A global bibliometric analysis on the relationship between tinnitus and temporomandibular disorders.

BACKGROUND AND OBJECTIVES: This global bibliometric review aimed to investigate trends in publications relating to tinnitus and TMD. METHODS: A search was performed in eight databases (June/2022), by independent researchers with relevant keywords about tinnitus and TMD, without restriction of date or language. Original research or case report/series evaluating prevalence, association and risk related to tinnitus and TMD were included. Independent examiners selected studies by title and abstract and performed data extraction. Data about publication and researchers, study population, objective, study design and diagnostic criteria for tinnitus and TMD were exported to VintagePoint® for bibliometric analyses. Data about the direct association between tinnitus and TMD were extracted. RESULTS: One hundred and seventeen articles from 25 countries were included, most observational (68.4%) and evaluating association (N = 60; 44.8%). Among the 60 studies of association, 22 (36.6%) presented results of a direct association between the presence/absence of tinnitus and the presence/absence of TMD. Brazil (19.5%) and the United States (12.7%) were the countries with the most publications, and Dentistry (48.6%) was the main publication area. A growth in publications in Dentistry was observed in the past 30 years and in the past 10 years in Medicine. Half of the studies included the elderly population (50.2%). The main diagnostic criterion for both tinnitus (37.8%) and TMD (28%) was general questionnaires and/or self-report. CONCLUSION: There is a growing trend in publications relating to tinnitus and TMD, especially in Dentistry, with a predominance of observational and association studies in the elderly population using questionnaires and/or self-report. More research with robust diagnostic methods and other study designs should be encouraged in the future.

Ten Years Follow Up of Patients with Tinnitus and Normal Hearing.

OBJECTIVE: To describe the natural history of tinnitus in normal hearing patients. STUDY DESIGN: This is a prospective longitudinal observational study. SETTING: Tertiary University Hospital. METHODS: In 2009 we studied 68 patients with significant tinnitus and normal hearing (Study Group-SG) compared to 46 patients with normal hearing and no tinnitus (Control Group-CG). We have been able to contact and recruit 24 patients from SG (35.3 %) and ten patients from CG) (21.74%) in 2019. Both groups were submitted to conventional audiometry, Distortion Product Otoacoustic Emissions (DPOAE), Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS) and Beck`S Depression and Anxiety Scales (BDS, BAS). These measures were compared with the same ones performed ten years ago in the same groups of patients. The software SPSS for windows version 21 was used. P values <0.05 were considered significant. Student t test was used to compare SG and CG results in 2019 and to compare 2009 and 2019 outcomes.. RESULTS: Hearing loss, especially in the higher frequencies, were significantly worse in SG compared to GC in 2019. DPOAE were significantly worse in SG and CG in 2019 however CG had more abnormal results than SG. These results suggest that outer hair cells lesions are not the only determinant for tinnitus and hearing loss development. CONCLUSIONS: These results suggest that outer hair cells lesions are not the only determinant for tinnitus and hearing loss development.

COVID-19, pandemia y acúfeno / COVID-19, pandemic and tinnitus

El acúfeno es un síntoma que puede presentarse aislado o en diferentes patologías. Se describe como la percepción de un sonido o percepción auditiva fantasma no producida por una vibración o estímulo acústico externo, que es inaudible para el entorno. La COVID-19 causada por el virus SARS-CoV-2, es una enfermedad que ha mostrado diversidad en su expresión, severidad, síntomas y secuelas. El acúfeno es una condición relacionada con el sistema auditivo que ha sido estudiada durante la pandemia por COVID-19 y se ha podido observar un incremento en la incidencia y/o exacerbación de la percepción de este síntoma, en donde se involucran múltiples factores que se vuelven importantes de considerar.

Tinnitus is a symptom that can occur in isolation or in different pathologies. It is described as the perception of a sound, or as a phantom auditory perception that is not produced by a vibration or external acoustic stimulus, which is inaudible to the environment. COVID-19 caused by the SARS-CoV-2 virus, is a disease that has shown diversity in its expression, severity, symptoms and sequelae. Tinnitus is a condition related to the auditory system that has been studied during the COVID-19 pandemic, and an increase in the incidence and/or exacerbation of the perception of this symptom has been observed, involving multiple factors that become important to consider.

Association between headache and tinnitus among medical students.

