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Introduction: Tinnitus is a condition that requires multidisciplinary care and monitoring. Widespread use of mobile devices and ready access to the internet offers a possible solution since smartphones can run apps programmed for a particular health problem. The aim of the article is to assess the scale and direction of how mobile apps are being created and used to diagnose and treat tinnitus. Material and methods: Publications in Google Scholar, PubMed, and ResearchGate were searched for the years 2010--2023. The results of the review were organized by themes. Results: Hits were organized into the following themes: (1) existing mobile apps for tinnitus, (2) apps supporting the diagnosis of tinnitus, (3) apps supporting tinnitus therapy, (4) a look to the future -- sensors built-in or connected to mobile devices, wearables, artificial intelligence (AI), and big data systems. Conclusions: Smartphone-based apps with ecological momentary assessment methods and the possibilities of using wearable diagnostic devices might be useful in better understanding the variability of tinnitus and perhaps its causes. Mobile crowdsensing and central databases with big data and artificial intelligence support appear to be a valuable resource for new scientific research. There are now mobile apps providing a variety of therapies -- sound therapy, self-help psychology, and educational training. Equally important for tinnitus therapy are smart devices managed by mobile apps -- hearing aids, cochlear implants, and other hearables. In the future, development of mobile technologies and artificial intelligence will help create smart therapy platforms for tinnitus. [ABSTRACT FROM AUTHOR]

Introduction: Children rarely self-report having tinnitus and so there is limited understanding of the problems they face and how tinnitus affects their daily lives. In situations where peripheral hearing is normal and the patient reports difficulty understanding speech, one may consider the co-occurrence of other causes, such as central auditory processing disorders (CAPD). The aim of the study was to assess the presence of CAPD symptoms in children with tinnitus. Material and methods: The study group consisted of 10,582 children 13 years old. The study material included questions about tinnitus experience, screening pure tone audiometry, and the results of the Scale of Auditory Behaviors (SAB), in its Polish adaptation, which was used to assess whether they may have CAPD. Results: In children with tinnitus, symptoms that may indicate CAPD were observed. In 2849 children, an SAB total score of less than 46 was obtained, an indication for an extended diagnosis. Among these same children 33.7% experienced tinnitus. The more frequently a child experienced tinnitus, the lower the mean overall SAB score. Conclusions: Children reporting tinnitus should receive additional diagnostic tests for CAPD. The diagnosis should be multispecialty and, in addition to hearing tests, include an in-depth interview, psychological and pedagogical evaluation, and psychoacoustic tests. [ABSTRACT FROM AUTHOR]

Introduction: Past studies have shown connections between the somatosensory system (the neck and temporomandibular joint region) and the auditory system. It is therefore likely that tinnitus patients might benefit from neck therapy. The aim of this study was to investigate the effects of physiotherapy of the neck, comprising cervical spine kinesiotherapy and interspinal muscles massage, on subjective tinnitus. We also investigated the effects of the therapy on the range of cervical spine motion and cervical muscles tension. Material and methods: This was a non-randomised controlled trial. Adult patients with chronic subjective tinnitus (n = 118) were enrolled in an intervention group and received 10 sessions, over 2 weeks, of neck therapy comprising active exercises, massage of the cervical interspinal muscles, and post-isometric relaxation exercises. There was also a control group (waiting list). The effects of the therapy on tinnitus were assessed at baseline, immediate post-treatment, and follow-up (2 weeks after the end of therapy) using the Polish Tinnitus Functional Index (TFI-Pl, primary outcome measure), a visual analogue scale (VAS) of tinnitus loudness, and the Polish Tinnitus Handicap Inventory (THIPl). Effects of therapy on neck were assessed using two measures: the range of cervical spine movement (cervical flexion, cervical rotation, and cervical side bending measured in cm using a tape measure); and muscle tension -- assessed by palpation and graded using a scale of either 0 (normal) or 1 (increased). Results: In the intervention group, the mean TFI score was reduced significantly from baseline (mean = 52.6, SD = 20.4) to post treatment (mean = 40.9, SD = 19.0, p < 0.001) and at follow-up (mean = 40.4, SD = 21.1, linear mixed model). In the control group, mean TFI score did not change significantly from baseline (mean = 46.8, SD = 20.1) to post treatment (mean = 45.8, SD = 40.9) and follow-up (mean = 45.2, SD = 26.2, linear mixed model). Improvement in tinnitus in the intervention group was accompanied by a reduction in cervical muscles tension and improvement in the range of cervical spine motion. Conclusions: Complex neck therapy of the neck appears to be a promising intervention for tinnitus treatment. Further randomised studies are needed to confirm the positive effects of the therapy on tinnitus and explore the mechanisms leading to improvement. [ABSTRACT FROM AUTHOR]

Introduction: To investigate the validity and reliability of a Turkish version of the Skarzynski Tinnitus Scale (STS) in a Turkish patient group. Material and methods: The study was conducted on 143 volunteers aged over 18 years who had complained of tinnitus for at least one month. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were used for construct validity. Criterion validity was analysed by a Spearman's bivariate correlation test. Reliability analyses were assessed with Cronbach's alpha internal consistency coefficients and test-- retest reliability with McNemar--Bowker and ICC coefficients. Results: A new three-factor structure was produced using EFA. The factors were similar to the original study except for Item 14. The STS gave similar measures to the tested Tinnitus Handicap Inventory scale. Nearly all item--total correlations were greater than 0.4, indicating good internal consistency. The internal consistencies of the items were 0.86--0.88; in the test--retest reliability analyses of the sub-scales, ICC scores were 0.90--0.96. Conclusions: The Turkish STS can be used reliably in all adults with a symptom of tinnitus. However, because one item in the new structure of the Turkish version is in a different sub-dimension it may necessary to conduct new validation studies. [ABSTRACT FROM AUTHOR]

Introduction: Otosclerosis is a bone remodeling disorder within the otic capsule of the temporal bone. According to the literature, 65-90% of patients with otosclerosis experience tinnitus. The most commonly used and most effective treatment for otosclerosis is surgery, including stapedotomy or formerly stapedectomy, with both these techniques providing satisfactory results in hearing improvement. Many clinicians and investigators report a substantial reduction of tinnitus after stapes surgery in patients with otosclerosis. Aim: To assess tinnitus reduction after stapedotomy. Material and methods: The study population was 95 patients with otosclerosis suffering from tinnitus. They completed the Tinnitus Functional Index (TFI) before stapedotomy and 3 months after the surgery. The minimal important change was estimated with the Clinical Global Impression (CGI) scale as the external criterion (anchor). The mean change method and the receiver operating characteristic (ROC) method were used to determine a minimal important change in tinnitus sensation. Results: The improvement in tinnitus after stapedotomy was reported by 69.4% of the patients with otosclerosis. Minimal important change in tinnitus was estimated as a reduction of 8.8 points in the TFI. Conclusions: The value of 8.8 points in the TFI can be used as a benchmark of stapedotomy effectiveness in otosclerosis patients suffering from tinnitus. [ABSTRACT FROM AUTHOR]

