Translation and validation of the Tinnitus Functional Index (TFI) into Kannada: a tool for clinical and research use in the Indian population.

PURPOSE: The Tinnitus Functional Index (TFI) is a widely recognized measure for evaluating tinnitus and is frequently used in both therapeutic and research contexts. Unfortunately, TFI is currently not available in any Indian languages. In a multilingual country like India, cross-cultural adaptation, translation, and validation of such scales in regional languages are critical to improving their use for clinical and research purposes. Therefore, this study focused on translating and validating the TFI in Kannada for use among the Indian population. MATERIALS AND METHODS: The original version of TFI was translated with the help of audiologists and linguistic experts who were proficient in Kannada. The translated version was content validation by five audiologists and a cognitive debriefing by native speakers to check the familiarity of words. The final version (TFI-K) was then administered to 181 participants with tinnitus. Along with the TFI, other scales like Tinnitus Handicap Inventory (THI) were also obtained to check the convergent validity. The obtained data was then subjected to various statistical analyses like internal consistency, convergent and discriminant validity, and factor analysis. RESULTS: The TFI-K was found to have an excellent internal consistency (Cronbach's α = 0.974) and good convergent validity (p < 0.001; r = 0.778) with THI-K. A principal component analysis with varimax rotation showed communalities ranging from 0.64 to 0.91. Scree plots with the TFI-K component showed a sharp decline after the first factor and approximately four factors above the eigenvalue of 1. The factor analysis results suggest that the TFI-K has a structurally intact 8-factor loading, with a few exceptions that are discussed in detail. CONCLUSION: The TFI-K has demonstrated remarkable dependability and satisfactory integrity, making it a valuable tool for assessment and treatment planning in clinical and research settings.

Tinnitus is known to impinge multiple domains.Assessing multiple domains provides a comprehensive understanding of the impact of tinnitus.Tinnitus Functional Index (TFI) has been cross-culturally translated into Kannada.Tinnitus Functional Index in Kannada (TFI-K) is reliable and valid and can be used clinically and in research.

Association of oxidative balance score with hearing loss and tinnitus: NHANES 1999-2018.

Background: Oxidative stress is associated with the occurrence of hearing loss and tinnitus. The oxidative balance score (OBS), a composite indicator evaluating the balance between antioxidant and pro-oxidative components across various dietary and lifestyle factors, indicates the overall oxidative balance status. However, the association of OBS with hearing loss and tinnitus has not been reported previously. Methods: Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 were analyzed. Weighted multivariable logistic regression, weighted multivariable linear regression, and restricted cubic spline curve (RCS) regression were employed to explore the relationship between OBS and hearing loss at speech, low, and high frequencies, along with tinnitus. Subgroup analysis and sensitivity analysis were used to ascertain the consistency across subgroups and stability of the results. Results: We included 13,715 and 21,644 individuals to investigate the association between OBS and hearing loss, as well as between OBS and tinnitus, respectively. The second, third, and fourth quartiles of OBS were significantly associated with a lower risk of hearing loss at speech, low, and high frequencies, as well as tinnitus, compared to the lowest quartile. The RCS regression analysis indicated a negative linear association of OBS with hearing loss and tinnitus. Most associations were maintained in subgroup analysis and sensitivity analysis. Additionally, the dietary and lifestyle OBS independently contribute to the protection against hearing loss and tinnitus. Conclusion: OBS is negatively correlated with the risk of hearing loss and tinnitus. The findings suggest that combined antioxidant diet and lifestyle hold promise as potential strategies for reducing the prevalence of hearing loss and tinnitus.

Tinnitus reduction after active bone-conduction implantation in patients with single-sided deafness: a prospective multicenter study.

