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Aim: The objective of this study was to estimate the prevalence of the tinnitus in 7- and 12-year-old children in Poland., Material and Methods: In this study 118,005, 7-year-old children and 23,339, 12-year-old children and their parents were asked about the presence of tinnitus by answering a questionnaire. 7-year-old children were asked by tester if they can hear noise in their ears or head., Results: The results showed that according to parents questionnaire answers tinnitus was present in group of 15,244 (12.9%) 7-year-old children and in group of 3886 (16.6%) 12-year-old children. Between 7-year-old children directly asked for tinnitus 29.3% (34,517) mentioned of having it. Group of 8060 (34.5%) 12-year-old children confirmed in questionnaire hearing tinnitus. Differences in the presence of tinnitus between 7- and 12-year-old children have proven to be statistically significant., Conclusions: Tinnitus is frequent complain among 7- and 12-year-old children. It is recommended to include to a questionnaire an inquiry about the presence of tinnitus during hearing screening tests performed recently more frequently at primary schools for early detection a diagnosis of tinnitus., (Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.)

Aim of the Study: To evaluate the influence of high frequency hearing loss (> 8000 Hz) on distortion product otoacoustic emissions registered in the frequency range from 0,5 to 8 kHz., Material and Methods: 280 ears with tinnitus and normal hearing (0.25-8 kHz) divided into 3 groups depending on the degree of high frequency hearing loss: group A--hearing threshold up to 20 dB for 10, 12.5, 14 and 16 kHz (68 ears); group B--hearing threshold 25-40 dB HL for at least one of four EHfs (93 ears); group C--hearing threshold above 40 dB HL for at least one of four EHFs (119 ears). For each group mean audiogram and DP-gram were obtained and statistical analysis was used for comparison across these groups., Results: Mean DPOAE values in group C were significantly lower in comparison with group A for the frequency range 2-8 kHz, and in comparison with group B were significantly lower for the frequency range 4-8 kHz., Conclusions: High frequency hearing loss (above 8 kHz) has a relevant influence on distortion product otoacoustic emissions registered at frequencies below 8 kHz in tinnitus patients. The greater is hearing loss above 8 kHz, the lower is DPOAE value below 8 kHz., (2012 Polish Otorhinolaryngology - Head and Neck Surgery Society.)

Objectives: In systemic sclerosis (SSc) there may occur hearing and balance disorders as a result of the immune-mediated inner ear damage, the etiology being vasculitis and fibrosis. The objective is the vestibular organ evaluation in patients with SSc regarding their prevalence and relationship to duration of the disease and Raynaud phenomenon and also to type and severity of SSc., Material: Twenty unselected, consecutive patients with diagnosed SSc, complying with international diagnostic criteria of the American Rheumatism Association (1982), were enrolled into the study. The control group consisted of 26 otologically healthy persons matched to the SSc group for age and sex., Methods: In all patients the questionnaire about audiovestibular history, otolaryngological examination, static and dynamic vestibular tests and the electronystsgmography (ENG) were performed. The patients were investigated with the electronystsgmography (ENG) for spontaneous, positional and caloric-induced nystagmus. Also visual ocular-motor tests were performer., Results: In the anamnesis 65% of patients reported vertigo, 55% - headaches, 50% - tinnitus, 40% - hyperacusis, 40% - hearing loss and 30% - ear fullness. Vertigo, dizziness balance disturbance and uncorrect results of Romberg and Utenberger tests were more frequent in patients with vestibular organ lesion. Abnormalities in vestibular organ in SSc patients were fund in 14 (70%) persons - the central type of lesion - 8 (40%), mixed type in 3 (15%) and peripheral in 3 (15%)., Conclusions: Ear involvement is frequent in systemic sclerosis and should be taken into consideration during diagnostic and therapeutic procedures.

