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Author: admin, 08.02.2014. Category: Tinnitus Causes And Cures

How to cite this article Valente JPP, Pinheiro LAM, Carvalho GM, Guimaraes AC, Mezzalira R, Stoler G, Paschoal JR, et al. OBJECTIVES: To evaluate the correlation between the degree of discomfort caused by tinnitus and the hearing loss level. RESULTS: 107 patients were studied and there was no correlation between the degree of annoyance of tinnitus with hearing loss, age, gender, presence of dizziness, of neck pain, headache, changes of the temporomandibular joint, the use of caffeine or excessive intake of carbohydrates. CONCLUSION: Dizziness, neck pain, headache and caffeine abuse are prevalent complaints in patients with tinnitus. In the literature, some factors possibly related to the nuisance caused by tinnitus have been tested, such as age, gender, presence of vestibular symptoms and hearing loss15,16,17,18. Therefore, the main objective of our study was to evaluate the correlation of the degree of discomfort caused by tinnitus with hearing loss. We conducted a clinical epidemiological study with a retrospective analysis of medical records of patients seen at the Otolaryngology Service of the State University from Campinas, in the period from February 2009 to April 2010.
The study included patients over 18 years who had unilateral or bilateral tinnitus with normal hearing or sensorineural hearing loss. Patients with pulsatile tinnitus or infectious disease of the external and middle ear were excluded. To measure the degree of discomfort caused by tinnitus, the patients were evaluated by visual-analogue scale (VAS), graduated from zero to ten. For associated clinical symptoms, there was a high prevalence of patients with dizziness, neck pain and headache. The correlation between the degrees of discomfort related to the tinnitus and the three groups separately showed that 48% of the patients in group I (normal hearing) rated their tinnitus as severe. Most studies in the literature show that the prevalence of patients with tinnitus and normal hearing is around 8% to 10%28.
We know there is a close relationship between tinnitus and audiometric conditions and also in situations of normal hearing22. In the literature, most studies suggest that hearing loss, regardless of its degree, is related to greater inconvenience caused by tinnitus8,29,36,37. Specifically evaluating patients in group I, a high prevalence of psychoaffective disturbs such as depression and anxiety disorder was found. In this study we found no difference within the group of patients with hearing loss (groups II and III), consistent with several other studies which have been published39,40,41. Concerning the related clinical symptoms, a high prevalence of patients with dizziness, neck pain, headache and abuse of caffeine was found, which could be acting as triggering factors or worsening of tinnitus.
In this study it was concluded that the degree of annoyance of tinnitus, using the visual analogue scale, was higher in patients without hearing loss and in females, but there was no statistical significance. Disciplina de Otorrinolaringologia, Cabeca e Pescoco - Universidade Estadual de Campinas (UNICAMP) - Campinas - SP - Brasil. Disciplina de Otorrinolaringologia, Cabeca e Pescoco - UNICAMP Faculdade de Ciencias Medicas, PO Box: 6111.
Paper submitted to the RBCMS-SGP (Publishing Management System) on October 12, 2011; and accepted on August 16, 2012. Please note: If you have a promotional code you'll be prompted to enter it prior to confirming your order. If you subscribe to any of our print newsletters and have never activated your online account, please activate your account below for online access. Various herbs and other supplements have been touted for their ability to improve cholesterol levels. As you've gotten older, have you noticed that you often find yourself marching around the house in a huff, searching for misplaced car keys or eyeglasses, or you just cannot remember the name of that new neighbor you met when walking the dog?
The way you live, what you eat and drink, and how you treat your body can affect your memory just as much as your physical health and well-being. If you're having the occasional twinge of joint pain when you go for a walk or climb stairs, or you're worried about arthritis because a parent had it, one step toward prevention is to check your weight. Sticking with exercise isn't always easy, but setting goals and having a plan for when your motivation lags can help. If a growth or mole looks like a melanoma, the doctor will take a biopsy to confirm the diagnosis. It might seem like retirement is a time to take it easy and devote yourself to gardening, golfing, and napping. What if men approached their health at midlife the same way that financial experts advise them to plan for retirement? Sleep shortfalls can lead to a range of health problems, from being more likely to catch a cold or gain weight to increased risk of developing heart disease or diabetes. A recent study at the University of Illinois has looked further into the experience of tinnitus starting with the brain, looking more closely into how the brain processes emotions in two groups of people – those with tinnitus and those without.
The research took a closer look into the reasons why some people who experience tinnitus respond differently to others with tinnitus. The outcomes of this research could have a significant impact on the development of tinnitus treatments and therapies. Tinnitus, often described a ringing or buzzing in the ear, can be difficult to live with and often causes symptoms of stress, anxiety, depression, insomnia and mood swings. Tinnitus is not a disease in itself but rather a symptom of another health condition such as noise exposure, ototoxic medications or trauma.
