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The Czech composer Bedrich Smetana (1824-1884) suffered sudden hearing loss with severe tinnitus at the age of fifty. Within a few months, his hearing deteriorated so much that soon he was deaf. He continued his work and composed many of today's best-known works without ever having heard them himself. In the String Quartet No. 1 he lets his tinnitus sound in the form of a very high "e" through the violin.The cause of Smetana's deafness has been subject of conjecture and speculation for many years. Today, the most likely cause of his deafness is a syphilis infection. Syphilis and its relationship to hearing loss are presented based on the current literature and placed in the context of the literature about Smetana's deafness., Der tschechische Komponist Friedrich (Bedrich) Smetana (1824-1884) erlitt im Alter von fünfzig Jahren eine plötzliche Hörminderung mit starkem Tinnitus. Innerhalb weniger Monate verschlechterte sich das Gehör dermaßen, dass er bald praktisch taub war. Sein kompositorisches Werk führte er weiter und komponierte viele der heute bekanntesten Werke, ohne diese selbst jemals gehört zu haben. In dem Streichquartett Nr. 1 lässt er seinen Tinnitus in Form eines sehr hohen "e" durch die Violine erklingen.Die Ursache einer Ertaubung war über viele Jahre Gegenstand von Vermutungen und Spekulationen. Heute gilt als wahrscheinlichste Ursache für die Ertaubung eine Syphilis-Infektion. Die Syphilis und ihr Bezug zur Schwerhörigkeit werden anhand der aktuellen Literatur vorgestellt und in den Kontext der Literatur um Smetanas Schwerhörigkeit gesetzt.

BACKGROUND: Pulsatile tinnitus (PT) may be due to a spectrum of cerebrovascular etiologies, ranging from benign venous turbulence to life threatening dural arteriovenous fistulas. A focused clinical history and physical examination provide clues to the ultimate diagnosis; however, the predictive accuracy of these features in determining PT etiology remains uncertain. METHODS: Patients with clinical PT evaluation and DSA were included. The final etiology of PT after DSA was categorized as shunting, venous, arterial, or non-vascular. Clinical variables were compared between etiologies using multivariate logistic regression, and performance at predicting PT etiology was determined by area under the receiver operating curve (AUROC). RESULTS: 164 patients were included. On multivariate analysis, patient reported high pitch PT (relative risk (RR) 33.81; 95% CI 3.81 to 882.80) compared with exclusively low pitch PT and presence of a bruit on physical examination (9.95; 2.04 to 62.08; P=0.007) were associated with shunting PT. Hearing loss was associated with a lower risk of shunting PT (0.16; 0.03 to 0.79; P=0.029). Alleviation of PT with ipsilateral lateral neck pressure was associated with a higher risk of venous PT (5.24; 1.62 to 21.01; P=0.010). An AUROC of 0.882 was achieved for predicting the presence or absence of a shunt and 0.751 for venous PT. CONCLUSION: In patients with PT, clinical history and physical examination can achieve high performance at detecting a shunting lesion. Potentially treatable venous etiologies may also be suggested by relief with neck compression.

This report details a case of neurosyphilis manifesting as concurrent ocular and otosyphilis, an uncommon presentation of the disease. Here, we describe the diagnosis and treatment of a 27-year-old immunocompetent Caucasian male who presented with uveitis and tinnitus. Physical exam was consistent with uveitis and audiometric testing revealed bilateral sensorineural hearing loss. Serum rapid plasma reagin (RPR) was reactive at 1:512 with a follow-up cerebrospinal fluid (CSF) venereal disease research laboratory (VDRL) test likewise reactive at 1:2, confirming neurosyphilis. The patient was treated with intravenous penicillin G with improvement of symptoms and with subsequent improvement of serum and CSF RPR. However, he ultimately represented with recurrent symptoms and fluctuating serum RPR levels, necessitating repeat treatment and ongoing clinical monitoring. Neurosyphilis can occur at any point during the course of a syphilis infection and may present with a variety of nonspecific findings. This case documents a particularly uncommon instance of simultaneous ocular and otosyphilis, a presentation of neurosyphilis that has only been described a handful of times.