Introduction: Tinnitus in children is still rarely mentioned in medical literature. The prevalence of pediatric tinnitus has been reported to range between 3-37% and higher in children with hearing loss., Objectives: The objective of this study was to estimate the prevalence of the tinnitus in 7 years old children and to conduct statistical analysis of the relation between tinnitus and hearing loss., Material and Methods: In this study 60 212 children and their parents were asked about the presence of tinnitus by answering a questionnaire at home. Additionally, children were asked if they can hear noise in their ears or head, before hand hearing screening test at school was conducted. The hearing screening test was performed using screening audiometer with air conduction., Results: The results showed that tinnitus was present in group of 8164 children (13.6%). Between children directly asked for tinnitus, 33% mentioned of having it. Over 75% of children did not complained of tinnitus spontaneously to parents. Children with hearing loss reported tinnitus twice more comparing to children with normal hearing., Conclusions: Tinnitus is frequent complain among 7 years old children. Children with hearing loss reported tinnitus twice more comparing to children with normal hearing. It is recommended to include to a questionnaire an inquiry about the presence of tinnitus during hearing screening tests performed recently more frequently at primary schools for early detection and diagnosis of tinnitus.

Introduction: The aim of the study was to assess the frequency of depression and its intensity in patients with diagnosed tinnitus and their correlation with selected audiological parameters., Material and Methods: 80 patients underwent the study, including 46 females (57.5%) and 34 males (42.5%) aged 20-84 suffering from tinnitus. The study methodology included: an interview, otorhinolaryngological examination, full audiological diagnostics and imaging test (CT or MR). Patients who qualified for the study completed a modified questionnaire according to the Beck Depression Inventory (BDI). THE STUDY RESULTS: The study found the depression level higher than the one in the general population and amounting to 45%, with 41.2% of the patients suffering from masked depression (a mean rating scale of 14-16), and 3.7% of the patients showing symptoms of moderate depression (27 points according to the rating scale). The own studies showed no statistically meaningful relation between intensification of depression in the studied patients and their age and sex as well as acoustic parameters such as frequency, tinnitus localization. However, a statistically variable relation was noted showing that the longer a patient suffered from tinnitus the more often depression occurred., Conclusions: The occurrence of depression among the studied patients with tinnitus is higher than in the Polish population. In the conducted studies dominated depression of mild intensity. It was affirmed that depression occurred more often in patients with tinnitus lasting longer than 5 years.

According to our observations tinnitus is becoming increasingly common amongst younger persons. About 25% of patients registered in our Tinnitus Clinic, are below the age of 35. Group of 235 tinnitus patients ranging in age from 18 to 35 years old were evaluated for this study. There were no other pre-selection criteria except the age. All of the patients answered the questions concerned with the cause of tinnitus. The results of our research indicate that infections (68.5%), noise exposure (27.7%) and stress (23.4%) are the most frequent cause of tinnitus among patients below 35 years.

Introduction: Acoustic neuroma usually presents as an unilateral tumor, seldom - bilateral and rarely in coexistence with other central nervous system neoplasms. The following paper reports such a case of a 21-year-old male patient presented with sudden deafness in left ear accompanied with tinnitus and vertigo. Symptoms started 4 weeks prior hospitalization. Their aggravation has been observed 7 days before admission to the hospital. Audiometry revealed moderate sensorineural hearing loss in left ear (for low and middle frequencies), brainstem auditory evoked potentials were absent on the left side and ENG examination showed left peripheral vestibular impairment. Initially patient received i.v. vasodilatators showing 20-25 dB improvement in low frequencies after 3 days of treatment. MRI study revealed in the left internal acoustic meatus mass (7 x 7 x 14 mm) suggesting acoustic neuroma and an oval mass (7 x 9 x 14 mm) in the pineal gland presenting radiological features of pinealoma. Patient has been qualified for neurosurgical treatment. Acoustic neuroma has been removed by suboccipital approach and pinealoma has been left for further observation as it was found incidentally. Histopathological examination confirmed diagnosis of left VIII nerve schwannoma. The left facial palsy (House-Brackmann III/IV grade) and profound hearing loss appeared after surgery. The postoperative course shows no evidence of acoustic neuroma recurrence.