Introduction: Audiological aliments like tinnitus and hyperacusis require multidisciplinary care. Therapy for these ailments should be available on a daily basis because of their troublesomeness in everyday functioning. To meet this challenge, specialists are looking for solutions in increasingly common access to the Internet and increasingly widespread use of mobile devices. Furthermore, smartphones have an application ecosystem that can be extended by new apps programmed for a particular health problem. Aim: Assessment of the scale and direction of creating and using mobile applications to diagnose and treat tinnitus and hyperacusis. Material and methods: Google Scholar and PubMed were searched for the 13 years 2010-2023. The search strategy used the following keywords: "tinnitus mobile applications", "hyperacusis mobile applications", "smartphone-based treatment tinnitus/hyperacusis", "smartphone-based diagnostic tinnitus/hyperacusis", "CBT apps", "sound and relaxation therapy apps", "tinnitus/hyperacusis therapy smart". The results of the review were catalogued and organized into themes. Results: Results were organized into the following themes: (1) ranking evaluation and analysis of applications supporting tinnitus/hyperacusis therapy existing in the Internet space, (2) applications supporting the diagnosis of tinnitus, with particular emphasis on the EMAs (Ecological Momentary Assesments), (3) applications supporting the therapy of tinnitus/hyperacusis (4) a look into the future - the use of sensors built-in or connected with mobile devices, the use of artificial intelligence (AI), bid data techonology. Conclusions: Smartphone-based applications with EMAs, sensors, possibility of using different wearable diagnostic devices can be helpful in better understanding the tinnitus variability and its causes. Combining the mobile applications with a mobile crowdsensing, central database and the support of AI techniques is a valuable source for developing scientific research. Clinically verified methods provided by mobile applications can become a part of the therapeutic process proposed by specialists and enable easy, cost-free and wide range of therapeutic support in dealing with tinnitus and hyperacusis. In tinnitus/hyperacusis therapy multifunctional smart devices managed by mobile applications such as: smart hearing aids, cochlear implants, hearables may be equally important. The development of mobile technologies and AI techniques will contribute to the creation of smart therapy platforms for tinnitus/hyperacusis in the future. [ABSTRACT FROM AUTHOR]

Introduction: Some research has indicated a possible link between hyperacusis and anxiety, suggesting that psychological factors may play a role in the severity of auditory sensitivity. However, the nature of this relationship in subjects with tinnitus and how it may differ between men and women remains unclear. Aim: The aim of the study is to investigate the relationship between hyperacusis and anxiety in men and women with tinnitus. Material and methods: The study group consisted of 51 men and 55 women with tinnitus and hyperacusis in similar age (men: M = 45.4; SD = 12.4; women: M = 44.9; SD = 12.8). The study was conducted in the Tinnitus Clinic of the tertiary Ear, Nose, and Throat Center in Kajetany (near Warsaw, Poland). The audiological examination included pure-tone audiometry, impedance audiometry, and measurement of uncomfortable [ABSTRACT FROM AUTHOR]

Introduction: Hyperacusis is a kind of decreased tolerance to sound and is difficult to measure objectively. It often co-occurs with tinnitus. There is a need for valid and reliable patient-reported outcome measures to capture this subjective phenomenon. Aim: The aim of the study to create a questionnaire capturing hyperacusis in terms of loudness, fear, and pain and then to evaluate its psychometric properties. Material and methods: The study group consisted of 106 patients, made up of 51 men and 55 women. They were aged between 19 and 72 years, mean 45.2 years (SD = 12.4). An initial pool of 33 questions capturing hyperacusis was subjected to expert evaluation and pilot testing. Then, a shortened 19-item version of the tool was checked out. Medical interview, au-diological examination and a set of questionnaires: Tinnitus Handicap Inventory, Hyperacusis Questionnaire, State-Trait Anxiety Inventory, and Visual Analogue Scale was completed by all subjects. Results: The final 14-item Hyperacusis Assessment Questionnaire showed an appropriate three-factor structure that explained 70.5% of the variance. Convergent validity and divergent validity were confirmed by correlations with other measures of hyperacusis, anxiety, tinnitus severity, misophonia, and hearing thresholds. Internal consistency as assessed with Cronbach's alpha was excellent (a = 0.91) as was reproducibility (intra-class correlation, ICC = 0.96). Conclusions: The new Hyperacusis Assessment Questionnaire is a psychometrically sound and brief tool that can assess the severity of hyperacusis in terms of loudness, fear, and pain. It can be used in clinical practice and scientific research for patients with hyperacusis and tinnitus. [ABSTRACT FROM AUTHOR]

Acquired auditory processing disorders including age dependent hearing loss, speech discrimination deficits, tinnitus or hyperacusis, require a personalized diagnosis to assign the individual cause within the auditory hierarchy to either the periphery, subcortical or distinct cortical or cortico-fugal neuronal dysfunctions. The well-functioning feedforward and feedback PV-IN network is an essential precondition for temporal intracortical network function in audition that above all senses relies on high speed of information flow (Zajac I.T. and Nettelbeck T., 2018). We hypothesize disease-specific deficits in temporal intracortical network function in auditory circuits. Therefore, the diagnostic of those should have a special significance. We used time-sensitive MEG-OPM measurements and aimed to study different auditory stimulus paradigms to detect fast auditory processing in different groups of tinnitus with and without hyperacusis or presbycusis. We expect this method to become an efficient diagnostic strategy to fathom peripheral or central contribution of the distinct auditory impairments in the future to improve individualized targeted interventional therapies. Here we will present preliminary results demonstrating the usability and function of the OPM-MEG for hearing research. [ABSTRACT FROM AUTHOR]

Introduction: Tinnitus is defined as the perception of sound without an external acoustic stimulus. Currently, there is no single effective treatment method for tinnitus that works for all patients. One of the newer approaches is bimodal stimulation, which combines acoustic stimulation with somatosensory pathway stimulation. The goal of therapy is to reduce the severity of tinnitus and improve the quality of life for patients suffering from tinnitus. Aim: The aim of this study was to evaluate the effectiveness of bimodal stimulation using the Lenire device in reducing tinnitus severity in 15 patients. Material and methods: The authors present the results of their own research on the use of bimodal stimulation therapy in 15 patients. The results of the Tinnitus Handicap Inventory (THI) questionnaire were analyzed. Results: The results of the authors own research on the use of bimodal stimulation with the Lenire device showed an effectiveness of 78%, with an average decrease in THI score of 34 points. Conclusions: Bimodal stimulation using the Lenire device may be an effective treatment method for tinnitus in patients with reduced sound tolerance. [ABSTRACT FROM AUTHOR]