PURPOSE: Single-sided deafness (SSD) presents significant challenges for patients, including compromised sound localization, reduced speech recognition, and often, tinnitus. These issues are typically addressed using interventions such as cochlear implantation (CI) and bone conduction implant (BCI). However, evidence regarding the efficacy of BCI in reducing tinnitus in SSD patients remains limited. This study explored the ability of a novel active transcutaneous BCI (Bonebridge BCI602) to alleviate tinnitus in SSD patients. STUDY DESIGN: Prospective cohort multicenter study. SETTING: Tertiary referral hospitals. METHODS: A prospective multicenter study of 30 SSD patients was conducted. The patients were divided into two groups: those with (n = 19) and without (n = 11) tinnitus. Audiometric assessments, subjective questionnaires including the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Bern Benefit in Single-Sided Deafness (BBSS), and tinnitus evaluations with the Tinnitus Handicap Inventory (THI) and tinnitogram were conducted before and after BCI surgery. RESULTS: THI scores after surgery were significantly reduced in SSD patients with tinnitus. Subjective satisfaction improved in both the tinnitus and non-tinnitus groups; however, the former group exhibited a significantly greater improvement in the APHAB questionnaire score. According to tinnitograms, the loudness of tinnitus decreased, particularly in patients with ipsilateral tinnitus. Patients with residual hearing had greater reductions in their THI scores. However, three patients without residual hearing had a relative worsening of tinnitus after surgery. CONCLUSION: The Bonebridge BCI602 effectively reduced tinnitus in SSD patients, particularly in those with residual hearing. Subjective satisfaction improved in both the tinnitus and non-tinnitus groups. These findings demonstrate the therapeutic potential of BCI for managing SSD and associated tinnitus.

Children's Tinnitus Questionnaire - A novel tool for assessing the impact of tinnitus on a child's everyday life.

OBJECTIVE: Self-report instruments are commonly used in tinnitus clinics, but they are presently available only for adults. There is a lack of a validated multi-item instrument to capture tinnitus-related problems in children and their impact on everyday life. This study has developed and validated a specifically child-centered questionnaire to assess the impact of tinnitus. METHODS: Development of the tool consisted of several stages. Following a pilot study on 12 children with tinnitus, a validation study was done on a further 192 children with tinnitus aged between 11 and 14 years. The children had an audiological examination, completed a Visual Analogue Scale (VAS) and the newly framed questionnaire. RESULTS: The development and validation process resulted in the new 11-item Children's Tinnitus Questionnaire (CTQ). It includes items concerning the impact of tinnitus on functional, cognitive, emotional and social domains. The validity of the new tool has been established by finding significant correlations between it and VAS loudness (r = 0.42), VAS annoyance (r = 0.67), and VAS coping (r = -0.41). Validity has also been confirmed by measuring differences in CTQ scores and 4 groups of children having graded incidences of tinnitus. The internal consistency assessed with Cronbach's alpha was high (α = 0.82). CONCLUSION: The Children's Tinnitus Questionnaire (CTQ) is the first fully validated multi-item instrument designed specifically for children. The tool has the potential to become a valuable new instrument for use in clinical practice and research; it might be useful for assessing the impact of tinnitus on those children who find that the condition creates problems in their everyday life.

[Effects of cochlear implantation on tinnitus in patients with single-sided deafness and asymmetrical hearing loss].

Objective:To evaluate the effects of cochlear implantation in patients with single-sided deafness（SSD） and asymmetrical hearing loss（AHL）. Methods:Seventeen Mandarin-speaking CI patients diagnosed as SSD/AHL were recruited in our study. The Tinnitus Handicap Inventory（THI） and the Visual Analogue Scale（VAS） were used to assess changes in tinnitus distress and tinnitus loudness in SSD patients at each time point（pre-operation and post-operation）. Results:The THI score and all 3 dimensions were significant decreased with CI-on than pre-operation（P<0.05）. Tinnitus VAS scores were also decreased, and VAS scores were lower with CI-on than with CI-off, and were both significantly different at each time point after CI switch-on（P<0.05）. Conclusion:CI could help SSD/AHL patients to suppress tinnitus and reduce the loudness of tinnitus. However, CI should not be a treatment of tinnitus.

[Brainstem auditory evoked responses in horses with hearing loss and during general anesthesia]. / Hör- und Hirnstammfunktionsprüfung beim Pferd: Resultate bei ausgewählten klinischen Szenarien.