BACKGROUND: Headache is a very common complaint and it is increasingly prevalent among university students. Tinnitus consists of subjectively perceived sounds that occur in the absence of an external auditory signal. Presence of headache and tinnitus in association has implications for therapy and prognosis, because this describes the temporality of the symptoms. Recognition of the epidemiological profile of symptomatic students might contribute to interventions. OBJECTIVE: To investigate the prevalence of the association between headache and tinnitus, and to describe the epidemiological profile of the study population and the chronological order of appearance of these symptoms. METHODS: Cross-sectional, observational and analytical study on a sample representative of an academic center. Data referring to the epidemiological and clinical profile of headache and tinnitus among medical students were collected through an online questionnaire built using the Google Forms tool. RESULTS: Out of the 234 participants, 26.1% reported having tinnitus and headache (p < 0.001). The participants with headache were more likely to be women (p = 0.045), white (p = 0.009) and 21-25 years old (p = 0.356). Among right-sided, left-sided and non-unilateral headaches, tinnitus was present predominantly in the non-unilateral type, but without statistical significance. Regarding timing, 18.0% of the students said that tinnitus started before headache, 57.4% said that headache started before tinnitus and 24.6% said that they started simultaneously. CONCLUSIONS: An important association between headache and tinnitus regarding lateralization and temporality was demonstrated. Thus, these data match the presumption that headache and tinnitus have a physiopathological connection.

Association between headache and tinnitus among medical students / Associação entre cefaleia e zumbido em acadêmicos de medicina

ABSTRACT Background: Headache is a very common complaint and it is increasingly prevalent among university students. Tinnitus consists of subjectively perceived sounds that occur in the absence of an external auditory signal. Presence of headache and tinnitus in association has implications for therapy and prognosis, because this describes the temporality of the symptoms. Recognition of the epidemiological profile of symptomatic students might contribute to interventions. Objective: To investigate the prevalence of the association between headache and tinnitus, and to describe the epidemiological profile of the study population and the chronological order of appearance of these symptoms. Methods: Cross-sectional, observational and analytical study on a sample representative of an academic center. Data referring to the epidemiological and clinical profile of headache and tinnitus among medical students were collected through an online questionnaire built using the Google Forms tool. Results: Out of the 234 participants, 26.1% reported having tinnitus and headache (p < 0.001). The participants with headache were more likely to be women (p = 0.045), white (p = 0.009) and 21-25 years old (p = 0.356). Among right-sided, left-sided and non-unilateral headaches, tinnitus was present predominantly in the non-unilateral type, but without statistical significance. Regarding timing, 18.0% of the students said that tinnitus started before headache, 57.4% said that headache started before tinnitus and 24.6% said that they started simultaneously. Conclusions: An important association between headache and tinnitus regarding lateralization and temporality was demonstrated. Thus, these data match the presumption that headache and tinnitus have a physiopathological connection.

RESUMO Antecedentes: A cefaleia é uma queixa muito frequente e a prevalência em estudantes universitários vem sendo cada vez mais comum. Os zumbidos constituem percepções subjetivas de sons que acontecem na ausência de um sinal auditivo externo ou não. A correlação desses sintomas é importante para fins terapêuticos e prognóstico, pois descrever a temporalidade dos sintomas e conhecer o perfil epidemiológico dos estudantes sintomáticos pode contribuir com intervenções. Objetivo: Investigar a prevalência da relação da cefaleia e zumbido, descrever o perfil epidemiológico da população estudada e a ordem temporal do aparecimento desses dois sintomas. Métodos: Estudo de corte transversal, observacional e analítico representativo de um centro acadêmico. Foram coletados dados referentes ao perfil epidemiológico e clínico da cefaleia e zumbido entre acadêmicos de Medicina, por meio de um questionário online construído na ferramenta Google Forms. Resultados: Dos 234 participantes, 26,1% relataram a presença de zumbido e cefaleia. Os participantes com cefaleia apresentaram maior probabilidade de serem mulheres, da raça branca e ter entre 21-25 anos. Dentre as cefaleias sem unilateralidade, as localizadas à direita e as localizadas à esquerda, o zumbido predominou no tipo sem unilateralidade, entretanto sem significância estatística. Observou-se que 18,0% dos acadêmicos relataram o início do zumbido antes da cefaleia, 57,4% relataram o início da cefaleia antes do zumbido, e 24,6% início simultâneo. Conclusões: Foi demonstrada uma importante relação entre cefaleia e zumbido acerca da lateralidade e temporalidade. Assim, esses dados se encaixam na presunção de que a cefaleia e o zumbido possuem uma ligação fisiopatológica.