Currently, conflicting views on the neural correlate of tinnitus hinder the development of effective diagnosis and therapy for tinnitus (Knipper et al., Ruttiger, 2020). Although hyperacusis often co-occurs with tinnitus, it is until now considered neither in clinical diagnosis nor for targeted, individualized therapies. On the basis of findings with objective functional biomarkers (PTT, ABR, fMRI, EEG) used in patients, we challenge the hypothesis that co-occurance of hyperacusis worsens tinnitus percept towards a disease that most requires treatment and therapy. In this context, the hypothesis of the successful use of cognitive therapies for hyperacusis and tinnitus is particularly interesting for future therapy development. [ABSTRACT FROM AUTHOR]

Introduction: The demands on psychometric procedures for therapy research in hyperacusis (HC) and their differentiation from phonophobia, misophonia and recruitment have increased. The widely used noise hypersensitivity questionnaires (GÜF, Nelting and Finlayson, 2004, Germany; Hyperacusis Questionnaire, HQ, Khalfa et al., 2002, France) are partly invalid and repeatedly criticized (Blasing et al., 2010; Fackrell et al., 2015), partly without instructions and without quartiles, implausible cut-point of the HQ. Material and method: We retrospectively evaluated 216 tin-nitus-inpatients (47% women, age 49 ± 10) with the evaluated Structured Tinnitus Interview (STI, Goebel and Hiller, 2002): 60% HC; 15% phonophobia/misophonia; 24.4% without HC. At T1 and T2, we evaluated the sensitivity to change of the individual items of GÜF and HQ, numerical analog scales (NAS), Tinnitus Questionnaire (TF, Goebel and Hiller, 1998), discomfort thresholds (UBS), factor analysis, internal consistency, retest reliability (rtt), d, convergent and discriminative validity, BDI, BDI-II, BSI. Results: Reevaluation GÜF: reliability: α = .93; best test quality item 5, 6, 10, 12, 13; quartiles 0-45, cut-off (AUC) > 16; correlation NAS-HK r = .68, HQ r = .88; TF r = 0.44; Pearson: rtt.83; ICC.93; UBS ≤ .2;; d: r = .57. Reevaluation HQ: reliability: α = .92; best test quality item 5, 8, 9, 12t; quartiles 0-42, cut-off (AUC) > 18; correlation NAS-HK r = .63, GÜF r = .95; TF r = 0.35; Pearson: rtt.84; ICC.87; UBS ≤ .2; d: r = .47. The multidimensional structure of the GÜF and HQ could not be confirmed. Evaluation Mini-HQ9: after a comprehensive individual item analysis, we merged the 9 most change-sensitive (Pearson) and most stable (rit) items from GÜF and HQ into a new "Mini-HQ9": reliability: α = .93; quartiles 0-27; cut-off (AUC) > 11; corr. CFT r = .95; HQ r = .88; common variance 77%; corr. NAS-HK r = .63; TF r = .35; Pearson: rtt.83; ICC. 79; UBS ≤ .2; test-retest d: r = .48. One-dimensional structure. Conclusions: The Mini-HQ9 summarizes the advantages of the GÜF and HQ and has proven itself as a standard instrument for graduation and effect studies of the HK in pilot studies with only 9 items. Women are more sensitive to noise (r = .21). HC instruments are not suitable for misopho-nia. The UBS only for recording relevant side differences. [ABSTRACT FROM AUTHOR]

Background: Hearing loss and hypertension are leading causes of disability, affecting over 360 million people. The aim of this study was to assess the impacts of factors such as vitamin D and sleep disorder on the risk of hearing loss among hypertensive patients. Material and methods: This prospective cohort study involved 885 patients aged between 25 and 65 years old who visited our ENT and Endocrinology departments. The study was based on biochemical tests, physical examination, hearing assessment, and Pittsburgh Sleep Quality Index test. Statistical analysis used bivariate and multivariate stepwise regression. Results: Of 855 hypertensive patients, 184 (21.5%) had hearing loss. There were statistically significant differences between hypertensive patients with and without hearing loss in terms of BMI, smoking, family history of diabetes, tinnitus, vertigo, and headache. Moreover, there were statistically significant differences between hypertensive patients with hearing loss versus those with normal hearing in terms of vitamin D, calcium, magnesium, potassium, fasting glucose, HbA1C, HDL, systolic and diastolic blood pressure, microalbuminuria, and sleep quality. Among hypertensive patients, a multivariate regression analysis (stepwise method) indicated that vertigo, systolic blood pressure, vitamin D deficiency, numbness in the hand, tinnitus, vigorous activity, metabolic syndrome, sleep disturbance, and obesity were all risk predictors of hearing loss. Conclusions: Controlling hypertension, vitamin D level, sleep, and lifestyle might lower the risk of hearing loss among hypertensive patients. [ABSTRACT FROM AUTHOR]

Background: The inclusion of patient-reported outcomes (PROs) in randomized controlled trials (RCTs) supplements outcomes of treatment efficacy with the patient's perspectives. The aim of this study was to evaluate reporting completeness of PROs in RCTs pertaining to tinnitus, using the Consolidated Standards of Reporting Trials (Consort-PRO) adaptation. Material and methods: We performed a search of Medline, Embase, and Cochrane Central Register of Controlled Trials (Central) for published RCTs related to tinnitus with at least one PRO measure from 2006 to 2020. Two investigators screened RCTs for inclusion. Using the Consort-PRO adaptation in an independent, masked fashion, investigators then evaluated all included RCTs. Similarly, all RCTs were evaluated using the Cochrane Collaboration Risk of Bias 2.0 tool. To assess relationships between trial characteristics and completeness of reporting, bivariate regression analyses were used. Results: From 878 publications, 37 RCTs met inclusion criteria. The mean Consort-PRO completeness of reporting across RCTs was 51.2% (SD = 20.8). Evaluation of our secondary outcome - assessment of study characteristics - demonstrated significantly higher completeness of reporting when (1) the Consort guideline was mentioned within the RCT (p = 0.01); (2) trials had 'some concerns' for bias (p = 0.001); and (3) trials had 'low' risk of bias (p = 0.001). Conclusions: Our study found that there was subpar Consort-PRO adherence within tinnitus RCTs. Due to the variance in symptom severity in tinnitus and the importance of PROs to clinical practice, we recommend journals include instructions to authors to use the Consort-PRO guideline before they publish RCTs. [ABSTRACT FROM AUTHOR]

Background: Noise exposure damages cochlear hair cells resulting in sensorineural hearing loss along with other symptoms like tinnitus and vertigo. One source of loud sound exposure in young adults is personal music systems (PMS). The present study investigated the auditory-related symptoms in regular PMS users by administering a questionnaire on PMS usage and associated symptoms in individuals who were regular users of PMS and compared results with non-regular PMS users. Material and methods: There were 260 young adults who participated in the study. Individuals who used PMS for ≥1 hour per day at a volume control setting of ≥60% for ≥2 years were considered regular PMS users, while other participants were considered non-regular PMS users. A custom-made questionnaire with a total of 24 questions was administered to all participants. Results: Statistical analysis indicated that the occurrence of symptoms such as reduced hearing and vertigo were significantly higher in regular PMS users than in non-regular users. However, other symptoms such as tinnitus, difficulty in perception of speech in noisy situations, ear pain, and headache were not significantly different between the groups. Conclusions: The findings substantiate the harmful effects of regular PMS usage on hearing and related functions. They also document the incidence of associated symptoms. [ABSTRACT FROM AUTHOR]