INTRODUCTION: The brainstem auditory evoked response (BAER) is a diagnostic approach to examine the hearing system of horses objectively. The aim of this BAER examination was the diagnosis of conductive or sensorineural hearing loss or deafness in horses with external otitis, head trauma, headshaking, tinnitus or skittish horses with eye disease. Brainstem dysfunction is induced by intracranial hypotension. BAER was used in horses with colic surgery which had a low arterial blood pressure during general anesthesia. The endoscopic finding of the guttural pouch was the ipsilateral mild to severe hypertrophy of the tympanostylohyoideum in horses with external otitis or head trauma. The otoscopic examination of standing sedated horses was done before BAER. The cartilagineous and osseous part of the external ear canal in horses with external otitis were obstructed with exsudate and tympanic membranes were not visible. Horses with right sided external otitis: right moderate to severe conductive hearing loss (significantly prolonged latencies of I, III, V and interpeak latencies I-III, I-V, III-V; thresholds of hearing levels 60 to 80 dB right); horses with left sided external otitis: left severe conductive hearing loss (no correct identification of BAER peaks, latencies not measurable, 80 dB); horse with left sided head trauma: severe left sided conductive hearing loss (blood in the left external ear canal, no visible tympanic membrane, no correct identification of BAER peaks, latencies not measurable, 80 dB); horses with head shaking: mild sensorineural hearing loss on both sides (on both sides osseous parts II/III with keratin scales of the junction, visible tympanic membranes, significantly prolonged V, I-III, I-V, 40 dB); moderate to severe skittish horses with chronic eye disease (mostly left sided equine recurrent uveitis): moderate sensorineural hearing loss on both sides (normal otoscopical findings, significantly prolonged latencies and interpeak latencies left; I-V, III-V right, 60 dB, pathological involvement in the auditory pathway of the brainstem between the cochlear nucleus and colliculus caudalis); horse with a tinnitus on both sides: mild sensorineural hearing loss on both sides (normal otoscopical findings, prolonged V, I-III, I-V, III-V, 40 dB, pathology of auditory nerve, cochlear nucleus and above the level of this nucleus); American paint horses: sensorineurale deafness on both sides (normal otoscopical findings, absent BAER peaks, isoelectric lines and 80 dB on both sides). The prolonged latencies of I, III and V including interpeak latencies I-III only left and I-V and III-V on both sides in horses with laparotomy during general anesthesia were associated with low arterial blood pressure (62 mmHg, median). These findings could demonstrate a hypotension in the brainstem too. The BAER could be a technical tool during general anesthesia for normalizing the arterial blood pressure and brainstem function to prevent imbalance of body movements after general anesthesia.

INTRODUCTION: L'examen objectif de l'audition chez le cheval est réalisé par la mesure des Potentiels Évoqués Auditifs (PEA) ou Brainstem Auditory-Evoked Response (BAER). L'objectif de ces examens est de diagnostiquer une surdité de transmission ou neurosensorielle ou une surdité chez les chevaux souffrant d'otite externe, de traumatisme crânien, de headshaking, d'acouphènes ou chez des chevaux craintifs souffrant d'une maladie oculaire. Étant donné que l'audiométrie du tronc cérébral vérifie également la fonction du tronc cérébral, des chevaux ayant subi une laparotomie et une déshydratation préopératoire ont été examinés pour détecter un dysfonctionnement du tronc cérébral dû à une baisse de la pression artérielle. L'otoscopie et l'audiométrie du tronc cérébral (système AEP Corona) ont été réalisées. Les résultats de l'otoscopie chez les chevaux atteints d'otite externe: Pars cartilaginea et ossea degré III, tympan non visible. Les résultats de l'endoscopie des poches gutturales chez les chevaux atteints d'otite externe exsudative ou de traumatisme crânien: toujours une augmentation ou une hypertrophie ipsilatérale du tympanostylohyoïdien. Les résultats de la BAER des chevaux atteints d' une otite externe à droite sont les suivants: surdité de transmission moyenne à sévère à droite (ondes I, III, V significativement prolongées, latences interpicales I-III, I-V, III-V par rapport au groupe de contrôle, valeurs limites au-dessus du seuil auditif normal 60 à 80 dB); chevaux atteints d'otite externe à gauche: surdité de transmission de haut niveau à gauche (ondes non identifiables, 80 dB à gauche); chevaux avec une fistule auriculaire à droite: surdité de perception bilatérale de bas niveau (allongement significatif des ondes III, V et des latences interpicales des deux côtés, 40 dB); cheval avec traumatisme crânien à gauche: surdité de transmission de degré élevé (à gauche, sang dans le conduit auditif externe, tympan non visible, ondes non identifiables, 80 dB); chevaux avec headshaking: surdité de perception de degré faible (des deux côtés, pars ossea de degré II, tympans visibles, allongement significatif V, I-III, I-V, 40 dB); chevaux présentant une peur et une maladie oculaire: surdité moyenne, neurosensorielle (otoscopie normale, allongement significatif de toutes les ondes et des latences interpeak à gauche, I-V, III-V à droite, 60 dB, vitesse pathologique de conduction des voies auditives dans le tronc cérébral); American Paint Horses: surdité neurosensorielle (otoscopie normale, ligne isoélectrique bilatérale des HA, 80 dB). Les ondes I, III et V prolongées et les latences interpicales I-III, I-V et III-V chez les chevaux ayant subi une laparotomie sont associées à la baisse de la pression artérielle (62 mmHg, médiane) pendant l'anesthésie générale et indiquent une hypotension dans le tronc cérébral. Pendant l'anesthésie générale, l'audiométrie du tronc cérébral offre une possibilité particulière de détecter le dysfonctionnement du tronc cérébral, de réguler la pression artérielle et de garantir un lever sans problème avec un équilibre auditif et visuel de la posture après l'anesthésie générale.