Profile and prevalence of people with tinnitus: a health survey. / Perfil e prevalência de pessoas com zumbido: inquérito em serviço de saúde.

PURPOSE: To estimate the prevalence and characterize the health profile, and tinnitus complaint, of the adult population of a health district in Campinas, in the State of São Paulo. METHODS: A in-service survey was conducted in all health centers in the district with a random approach to the adult population seeking care at the unit. The sample consisted of 1,720 people, including 1,569 subjects who agreed to participate in the survey and answered a questionnaire including questions on general health and tinnitus. Two regression models were performed according to the variables and a 5% significance level was was adopted for the statistical analysis. RESULTS: 496 people reported tinnitus, representing a prevalence of 31.6%. Most of the sample was female, had at least one chronic disease and made continuous use of some medication. Respondents reported hearing complaints and the most common type of tinnitus was reported as unilateral, intermittent and acute. The regression models performed showed a higher chance of tinnitus with advancing age and with the occurrence of diabetes and thyroid disorder. CONCLUSION: Tinnitus is related to the occurrence of chronic diseases and advancing age, may cause discomfort and is a reason for seeking treatment. Further population studies are required in different contexts in the Brazilian scenario.

OBJETIVO: Estimar a prevalência e caracterizar o perfil de saúde, e a queixa de zumbido, da população adulta de um distrito de saúde do município de Campinas, no estado de São Paulo. MÉTODO: Foi realizado um inquérito em serviço em todos os centros de saúde do distrito com abordagem aleatória da população adulta que entrasse na unidade. A amostra contou com 1.720 pessoas, sendo que 1.569 concordaram em participar da pesquisa e responderam a um questionário contendo perguntas de saúde em geral e sobre zumbido. Para a análise estatística, foram realizados dois modelos de regressão de acordo com as variáveis e o nível de significância considerado foi igual a 5%. RESULTADOS: 496 pessoas referiram queixa de zumbido, configurando uma prevalência de 31,6%. A maioria da amostra pertence ao gênero feminino, tem pelo menos uma doença crônica e faz uso contínuo de alguma medicação. Os entrevistados relataram queixa auditiva e o zumbido mais referido foi unilateral, intermitente e agudo. Nos modelos de regressão realizados, observou-se maior chance de zumbido com o avançar da idade e com a ocorrência de diabetes e alteração de tireoide. CONCLUSÃO: O zumbido apresenta relação com a ocorrência de doenças crônicas e o avançar da idade, tem potencial de gerar incômodo para o indivíduo e é motivo para a busca por tratamento nos serviços de saúde. São necessários mais estudos populacionais em diferentes contextos no cenário brasileiro.

Self-Reported Hearing Loss and Associated Factors in Older Adults at a Memory Clinic.

Purpose The prevalence of dementia has increased in recent years and, along with hearing loss, can negatively impact the health of older adults. The purpose of this retrospective cross-sectional study was to establish self-reported hearing loss and associated factors in older adults at a memory clinic. Method Researchers conducted a retrospective cross-sectional study on factors associated with self-reported hearing loss (i.e., lifestyle, general health, cognition, functional capacity). Data were taken from medical records of older adults (≥ 60 years old) who received care between 2017 and 2018 at a memory clinic located at the Southern Santa Catarina University in Brazil. Analysis included the Pearson chi-squared test and logistic regression, estimation of the crude and adjusted odds ratios (OR), with respective confidence intervals of 95%. Results Researchers analyzed the medical records of 257 older adults and verified a prevalence of 13.2% of these adults with self-reported hearing loss. There was a higher prevalence of the outcome (i.e., self-reported hearing loss) in older adults who reported tinnitus (35.2%), those with mild cognitive impairment (14.7%), and those who were sedentary (19.2%). After adjustment for confusion factors, tinnitus (OR = 4.63; p = .019) and sedentarism (OR = 2.89; p = .029) were still associated with the outcome. Conclusions Tinnitus and sedentarism were associated with hearing loss in older adults receiving care at a memory clinic. As a public health issue, presbycusis needs to be included in the health planning and health promotion agendas, with effective control, prevention, and treatment measures.