Somatic tinnitus is a condition that results from cervical spine or temporomandibular disorders. It commonly affects 36--43% of the Belgian population. We present a single case experimental design of a 38 year old somatic tinnitus patient having neck pain, headache, and ringing sensation in both ears. Six sessions of soft tissue mobilization were performed for 30 minutes on alternate days for two weeks. Postural re-education exercises were instructed as a home regime. Outcome measures were Visual Analogue Scale, Tinnitus Handicap Inventory, and digital calibrated algometer which were evaluated at baseline and after the last treatment session. Following 6 sessions of treatment there was a significant improvement in outcome measures. This study implies positive results of manual therapy on quality of life and pain pressure threshold in somatic tinnitus patients. [ABSTRACT FROM AUTHOR]

Introduction: Tinnitus is usually a chronic (ongoing) condition which in many cases significantly impairs the affected person's quality of life. Their habituation to tinnitus depends on the patient's personality resources. The aim of this research was to determine if a particular psychological meta-resource, in this case a sense of coherence, is related to the perceived annoyance of tinnitus. Material and methods: The study included 176 people (123 females, 53 males) aged 31-80 (M = 59.1) diagnosed with tinnitus. To measure the sense of coherence, we used the Sense of Coherence Questionnaire (SOC 29), and to evaluate the tinnitus annoyance, we used the Tinnitus Handicap Inventory (THI). The subjects also filled in a survey to capture sociodemographic data and their medical history. Results: The sense of coherence (in total and in particular aspects) turned out to be significantly correlated with tinnitus annoyance (in total and in particular aspects). The overall level of coherence turned out to be an essential predictor for the overall level of tinnitus annoyance. The degree of manageability was a particularly important component of the sense of coherence which affected tinnitus annoyance. Conclusions: In people with a strong sense of coherence, especially with a strong manageability component, there is a lower level of tinnitus annoyance. Psychological interventions -- counselling, psychoeducation, psychotherapy -- support the development of a sense of coherence and can reduce tinnitus annoyance. [ABSTRACT FROM AUTHOR]

Introduction: Øreblue® is a new treatment method for tinnitus and hyperacusis combining auditive rehabilitation and psychological therapy. The present monocentric observational retrospective study was to assess patient's judgements of its effectiveness. Material and methods: From January 2011 to June 2015, 74 consecutive healthy patients (male/female, 51/23; median age, 51.5 years) with chronic tinnitus (without hyperacusis, 32) or hyperacusis (with tinnitus, 42) were treated according to priority at the Hearing Institute of Resources (La Rochelle, France). They were asked to rank their discomfort, quality of life, and sleep quality before and 1 month after treatment using 10-point scales ranging from 0 (no discomfort, poor quality of life, or poor sleep quality) to 10 (unbearable discomfort, best quality of life, or best sleep quality) and their global impression of change on a 10-point scale ranging from 0% (not improved) to 100% (fully improved). These data which were reported in patient medical files were retrospectively analysed in 2018. Results: Discomfort, which was severe at inclusion (8.9±0.8), drastically decreased after treatment (change -8.5±1.3). Quality of life and sleep improved (from 2.2±1.4 and 2.0±1.9 to 8.3±1.4 and 4.9±2.1, respectively). 81.3% of the patients with tinnitus and 100% of patients with hyperacusis claimed to be fully improved. No adverse events were reported during the study. Conclusions: The Øreblue® method was effective on discomfort related to tinnitus or hyperacusis; it greatly improved quality of life and sleep. Further studies, especially multicentric or randomised, possibly with imaging and long-term follow-up, should be performed to strengthen these encouraging findings. [ABSTRACT FROM AUTHOR]

Background: Arnold--Chiari malformation is defined as a congenital neuroanatomic deformity of the craniocervical junction, which is characterized by herniation of contents from the posterior cranial fossa through the foramen magnum into the cervical spinal canal. There is limited literature on audiological and vestibular evaluation on individuals with Arnold--Chiari malformation. Thus, the present study reports the results of a detailed audio-vestibular evaluation in an adult female diagnosed with Arnold--Chiari malformation. Case report: A detailed audio-vestibular evaluation was carried out in an adult female diagnosed with Arnold--Chiari malformation. Pure tone audiometry, immittance evaluation, otoacoustic emissions, auditory brainstem response (ABR), cervical vestibular evoked myogenic potential (cVEMP), ocular vestibular evoked myogenic potential (oVEMP), and video head impulse test (vHIT) were recorded, and the results were analyzed. The results of the study showed an abnormal prolongation of inter-peak latencies in the ABR, which was seen in both ears. Also, cVEMP and oVEMP was absent in both ears. The results suggest possible compression of the cerebellar tonsils on the cochlear and vestibular nuclei. Conclusions: The study suggests that individuals with Arnold--Chiari malformation should undergo a detailed audio-vestibular evaluation to understand the pathophysiology of the disorder, which can guide further management. [ABSTRACT FROM AUTHOR]

Background: Every year more people suffer from tinnitus. Therapy for the condition requires a comprehensive approach to the patient. Despite the existence of many treatment methods, none is 100% effective. After a physician has excluded organic diseases, it is standard practice to try sound therapy. The aim of this study was to evaluate the effectiveness of sound therapy by means of a free mobile application ReSound Tinnitus Relief in a patient with very troublesome tinnitus. Case study: The patient, a 34-year-old woman, reported very troublesome tinnitus, described as a constant, non-pulsating ringing sound felt "inside the head". The patient was offered sound therapy using a widely available application installed on a mobile phone. Progress of the therapy and changes in tinnitus perception were evaluated using two standardized questionnaires: the Tinnitus Handicap Inventory and the Tinnitus Functional Index. Results from both questionnaires showed that overall tinnitus annoyance decreased after 3 and 6 months of use. Conclusions: The data demonstrate that the use of sound therapy on a mobile app can provide satisfactory results, at least in this patient. However, it is not possible to say that such sound therapy will bring relief to all patients. Nevertheless, it is an option that a doctor can offer to their patient. A further study is needed on a large group of people to confirm whether it is possible to replace conventional sound generators with mobile solutions. [ABSTRACT FROM AUTHOR]