"I feel [so alone] nothing" - emotional vulnerability and detachment as transdiagnostic key characteristics of patients with chronic tinnitus: a schema mode model approach.

Background: Gold-standard approaches for chronic tinnitus involve hearing amplification measures and psychological therapy, where applicable. Whilst schema therapy is accumulating evidence as a transdiagnostically useful treatment framework, its applicability for patients with chronic tinnitus has not yet been examined. The present study (a) explores latent dimensions of psychological distress in a sample of chronic tinnitus patients, and (b) examines whether the schema mode model might explain these dimensions - thus constituting a potentially helpful conceptualization and treatment framework. Methods: N = 696 patients with chronic tinnitus completed the Tinnitus Questionnaire, Tinnitus Handicap Inventory, Hospital Anxiety and Depression Scale, Perceived Stress Questionnaire and ICD-10 Symptom Rating. As criterion, patients further completed the Schema Mode Inventory (SMI-r) - which assesses psychological constructs linked to negative self-beliefs ("parent modes"), primary emotions resulting from unmet psychological needs ("child modes"), and secondary emotional or behavioral attempts to reinstate or maintain psychological equilibrium ("coping modes"). A varimax-rotated principal axis factor analysis grouped the primary item pool. Factor scale scores were then correlated with the SMI-r. Results: A three-factor solution explained 37.4% of variance and represented 78% of the included items. Following item content examination, the factors represented (1) General emotional distress, (2) Tinnitus-attributed emotional distress, and (3) Socio-audiological impairment. Factors 1|2 correlated highly (r = 0.70), Factors 2|3 moderately (r = 0.62). Linked to the schema mode model, Factor 1 correlated highly with the "vulnerable child" (r = 0.78), and moderately with the "parent", "angry child", and "detached protector" modes (0.53 < r < 0.65). Factor 2 correlated moderately with the "vulnerable child" (r = 0.53). Factor 3 was largely uncorrelated with SMI-r scores - although a low correlation with the "detached protector" warrants further examination. Conclusion: "General" and "tinnitus-attributed" emotional distress correlate highly - warranting holistic (not symptom-specific) psychological case conceptualization and treatment planning. Viewed from a schema mode perspective, the "vulnerable child" explains substantial variance across both dimensions. Consequently, autobiographically anchored, unmet emotional needs and emotional detachment constitute key treatment targets. Social-audiological impairment should be multimodally conceptualised and treated with hearing aids and psychological support measures, as applicable.

Flow Analysis of Central Venous Outflow Tract: A New Approach to Understanding Pulse-Synchronous Tinnitus.

OBJECTIVE: Pulse-synchronous tinnitus (PST) has been linked to multiple anatomical variants of the central venous outflow tract (CVOT) including sigmoid sinus (SS) dehiscence and diverticulum. This study investigates flow turbulence, pressure, and wall shear stress along the CVOT and proposes a mechanism that results in SS dehiscence and PST. STUDY DESIGN: Case series. SETTING: Tertiary Academic Center. METHODS: Venous models were reconstructed from computed tomography scans of 3 patients with unilateral PST. Two models for each patient are obtained: a symptomatic and contralateral asymptomatic side. A turbulent model-enabled commercial flow solver was used to simulate the pulsatile blood flow over the cardiac cycle through the models. Fluid flow through the transverse and SS junction was analyzed to observe the velocity, pressure, turbulent kinetic energy (TKE), and shear stress over a simulated cardiac cycle. RESULTS: Fluid flow on the symptomatic side showed increased vorticity in the presence of an SS diverticulum. Higher TKE with periodicity following the cardiac cycle was observed on the symptomatic side, and a sharp increase was observed if SS diverticulum was present. Shear stress was highest near the narrowest segments of the vessel. Pressure was observed to be lower on the symptomatic side at the transverse-SS junction for all 3 patients. CONCLUSION: Computational fluid dynamics modeling of blood flow through the CVOT in PST suggests that low pressure may be the cause of dehiscence, and tinnitus may result from periodic increases in TKE.