Hearing loss, tinnitus, and hypertension: analysis of the baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

OBJECTIVES: To investigate the association among hypertension, tinnitus, and sensorineural hearing loss and evaluate the influence of other covariates on this association. METHODS: Baseline data (2008-2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were analyzed. Altogether, 900 participants were evaluated. The baseline assessment consisted of a 7-hour examination to obtain clinical and laboratory variables. Hearing was measured using pure-tone audiometry. RESULTS: Overall, 33.3% of the participants had hypertension. Participants with hypertension were more likely to be older, male, and diabetic compared to those without hypertension. The prevalence of tinnitus was higher among hypertensive participants and the odds ratio for tinnitus was higher in participants with hypertension than in those without hypertension. However, the difference was not significant after adjusting for age. Audiometric results at 250-8,000 Hz were worse in participants with hypertension than in those without hypertension in the crude analysis; however, the differences were not significant after adjustment for age, sex, diagnosis of diabetes, and exposure to noise. No significant difference was observed in hearing thresholds among participants having hypertension for <6 years, those having hypertension for ≥6 years, and individuals without hypertension. CONCLUSION: Hearing thresholds were worse in participants with hypertension. However, after adjusting for age, sex, diagnosis of diabetes, and exposure to noise, no significant differences were observed between participants with and without hypertension. A higher prevalence of tinnitus was observed in participants with hypertension compared to those without hypertension, but without significance after adjusting for age.

Provider Documentation of Tinnitus in Childhood Cancer Survivors.

Tinnitus is a known complication of treatment for childhood cancer and potentially reduces the quality of life for childhood cancer survivors (CCS). Although current guidelines recommend annual surveillance in CCS at risk for tinnitus, current screening practices among pediatric oncology survivorship providers are unknown. The authors performed a retrospective cohort study to assess the adequacy of current tinnitus screening in survivorship care. The 5.6% prevalence of tinnitus reported by the Childhood Cancer Survivorship Study, the largest ongoing follow-up cohort of CCS, served as the baseline for comparison for our rate of documented positive screening for tinnitus. Survivorship providers identified tinnitus in 3 of 624 (0.48%) eligible CCS, which was significantly lower than the prevalence in the Childhood Cancer Survivorship Study (P<0.0001). Survivorship providers documented any screening for tinnitus (positive or negative) in 15 of 624 (2.4%) CCS. Screening practices significantly differed by ototoxic exposure history and age at follow-up. This study demonstrates that screening and detection of tinnitus are underdocumented by survivorship providers, raising concern for inadequate screening practices. Improved screening may facilitate the recognition and treatment of this late effect, improving the quality of life for CCS.

Tinnitus in Fibromyalgia.

OBJECTIVE: To assess the impact of tinnitus in fibromyalgia. METHODS: A quantitative controlled study was carried out. The 25-item Tinnitus Handicap Inventory (THI) and the Revised Fibromyalgia Impact Questionnaire (FIQR) were administered to 27 patients who fulfilled the revised diagnostic criteria for fibromyalgia of the American College of Rheumatology and to 26 healthy controls who had no history of suffering from fibromyalgia or any other rheumatological or neurological illness. RESULTS: The two groups were matched for age, sex and ethnicity. The fibromyalgia patients were significantly more likely to suffer from tinnitus than the controls: 16 (59.3%) of the patients suffered from tinnitus, compared with two (7.7%) of the controls (p < 0.001). The median (interquartile range) total THI score for the fibromyalgia group was 6 (44), which was significantly higher than that of 0 (0) for the control group (p < 0.001). The fibromyalgia group scored significantly higher than the control group for 24 of the 25 THI items. The total THI score across all subjects was positively correlated with the FIQR scores (rs = 0.408, p = 0.002). CONCLUSION: Fibromyalgia is associated with a relatively high prevalence of tinnitus.