During the study, a mixture of positive, negative and neutral emotional sounds were played to people without tinnitus and to people who experienced varying levels of tinnitus.

Functional MRI scans showed that people experiencing tinnitus were engaging different areas of their brain, compared to those without. The severity of tinnitus is based on the level of distress experienced by the individual, mainly explained by how well patients adjust to the ringing in their ears. The second part of the study revealed that those experiencing less severe tinnitus were actually using a different path in the brain to process emotional information. This could have large implications on treatments and therapies for tinnitus, for which there is no cure. Tinnitus is experienced by millions worldwide, with a reported 25 million people in the US reporting tinnitus symptoms lasting a minimum of 5 minutes in the previous year. The study revealed that those with less severe tinnitus (meaning those which were experiencing less tinnitus stress) were using the part of the brain usually used for impulse control, attention and planning.
Cubex have been employing the use of yoga and mindfulness based cognitive therapy as part of their individualised treatment plans supporting patients with tinnitus.
The results of this study will inform many other modern treatments for tinnitus similar to mindful breathing, focusing on the brain and the perception of sound to reduce the impact of the condition.
To speak with an audiologist about tinnitus and the current treatments and therapies available to manage tinnitus, contact Cubex. THE sound of silence is something people with tinnitus would treasure - do you know what suffering with the condition is really like?
Treatment options should be discussed with your audiologist to determine which method is right for you. The limitations caused by tinnitus are related to psychological factors, mood changes and psychiatric conditions, while other factors related to discomfort caused by tinnitus are being studied.
Materials and Methods: A retrospective study of the patients treated at the Otolaryngology Service of the State University from Campinas for 15 months, using the Visual-Analogue Scale to classify the degree of discomfort by tinnitus. Some patients describe tinnitus as loud and intense, which may trigger psychosocial disorders and compromise their quality of life4,5. The THI is the most accepted method to evaluate tinnitus, because of its easy application, interpretation and the fact that it addresses several aspects of the patient?s quality of life13,14.
In the genesis of tinnitus, the consensus is that hearing loss acts as one of the main triggers at the onset of tinnitus19, beyond a discussion of a common pathway that integrates all the central relationships of tinnitus20,21.
In addition, the presence of associated clinical symptoms and general data were also evaluated.
For the analysis epidemiological data such as gender and age; and clinical features like the presence of unilateral or bilateral tinnitus, dizziness, headache, neck pain, temporomandibular joint disorder (TMJD) and abuse of caffeine or carbohydrates were used. Distribution of population (n = 107) in the groups classified according to hearing loss group I (n = 23), Group II (n = 38) and Group III (n = 46). Distribution of age groups classified according to the hearing loss, Group I (n = 23), Group II (n = 38) and Group III (n = 46).
Distribution of patients according to gender in the groups classified according to the hearing loss, Group I (n = 23), Group II (n = 38) and Group III (n = 46). Some authors also demonstrated the great value of associated symptoms like those described above26. Epidemiological studies show that one third of the population has experienced the sensation of tinnitus at least once in life.
Concerning the three groups separately, it was observed that in group I (normal hearing) there was a higher prevalence of patients below 45 years old. Heller and Bergman in 1953 showed that 94% of normal hearing patients reported sensation of tinnitus in completely quiet environments34.
Considering the patients with hearing loss (groups II and III), this percentage was 28%, suggesting that patients with tinnitus and normal hearing are more related to tinnitus annoyance. Several studies indicate that these disturbances are mainly involved in the genesis and perpetuation of tinnitus39. For example, some people can experience high levels of distress and anxiety when experiencing tinnitus whilst others are able to mostly ignore it and remain calm. However, some people experiencing this report no ill-effects in their day-to-day lives and describe tinnitus as “no big deal”.
It is a perception of sound when no sound is present, a perception which is handled by the brain. These sounds varied from children laughing, babies crying and the sound of a water bottle opening. Researchers then went on to compare the brain activity of only those participants experiencing tinnitus, comparing the various severity levels of tinnitus.
Patients with severe tinnitus were using the area of the brain known to be used for emotional processing (the amygdala).
Given that there is no cure for tinnitus, this study is especially important to improve the treatments and therapies available that can reduce the severity of the condition.
This could suggest that the practice of mind control and focused attention could help to reduce the stress of tinnitus. These practices are essential for contributing to a healthy and happy brain and have already been helping some patients to reduce the severity of their tinnitus.