Blast Exposure Associations With Hearing Loss and Self-Reported Hearing Difficulty.

OBJECTIVE: Examine associations between military blast exposures on hearing loss and self-reported hearing difficulties among Active-Duty Service Members (ADSM) and Veterans from the Noise Outcomes in Servicemembers Epidemiology (NOISE) study. STUDY DESIGN: Cross-sectional. SETTING: Multi-institutional tertiary referral centers. METHODS: Blast exposure was assessed with a comprehensive blast questionnaire. Outcome measures included pure-tone hearing thresholds; Speech Recognition in Noise Test; Hearing Handicap Inventory for Adults (HHIA); and Speech, Spatial and Qualities of Hearing Scale (SSQ)-12. RESULTS: Twenty-one percent (102/494) of ADSM and 36.8% (196/533) of Veterans self-reported blast exposure. Compared to ADSM without blast exposure, blast-exposed ADSM had increased odds of high frequency (3-8 kHz) and extended-high frequency (9-16 kHz) hearing loss (odds ratio [OR] = 2.5, CI: 1.3, 4.7; OR = 3.7, CI: 1.9, 7.0, respectively). ADSM and Veterans with blast exposure were more likely than their nonblast exposed counterparts to report hearing difficulty on the HHIA (OR = 1.9, CI: 1.1, 3.3; OR = 2.1, CI: 1.4, 3.2, respectively). Those with self-reported blast exposure also had lower SSQ-12 scores (ADSM mean difference = -0.6, CI: -1.0, -0.1; Veteran mean difference: -0.9, CI: -1.3, -0.5). CONCLUSION: Results suggest that blast exposure is a prevalent source of hearing injury in the military. We found that among ADSM, blast exposure was associated with hearing loss, predominately in the higher frequencies. Blast exposure was associated with poorer self-perceived hearing ability in ADSM and Veterans. IRB: #FWH20180143H Joint Base San Antonio (JBSA) Military Healthcare System; #3159/9495 Joint VA Portland Health Care System (VAPORHCS) Oregon Health and Science University (OHSU).

Abnormal static and dynamic brain network connectivity associated with chronic tinnitus.

In order to comprehensively understand the changes of brain networks in patients with chronic tinnitus, this study combined static and dynamic analysis methods to explore the abnormalities of brain networks. Thirty-two patients with chronic tinnitus and 30 age-, sex- and education-matched healthy controls (HC) were recruited. Independent component analysis was used to identify resting-state networks (RSNs). Static and dynamic functional network connectivity (FNC) were performed. The temporal properties of brain network including mean dwell time (MDT), fraction time (FT) and numbers of transitions (NT) were calculated. Two-sample t test and Spearman's correlation were used for group compares and correlation analysis. Four RSNs showed abnormal FNC including auditory network (AUN), default mode network (DMN), attention network (AN) and sensorimotor network (SMN). For static analysis, tinnitus patients showed significantly decreased FNC in AUN-DMN, AUN-AN, DMN-AN, and DMN-SMN than HC [p < 0.05, false discovery rate (FDR) corrected]. For dynamic analysis, tinnitus patients showed significantly decreased FNC in DMN-AN in state 3 (p < 0.05, FDR corrected). MDT in state 3 was significantly decreased in tinnitus patients (t = 2.039, P = 0.046). In the tinnitus group, the score of tinnitus functional index (TFI) was negatively correlated with MDT and FT in state 4, and the duration of tinnitus was positively correlated with FT in state 1 and NT. Chronic tinnitus causes abnormal brain network connectivity. These abnormal brain networks help to clarify the mechanism of tinnitus generation and chronicity, and provide a potential basis for the treatment of tinnitus.