Background: Auditory brainstem implantation (ABI) is a modern method of treating hearing impairment, directed especially to patients with neurofibromatosis type 2 (NF2). One of the co-occurring symptoms in these patients is tinnitus; however, little is known about its prevalence and severity. This study evaluated the self-reported hearing ability, hearing-related quality of life, and tinnitus severity in 4 adult ABI users. Material and methods: The study was a retrospective design. A series of 6 patients who underwent ABI in a single tertiary referral center were asked to fill in two sets of questionnaires referring to their pre- and postoperative experiences. The Abbreviated Profile of Hearing Aid Benefit (APHAB) was used to evaluate self-perceived hearing ability and Nijmegen Cochlear Implant Questionnaire (NCIQ) to assess hearing-related quality of life. Tinnitus perception was evaluated using Tinnitus and Hearing Survey and Tinnitus Handicap Inventory (THI). Results: Of the 6 patients who initially agreed to participate, 4 returned questionnaires. Based on the self-reported results, it was found that each patient noticed an improvement in hearing ability (mean improvement in APHAB score of M = 25; SD = 27), which was greatest in background noise conditions. A considerable improvement was also noted in the patients' hearing-related quality of life (mean improvement in NCIQ score of M = 38; SD = 13), which was most pronounced for basic and advanced sound perception. Tinnitus disappeared completely in two patients and was reduced in one patient (mean improvement in THI score for these patients of M = 25; SD = 21). An increase in tinnitus severity from 26 to 84 points in THI was observed in the remaining patient, who had the greatest intensity of NF2 symptoms in the postoperative period and reported the smallest benefits with ABI. Conclusion: Brainstem implantation has the potential to improve self-reported hearing ability, hearing-related quality of life, and reduce tinnitus in NF2 patients. However, more prospective studies are needed to confirm and further explore this potential. [ABSTRACT FROM AUTHOR]

Background: This paper is a review of the literature on electrical stimulation of the ear to treat tinnitus. This method of treatment has been used since the 1970s and different techniques have been explored. The primary aim of this work was to review the literature on electrical stimulation of the ear to suppress tinnitus, with a specific focus on the methods and stimulation parameters used so far and the efficacy of the different methods. A secondary aim was to formulate recommendations on electrical ear stimulation parameters that suppress tinnitus. Material and methods: Four databases were searched: PubMed, Ovid Embase, Web of Science, and Science Direct. Database searches were conducted during November 2018 using the search terms: tinnitus and electrical stimulation. Inclusion criteria: All research articles on invasive and non-invasive electrical stimulation of the ear for suppressing tinnitus were included. Other inclusion criteria were records in English and involving adult human participants. Exclusion criteria: Studies on intracochlear stimulation using cochlear implants and studies where stimulation extended beyond the ear (e.g. transcutaneous electrical nerve stimulation, TENS) were excluded. Results: Twenty publications met the inclusion criteria and were analysed in this review. A comparison was made between invasive and non-invasive electrical ear stimulation in terms of efficacy, type of current used, laterality of stimulation, intensity and frequency of the current, duration of tinnitus suppression, and adverse effects. Due to the non-standardised methodology of the studies, there was only a low level of evidence available in terms of the advantages of a particular technique or stimulation parameter. The difficulties in comparing the effectiveness of the studies were related to many factors, and these are discussed. One factor is the variability in outcome measures, including different definitions of treatment success and limited use of standardised or validated outcome measures. Conclusions: Based on the reviewed literature, it is concluded there is no clear advantage of one stimulation condition over the other in terms of method, stimulation parameter, or effectiveness. This leads us to conclusion that the present body of evidence is insufficient to formulate definite recommendations for electrical ear stimulation. [ABSTRACT FROM AUTHOR]

Background: There is an unknown relationship between hearing loss, vestibular disorders, and mega cisterna magna. The purpose of this case report is to describe, for the first time, hearing and vestibular examinations and rehabilitation for an older adult with mega cisterna magna. Case Report: This study presents the case of a 54-year-old male who complained of being hard of hearing (bilaterally), tinnitus, and dizzy spells. He had a history of working in noisy environments but no familial history of hearing loss. Several audiological and vestibular tests and magnetic resonance imaging (MRI) were administered. The subject was counseled about hearing aids and fitted with a 'bilateral contralateral routing of signal' (BiCROS) amplification system to overcome his hearing difficulties. Conclusions: Mega cisterna magna can be either silent and cause no symptoms, or produce symptoms such as hearing loss, tinnitus, and dizziness. Aging and noise exposure are major causes of hearing loss and tinnitus. Further research is needed to determine the audiological and vestibular symptoms of a larger sample of patients with mega cisterna magna. [ABSTRACT FROM AUTHOR]

Background: Tinnitus is defined as a perception of sound in the absence of an external sound source and is clinically classified as a symptom. Despite the high prevalence and impact of tinnitus on a person's quality of life, treatment options are limited. For example, hearing aids (HA) are a possible therapeutic approach for patients with tinnitus-associated hearing loss, however, there is a paucity of relevant findings on the effectiveness of these devices in reducing tinnitus and improving quality of life. Nevertheless, in the current absence of a cure for tinnitus, auditory amplification seems to contribute to reducing the perception of tinnitus sound and the discomfort associated with it, due to the amplification of external sounds that may mask or cover up the tinnitus. Therefore, we examined the effects of this amplification approach in patients with tinnitus associated with sensorineural hearing loss (SNHL). Material and methods: Eleven patients (9 females, 2 males; mean age 62.36 ± 5.89 years) with both hearing loss and tinnitus were enrolled. Study eligibility criteria specified SNHL, based on a pure tone average of hearing thresholds at 0.5, 1, 2 and 4 kHz > 20 dB, as well as not having previously received any counselling or cognitive therapy for tinnitus. Tinnitus was examined using tinnitogram test and 25 items of the Tinnitus Handicap Inventory (THI). Data management and analyses were performed using IBM SPSS Statistics 27. Correlations between the THI and the use of hearing aids, as well as between THI scores and perceived tinnitus intensity, were evaluated using Spearman's correlation coefficient. Statistical results were considered significant at the alpha level < 0.05. Results: Tinnitus was bilateral in 54.5% of the patients and unilateral in 45.5%. Hearing aids were worn by 6 patients (63.64%) for a mean time of 9.69 years. For patients who wore hearing aids, significantly lower scores were found on the THI compared to unfitted participants (mean THI scores of 19.10 vs 49.50; Rp = 0.66; p = 0.03). Likewise, a moderate correlation was found between tinnitus intensity and THI, with higher tinnitus intensity associated with higher scores of THI (Rp = 0.70, p = 0.02). Conclusions: Marked effects on tinnitus were observed in participants with hearing aids, showing significant improvements with auditory amplification. Acoustic therapy using hearing aids seems to be effective for tinnitus-associated hearing loss. [ABSTRACT FROM AUTHOR]