Perfil e prevalência de pessoas com zumbido: inquérito em serviço de saúde / Profile and prevalence of people with tinnitus: a health survey

RESUMO Objetivo Estimar a prevalência e caracterizar o perfil de saúde, e a queixa de zumbido, da população adulta de um distrito de saúde do município de Campinas, no estado de São Paulo. Método Foi realizado um inquérito em serviço em todos os centros de saúde do distrito com abordagem aleatória da população adulta que entrasse na unidade. A amostra contou com 1.720 pessoas, sendo que 1.569 concordaram em participar da pesquisa e responderam a um questionário contendo perguntas de saúde em geral e sobre zumbido. Para a análise estatística, foram realizados dois modelos de regressão de acordo com as variáveis e o nível de significância considerado foi igual a 5%. Resultados 496 pessoas referiram queixa de zumbido, configurando uma prevalência de 31,6%. A maioria da amostra pertence ao gênero feminino, tem pelo menos uma doença crônica e faz uso contínuo de alguma medicação. Os entrevistados relataram queixa auditiva e o zumbido mais referido foi unilateral, intermitente e agudo. Nos modelos de regressão realizados, observou-se maior chance de zumbido com o avançar da idade e com a ocorrência de diabetes e alteração de tireoide. Conclusão O zumbido apresenta relação com a ocorrência de doenças crônicas e o avançar da idade, tem potencial de gerar incômodo para o indivíduo e é motivo para a busca por tratamento nos serviços de saúde. São necessários mais estudos populacionais em diferentes contextos no cenário brasileiro.

Abstract: Purpose To estimate the prevalence and characterize the health profile, and tinnitus complaint, of the adult population of a health district in Campinas, in the State of São Paulo. Methods A in-service survey was conducted in all health centers in the district with a random approach to the adult population seeking care at the unit. The sample consisted of 1,720 people, including 1,569 subjects who agreed to participate in the survey and answered a questionnaire including questions on general health and tinnitus. Two regression models were performed according to the variables and a 5% significance level was was adopted for the statistical analysis. Results 496 people reported tinnitus, representing a prevalence of 31.6%. Most of the sample was female, had at least one chronic disease and made continuous use of some medication. Respondents reported hearing complaints and the most common type of tinnitus was reported as unilateral, intermittent and acute. The regression models performed showed a higher chance of tinnitus with advancing age and with the occurrence of diabetes and thyroid disorder. Conclusion Tinnitus is related to the occurrence of chronic diseases and advancing age, may cause discomfort and is a reason for seeking treatment. Further population studies are required in different contexts in the Brazilian scenario.

Hearing loss, tinnitus, and hypertension: analysis of the baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

OBJECTIVES: To investigate the association among hypertension, tinnitus, and sensorineural hearing loss and evaluate the influence of other covariates on this association. METHODS: Baseline data (2008-2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were analyzed. Altogether, 900 participants were evaluated. The baseline assessment consisted of a 7-hour examination to obtain clinical and laboratory variables. Hearing was measured using pure-tone audiometry. RESULTS: Overall, 33.3% of the participants had hypertension. Participants with hypertension were more likely to be older, male, and diabetic compared to those without hypertension. The prevalence of tinnitus was higher among hypertensive participants and the odds ratio for tinnitus was higher in participants with hypertension than in those without hypertension. However, the difference was not significant after adjusting for age. Audiometric results at 250-8,000 Hz were worse in participants with hypertension than in those without hypertension in the crude analysis; however, the differences were not significant after adjustment for age, sex, diagnosis of diabetes, and exposure to noise. No significant difference was observed in hearing thresholds among participants having hypertension for <6 years, those having hypertension for ≥6 years, and individuals without hypertension. CONCLUSION: Hearing thresholds were worse in participants with hypertension. However, after adjusting for age, sex, diagnosis of diabetes, and exposure to noise, no significant differences were observed between participants with and without hypertension. A higher prevalence of tinnitus was observed in participants with hypertension compared to those without hypertension, but without significance after adjusting for age.

Caracterización clínica y sociodemográfica de los pacientes con tinnitus en un centro especializado de Medellín / Clinical and sociodemographic characteristics of patients with tinnitus at specialized unit in Medellín