Impact of emotional states on tinnitus sound therapy efficacy based on ECG signals and emotion recognition model.

BACKGROUND: Diagnosis and severity assessment of tinnitus are mostly based on the patient's descriptions and subjective questionnaires, which lacks objective means of diagnosis and assessment bases, the accuracy of which fluctuates with the clarity of the patient's description. This complicates the timely modification of treatment strategies or therapeutic music to improve treatment efficacy. NEW METHOD: We employed a novel random convolutional kernel-based method for electrocardiogram (ECG) signal analysis to identify patients' emotional states during Music Tinnitus Sound Therapy (Music-TST) sessions. Then analyzed correlations between emotional changes in different treatment phase and Tinnitus Handicap Inventory (THI) score differences to determine the impact of emotions on tinnitus treatment efficacy. RESULTS: This study revealed a significant correlation between patients' emotion changes during Music-TST and the therapy's effectiveness. Changes in arousal and dominance dimension, were strongly linked to THI variations. These findings highlight the substantial impact of emotional responses on sound therapy's efficacy, offering a new perspective for understanding and optimizing tinnitus treatment. COMPARISON WITH EXISTING METHODS: Compared to existing methods, we proposed an objective indicator to assess the progress of sound therapy, the indicator could also be used to provide feedback to optimize sound therapy music. CONCLUSIONS: This study revealed the critical role of emotion changes in tinnitus sound therapy. By integrating objective ECG-based emotion analysis with traditional subjective scale like THI, we present an innovative approach to assess and potentially optimize therapy effectiveness. This finding could lead to more personalized and effective treatment strategies for tinnitus sound therapy.

Tinnitus update: what can be done for the ringing?

Physicians will frequently encounter patients who report tinnitus. Tinnitus is a symptom whereby there is the perception of sound or sounds in the ear or head in the absence of an external source of sound. Most individuals experiencing tinnitus will have a neutral reaction to the percept, but in a small proportion of patients, tinnitus can be a debilitating symptom. When it causes burden, patients can be affected in multiple different facets of life, including impairment in sleep, hearing cognition and psychological and psychiatric well-being, often resulting in high healthcare utilisation and societal costs. Hence, chronic, disabling tinnitus is a complex condition with multifactorial causes and multiple perpetuating biopsychosocial factors. Despite efforts to increase knowledge about its pathophysiology and research into treatments, little impact on real-world clinical practice has been seen. There are no proven effective pharmacological treatments or complementary medicines specifically for chronic, disabling tinnitus. Despite this, there is a role for treating this condition through a multidisciplinary approach specifically targeting comorbid active psychiatric conditions, using hearing aids in appropriate clinical settings such as in those with a coassociated confirmed hearing loss, and specialised cognitive behavioural therapy for patients reporting bothersome tinnitus. Cognitive behavioural therapy remains the most valuable evidence-based intervention in this regard. This narrative review attempts to summarise the current understanding in terms of pathophysiology, assessment and treatment of tinnitus for the internal physician who may encounter patients with disabling, chronic tinnitus.

Consecutive Dual-Session Transcranial Direct Current Stimulation in Chronic Subjective Severe to Catastrophic Tinnitus with Normal Hearing.

Transcranial direct current stimulation (tDCS) is emerging as a promising non-invasive intervention for tinnitus by aiming to modulate abnormal brain activity. This study investigated the efficacy of dual-session tDCS for the relief of perception, distress, and loudness in patients with severe chronic subjective tinnitus and assessed the duration of tinnitus suppression effects compared to single-session and control groups over a 2-month follow-up. In a prospective, randomized, single-blind, placebo-controlled trial, 30 participants with severe chronic subjective tinnitus underwent bifrontal tDCS. The control group (n = 9), single-session group (n = 10), and dual-session group (n = 11) received 2 mA stimulation for 20 min per session, twice a week for one month. The treatment response was monitored weekly using the Visual Analogue Scale (VAS), with additional assessments using the Tinnitus Handicap Inventory (THI) and Beck Depression Inventory (BDI) at the fourth and eighth weeks. The single- and dual-session groups showed statistically significant improvements in VAS, THI, and BDI scores compared to the control group. THI and BDI scores showed a significant difference between the single- and dual-session groups. The dual-session group demonstrated a more sustained tinnitus suppression effect than the single-session group. tDCS has been validated as an effective intervention for the suppression of tinnitus, with the dual-session protocol showing longer-term benefits. These findings support the potential of tDCS as a treatment for tinnitus, particularly in dual-session applications.