Introduction: Surgical treatment of otosclerosis requires considerable experience of the otosurgeon, especially in advanced cases or in an ear with an unusually narrow external auditory canal, a narrow niche of the round window, a significantly thickened stapes footplate, or an exposed or hanging facial nerve. Case involving subsequent reoperations by different surgeons can be particularly difficult. Collective knowledge of treatment failures during otosclerosis reoperation, as set out in the literature, does not list the difficulties encountered, fails to assess most causes of failure, and does not describe remedies and corrective techniques. Material and methods: The course of treatment followed by a 55-year-old complaining of progressive, bilateral, mixed hearing loss due to otosclerosis is described. The patient's treatment consisted of stapes mobilization, followed by stapedotomy and restapedotomy of the right ear, and stapetodomy of the left ear. Results: There was short-term improvement of hearing after mobilization of the stapes, but its subsequent deterioration, with elevation of both the air- and bone-conduction thresholds in the right ear, were indications for reoperation and stapedotomy. Short-term improvement in hearing was achieved after the operation, followed by rapid hearing loss. Due to this and growing balance disorders after nearly a year, a restapedotomy was performed with complete closure of the air-bone gap. Then, due to hearing deterioration in the left ear, a successful stapedotomy was performed in this ear. Conclusion: Revision operations in otosclerosis require a lot of experience of the otosurgeon due to the many reasons for failure, particularly when the first surgery was performed elsewhere. An air-bone gap, severe tinnitus, and balance disorders are indications for reoperation by an experienced otosurgeon, as common causes of failure are postoperative adhesions and subsequent stapes immobilization. [ABSTRACT FROM AUTHOR]

Otosclerosis is most often diagnosed in adults, especially women. It is much less common in children and even rarer in boys. The aim of this paper is to present the case history and results of surgical treatment of a 5-year-old boy with bilateral conductive hearing loss and tinnitus. Results of surgical treatment show mean air-bone closure of 25 dB and cessation of tinnitus. Surgical treatment for otosclerosis is recommended regardless of the patient's age. Additional motivations for surgical intervention in children are: severe progressive hearing loss, tinnitus, and rising bone-conduction threshold. [ABSTRACT FROM AUTHOR]

Background: The COCH gene encoding cochlin is highly expressed in the inner ear but the exact physiological function of the protein still remains unknown. Pathogenic variants located in COCH cause autosomal dominant hearing loss with possible vestibular involvement. Material and methods: A five-generation Polish family with autosomal dominant hearing loss and tinnitus was recruited for the study. Audiological and vestibular assessments were conducted and clinical exome sequencing was performed in the index patient. Next, co-segregation of the detected variant with hearing loss in the family was confirmed using Sanger sequencing. Results: All affected individuals presented postlingual, progressive hearing loss mainly affecting high frequencies. No vestibular dysfunction was detected. In this study, we have identified a very rare COCH p.Ile372Thr pathogenic variant that segregated with the disease. Conclusions: Our study provides an independent confirmation of the pathogenic role of COCH p.Ile372Thr in hearing loss. In addition to hearing loss, individuals with COCH pathogenic variants may also suffer from tinnitus and vertigo. [ABSTRACT FROM AUTHOR]

Tinnitus is a bothersome symptom with various etiologies. Pulsatile tinnitus constitutes only a small percentage of tinnitus types and is due to a vascular pathology close to the inner ear which causes a sensation of noise. Many vascular lesions are associated with pulsatile tinnitus: paraganglionoma, persistent stapedial artery, a vascular loop in the internal auditory meatus or cerebello-pontine angle, carotid-vertebral stenosis, and arterio-venous malformation. We report one case of pulsatile tinnitus that originated in a venous diverticulum of the sigmoid sinus and which was transmitted to the inner ear through perisinus pneumatisation. Treatment options for this condition are discussed, with insights from the literature. [ABSTRACT FROM AUTHOR]

Background: Cogan's syndrome is a very rare autoimmune disease characterized by the coexistence of inflammatory lesions in the eyeball and inner ear dysfunction. The symptoms of Cogan's syndrome within the inner ear appear suddenly and resemble Meniere's disease symptoms: severe vertigo, nausea, vomiting, and usually bilateral, fluctuating sensorineural hearing loss with concomitant tinnitus. Case report: A 59-year-old woman was admitted to the Otolaryngology Head and Neck Surgery Clinic to undergo cochlear implantation. At 57 years of age, the patient had been diagnosed with scleritis. About a year later, vertigo and nausea arose, followed by rapidly progressing hearing loss - at first in the left ear and subsequently in the right, accompanied by tinnitus. At the time of implantation, the patient's speech discrimination score was 0% for both ears. Taking into consideration the audiometric tests results and imaging scans, promontorial cochle- ostomy was carried out during the cochlear implantation procedure. In the postoperative period, no complications were observed. After 24 months of using the speech processor, the subjective assessment of speech intelligibility given by the patient on a 0-10 scale was 8.5 in quiet and 5.0 in a noisy environment. The patient could identify 95% of monosyllabic words in silence and 35% in noise (in conditions of SNR +10 dB, speech level at 70 dB HL, and noise level at 60 dB HL). The benefits obtained were confirmed by results of an Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. The patient is presently eligible for cochlear implantation in the other ear. Conclusions: Cochlear implantation was effective in improving hearing in a patient with Cogans syndrome. [ABSTRACT FROM AUTHOR]

Introduction: Cochlear implantation is the most effective method of hearing rehabilitation in a group method in group of patients with severe and profound sensorineural hearing loss. Furthermore, tinnitus is a frequent symptom related to hearing impairment. The aim of this study was to assess severity of tinnitus before and after cochlear implantation. Material and methods: This study included 70 patients (35 women and 35 men), who were implanted. Tinnitus severity was evaluated three times: preoperatively, at activation and one month after implantation. Tinnitus and Hearing Survey (THS), Tinnitus Handicap Inventory (THI) and Tinnitus Functional Index (TFI) were used to assess tinnitus severity. THS and THI adaptation were conducted in the World Hearing Center of the Institute of Physiology and Pathology of Hearing. Results: The results showed that tinnitus was experienced in 65.7% of patients who were qualified to cochlear implantation. One-sided tinnitus (in the operated ear) was experienced in 54.4% cases and bilateral tinnitus in 45.6%. Hearing impairment was the primary complaint of 93.5% cases. Preoperatively, severity of tinnitus was assessed as moderate (THI M=39.9; SD=23.4; TFI M=38.4; SD=21). Results after one monthly observation suggested mild tinnitus severity (M=25.6; SD=21.9; TFI M=29.2; SD=20.6). Conclusions: Monthly observation showed that severity of tinnitus after cochlear implantation decreased. [ABSTRACT FROM AUTHOR]