Introduction: The aim of the study was to analise tinnitus diagnosis and treatment on the basis of our experiences., Material and Methods: 137 patients hospitalizated in Otolaryngology and Laryngological Oncology Clinic because of tinnitus (88 women - 64% and 49 men - 35,8%) were included to the study. The diagnostic procedures were unified that enabled put forward correct diagnosis. After history and otoscopy, detailed audiologic diagnostic procedures (pure tone audiometry, suprathreshold audiometry, speech audiometry, acoustic immittance measures, auditory brainstem responses) were taken. Electronystagmography and videonystagmography, tinnitus loudness match, head and neck radiologic examinations supplemented diagnostic procedures. Alternative tinnitus treatment options were applied., Results: Study confirmed that tinnitus is the most frequent in patients above 50 years old (67,8% of participants). Tinnitus frequently coexist with bilateral sensorineural hearing impairment (69,1% of participants). 40,1% from asalysed group of patients complained of tinnitus of medium frequencies and 30,6% of patients complained of high frequency tinnitus. 42,3% of participants suffered from vertigo., Conclusions: The risk of tinnitus increases in patients above 55 years old that suffer from metabolic conditions and cervical spondylosis. Tinnitus frequently coexist with bilateral sensorineural hearing impairment and are bilateral or they are noticeable in better hearing ear. The most beneficial to tinnitus is causal and symptomatic treatment with several methods application.

Introduction: The aim of this work was to assess the value of impedance audiometry in the differential diagnostics of hearing disorders, especially in patients suffering from tinnitus., Material and Methods: The analysis dealt with results of the audiological tests in 198 patients (116 female and 82 male), hospitalised in 2007 due to their hearing deterioration, tinnitus or sudden deafness. The conducted audiological tests covered threshold and suprathreshold pure tone audiometry, speech audiometry, BERA and impedance audiometry. RESULTS OF THE STUDIES: Women (58.5%) and people over 50 years old (58.6%) constituted the majority of the patients. In 166 (83.8%) patients the conducted tests via impedance audiometry did not prove any deviations from the normal condition, the lesions referred to both ears in 32 (16.9%) patients and one ear in 17 (8.5%) patients. An incorrect tympanogram was found in 23 people, including type As in 11, type Ad in 2, type B in 4 and type C in 6 subjects. Low values of acoustic receptivity of the middle ear were noted in 20 ears, whereas high values in 11 ears. In 3 ears we found low values of the gradient (below 0.3), high values--in 11 ears. The middle ear pressure between -170 and -350 daPa was noticed in 20 ears, and positive values, above +50 daPa up to +75 daPa, in 3 ears. Disorders in the stapedial reflex registration were observed in 38 (19.1%) patients. The assessment of the conducted subjective and objective audiological examinations allowed to recognise bilateral perceptive hearing injuries in 139 patients, including 49 (25.9%) of cochlear origin with OWG, in further 70 patients the hearing loss referred to higher frequencies and was rather slight., Conclusions: The own experiences indicated that the impedance audiometry constitutes the integral part of contemporary audiological diagnostics and still remains an objective method facilitating quick, non-invasive evaluation of the functions of particular elements in the middle ear.

The Arnold-Chiari malformation is very rare hindbrain abnormalities characterized by herniation of the hindbrain through the foramen magnum. It usually does not present until adulthood, and then its symptoms may be varied and subtle. Patient 49 years was diagnosed in Foniatrics and Audiology Clinic because of tinnitus in left ear lasting 3 months. She underwent audiological diagnostic, that did not reveal any abnormalities, except for electrogustometry and hyporeflexia of stapedial reflex and labyrinth on the left side. In MRI scan we have noticed hindbrain abnormalities characteristic for Chiari type I malformation. Treatment consisted of immediate supportive care as needed but without surgical decompression, which was found unnecessary.