The Effect of Physical Therapy on Somatosensory Tinnitus.

Objective: The objective of this work was to assess the effect of physical therapy in patients with somatosensory tinnitus (ST) and explore the influence of physical therapy on clinical variables obtained before treatment. Methods: A total of 43 patients with ST were randomized to the immediate-start group (n = 20) and delayed-start group (n = 23). All patients received physical therapy for 1 week (seven sessions). Each session lasted 60 min. The Visual Analogue Scale (VAS), Tinnitus Handicap Inventory (THI), and numerical pain rating scale (NPRS) scores were documented at baseline and after treatment (week 1) for all patients. For subjects in the immediate-start group, the THI, VAS, and NPRS scores were measured after therapy (weeks 6, 9, and 12, respectively). Medical history characteristic functional activity scale (HCFA) scores were measured at baseline to assess the association between somatic symptoms and tinnitus. Results: At week 1, VAS, THI, and NPRS scores of patients in the immediate-start group were improved by 1.25 ± 1.59, 11.10 ± 15.10, and 0.95 ± 1.54 points, respectively, and were significantly higher than those in the delayed-start group (p < 0.05). The change in VAS, THI, and NPRS scores in the treatment group was significantly positively correlated with the scores of the HCFA before treatment (r = 0.786, p < 0.001; r = 0.680, p = 0.001; r = 0.796, p < 0.001). There was no significant difference in THI, VAS, and NPRS scores among patients in the immediate-start group between weeks 1, 6, 9, and 12 after treatment (p > 0.05). Conclusions: Although more participants were necessary in the further study, the study implies that physical therapy can reduce physical pain, improve tinnitus symptoms, and quality of life in ST patients without hearing loss, and the short-term curative effect is stable, especially for tinnitus patients with clear somatic symptoms.

Correlation between hearing loss and mild cognitive impairment in the elderly population: Mendelian randomization and cross-sectional study.

Background: Hearing loss and tinnitus have been linked to mild cognitive impairment (MCI); however, the evidence is constrained by ethical and temporal constraints, and few prospective studies have definitively established causation. This study aims to utilize Mendelian randomization (MR) and cross-sectional studies to validate and analyze this association. Methods: This study employs a two-step approach. Initially, the genetic data of the European population from the Genome-wide association studies (GWAS) database is utilized to establish the causal relationship between hearing loss and cognitive impairment through Mendelian randomization using the inverse variance weighted (IVW) method. This is achieved by identifying strongly correlated single nucleotide polymorphisms (SNPs), eliminating linkage disequilibrium, and excluding weak instrumental variables. In the second step, 363 elderly individuals from 10 communities in Qingdao, China are assessed and examined using methods questionnaire survey and pure tone audiology (PTA). Logistic regression and multiple linear regression were used to analyze the risk factors of MCI in the elderly and to calculate the cutoff values. Results: Mendelian randomization studies have shown that hearing loss is a risk factor for MCI in European populations, with a risk ratio of hearing loss to MCI loss of 1. 23. The findings of this cross-sectional study indicate that age, tinnitus, and hearing loss emerged as significant risk factors for MCI in univariate logistic regression analysis. Furthermore, multivariate logistic regression analysis identified hearing loss and tinnitus as potential risk factors for MCI. Consistent results were observed in multiple linear regression analysis, revealing that hearing loss and age significantly influenced the development of MCI. Additionally, a notable finding was that the likelihood of MCI occurrence increased by 9% when the hearing threshold exceeded 20 decibels. Conclusion: This study provides evidence from genomic and epidemiological investigations indicating that hearing loss may serve as a risk factor for cognitive impairment. While our epidemiological study has found both hearing loss and tinnitus as potential risk factors for cognitive decline, additional research is required to establish a causal relationship, particularly given that tinnitus can manifest as a symptom of various underlying medical conditions.

The effect of cochlear implantation on tinnitus in patients with post lingual bilateral profound hearing loss.