BACKGROUND: Superior Semicircular Canal Dehiscence (SSCD) is a dehiscence of the otic capsule which normally lies over the superior semicircular canal. This database constitutes the largest series of SSCD patients to date. OBJECTIVE: To determine what preoperative factors, if any, contribute to postoperative outcomes and evaluate symptom resolution in a large SSCD patient cohort. METHODS: A single-institution, retrospective chart review collected patient demographics, intraoperative findings, and pre-and postoperative symptoms. Fishers exact t-test was performed for unpaired categorical variables, with a significance level of p < 0.05. RESULTS: 350 SSCD repairs were performed. The median age was 52 years (range: 17-86 years, ± 6.4 years), and the median follow-up duration was 4.6 months (range: 0.03-59.5 months, ± 6.8 months). Preoperative hearing loss was significantly associated with female sex (p = 0.0028). The most reported preoperative symptoms were tinnitus (77.4%), dizziness (74.0%), autophony (66.3%), amplification (63.7%), and disequilibrium (62.6%). Between patients who received unilateral versus bilateral SSCD repair, the greatest postoperative symptomatic resolution was seen in autophony (74.9%, p < 0.001), amplification (77.3%, p = 0.00027), hyperacusis (77.4%, p = 0.023), hearing (62.9%, p = 0.0063), and dizziness (54.6%, p < 0.001) for patients with unilateral SSCD repair. CONCLUSION: Surgical repair via the middle cranial fossa approach can significantly resolve auditory, vestibular, and neurological symptoms of patients with SSCD. Although this is one of the largest single-institution SSCD studies to date, future multi-institutional, prospective studies would be beneficial to validate these results.

Zygomaticomaxillary Complex (ZMC) Fracture is basically a very complicated fracture which affects the facial bones, orbit and maxilla. A close anatomical proximity of the Zygomaticomaxillary Complex to important structures such as Temporomandibular joint (TMJ), Eustachian tube and Facial nerve put concerns on general health of an ear. It is evident that, within two years of the injury, Zygomaticomaxillary Complex Fractures are linked to a higher chance of acquiring ear-related conditions such as Peripheral Vertigo, Tinnitus, and Sudden Hearing Loss. There is also a higher chance of developing trigeminal neuralgia in people with zygomaticomaxillary complex (ZMC) fractures. There should a comprehensive ear examinations and appropriate managements in patients having ZMC Fractures to reduce the impact on ear health. The goal of this article is to investigate the possibility of risk of ear-related illnesses following fractures to the zygomaticomaxillary complex (ZMC).

Tinnitus is the perception of sound in the absence of an identifiable internal or external sound source. This symptom affects approximately 14% of the adult population, with prevalence increasing with age. In this study we evaluated the association between emotional state and tinnitus severity in a sample of 53 participants before they started sound therapy. To assess emotional state, the Hospital Anxiety and Depression Scale (HADS) was used, divided into its two subscales for anxiety (HADA) and depression (HADD). To assess tinnitus severity, the Tinnitus Handicap Inventory (THI) and Tinnitus Functional Index (TFI) were used. The sample population showed a strong positive correlation between the HADA and HADD scales and the THI and TFI questionnaires (r = 0.80 and 0.81, respectively). The results corroborate the association between emotional state and tinnitus severity, emphasising the need for an interdisciplinary treatment approach that covers both physical and emotional aspects., El acúfeno o tinnitus es una percepción sonora sin que exista una fuente acústica interna o externa identificable. Este síntoma afecta aproximadamente al 14% de la población adulta, y dicho porcentaje aumenta con la edad. En este estudio se evalúa la relación entre el estado emocional y el grado de severidad del acúfeno en una muestra de 53 participantes antes de comenzar una terapia sonora. Para la valoración del estado emocional se utilizó el cuestionario Hospital Anxiety and Depression Scale (HADS), dividido en sus dos subescalas: ansiedad (HADA) y depresión (HADD). Para la severidad del acúfeno, se han utilizado los cuestionarios Tinnitus Handicap Inventory (THI) y Tinnitus Functional Index (TFI). En la muestra se encontró una fuerte correlación positiva entre las escalas de ansiedad (HADA) y depresión (HADD) con los cuestionarios THI y TFI (r = 0,80 y 0,81, respectivamente). Los resultados respaldan la relación entre los trastornos emocionales y la severidad del acúfeno, subrayando la necesidad de un enfoque interdisciplinar para su tratamiento que aborde tanto los aspectos físicos como los emocionales