Introduction: Symptoms encompassing sensorineural hearing loss, tinnitus and vertigo occur in many diseases of various origin. The diagnostics in such cases is especially difficult and often requires interdisciplinary cooperation. Despite of that many cases remain unexplained., Material and Method: The two cases with above mentioned symptoms (52 year-old woman and 46 year-old man) with differentiated clinical course were presented. The woman for one year experienced left sided, extreme tinnitus with paroxysmal vertigo and dizziness. The man with sudden monolateral hearing loss and tinnitus that disappeared after corticosteroid therapy, complained about recurrence of fluctuating hearing loss and tinnitus accompanied by chronic instability. The diagnostics of hearing and balance organs was performed (pure tone audiometry, impedance audiometry, DPOAE, ABR, ENG) complemented with computed tomography and Nuclear Resonance., Results: Female patient presented bilateral mild sensorineural hearing loss, more intensive on the left side, male patient right sided sensorineural hearing loss in the frequencies from 250 to 1500 Hz. The elongation of some peak values in ABR test (with bilaterally proper otoacoustic emissions) as well as partial canal paresis on the hearing loss side suggested primary diagnosis of neoplasmatic process. It was an indication to perform radiological diagnostics. The radiologic findings revealed the contact of vestibulo-cochlear nerve with the loop of cerebellar inferior anterior artery within the internal acoustic canal., Conclusions: The course of the disease and diagnostic tests do not provide characteristic data that let diagnose neuro-vascular conflict. One has to be aware of such possibility in patients with intensive vertigo and dizziness that do not improve after treatment when other causes do not justify the symptoms.

Tinnitus in childhood is quite common when children are directly asked about this syndrom. Children rarely spontaneously complain of tinnitus. Material consists of 67 children (6-18 year old) with tinnitus, treated in the Pediatric Otolaryngology Clinic and Outpatient. Between children there were 2 groups: I tinnitus connected with hearing loss--35 children, II tinnitus without hearing loss--32 children. Methods. Anamnesis, otolaryngologic, neurologic, psychologic examinations, panel of audiologic tests before and after treatment of betahistine. In 12 patients there were recognized conductive hearing loss and they were excluded from therapy of betahistine. 55 children were treated with betahistine (Betaserc). Results indicates that betahistine is a good drug in therapy of tinnitus in children.

In balance system assessment there is no single set of tests applicable for all patients. A comprehensive medical history plays a main role in balance assessment. Patients often describe the same disorders in different ways. The aim of our work was to analyze effectiveness of betahistine hydrochloride (Betaserc) treatment on vertigo, nausea, vomiting, tinnitus and progressive hearing loss basing on the medical assessment (interview) performed by doctors and patient's personal questionnaires as well as to collect and accumulate data about balance system disorders. We prepared questionnaires for both doctors and patients. The doctor's questionnaire was divided into three sections. In the first section we included questions about direct cause of visit at the doctor's office. Questions were covering problems regarding balance system disorders (difficulty to keep erect position), vertigo, tinnitus, hearing impairment and other problems. The second section of the questionnaire included assessment of treatment effectiveness through the first 14 days and on the 28th day (a control visit). A third section of the questionnaire was focused on estimation of intensity of balance system disturbances. Patient's questionnaire included everyday self observations of intensity of disturbances within the 14 days observation period. We analyzed data of 980 patients, of the age between 16 and 96 years (mean age--54.1). There were 57.8% females and 42.2% males. From the group of 980 patients we separated a group of patients under 40 and over 60 years of age for additional analysis. Having analyzed doctors questionnaires we noted that the most frequent cause of patients' visits were: vertigo--in 770 people (78.57%), tinnitus--in 708 people (72.24%), disturbance of balance system--in 612 people (62.45%), hearing loss--in 607 people (61.94%) and other problems--in 72 people (7.35%). Patients over 60 years of age described vertigo as rolling and falling (38.92%). Patients under 40 years of age described vertigo as a body rotation and they were able to indicate direction of rotating movement (53.78%) in this group balance disturbances were intensified by moving of the head (56.49%). Both doctors and patients noticed higher percentage of answers "none" and "minimal difficulty in everyday life" on 14th and 28th day of observation in all analyzed groups, especially in people under 40 years of age. Properly prepared questionnaire for doctors and patients is very helpful not only at initial interview but also at reviewing the current condition of patient as well as at monitoring effects of treatment. Aliments and symptoms self noticed by patients are more serious and troublesome than those noticed by doctors. Ailments linked to disturbances of balance system noticed by group of patients under 40 years of age are usually sudden and shorter in duration and more intensive than in group of patients over 60 years of age. Betaserc used in treatment of balance system disorders lessens the insensitivity of vertigo, gait disturbances and nausea/vomiting. It does not affect hearing loss or tinnitus. The first therapeutic goals are achieved (especially in patients under 40 years of age) after 14 days of treatment.