Resumen Introducción: teniendo en cuenta la repercusión del tinnitus en la calidad de vida de los pacientes, el objetivo de este estudio es conocer las características específicas clínicas y sociodemográficas de los pacientes que asistieron ambulatoriamente a la unidad especializada de tinnitus de la Clínica Orlant, ubicada en la ciudad de Medellín, Colombia. Comprender las peculiaridades de los pacientes con acúfenos constituye un enfoque para proponer medidas de prevención y tratamiento dirigido, siendo este el primer estudio con estas características que se realiza en Colombia. Materiales y métodos: estudio retrospectivo de pacientes referidos por primera vez a la consulta especializada de tinnitus en el centro de especialistas en Otorrinolaringología y Otología, Clínica Orlant, en un año. Se obtuvo información demográfica y se recopilaron datos de las historias clínicas. Resultados: se incluyeron 61 pacientes, cuya edad media fue de 52,5 años. El 54,1 % presentó tinnitus bilateral, el 78,7 % refirió tono agudo y el 59 % intensidad moderada. Entre los síntomas asociados, el 67,2 % refirió sensación de giro y el 80,3 % desequilibrio o inestabilidad. El 23 % tenía hipertensión arterial, 5 pacientes recibieron ototóxicos, el 34,4 % tuvo exposición crónica al ruido y el 8,2 % hipoacusia súbita. El 21,3 % tenía diagnóstico de trastorno psiquiátrico. El 65,5 % diagnóstico de hipoacusia, el 52,5 % bilateral y el 54,1 % de tipo neurosensorial Conclusión: las características del tinnitus más comunes fueron la presentación bilateral, duración mayor de tres meses, tonalidad aguda y de intensidad moderada. Se encontró una representación similar de algunas características en la población de otras áreas geográficas.

Audiological Evaluation of Patients With Somatosensory Tinnitus Attributed to Temporomandibular Disorders.

Purpose Tinnitus and temporomandibular disorders have already been associated in the literature, but despite many studies, it is still an intriguing discussion point. This study aimed to evaluate the prevalence of hearing loss among somatosensory tinnitus patients with temporomandibular disorders and to assess the influence of tinnitus on patients' quality of life. Method An otolaryngologist examined 585 patients in order to detect and evaluate the presence of tinnitus. Subjects were evaluated using the Portuguese version of the Research Diagnostic Criteria for Temporomandibular Disorders. An analysis of the somatic component of tinnitus was performed. Tinnitus was rated according to its onset (at least 6 months) and intensity with a visual analog scale. The sample was composed of 100 patients with somatosensory tinnitus divided into two groups: Group 1 (with temporomandibular disorder, n = 85) and Group 2 (without temporomandibular disorder, n = 15). The audiological evaluation was composed of pure-tone audiometry, high-frequency audiometry, tympanometry, and transient-evoked otoacoustic emissions. The impact of tinnitus on quality of life was assessed by the Tinnitus Handicap Inventory adapted and validated to Portuguese language. Results Pure-tone audiometry did not differ with statistical significance between groups (p = .29), neither did the high-frequency audiometry results (p = .74). Tinnitus Handicap Inventory scores also did not show any differences between Groups 1 and 2 (p = .67). Conclusions Subjects with somatosensory tinnitus, who also have temporomandibular disorders, do not seem to have hearing impairment. Also, they do not have a higher quality of life handicap when compared to those without tinnitus and temporomandibular disorder.

Etiología del acúfeno pulsátil. Caso clínico / Etiology of pulsatile tinnitus. Case report

Resumen El acúfeno es un síntoma relativamente frecuente en una consulta de otorrinolaringología. Se han descrito interacciones en las células ciliadas externas o internas, desequilibrios en el balance de las fibras aferentes y fenómenos de reorganización cortical tras lesiones periféricas que están involucrados en un 90%-95% de las causas del acúfeno. El restante 5%-10% está constituido por un tipo de acúfenos llamados objetivos, que no comparten estos mecanismos fisiopatológicos, sino que se originan en alguna estructura del organismo generalmente ajena a la vía auditiva y estimulan el aparato auditivo igual que lo haría un sonido del exterior. Presentamos el caso de un varón de 52 años remitido al Servicio de Otorrinolaringología de nuestro hospital por acúfeno pulsátil de meses de evolución, sin asociar hipoacusia, ni vértigo, ni otra sintomatología.

Abstract Tinnitus is a relatively frequent symptom in an otolaryngology consultation. Interactions in external or internal hair cells, imbalances in the afferent fiber balance and cortical reorganization phenomena after peripheral injuries have been described in 90%-95% of the causes of tinnitus. The remaining 5%-10% is comprised of a type of tinnitus called objective, which do not share these pathophysiological mechanisms, but originate from some structure of the body generally external to the auditory pathway and stimulate the auditory apparatus just as a sound from the exterior. We present the case of a 52-year-old man referred to the Otolaryngology service at our hospital for pulsatile tinnitus of months of evolution, with no hearing loss, vertigo, or other symptoms associated.

