37.5 % of patients. No significant difference in ECochG outcomes was noted based on tinnitus laterality. Patients with an elevated SP/AP ratio reported more sleep disturbances, higher depression scores, attention problems, and aural fullness. These patients also exhibited lower loudness discomfort levels and low-frequency hearing losses. Significant correlations were found between elevated SP/AP ratios and DPOAE responses. CONCLUSIONS: The findings highlight the SP/AP ratio in ECochG as a valuable biomarker for assessing clinical and psychological aspects of tinnitus, indicating its potential utility in tailoring treatment strategies. Elevated SP/AP ratios were associated with sleep disturbances, depression, attention problems, aural fullness, hyperacusis, and low-frequency hearing loss, suggesting a complex interplay between cochlear pathology and tinnitus perception. This study underscores the need for a nuanced understanding of ECochG results in the clinical evaluation of tinnitus, potentially guiding more personalized management approaches.

[Surgical technique and effect of the pulsatile tinnitus associated with sigmoid sinus on the dominant side of reflux].

Objective:To explore the effect of surgical treatment of the pulsatile tinnitus associated with sigmoid sinus on the dominant side of reflux. Methods:The clinical data of 43 patients with reflux dominant side pulsating tinnitus admitted by the same doctor from 2017 to 2023 were retrospectively studied to observe the curative effect of surgical treatment. Operation method: The sound insulation barrier was established by repair technique of bone wall defect of sigmoid sinus with "capping method", without changing the blood flow and blood vessel wall of sigmoid sinus. Results:No surgical complications occurred in all patients. During the follow-up period of 3 months to 6.9 years, 14 patients（32.6%） were cured, 18 patients（41.9%） were significantly effective, 4 patients（9.3%） were effective, and 7 patients（16.3%） were ineffective. The difference of tinnitus grade before and after surgery was statistically significant. Conclusion:In this group of cases, the sound insulation barrier was established by "capping method" technique of repairing bone wall defect of sigmoid sinus, which effectively avoided the disturbance of hemorheology status and vascular wall, thus avoiding the risk of venous wall stenosis and thrombosis on the dominant reflux side. The surgical method was easy to master, and the curative effect was significant, which was worthy of clinical promotion.

Tinnitus reduction in patients with single-sided deafness: the effect of cochlear implantation, bone conduction devices, and contralateral routing of sound hearing aids investigated in a randomized controlled trial.

Objectives: Single-sided deafness (SSD) is often accompanied by tinnitus, resulting in a decreased quality of life. Currently, there is a lack of high level of evidence studies comparing different treatment options for SSD regarding tinnitus reduction. This randomized controlled trial (RCT) evaluated the effect of a cochlear implant (CI), bone conduction device (BCD), contralateral routing of sound (CROS), and no treatment on tinnitus outcomes in SSD patients, with follow-up extending to 24 months. Methods: A total of 120 adult SSD patients were randomized to three groups: CI, a trial period with first a BCD on a headband, then a CROS, or vice versa. After the trial periods, patients opted for a BCD, CROS, or no treatment. At the start of follow-up, 28 patients were implanted with a CI, 25 patients with a BCD, 34 patients had a CROS, and 26 patients chose no treatment. The Tinnitus Handicap Inventory (THI), Tinnitus Questionnaire (TQ), the Visual Analog Scale (VAS), and the Hospital Anxiety and Depression Scale (HADS) were completed at baseline and at 3, 6, 12, and 24 months of follow-up. Results: The CI and BCD groups showed significantly decreased tinnitus impact scores. The CI group showed the largest decrease, which was already observed at 3 months of follow-up. Compared to the baseline, the median THI score decreased by 23 points, the TQ score by 17 points, and the VAS score by 60 points at 24 months. In the BCD group, the TQ score decreased by 9 points, and the VAS decreased by 25 points at 24 months. The HADS anxiety and depression subscale showed no indication for anxiety or depression at baseline, nor at 24 months, for all groups. Conclusion: In this RCT, SSD patients treated with a CI or BCD showed an overall decrease in tinnitus impact scores up to 24 months compared to baseline. The CI group reported a stable and the largest reduction. Cochlear implants appear to be superior to BCD and CROS, and no treatment for achieving partial or complete resolution of tinnitus in patients with SSD. Clinical trial registration: Netherlands Trial Register, www.onderzoekmetmensen.nl/nl/trial/26952, NTR4457, CINGLE trial.

