Purpose. Subjective tinnitus has different forms and degrees of severity. Many studies in the literature have assessed psychoacoustic characteristics of tinnitus but hardly any of them had focused on the association of audiological profile with onset duration and loudness perception. The aim of this study was to evaluate existence of any association between tinnitus loudness/onset duration and audiological profile to explain differences in prognosis. Method. Study design was prospective. The sample consisted of 26 subjects having tinnitus, which was divided into tinnitus and nontinnitus ears. Audiological profile included pure-tone audiometry, speech audiometry, tympanometry, acoustic reflex test, and auditory evoked potentials (early and middle latency). Unpaired t-test was applied to compare two subgroups. Correlation and association between tinnitus onset duration/loudness perception and audiological profile were also assessed by calculating Spearman’s coefficient and Fischer exact value. Results. The two subgroups had significant differences for pure-tone and speech audiometry hearing thresholds. A significant association was observed between the high frequency/extended high frequency and tinnitus loudness/onset duration. Conclusion. The changes in hearing thresholds and auditory pathway are associated with an increase in tinnitus loudness and its onset duration. This knowledge would be helpful to differentiate between severity and chronicity of the patients for planning therapeutic management and predicting prognosis. 1. Introduction Subjective tinnitus is the perception of sounds by the patient without any physical presence of acoustic stimulus [1]. The perceived localization of tinnitus is reported as from one ear, from both the ears with the same or different intensity, or from inside the head [2]. It might be perceived as a weak pure tone, ringing of bells, shrill birds’ chirping, noise of whizzing air, or loud noise of a jet engine. Subjective tinnitus has different forms and degrees of severity, and the diagnosis has to be made solely on the information provided by the patient [3, 4]. The severity is classified by the patient’s own estimate as slight, moderate, and severe depending on the problem and annoyance faced [5]. A particular treatment that helps one patient may fail for others, suggesting that there are different forms of tinnitus which differ in their pathophysiology and their response to specific treatments [6]. The clinical subtypisation of different forms of tinnitus is an important step towards the goal of individualized
References
[1]
J. A. Henry, K. C. Dennis, and M. A. Schechter, “General review of tinnitus: prevalence, mechanisms, effects, and management,” Journal of Speech, Language, and Hearing Research, vol. 48, no. 5, pp. 1204–1235, 2005.
[2]
J. L. Stouffer and R. S. Tyler, “Characterization of tinnitus by tinnitus patients,” Journal of Speech and Hearing Disorders, vol. 55, no. 3, pp. 439–453, 1990.
[3]
A. R. Moller, “Pathophysiology of tinnitus,” Otolaryngologic Clinics of North America, vol. 36, pp. 249–266, 2003.
[4]
A. R. Moller, “Tinnitus,” in Neurotology, R. K. Jackler and D. E. Brackmann, Eds., pp. 182–193, Elsiever; Mosby, San Diego, Calif, USA, 2nd edition, 2005.
[5]
G. F. Reed, “An audiometric study of two hundred cases of subjective tinnitus,” Archives of Otolaryngology, vol. 71, pp. 94–104, 1960.
[6]
M. Landgrebe, F. Zeman, M. Koller et al., “The Tinnitus Research Initiative (TRI) database: a new approach for delineation of tinnitus subtypes and generation of predictors for treatment outcome,” BMC Medical Informatics and Decision Making, vol. 10, no. 1, article 42, 2010.
[7]
W. Hiller and C. Haerk？tter, “Does sound stimulation have additive effects on cognitive-behavioral treatment of chronic tinnitus?” Behaviour Research and Therapy, vol. 43, no. 5, pp. 595–612, 2005.
[8]
L. M. Ward and M. Baumann, “Measuring tinnitus loudness using constrained psychophysical scaling,” American Journal of Audiology, vol. 18, no. 2, pp. 119–128, 2009.
[9]
G. Andersson, “Tinnitus loudness matchings in relation to annoyance and grading of severity,” Auris Nasus Larynx, vol. 30, no. 2, pp. 129–133, 2003.
[10]
G. Andersson and L. McKenna, “The role of cognition in tinnitus,” Acta Oto-Laryngologica, vol. 126, supplement 556, pp. 39–43, 2006.
[11]
V. Kaldo, Cognitive behavioral therapy as guided self-help to reduce tinnitus distress, Acta Universitatis Upsaliensis, Uppsala, Sweden, 2008.
[12]
J. A. Vernon and M. B. Meikle, “Tinnitus: clinical measurement,” Otolaryngologic Clinics of North America, vol. 36, no. 2, pp. 293–305, 2003.
[13]
S. Silman and C. A. Silverman, “Basic audiologic testing,” in Auditory Diagnosis-Principles and Applications, S. Silman and C. A. Silverman, Eds., pp. 10–70, Academic Press, San Diego, Calif, USA, 1991.
[14]
W. Selters and D. Brackmann, “Acoustic tumor detection with brain stem electric response audiometry,” Archives of Otolaryngology, vol. 103, no. 4, pp. 181–187, 1977.
[15]
L. E. Roberts, G. Moffat, and D. J. Bosnyak, “Residual inhibition functions in relation to tinnitus spectra and auditory threshold shift,” Acta Oto-Laryngologica, vol. 126, no. 556, pp. 27–33, 2006.
[16]
R. R. A. Coles, “Epidemiology of tinnitus: (2) Demographic and clinical features,” Journal of Laryngology and Otology, vol. 97, no. 9, pp. 195–202, 1983.
[17]
G. Barnea, J. Attias, S. Gold, and A. Shahar, “Tinnitus with normal hearing sensitivity: extended high-frequency audiometry and auditory-nerve brain-stem-evoked responses,” Audiology, vol. 29, no. 1, pp. 36–45, 1990.
[18]
A. R. Moller, M. B. Moller, P. J. Jannetta, and H. D. J. Hae Dong Jho, “Compound action potentials recorded from the exposed eighth nerve in patients with intractable tinnitus,” Laryngoscope, vol. 102, no. 2, pp. 187–197, 1992.
[19]
G. M. Gerken, P. S. Hesse, and J. J. Wiorkowski, “Auditory evoked responses in control subjects and in patients with problem-tinnitus,” Hearing Research, vol. 157, no. 1-2, pp. 52–64, 2001.
[20]
C. E. Schreiner and S. W. Cheung, “Cortical plasticity and tinnitus,” in Tinnitus: Theory and Management, J. B. Snow, Ed., pp. 189–202, BC Decker, London, UK, 2004.
[21]
R. S. Tyler, “Neurophysiological models, psychological models, and treatments for tinnitus,” in Tinnitus Treatment Protocols, R. S. Tyler, Ed., 2005.