Tinnitus is a problem that has been increasing in society and is present for multiple causes, but the most common is the one that occurs in people with sensorineural hearing loss, being less frequent in conductive or mixed hearing loss, as a result of this problem. Therefore, determining the prevalence of tinnitus in patients with sensorineural hearing loss is of great interest for speech-language pathologists, in order to better understand tinnitus and its auditory and emotional consequences. American statistical data after the application of surveys carried out by the American Tinnitus Association (ATA), indicate that one out of every five inhabitants suffers from permanent tinnitus, estimating about sixty or seventy million people in the United States, of which 20% is severe (11,12), and it is also shown that 7% of the population has attended a consultation at least once for this reason. Tinnitus is a symptom and not a disease. By itself, it does not represent any diagnosis. It is a symptom of some other circumstance. The effects caused by tinnitus on the quality of life of patients with sensorineural hearing loss in the city of Cuenca have never been studied exhaustively, so it is pertinent to conduct such a study to determine the prevalence of tinnitus, establish the degree of disability and thus provide the best treatment to optimize their lifestyle.

Tinnitus is a heterogeneous hearing disorder with no cure at present, but some treatments, such as a combination of counselling and sound therapy, can alleviate the discomfort it causes. The sound therapy efficiency depends on both the type of sound stimulus and the time of exposure. This study describes the fundamentals of a personalized sound therapy that stimulates the auditory system with either continuous or sequential sounds whose spectra are adjusted to the hearing levels of the participants. This sound therapy is called Enriched Acoustic Environment and is assessed in a sample of 137 participants with tinnitus. Tinnitus-related distress relief was clinically relevant and statistically significant for 90% of these patients. This was quantified as a mean decrease of 24.3 points on the Tinnitus Handicap Inventory. 31% of participants were treated with sequential stimuli and ach- ieved greater relief of distress (29.4 points on their Tinnitus Handicap Inventory score) compared to those treated with continuous sound (69%). According to these results, sequential sound seems to be optimal compared to continuous sound.

Background: Tinnitus is the phantom perception of a sound that is not associated with an external stimulus source. The severity of tinnitus can vary from very mild to catastrophic, the latter generating greater disability, hindering daily activities. Tinnitus is associated with metabolic disorders such as diabetes, which is the second most frequent metabolic disease worldwide. Objective: To determine the degree of disability caused by tinnitus in users of the “Casa de la Diabetes” during the period 2023-2024. Methodology: Prospective, quantitative, descriptive, cross-sectional, descriptive study with a sample of 132 participants. Due bioethical and confidentiality considerations were taken into account for data collection. The variables were recorded by means of a self-developed form, subsequently, the Tinnitus Handicap Test (THI) was applied. The tabulation was performed in: IBM SPSS STATISTICS version 29.0.1.0. Results: The most frequent degree of disability was mild with 12.9%, the moderate degree of disability was present in 12.4%, the catastrophic degree of disability with 3.0%. Conclusions: The present descriptive study demonstrates that users of the “Casa de la Diabetes” present disability associated with tinnitus from non-disabling to the catastrophic degrees of disability the latter limits activities of daily living. Theses data provide a basis for future research and guide the generation of strategies to improve their quality of life.