Many issues concerning sudden sensorineural hearing loss (SSNHL) remain unresolved. An especially troublesome and uncharted field is SSNHL in children. The aim of the present literature review was to recognize, critically evaluate, and synthesize knowledge on pediatric SSNHL derived from available studies. Articles published between 2000 and 2016 in the English and Polish languages were investigated. Included in the analysis were studies examining children and adolescents ≤18 years or, in the case of comparative studies of children and adults, reports which treated the younger age group as a separate entity. An increase in the attention given to pediatric SSNHL could be observed over the last 16 years. Due to substantial differences in approach found in the analyzed articles, it was impossible to conduct a meta-analysis and provide descriptive statistics. The average age of the investigated children was 12 years. There was no difference in SSNHL prevalence between either gender. Unilateral cases were much more common than bilateral, and no preponderance for left or right ear was noted. The most common factors accompanying SNSHL were tinnitus and vertigo; the most common proposed etiologies were idiopathic and viral infections. There were two main treatment types: steroids (oral, intratympanic, intravenous) and hyperbaric oxygen therapy. Depending on the treatment protocol, the rate of complete recovery ranged from 9 to 57%. The most common positive prognostic factors were mild degrees of hearing loss, occurrence of tinnitus, and early treatment onset, whereas bilateral hearing loss and vertigo were found to be negative prognostic factors. [ABSTRACT FROM AUTHOR]

Background: Anxiety and/or depression contribute to the individual's inability to perform daily tasks, affecting sleep and causing constant insomnia. Sleep disorders are associated with the occurrence of tinnitus and mental disorders. Tinnitus, a symptom characterized by the perception of a sound, touch or whistle, in the absence of an external stimulus. This study aims the prevalence of tinnitus in the general population, its connections to sleep and mental health, as well as the repercussions on quality of life. Material and methods: This study was conducted on Google-Forms where the following questionnaires were applied: Sociodemographic and Health Questionnaire, Tinnitus Handicap Inventory Questionnaire (THI), Anxiety, Depression and Stress Scale, 21 items (EADS-21) and Abbreviated Quality of Life Assessment Instrument (WHOQOL-Bref). The collection lasted 3 months. Results: The sample was composed of459 individuals, mostly female (76.9%), single (74.3%), from the central area (75.6%), aged between 18 and 25 years (46.4%) in which 28.1% have stress. The prevalence of tinnitus is 22.0%, with 14.2% being bilateral and 13.1% having a reduced degree of severity (grade I). As for the EADS-21 questionnaire, the three categories (stress, anxiety, and depression) improved their values, decreasing them stress: M = 6.77 ± 4.89; anxiety: M = 3.64 ± 3.75 and depression: M = 4.64 ± 4.06. Finally, as for the WHOQOL-Bref questionnaire, the physical domain has lower values (M = 1.86 ± 0.40), contributing negatively to the quality of life of the individual. Conclusions: The present study made it possible to perceive the prevalence of tinnitus in the general population, 22%, having a negative impact on quality of life and mental health. [ABSTRACT FROM AUTHOR]

Introduction: Neuroendocrine adenomas are tumors with double differentiation. Middle ear location of those tumors is rare. NAME causes various clinical signs. One of them could be tinnitus. Material and methods: A 23-years old patient was admitted to World Hearing Center due to right-sided hearing loss and tinnitus. Physical examination suggested tumor of the middle ear. Patient underwent surgical treatment (atticoantromastoidectomy) with pathologic tissues excision and myringoplasty. For tinnitus evaluation, several questionaries' were applied (TFI, THI, THS). Result: Postoperative period was uneventful. Patient reported hearing improvement and tinnitus reduction. Histological examination revealed neuroendocrine adenoma of the middle ear. [ABSTRACT FROM AUTHOR]

Introduction: Pulsatile tinnitus is perceived as a rhythmic pulsing and can be experienced as a thumping or whooshing sound. About 3% of tinnitus patients experience this type of tinnitus. Case report I: A 28-year-old woman visited a tertiary referral center with pulsatile tinnitus of left ear for 1week. The audiology test and physical examination were no significant findings. On temporal bone MRI including angiography, she was found dural arteriovenous fistula (dAVF) in the left transverse sinus. She transferred to neurosurgery for performing embolization of dAVF. After surgery, her symptom was completely disappeared. Case report ll: A 35-yearold man with pulsatile tinnitus of right ear for 3 weeks visited the outpatient department. The physical examination, audiology tests, and even temporal bone CT were no significant findings. On temporal bone MRI including angiography, he was found dural arteriovenous fistula (dAVF) in right clivus and jugular foramen. After explaining the situation to the patient, he was transferred to neurosurgery for surgical intervention. Discussion: In these cases, two types of dAVF were identified as the cause of pulsatile tinnitus. We reported rare vascular tinnitus of two cases with literature review. [ABSTRACT FROM AUTHOR]

Objectives: Tinnitus is defined as a sounds heard in one or both ears or in head, without any external acoustic factors. These noises can occur permanently or intermittently, causing a great deal of troubles in everyday human life. According to literature, most of patients report lower tinnitus distress after cochlear implantation, compared to the preoperative period. Skaryski Tinnitus Scale (STS) questionnaire, constructed of 15 questions, takes into account the impact of tinnitus on both the psychological (emotional, cognitive) and functional domains and the patient's ability to cope with tinnitus-related distress. Aim: The aim of the study was to check if there is a change of tinnitus perception after cochlear implantation according to Skarżyński Tinnitus Scale (STS) questionnaire. Material: The object of these study are patients undergoing their first cochlear implantation (none of the ears were previously operated) from February 2018. Methods: To assess the change in the occurrence of tinnitus, the Skarżyński Tinnitus Scale (STS) questionnaire was used. All of the patients were asked to fill in the questionnaire three times: preoperatively, one month after implantation and five months after implantation. As a whole, the STS has excellent reliability (ICC=0.94) and good internal consistency (α=0.91). The results of EFA and content analysis of wording of the items justified the three-factorial structure. The convergent validity was proven by a significant positive correlation with THI, TFI and THS Subscale A scores. Results: The analysis of the STS questionnaire results shows that in the preoperative period almost half (49%) of the respondents suffer from tinnitus, which has a significant impact on their quality of life. These patients obtained a high or very high result. After implantation (one month after activating the speech processor), the percentage of patients suffering from severe tinnitus (high or very high result) decreased to 29%, and within 5 months after the activation of the sound processor to 27%. Reduction of the demandingness of tinnitus in patients with hearing loss qualified for cochlear implantation had a significant impact on their quality of life and everyday functioning in society. Conclusions: Statistical analysis shows that STS is a brief but robust tool well-suited to clinical practice. A feature of STS is that it takes into account the impact of tinnitus on the patient's psychological (emotional, cognitive) and functional domains as well as their ability to cope with tinnitus-related distress. According to literature, the number of patients with tinnitus problem may increase in the future. Tinnitus is the cause of concentration disorders, increased tension and anxiety or depression and as a consequence, they can lead to withdrawal from professional and social life. Thereupon, it seems that the diagnosis and treatment of tinnitus might be a significant challenge for the health care system, especially in countries, were live expectancy increases. [ABSTRACT FROM AUTHOR]