INTRODUCTION: In this study we investigated the effect of cochlear implantation on tinnitus in patients with post lingual bilateral profound hearing loss. METHODS: In this retrospective study, 66 post-lingual deaf patients over 18 years old who referred for cochlear implantation and complained of tinnitus were included. Patients were divided into two groups with residual hearing (in frequency 250-500 Hz) and without residual hearing. All data including age, gender, type of implants, type of surgery, cause of the disease, and information on the THI score before cochlear implantation, one month after cochlear implantation and one year after cochlear implantation was recorded and analyzed. RESULTS: Nine patients had residual hearing, while 57 patients did not. After one month and one year, in both groups, the mean THI score has decreased significantly (p-value = 0.001), but there was no significant difference in the mean THI score before surgery and one month and one year after surgery between two groups with and without residual hearing. There was no significant difference in tinnitus severity according to THI-grade between two groups. Also there was no significant difference in THI score and the cause of the hearing loss, type and insertion method of implantation, one month and one year after the surgery between two groups. CONCLUSION: According to our results, the was no significant correlation between residual hearing and tinnitus score before surgery, one month and one year after the surgery.

Symptoms and Factors Associated With Eustachian Tube Dysfunction Among the Population of Qassim, Saudi Arabia.

Introduction The Eustachian tube regulates middle ear functions such as ventilation and pressure normalization. Eustachian tube dysfunction (ETD) is defined as the failure of the Eustachian tube to maintain one or more of its functions. It is a common condition that is associated with other middle ear disorders such as cholesteatoma, tympanic membrane atelectasis, and otitis media with effusion (OME). This study aims to assess ETD prevalence and risk factors in the Qassim region. Methodology This cross-sectional study was conducted in the Qassim region of Saudi Arabia during the period from September 20 to October 10, 2023. Data were gathered via a validated, self-administered electronic questionnaire that encompasses socio-demographic information, the prevalence of ETD, and the prevalence of its various symptoms, as assessed by the Eustachian Tube Dysfunction Questionnaire (ETDQ-7). Results Our study in Qassim, Saudi Arabia, with 467 participants reveals a high prevalence of ETD at 12.2%. The 18-25 age group dominates (50.1%), with a majority of females (66.2%). Symptom analysis using the ETDQ-7 questionnaire shows varied prevalence, with severe pain (7%) and muffled hearing (29.8%) notable. Logistic regression identifies significant predictors, including hearing loss history (odds ratio = 28.2) and smoking (odds ratio = 3.70). Specific symptoms, such as feeling blocked or underwater, significantly correlate with more severe ETD symptoms (odds ratio = 1.73). Conclusion Our study highlights a notable prevalence of ETD. Significant predictors, including hearing loss history and smoking, were identified. Specific symptoms, such as feeling blocked or underwater, were associated with more severe ETD symptoms.

Explainable AI Method for Tinnitus Diagnosis via Neighbor-Augmented Knowledge Graph and Traditional Chinese Medicine: Development and Validation Study.

BACKGROUND: Tinnitus diagnosis poses a challenge in otolaryngology owing to an extremely complex pathogenesis, lack of effective objectification methods, and factor-affected diagnosis. There is currently a lack of explainable auxiliary diagnostic tools for tinnitus in clinical practice. OBJECTIVE: This study aims to develop a diagnostic model using an explainable artificial intelligence (AI) method to address the issue of low accuracy in tinnitus diagnosis. METHODS: In this study, a knowledge graph-based tinnitus diagnostic method was developed by combining clinical medical knowledge with electronic medical records. Electronic medical record data from 1267 patients were integrated with traditional Chinese clinical medical knowledge to construct a tinnitus knowledge graph. Subsequently, weights were introduced, which measured patient similarity in the knowledge graph based on mutual information values. Finally, a collaborative neighbor algorithm was proposed, which scored patient similarity to obtain the recommended diagnosis. We conducted 2 group experiments and 1 case derivation to explore the effectiveness of our models and compared the models with state-of-the-art graph algorithms and other explainable machine learning models. RESULTS: The experimental results indicate that the method achieved 99.4% accuracy, 98.5% sensitivity, 99.6% specificity, 98.7% precision, 98.6% F1-score, and 99% area under the receiver operating characteristic curve for the inference of 5 tinnitus subtypes among 253 test patients. Additionally, it demonstrated good interpretability. The topological structure of knowledge graphs provides transparency that can explain the reasons for the similarity between patients. CONCLUSIONS: This method provides doctors with a reliable and explainable diagnostic tool that is expected to improve tinnitus diagnosis accuracy.