Background and Objective Tinnitus would benefit from an objective biomarker. The goal of this study is to identify plasma biomarkers of constant and chronic tinnitus among selected circulating inflammatory proteins. Methods A case–control retrospective study on 548 cases with constant tinnitus and 548 matched controls from the Swedish Tinnitus Outreach Project (STOP), whose plasma samples were examined using Olink’s Inflammatory panel. Replication and meta-analysis were performed using the same method on samples from the TwinsUK cohort. Participants from LifeGene, whose blood was collected in Stockholm and Umeå, were recruited to STOP for a tinnitus subtyping study. An age and sex matching was performed at the individual level. TwinsUK participants (n = 928) were selected based on self-reported tinnitus status over 2 to 10 years. Primary outcomes include normalized levels for 96 circulating proteins, which were used as an index test. No reference standard was available in this study. Results After adjustment for age, sex, BMI, smoking, hearing loss, and laboratory site, the top proteins identified were FGF-21, MCP4, GDNF, CXCL9, and MCP-1; however, these were no longer statistically significant after correction for multiple testing. Stratification by sex did not yield any significant associations. Similarly, associations with hearing loss or other tinnitus-related comorbidities such as stress, anxiety, depression, hyperacusis, temporomandibular joint disorders, and headache did not yield any significant associations. Analysis in the TwinsUK failed in replicating the top candidates. Meta-analysis of STOP and TwinsUK did not reveal any significant association. Using elastic net regularization, models exhibited poor predictive capacity tinnitus based on inflammatory markers [sensitivity = 0.52 (95% CI 0.47–0.57), specificity = 0.53 (0.48–0.58), positive predictive value = 0.52 (0.47–0.56), negative predictive values = 0.53 (0.49–0.58), and AUC = 0.53 (0.49–0.56)]. Disc

Ménière's Disease (MD) is a rare condition of the inner ear characterized by vertigo, sensorineural hearing loss, and tinnitus. Although its exact cause remains elusive, it has been associated with endolymphatic hydrops, an excess of endolymph in the inner ear. An autosomal dominant genetic component has been observed in around 10% of cases. Diagnosis is based on clinical criteria, distinguishing between definitive and probable MD. For newly diagnosed patients, an initial conservative approach is suggested, which may involve lifestyle changes and dietary adjustments. Pharmacological treatment, such as betahistine, diuretics, and intratympanic therapies, is an option. In extreme cases, surgery is considered. Despite its challenges, a multidisciplinary understanding is crucial to address this complex condition effectively., La Enfermedad de Ménière (EM) es una afección rara del oído interno que provoca vértigo, hipoacusia neurosensorial y acúfenos. Aunque su origen exacto sigue siendo enigmático, se ha vinculado con hidropesía endolinfática, un exceso de endolinfa en el oído interno. Un componente genético autosómico dominante se ha observado en alrededor del 10% de los casos. El diagnóstico se establece en base a criterios clínicos, diferenciando entre EM definitiva y probable. Para nuevos pacientes, se sugiere un enfoque conservador inicial que podría incluir cambios en el estilo de vida y dieta. El tratamiento farmacológico, como betahistidina, diuréticos y terapias intratimpánicas, es una opción. En casos extremos, la cirugía es considerada. A pesar de sus desafíos, una comprensión multidisciplinaria es crucial para abordar esta compleja afección.

Introduction Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) virus mainly affecting the respiratory and circulatory system. In many, neuro-otological changes have been noted – tinnitus being one of the leading clinical manifestations which has skipped the limelight due to the other deadly complications of the disease. The study aims to assess the relation between COVID-19 infection and tinnitus, its relation with vaccination against COVID-19 and to assess the change in intensity of tinnitus at the end of 10 weeks after medical treatment in the patients with and without a positive COVID-19 RTPCR (Reverse Transcription-Polymerase Chain Reaction) report. Materials and Methods An institution based prospective comparative study was done in a tertiary hospital in Kolkata, West Bengal between July 2021 to December 2021. All patients aged between 18 and 65 years, with recent onset of subjective tinnitus since March 2020 (COVID-19 1st wave), were included in this study. Intensity of tinnitus was assessed at the end of 10 weeks after medical treatment with the help of Tinnitus Handicap Inventory (THI). Results Among the 84 patients with tinnitus - 20 had a history of (H/O) COVID-19 infection, 64 didn’t. Among the 20 patients who developed tinnitus post-COVID-19 infection, 2(10%) had been vaccinated while 39 out of the 64(60.9%) patients without a had been vaccinated against COVID-19 disease. At the end of 10 weeks post-treatment, 6 out of 20(30%) patients with a H/O COVID-19 showed an improvement in THI score– of them, 2 were vaccinated while 33 out of 64(51.56%) patients without a H/O COVID-19 showed improvement in THI score – of them 28 were vaccinated against COVID-19. Conclusion Our study concludes that the chances of developing tinnitus is more in those who have not been vaccinated against COVID-19 and post-medication improvement of tinnitus in COVID-19 infected patients was mu