Identification and Treatment of an Underlying Contributor–if impacted earwax, medications, or underlying inflammation or disease are contributing and can be treated effectively, tinnitus symptoms may be significantly reduced. Drug Therapies–although there are currently no drugs approved specifically to treat tinnitus, research on anti-anxiety, antidepressant, and antihistamine medications have shown positive results in some cases. In its most common form, tinnitus is presented as a phantom sensation which is not associated with an external sound stimulus1.

Some studies show that the limitations caused by tinnitus are related to psychological factors, such as mood swings, irritability and psychiatric diseases6,7,8,9. However, previous studies have shown that EVA, in which the patient classifies his discomfort related to tinnitus from 1 to 10, has a good correlation with the THI10-14.
However, hearing loss and its relationship with the distress associated with tinnitus is still controversial. All patients underwent complete ENT examination and pure tone audiometry, testing the following frequencies: 250, 500, 1,000, 2,000, 3,000, 4,000, 6,000 and 8,000 Hz.
They were classified in three degrees of discomfort: mild (0-3), moderate (4-7) and severe (8-10). When compared to the level of discomfort related to tinnitus (VAS), none of the factors evaluated showed statistically significant results.
However, there was no statistically significant difference between the three groups (Table 3). A possible explanation for this finding might be the fact that the work has been performed in Otoneurology, in which the main complaint is tinnitus and not hearing loss. Sanchez in 2005 also observed that the average age of patients with tinnitus and normal audiometry was lower compared to patients with hearing loss23.
Riga in 2007, by testing for suppression of otoacoustic emission distortion products, suggested that patients with normal hearing may have a dysfunction of the cochlear efferent system, specifically the medial olivocochlear bundle35. Savastano in 2008, using the THI, found a higher number of patients who rated the annoyance by tinnitus in the group with moderate normal audiometry38. Another hypothesis that could explain a greater discomfort in patients with normal hearing would be the impossibility of adaptation of a hearing aid in these patients.
It is noteworthy that the diagnostic accuracy is essential to any attempt to relieve tinnitus42.
Benzodiazepines and GABAergics in Treating Severe Disabling Tinnitus of Predominantly Cochlear Origin.
Adaptacao para a lingua portuguesa do questionario Tinnitus Handicap Inventory: validade e reprodutibilidade.
Final Common Pathway for Tinnitus: Theoretical and Clinical Implications of Neuroanatomical Substrates. Abnormal auditory mismatch response in tinnitus sufferers with high-frequency hearing loss is associated with subjective distress level.
Avaliacao da relacao entre severidade do zumbido e perda auditiva, sexo e idade do paciente. Impact of Tinnitus on Quality of Life, Loudness and Pitch Match, and High-Frequency Audiometry. Tinnitus with normal hearing sensitivity: extended high-frequency audiometry and auditory nerve brain-stem-evoked responses.
Hearing disorders in the population: first phase findings of the MRC national study of hearing.
Guidelines for the grading of tinnitus severity: the results of a working group commissioned by the British Association of Otolaryngologists, Head and Neck Surgeons, 1999. A Clinical Study of the Efferent Auditory System in Patients With Normal Hearing Who Have Acute Tinnitus.
The aetiology of tinnitus: risk factors for tinnitus in the UK population-a possible role for conductive pathologies. The variety of experiences has led to this research and it seems the disparity can actually be explained.
In 2004, Weisz showed that patients with hearing loss at high frequencies are more subjectto tinnitus nuisance22.
As for their gender, 72% of patients were women, with similar distribution among the three groups (Figures 2 and 3). Comparing the buzzing nuisance related to the presence or absence of hearing loss (Group I x II + III) no statistically significant difference was observed. In: Proceedings of the Sixth International Tinnitus Seminar - The Tinnitus and Hyperacusis Center. In: Proceedings of the Fifth International Tinnitus Seminars The Tinnitus and Hyperacusis Center. In that model, damage to peripheral organs act as triggers of tinnitus, and is supported by events that occur in the central auditory pathway, such as maladaptive neuroplastic processes and phenomena such as hyperactivity of the auditory cortex.
As for a correlation between age and gender with a degree of discomfort caused by tinnitus through the EVA, there was no significant difference (Table 1). Finally, comparing groups II and III (respectively loss in patients with high frequency and loss in patients in general), no difference was found.
This can be explained by the increased demand of women to medical services, or the greater prevalence of psychological disorders in this group, such as anxiety and depression31,32.
In 2010, the same author, using the THI, found no significant correlation between degree of hearing loss and discomfort related to tinnitus24. On the other hand, when the risk factor under study is the exposure to noise, there is a higher prevalence of the male sex33. Despite of this prevalence among women, our work suggests that tinnitus-related annoyance is similar in both groups.

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