Interleukin-1 alpha gene polymorphism (IL-1α) and susceptibility to tinnitus in the elderly.

AIM: To investigate the association between the single nucleotide polymorphism in the position-889 (C/T) of the promoter region of the IL-1α gene and the susceptibility to tinnitus. METHOD: This was a case-control study with a sample of 108 independent elderly people over 60 years of age. Information on exposure to occupational noise and tinnitus was obtained by interviews. The genetic polymorphism was analyzed by polymerase chain reaction followed by cleavage with restriction enzyme NcoI. Data were analyzed using the Chi-square test, with the significance level set at 5%. For the statistical analysis all individuals with tinnitus on the right ear were eligible. RESULTS: Among elderly with tinnitus, 42.9% had a history of exposure to occupational noise. There was statistically significant association between IL-1α gene polymorphism and tinnitus in subjects without a history of exposure to occupational noise (P = 0.006 and χ2 = 10.39). The elderly with the T allele were less likely to have tinnitus due to occupational noise exposure when compared to those carrying the C allele. CONCLUSION: This study suggests an association between the IL-1α gene polymorphism with susceptibility to tinnitus in individuals without a history of exposure to occupational noise. The present study demonstrated that allele T of IL-1α is a protective factor for presence and severity of tinnitus in the elderly and allele C contributes to the pathogenesis of the inflammatory response. The present observation implied the signaling IL-1α is involved in ear aging.

Associação entre disfunção temporomandibular e zumbido em idosos / Association between temporomandibular disorders and tinnitus in the elderly

RESUMO Objetivo Verificar a associação entre zumbido e disfunção temporomandibular em idosos. Métodos Estudo transversal realizado com a inclusão de idosos com vida independente. A disfunção temporomandibular foi avaliada por exame odontológico e o zumbido foi verificado pela história médica. A análise estatística foi realizada utilizando o teste Qui-quadrado, o risco relativo e a regressão logística. Resultados O zumbido foi observado em 82,9% dos indivíduos com disfunção temporomandibular e, através desta análise, observou-se que a disfunção temporomandibular é um fator de risco para o zumbido. Conclusão Houve associação entre zumbido e disfunção temporomandibular na população idosa. Ressalta-se a importância de identificar fatores de risco para o zumbido, que podem ser modificados por meio de intervenções específicas, uma vez que esta prática é essencial na prevenção de episódios futuros, bem como na gestão do processo de tratamento de pacientes idosos, em geral.

ABSTRACT Purpose To verify the association between tinnitus and temporomandibular dysfunction in the elderly. Methods A cross sectional study was conducted with the inclusion of elderly individuals with independent living. Temporomandibular dysfunction was assessed by odontological evaluation and tinnitus was verified by medical history. Statistical analysis was performed using the chi-square test, relative risk and logistic regression. Results Tinnitus was observed in 82.9% of individuals with temporomandibular dysfunction and through this analysis is shown that temporomandibular dysfunction as a risk factor for tinnitus. Conclusion The results showed that there was association between tinnitus and temporomandibular dysfunction in the elderly population and emphasizes the importance of identifying risk factors for tinnitus that can be modified through specific interventions, since it is essential in the prevention of future episodes, as well as managing the process of treatment of elderly patients in general.

[Conditional probability analysis between tinnitus and comorbidities in patients attending the National Rehabilitation Institute-LGII in the period 2012-2013]. / Análisis de probabilidad condicional entre el acúfeno y comorbilidades asociadas en pacientes que acudieron al Instituto Nacional de Rehabilitación-LGII en el periodo 2012-2013.