Denna artikel undersöker hur man kan skapa ökad förståelse för hörselskador i vardagliga ljudmiljöer med hjälp av en realtidssimulation. Den producerade simulationen är binaural, och innefattar olika element av hörselskador såsom hörselnedsättning och tinnitus, samt sköter uppspelning av producerade ljudmiljöer i ett 4.0-surroundformat. Artikeln tar avstamp i tidigare forskning, beskrivningar av hörselskador i vetenskaplig litteratur, samt självbedriven etnografi med hörselskadade individer. Processen för framtagningen av simulationen beskrivs, och de olika steg som tagits för att anlända vid en fullständig slutprodukt redogörs. Upplevelsen utvärderas med hjälp av kvalitativa användartester med 13 deltagande studenter, där resultatet pekar på att simulationen har bidragit till en ökad förståelse för hörselskador i vardagliga ljudmiljöer., This article explores how a real-time simulation can contribute to better understanding regarding hearing impairments in everyday sound environments. The produced simulation is binaural, and includes different elements of hearing impairment such as hearing loss and tinnitus, and handles playback of produced sound environments in a 4.0-surround format. The article is built upon previous research, descriptions of hearing impairments in scientific literature, as well as self-executed ethnography with hearing impaired individuals. The process of designing the simulation is described, as well as the different steps taken in order to arrive at a final product. The experience is evaluated through qualitative user testing with 13 participating students, where the results indicate that the simulation has contributed to a better understanding of hearing impairments in everyday sound environments.

In Deutschland berichten zwischen 5% und 15% der Gesamtbevölkerung, einen Tinnitus zu haben (Hoffmann & Reed, 2004). Das subjektive Empfinden der Belastung, welche die Betroffenen erleben, und wie dieses bewältigt wird, ist schwer greifbar (Weise, 2011). Die vorliegende qualitative Interviewstudie mit sechs TinnituspatientInnen aus Österreich zwischen 49 und 69 Jahren wurde durchgeführt, um zu untersuchen, ob die von ihnen genutzten Copingmechanismen ihren Ursprung in der persönlichen Biographie haben. Es wurde festgestellt, dass die ProbandInnen größtenteils ähnliche Erfahrungen in ihrer Kindheit und Jugend gemacht haben, jedoch unterschiedlich mit ihrem Tinnitus umgehen. Auffällig ist, dass der Großteil der ProbandInnen in Kindheit und Jugend für ihr Alter unangemessen hohe Verantwortung tragen mussten. Es herrschen einige Parallelen zwischen bestimmten Verhaltensweisen und späteren Umgangsformen mit Tinnitus, aber aufgrund der geringen Menge an Daten konnte die Forschungsfrage nicht ausreichend beantwortet werden., In Germany, between 5% and 15% of the total population report having tinnitus (Hoffmann & Reed, 2004). The subjective experience of the burden that those affected experience, and how it is coped with, is difficult to grasp (Weise, 2011). The present qualitative interview study with six tinnitus patients in Austria, aged between 49 and 69, was conducted to investigate whether the coping mechanisms they use have their origin in their personal biography. It was found that the participants mostly had similar experiences in their childhood and youth, but handle their tinnitus differently. It is striking that the majority of participants had to bear inappropriate levels of responsibility for their age in childhood and youth. There are some parallels between certain behaviors and later coping strategies with tinnitus, but due to the small amount of data, the research question could not be sufficiently answered., Masterarbeit Universität Innsbruck 2023

(1) Objective: Social representations theory (SRT) is a body of theory within social psychology concerned with how individuals, groups, and communities collectively make sense of socially relevant or problematic issues, ideas, and practices. SRT has been increasingly sued in the area of health and disability. The current study examined the social representations of "tinnitus" and "health" among individuals with tinnitus who are seeking online psychological interventions. (2) Materials/Method: The data were gathered using a free association task about their "tinnitus" and "health" from 399 individuals with tinnitus. The data were analyzed using both qualitative and quantitative analyses methods. (3) Results: The responses resulted in 39 and 30 categories respectively, for "tinnitus" and "health". The most commonly occurring categories for tinnitus included: descriptions of tinnitus (18%), annoying (13.5%), persistent (8%), and distracting (5%). The most commonly occurring categories for health included: content (12%), conditions (8%), active (7%), take control (6%), and overweight (5%). The responses to tinnitus had predominantly negative connotations (i.e., 76.9%) whereas a larger proportion of responses toward their health was related to positive connotations (i.e., 46.4%). These frequently occurring items were also dominant in similarities analysis. Prototypical analysis of tinnitus responses identified categories horrible and bothersome to be key items in the central zone. The categories in central zone of health responses included: content, active, healthy, grateful, and overweight. (4) Conclusions: Individuals with tinnitus have very negative view of their tinnitus impacting their psychological status. Tinnitus management should focus on reducing the negative associations toward their tinnitus and strengthen the positive aspects related to their general health., Funding: National Institute on Deafness and Communication Disorders (NIDCD) of the National Institute of Health (NIH) [R21DC017214]