Distortion Product Otoacoustic Emission (DPOAE) has been used as a tool to determine the presence of cochlear pathology. It is well known that the damage of Outer Hair Cells (OHCs) results in reduced auditory sensitivity and generation of tinnitus. At the same time tinnitus arises in normal hearing persons as well. The aim of this study was the assessment of the DPOEA amplitude and the behavior of DP I/O function in tinnitus patients with normal hearing threshold. The group of 48 tinnitus patients (92 ears) with normal hearing threshold and the control group of 30 normal hearing patients (40 ears) were investigated for this study. All subjects have undergone the measurement of DPOAE and DP I/O functions for frequencies: 1000, 2000 and 4000 Hz. In the tinnitus group there were observed the decrease in DPOAE amplitude for some frequencies and the steeper slope of I/O function. This means that the places with localized damage or dysfunction of OHCs on the basilar membrane can be responsible for the origin of tinnitus.

29 out of 49 patients, who were treated in 1996-1998 with Xylocaine and directive counselling for their tinitus, were reevaluated. Non of the patients used any other pharmacological treatment of the tinnitus or underwent full tinnitus retraining therapy (TRT) since 10-days treatment with Xylocaine had been completed. Initially 65.3% of patients declared improvement in their tinnitus. After over 5 years of observation success rate decreased to only 41.3%. Since the positive effect of 10-days treatment with Xylocaine and directive counselling was not stable we concluded that tinnitus patients should receive full TRT.

Of the 150 patients admitted in 2001 to the Tinnitus Center located at the Nofer Institute of Occupational Medicine, Łódź, Poland, 80 were subjected to complex examinations consisted of standardized questionnaire on medical history, psychological tests and audiological assessment. The diagnostic procedure was completed for 52 patients (23 females and 29 males; mean age: 53 years). In this group, five patients were found to have conductive hearing loss due to chronic eustachtis or otosclerosis. They were excluded from further studies. Among the other 47 patients, 26 showed normal hearing threshold and 21 suffered from uni- or bilateral sensorineural hearing loss. Hyperacusis was diagnosed in 16 cases. The measurements of brainstem evoked potentials revealed V wave latency asymmetry in 7 cases, which implied the necessity to perform CT or MNR. In neither of cases did this diagnosis confirm the suspected tumor development (n. VIII neurinoma or pontocerebral angle tumor. The preliminary assessment of treatment efficacy for subjective tinnitus with use of retraining therapy yielded the following conclusions: 1. The application of hearing aid brings about an immediate improvement in the patient's self-assessment of hearing and a better tolerance towards tinnitus. 2. A systematic all-day wear of noise generators contributes to the patient's increased tolerance towards tinnitus, improved mental condition and alleviated hyperacusis. 3. The efficacy of the tinnitus retraining therapy, following Jastreboff, depends on providing the patient with detailed information on the causes and mechanisms of tinnitus development. 4. The negative diagnostics for tumor within the cranial cavity has not only a soothing effect on the patient as it relieves his/her stress, but it can also be a good starting point for the tinnitus retraining therapy.