BACKGROUND: Tinnitus is defined as the conscious perception of a sensation of sound that occurs in the absence of an external stimulus. This audiological symptom affects 7% to 19% of the adult population. The aim of this study is to describe the associated comorbidities present in patients with tinnitus usingjoint and conditional probability analysis. PATIENTS: Patients of both genders, diagnosed with unilateral or bilateral tinnitus, aged between 20 and 45 years, and had a full computerised medical record, were selected. METHODS: Study groups were formed on the basis of the following clinical aspects: 1) audiological findings; 2) vestibular findings; 3) comorbidities such as, temporomandibular dysfunction, tubal dysfunction, otosclerosis and, 4) triggering factors of tinnitus noise exposure, respiratory tract infection, use of ototoxic and/or drugs. RESULTS: Of the patients with tinnitus, 27 (65%) reported hearing loss, 11 (26.19%) temporomandibular dysfunction, and 11 (26.19%) with vestibular disorders. When performing the joint probability analysis, it was found that the probability that a patient with tinnitus having hearing loss was 2742 0.65, and 2042 0.47 for bilateral type. The result for P (A ∩ B)=30%. Bayes' theorem P (AiB) = P(Ai∩B)P(B) was used, and various probabilities were calculated. Therefore, in patients with temporomandibulardysfunction and vestibular disorders, a posterior probability of P (Aі/B)=31.44% was calculated. CONCLUSIONS: Consideration should be given to the joint and conditional probability approach as tools for the study of different pathologies.

Association of tinnitus and hearing loss in otological disorders: a decade-long epidemiological study in a South Indian population / Associação de zumbido e perda auditiva em distúrbios otológicos: estudo epidemiológico de uma década em uma população do Sul da Índia

Abstract Introduction: Tinnitus is a common disorder that occurs frequently across all strata of population and has an important health concern. Tinnitus is often associated with different forms of hearing loss of varying severity. Objective: The present study aimed to identify the association of tinnitus with hearing loss in various otological disorders of a South Indian population. Methods: A total of 3255 subjects referred to the MAA ENT Hospital, Hyderabad, from 2004 to 2014, affected with various otological diseases have been included in the present cross-sectional study. Diagnosis of the diseases was confirmed by an ear, nose, and throat (ENT) specialist using detailed medical and clinical examination. Statistical analysis was performed using the χ 2 test and binary logistic regression. Results: Tinnitus was observed in 29.3% (956) of the total study subjects that showed an increased prevalence in greater than 40 years of age. There was a significant increase in risk of tinnitus with middle (OR = 1.79, 95% CI = 1.02-3.16) and inner (OR = 3.00, 95% CI = 1.65-5.45) inner ear diseases. It was noted that 96.9% (n = 927) of the tinnitus subjects was associated with hearing loss. Otitis media (60.9%), presbycusis (16.6%) and otosclerosis (14.3%) are the very common otological disorders leading to tinnitus. Tinnitus was significantly associated with higher degree of hearing loss in chronic suppurative otitis media (CSOM) subjects. Conclusion: The present study could identify the most prevalent otological risk factors leading to development of tinnitus with hearing loss in a South Indian population.

Resumo Introdução: O zumbido é um distúrbio comum que ocorre com frequência em todos os estratos da população, constituindo um problema importante de saúde. O zumbido é frequentemente associado a diferentes formas de perda auditiva e sua gravidade é variada. Objetivo: O presente estudo teve como objetivo identificar a associação entre zumbido e perda auditiva em várias doenças otológicas na população do Sul da Índia. Método: No total, 3.255 indivíduos encaminhados ao Hospital MAA ENT em Hyderabad de 2004 a 2014, com diversas doenças otológicas, foram incluídos neste estudo transversal. O diagnóstico das doenças foi confirmado pelo otorrinolaringologista por meio de exames médico e clínico detalhados. A análise estatística foi realizada com o teste do χ2 e regressão logística binária. Resultados: Zumbido foi observado em 29,3% (956) do total de participantes do estudo, com maior prevalência em indivíduos com mais de 40 anos de idade. Houve um aumento significante do risco de zumbido em doenças da orelha média (OR = 1,79, IC 95% = 1,02-3,16) e interna (OR = 3,00, IC 95% = 1,65-5,45). Observamos que em 96,9% (n = 927) dos indivíduos com zumbido houve associação com perda auditiva. Conclusão: O presente estudo pôde identificar os fatores etiológicos mais prevalentes que levam ao desenvolvimento de zumbido associado à perda auditiva em uma população do Sul da Índia. Otite média (60,9%), presbiacusia (16,6%) e otosclerose (14,3%) são doenças otológicas frequentemente associadas ao zumbido. Em indivíduos com otite média crônica supurativa (OMCS), o zumbido foi significantemente associado ao maior grau de perda auditiva.