ObjectiveTinnitus is defined as the perception of sound in the absence of an external source. We propose the hypothesis that migraine can cause exacerbation of tinnitus in some patients.MethodsEnglish literature from PubMed has been reviewed.ResultsStudies have reported a high prevalence of cochlear symptoms in patients with migraine headaches and up to 45% of tinnitus patients have been shown to concomitantly suffer from migraine. Both conditions are thought to stem from central nervous system disturbances, involving disruption of the auditory and trigeminal nerve pathways. One proposed mechanism of this association is the modulation of sound sensitivity by trigeminal nerve activation of the auditory cortex during migraine attacks, resulting in tinnitus fluctuation in some patients. Increased brain and inner ear vascular permeability resulting from trigeminal nerve inflammation, can also cause observed headache and auditory symptoms. Tinnitus and migraine also share a number of symptom triggers including stress, sleep disturbances, and dietary factors. These shared features may help explain promising results of migraine therapies for the treatment of tinnitus.ConclusionGiven the complex association between tinnitus and migraine, further investigation is needed to identify the underlying mechanisms and determine the optimal treatment strategies for managing migraine-related tinnitus patients.

OBJECTIVE: To characterize migraine pathophysiology, presentation, and current treatment strategies, specifically in regard to vestibulocochlear manifestations of migraine. METHODS: Narrative review of available literature. RESULTS: Migraine disorder can be described as a spectrum of otologic manifestations, with vestibular migraine now recognized with fully-fledged diagnostic criteria. Otologic manifestations are theorized to be due, in part, to trigeminal innervation of the inner ear structures and calcitonin gene-related peptide (CGRP) expression within the labyrinth. Patients can experience vertigo, aural fullness, enhanced tinnitus, and hearing loss without the characteristic migraine headache, leading to under recognition of these symptoms as migraine-related. Menieres disease, mal de débarquement syndrome, persistent postural perceptual dizziness, and recurrent benign paroxysmal positional vertigo have close associations to migraine and may exist on the migraine spectrum. Migraine treatment consists of two goals: halting acute attacks (abortive therapy) and preventing attacks (prophylactic therapy). Abortive medications include triptans, corticosteroids, anti-histamines, and anti-emetics. Pharmacologic prophylaxis in conjunction with lifestyle modifications can decrease frequency and severity of symptoms and include tricyclic antidepressants, calcium channel blockers, anti-epileptic medications, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, beta-blockers, gepants, and monoclonal antibodies to CGRP. Promising evidence is emerging regarding the ability of migraine medications to positively treat the various otologic symptoms of migraine. CONCLUSION: Migraine disorder manifesting with primarily cochleovestibular symptoms can be challenging to diagnose and manage for practicing clinicians. Patients with various vestibulopathies that are closely related to migraine may benefit from migraine treatment. Lifestyle choices and