Excessive smartphone use increases self-reported auditory and vestibular symptoms.

BACKGROUND: With widespread smartphone use, there is growing concern about their potential impact on human health. OBJECTIVE: The effects of smartphone use on self-reported hearing ability, tinnitus, balance, falls, and anxiety level were investigated in this study. METHODS: This study included 682 participants who were divided into 2 groups: a high smartphone use (HSU) group and a low smartphone use (LSU) group. Both groups were evaluated for hearing ability using the Amsterdam inventory for auditory disability and handicap; balance status using the vertigo, dizziness, imbalance symptom scale; anxiety status using the Beck anxiety index; and fall and tinnitus status using the visual analog scale. RESULTS: The HSU group showed significantly worse hearing ability, tinnitus, balance, falling, and anxiety status results than the LSU group (p < 0.001). There was a positive correlation between smartphone addiction severity and auditory impairment, tinnitus, risk of falling, and anxiety, as well as a negative correlation with balance score (p < 0.001). CONCLUSION: The findings suggest that individuals with excessive smartphone use are more likely to experience hearing, tinnitus, balance, falling, and anxiety problems than those who use smartphones less frequently. Excessive smartphone use may be considered a potential risk factor for these problems.

A Systematic Review on Hearing and Balance in Patients with Chronic Kidney Disease with and Without Hemodialysis.

Objective: Exploring the auditory and vestibular manifestations associated with chronic kidney disease (CKD) has been growing in recent years. Understanding these complaints in CKD patients is crucial for comprehensive patient care. This review aimed to investigate the audiological findings and profiles across various stages of CKD and guide for informed decision-making in their management. Methods: Relevant articles from PubMed, ScienceDirect, EBSCO Medline, SCOPUS, Google Scholar, and Clinical Key were identified for review. The selected articles were published from 2008 to 2023 and written in English language. A total of 41 articles on auditory and vestibular assessments in CKD were eligible for review. Results: Pure tone audiometry (PTA), immittance audiometry (IA) and otoacoustic emissions (OAEs) were the most commonly employed hearing tests respectively, with a higher frequency of utilization in hemodialysis cases compared to non-hemodialysis ones. Also, vestibular evoked myogenic potentials (VEMPs) emerged as the most popular vestibular test among hemodialysis patients while questionnaires were frequently employed in CKD patients. Moreover, our analysis suggests a potential association between the duration of hemodialysis and the development of tinnitus and vertigo. Abnormalities were also observed in auditory brainstem response (ABR), speech audiometry, central auditory processing tests and videonystagmography (VNG) assessment in hemodialysis and non-hemodialysis patients. Conclusion: CKD patients, particularly those undergoing hemodialysis, face a higher risk of hearing loss, tinnitus, and vestibular complaints. Performing otoacoustic emissions and vestibular-evoked myogenic potentials along with PTA on CKD patients, regardless of the disease stage is recommended to more effective management of audiovestibular complaints in these population.

The Prevalence of Insomnia Among Patients With Chronic Tinnitus in the General Population of the Kingdom of Saudi Arabia.