Background: Tinnitus is an auditory phantom sensation without the presence of an external sound source. Approximately 10--15% of the adult world population suffers from tinnitus, making it a highly prevalent symptom. The clinical origin and representation are extremely heterogenous. While some are not troubled by tinnitus, others experience it as debilitating. This is possibly due to other associated biopsychosocial complaints and comorbidities, such as elevated stress, hearing problems, hyperacusis, cognitive difficulties, sleep disturbances, anxiety and depression, that might further burden the health-related quality of life (HRQOL) of tinnitus patients by affecting the severity or tolerance of tinnitus. Objective: This review aims to assess whether the presence of tinnitus is negatively correlated with HRQOL evaluated by self-report questionnaires or whether results on these questionnaires are significantly different for patients with tinnitus in comparison to subjects without tinnitus. Method: This systematic review adheres to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA guidelines). The following databases were consulted: PubMed (National Center for Biotechnology Information), ScienceDirect, Cochrane Library, Web Of Science, and Embase (OVID). The search queries consisted of the terms tinnitus and HRQOL and their synonyms and the eligible questionnaires: EQ-5D- 3L, HUI3, SF-8 and SF-36. Results: In first instance, 777 possibly relevant search results were found. In total, 99 duplicates were removed before the primary screening was fulfilled for the remaining 678 articles. Based upon this screening on the title and abstract, 654 articles were excluded. The remaining 24 articles were screened on full text. Ten studies were considered eligible. Half of them found a significant negative correlation between the severity of tinnitus and EQ-5D-3L, HUI3, SF-8 and SF-36. The other half of the studies concluded that, in general, patients with tinnitus scored significantly lower for these HRQOL-questionnaires in comparison to subjects without tinnitus. Conclusions: The assessment of the current literature led to the following conclusions. First of all, a negative correlation between tinnitus and HRQOL, as measured by self-report questionnaires, is present. Secondly, the general scores on HRQOL questionnaires are lower for tinnitus patients in comparison to subjects without tinnitus. The heterogeneity in outcome measures causes a lack of comparability of results. This forms an important point of interest for future research. [ABSTRACT FROM AUTHOR]

Intorduction: Age related hearing loss (presbycusis) presents itself by elevated auditory thresholds and decreased speech intelligibility especially in a noisy environment. Occurrence of tinnitus (phantom noise) commonly coincides with the onset of presbycusis. Although both are believed to originate from the auditory periphery, they have several functional and morphometric effects also in central parts of auditory and limbic system. Aim: The aim of our project is to identify possible changes within the white matter of auditory pathway above inferior colliculus (IC) and also within the connections towards the limbic system (amygdala). Material and methods: Six groups of volunteers were used in this study: elderly with expressed presbycusis, elderly with mild presbycusis, young controls, elderly with expressed presbycusis and with tinnitus, elderly with mild presbycusis and with tinnitus and subjects with normal hearing and with tinnitus. Tractographic data were acquired using a 3 T Siemens Tim Trio system (Siemens), with a 12-channel head coil. Streamline tracking was performed on common FOD template using probabilistic algorithm iFOD2. Spherical masks on both inferior colliculi were defined manually. Mask of the Heschl gyrus was obtained by applying morphing of Destrieux atlas mask of one representative subject to FOD template. These masks were used as ROIs for targeted exploratory tracking and definition of fixel mask). Fixel based analysis was used for detection of changes (using connectivitybased fixel enhancement, family-wise error corrected) in the following three metrics: fibre density, fibre cross-section, fibre density and cross-section. Results: We were able to identify auditory pathway above the level of IC, and connections from IC towards the amygdala and from AC to amygdala. The only observed changes of the white matter within the auditory and auditory -- limbic pathways were due to ageing. No statistically significant changes due to hearing loss were found. Tinnitus caused a borderline change in the part of the pathway from the inferior colliculus toward amygdala. Conclusions: This is probably the first study using fixel based analysis in the auditory system. Although we were bale to identify age related changes within the studied tracts, in all used metrics, no hearing loss related changes were present. The presence of borderline tinnitus changes in the adjacent pathway from the inferior colliculus to amygdala support the idea of involvement of the limbic system in the tinnitus network. [ABSTRACT FROM AUTHOR]

Background: Osteogenesis imperfecta is a congenital disorder underlain by an inherited deficiency of a connective tissue component. Different clinical symptoms related to various collagen mutations make it possible to distinguish several types of osteogenesis imperfecta. The most common four symptoms are defects of the osteoarticular system, sclera, skin, and hearing loss. Case report: We report the case of a 60 year-old patient who was referred to the Institute of Physiology and Pathology of Hearing with bilateral progressive hearing loss, which she had first noted about 35 years ago. Based on clinical findings, the patient was diagnosed with osteogenesis imperfecta. She had a history of multiple bone fractures, short stature, and minor teeth malformations. No genetic test results were available for this patient. Based on results of an examination and the character of the hearing loss, the patient was referred for surgical treatment: explorative tympanotomy with bilateral reconstruction in stages. Both surgeries revealed fixation of the stapes and a thickened stapes footplate. Stapedotomies were performed in each ear. Follow-up after surgeries included pure tone audiometries. Results: Surgical intervention resulted in closure or reduction of the air-bone gap on both sides, demonstrating effectiveness of the treatment. Conclusions: In osteogenesis imperfecta hearing loss is a common comorbidity of anomalies in the osteoarticular system. A thickened and fixated stapes footplate can contribute to conductive component of hearing loss. Exploratory tympanotomy with stapedotomy is the method of choice in such cases. It allows the air-bone gap to be reduced and a subjective improvement of hearing, to reach, as this report demonstrates. [ABSTRACT FROM AUTHOR]

Background: The medial olivocochlear system (MOCS), part of the efferent auditory pathway, causes an inhibitory effect on the outer hair cells, thus protecting them against extreme noise exposure and improving speech discrimination in noisy environments. This study aims to assess the MOCS function and aging in tinnitus patients with the use of contralateral suppression (CS) of otoacoustic emissions (OAEs). Material and methods: 136 subjects took part in this study, divided in 6 groups (control group, right-side tinnitus, left-side tinnitus, bilateral tinnitus, presbycusis without tinnitus and presbycusis with tinnitus). CS of transiently- evoked (TEOAEs) and distortion products OAEs (DPOAEs) was measured for each group and pair- wise comparisons between the groups were performed. Results: CS was less frequent and the mean values of CS were significantly lower in the tinnitus ears than normal ones. The mean values of CS of ears with presbycusis were in some cases higher than ears with presbycusis and tinnitus and also than ears with tinnitus and normal hearing. Not particular statistical differences were found between the method used (TEOAEs or DPOAEs) and the comparisons between the groups. Conclusions: The absence and lower values of CS in tinnitus ears imply a MOCS dysfunction as a main factor of tinnitus generation. Tinnitus seems to have a more detrimental effect to the MOCS function than presbycusis. CS of TEOAEs and DPOAEs are equally sensitive methods in detecting MOCS dysfunction in patients with tinnitus. [ABSTRACT FROM AUTHOR]