48 patients (25 woman, mean age 42 +/- 9.9 years and 23 men, mean age 46.6 +/- 8.3 years) suffering from vertigo, tinnitus and hearing loss of unknown origin were included into this study. The occurrence and coexistence of symptoms was measured. Insulin levels were measured fasting and at the second hour of OGTT. Results were compared with the control group of 31 healthy persons (16 women, mean age 41.3 +/- 5.6 years and 15 men, mean age 47.6 +/- 9.4 years). The character of vertigo, localization of hearing loss and electronystagmographic findings showed the pathology of the inner ear. The occurrence of hyperinsulinemia was significantly more common in the patients group--43.8%, comparing to the control group--22.6%. Also the insulin levels in the second hour of OGTT, were statistically significantly higher in patients that in the control group.

The aim of this study was to evaluate the occurrence of hyperlipidemia in patients suffering from vertigo, and/or tinnitus and/or hearing loss of unknown origin. 48 patients (25 women and 23 men) were included into this study. All patients had a negative previous medical history of any metabolic, cardiovascular or neurological disorders. Our results were compared to the control group of 31 healthy persons (16 women and 15 men). All subjects had a complete neurootologic examination, appropriate audiometric and vestibular studies. In biochemical evaluation lipid phenotype studies were performed. Hyperlipidemia were classified according to Friedricson criteria. There were some differences in lipid phenotype and severity of hyperlipidemia between this two group.

The group of patients suffering from tinnitus was treated with intravenous Xylocaine. Ten consecutive doses of Xylocaine (2 mg/kg b.m.) were administered during a period of ten days. Changes of amplitudes of TEOAE in relation to tinnitus suppression was assessed. In 91.5% of cases we observed correlation between amplitude changes and complaint abatement. Both amplitude changes and the time of tinnitus suppression increased after ten days of treatment in comparison with single dose of Xylocaine. The differences of amplitude variations between tinnitus and non tinnitus ear group was statistically significant (Wilcoxon test p < 0.05). The treatment with Xylocaine was considered to be the beginning of long-term procedure aimed at causing habituation of tinnitus in patients conscience (TRT).

The present study was performed on 32 patients in order to investigate the effect of low-power laser on their tinnitus. The patients were divided into two groups. One group received laser therapy and the other was given a placebo procedure. The effect was evaluated by the use of visual analogue scales. Within the patient group transiently evoked otoacoustic emissions (TEOAE) were measured before, during and after therapy. No significant difference between laser and placebo was found in annoyance or loudness of the tinnitus and in changes of TEOAE amplitude. These results indicate that there is no relationship between the effect of low-power laser and changes in cochlear micromechanics.

120 patients aged 20-81 years were treated at the Otolaryngology Clinic of the CM UJ in years 1994-1996 for tinnitus. The radiological method showed degenerative changes of the cervical spine in 100 of them. The otolaryngological and neurological methods excluded any reason of tinnitus other than distempers of vertebrobasilar arterial system. The ACUSON 128 XP/10 (Duplex Scan + Color Doppler) was used during examination of blood flows in vertebrobasilar arterial system. The correlation index was calculated as a proportion between the number of patients with pathological vertebral artery blood flow and the total number of patients. For all patients aged 20-81 it was 45.0%. The correlation index for the subsequent age groups grew proportionally to the age of patients, reaching values from 0% to 73.7%.

The authors described the treatment of 36 patients with persistent tinnitus. In the past the patients were treated with other methods without positive results. After audiological examinations Promontory Stimulator (Cochlear Co.) for electrical stimulation was used. During the electrical stimulation one electrode was inserted in external auditory meatus and the other on planum mastoideum. Bursts of biphasic pulses of 0.1 ms duration were used during electrical stimulation. Electrical stimulation was applied 10 min. during 10 days. The patients estimated effects of treatment and results are presented in table. The authors obtained satisfactory results in 48% of the patients.

The authors presented a case of objective tinnitus in patient with glomus tumor suspicion. Tinnitus epidemiology, classification, causes and diagnostic procedure were described. Any organic alterations, which would cause tinnitus, did not find.