BACKGROUND:  Tinnitus is a perception of sound without external sound stimulation. Subjective tinnitus is the most common type and is unrelated to external sounds. It is a symptom, not an illness, and is often linked to various psychological factors like anxiety and depression. Insomnia is a personal sense of difficulty falling asleep and issues with sleep initiation, length, consolidation, or quality while having ample chance to sleep, which impairs one's ability to function during the day. Sleep problems are prevalent in individuals with chronic tinnitus. OBJECTIVE:  We aimed to assess insomnia prevalence in chronic tinnitus patients in Saudi Arabia. METHOD:  Our study, an online cross-sectional survey, included 434 Saudi participants with chronic insomnia, utilizing a Google Forms questionnaire (Google LLC, Mountain View, California, United States). RESULTS:  A total of 434 participants responded to the online survey. The most represented age group was 18-25 years, and 319 (73.5%) of the respondents were female. Approximately one-third (34.6%, n=150) were from the southern region. In the sample, 184 (42.4%) participants had bilateral tinnitus, and 105 (24.2%) had had tinnitus for over two years. Around 62.7% of the participants suffered from insomnia due to tinnitus. In terms of sleep quality, 174 (40.1%) participants took over 40 minutes to fall asleep, 85 (19.5%) were often afraid to sleep due to disturbed sleep, and 63 (14.5%) frequently used sleep pills. CONCLUSION:  Our study of over 400 Saudi chronic tinnitus patients revealed that a large percentage of tinnitus patients have insomnia, influenced by geographic region and tinnitus duration. Our findings offer valuable insights, emphasizing the necessity for additional research to inform interventions aimed at enhancing the quality of life of individuals with chronic tinnitus.

The Association between Dietary Intakes of Vitamins and Minerals with Tinnitus.

BACKGROUND: Tinnitus is the phantom perception of sound in the ears or head which may result from inflammation of the auditory pathway. A healthy diet consisting of a range of vitamins and minerals may be protective against tinnitus. This study aims to determine the association between intakes of dietary vitamins and minerals and the prevalence and incidence of tinnitus over 10 years. METHODS: In this longitudinal cohort study of 2947 participants (aged ≥ 50 years), 935 (32%) cases of tinnitus were identified and included in prevalence analyses. The remaining 2012 participants were followed to establish 10-year incidence of tinnitus. A validated semi-quantitative food frequency questionnaire was used to determine intakes of dietary vitamins and minerals. RESULTS: No significant associations with tinnitus prevalence were found. However, iron and zinc were significantly associated with incident tinnitus. There was a 44% (multivariate-adjusted HR: 1.44, 95% CI: 1.07-1.93) increased risk of developing incident tinnitus over 10 years with lower zinc intakes and a 35% increased risk with lower iron intakes (multivariate-adjusted HR: 1.35, 95% CI: 1.00-1.80). CONCLUSION: Higher intakes of zinc and iron were significantly associated with lower tinnitus risk. Due to a lack of comparable high-quality data, future research studies should include robust study designs.

Beyond the Buzz: Cortical and subcortical brain changes in patients with pulsatile tinnitus.

Pulsatile tinnitus (PT) can be a debilitating condition characterized by rhythmic, heartbeat-synchronous sounds, which can severely impact patients' quality of life. Understanding the neuroanatomical changes in PT patients may provide critical insights into the impacts of this condition. This study aimed to investigate potential differences in cortical and subcortical brain volume between adults with PT and age-matched controls (60 to 70 years of age). A retrospective, cross-sectional analysis of imaging and medical records was conducted, with data collected from January 2015 to December 2021. The study was conducted in a tertiary referral center with a specialized tinnitus clinic. A total of 135 adults diagnosed with PT and 135 age-matched controls were included. All participants were screened for PT and relevant medical history, with consecutive sampling used for selection. Cortical and subcortical brain volume differences between PT patients and controls were measured using Freesurfer. PT patients (n = 79, after exclusion of patients with inadequate imaging data) exhibited significant decreases in cortical thickness in the anterior cingulate and entorhinal cortex, and decreased volume in the left putamen, compared to age-matched controls (n = 135). PT patients also demonstrated significant increased volume in frontal and occipital lobe structures, the cerebellum, hippocampi, and ventral pallidum. In conclusion, our findings suggest that individuals with PT may have structural differences in brain regions related to auditory processing, and depression, which provides additional evidence of the psychiatric sequalae of PT. These findings demonstrate that there are neuroanatomical alterations in patients with PT, emphasizing the value in evaluating and treating this disease to prevent these neuroanatomical differences from developing.