Meniere’s Disease (EM) is a chronic disease of the inner ear that mainly affects adults in comparison to the child population. Its prevalence depends on the geographic area of the patient with a dominant association in the female gender. It is characterized by spontaneous and recurrent attacks of vertigo, predominantly unilateral sensorineural hearing loss, and tinnitus. The etiology of this pathology is not clear, however it is considered multifactorial. Proper diagnosis is centered on a good clinical history and physical examination supported by the criteria proposed by the American Academy of Otolaryngology and Head and Neck Surgery (AAO-HNS). The treatment aims to reduce vertigo attacks as well as improve and preserve hearing loss, pharmacological and non-pharmacological treatments have been related to the prevention of vertigo attacks and improvement of symptoms and hearing loss associated with EM., La enfermedad de Ménière (EM) es una enfermedad crónica del oído interno que afecta principalmente a los adultos en comparación a la población infantil. Su prevalencia depende del área geográfica del paciente con una asociación dominante en el género femenino. Se caracteriza por ataques de vértigo espontáneos y recurrentes, hipoacusia neurosensorial de predominio unilateral y acúfenos. La etiología de esta patología no está clara, sin embargo, se considera multifactorial. El diagnóstico adecuado se centra en una buena historia clínica y examen físico con apoyo de los criterios propuestos por la Academia Americana de Otorrinolaringología y Cirugía de Cabeza y Cuello (AAO-HNS). El tratamiento tiene como objetivo la disminución de los ataques de vértigo, así como evitar la pérdida de audición. Se han relacionado tratamientos tanto farmacológicos como no farmacológicos para la prevención de los ataques de vértigo y mejoría de la sintomatología y de la hipoacusia manifestada en EM

Introduction: Sound therapy is a common tinnitus treatment, where the tinnitus percept is either fully or partially masked by an external sound. Some tinnitus patients experience a decrease in tinnitus related distress after the use of sound therapy. Differences in the neural response to sound therapy may form a basis for classifying tinnitus patients. Methods: In this study, the long-term (2 months) effects of sound therapy on the oscillatory brain activity and tinnitus related distress were investigated in chronic tinnitus patients. Baseline oscillatory activity in the group of tinnitus participants was also compared to a matched control group. Results: No differences were found in the oscillatory activity when comparing the tinnitus group to the control group. Differences were found for the frequency range between 27.5 and 41.5 Hz corresponding to high beta and gamma power when comparing the tinnitus group before and after the use of sound therapy. Furthermore, a reduction of the tinnitus-related distress was found after the long-term use of sound therapy. However, there was no correlation between the changes in the oscillatory activity and the reductions of the tinnitus-related distress. Discussion: Overall, the lack of correlation between the changes in tinnitus-related distress and changes in power activity hampers the interpretability of the findings and undermines the utility of using oscillatory activity as a biomarker for the effect of sound therapy treatment.

Uvod: Prezbiakuzija i tinitus su veoma učestala stanja kod starijih osoba. Postoji dosta dokaza, baziranih na samoproceni, da obe pojave utiču na kvalitet života i psihosocijalno funkcionisanje ovih osoba. Međutim, većina istraživanja se bavila izolovano prezbiakuzijom i tinitusom, tako da ima veoma malo dokaza kako ova dva stanja deluju kada zajedno egzistiraju. Cilj: Cilj ovog rada je da se ispita kako tinitus utiče na subjektivni doživljaj hendikepa kod osoba sa prezbiakuzijom. Metode: U uzorku je bilo 100 ispitanika oba pola, prosečne starosti 67,11 godina. Uzorak je bio podeljen u dve grupe: E1 – ispitanici sa prezbiakuzijom i tinitusom i E2 – ispitanici sa prezbiakuzijom bez tinitusa. Korišćena su dva upitnika za prikupljanje podataka: Upitnik za prikupljanje opštih sociodemografskih podataka i Inventar slušnog hendikepa za starije. Rezultati: Rezultati pokazuju da tinitus značajno utiče na subjektivni doživljaj hendikepa kod osoba sa prezbiakuzijom u emocionalnom (E1 M=30,58; E2 M – 20,68; p=0,001) i socijalnom funkcionisanju (E1 M=29,49; E2 M=22; p=0,006), kao i u ukupnim rezultatima (E1 M=60,05 E2 M=42,68; p=0,001). Zaključak: Na osnovu ovih rezultata može se zaključiti da tinitus, koji je čest entitet u prezbiakuziji, predstavlja veoma ozbiljnu pojavu koja značajno utiče na lični doživljaj izraženosti teškoća u psihosocijalnom funkcionisanju odraslih osoba., Introduction: Presbycusis and tinnitus are very common conditions in elderly people. There is a lot of evidence, based on self-assessment, that both of these phenomena affect the quality of life and psychosocial functioning of persons. Most research has dealt with these phenomena in isolation, so there is very little evidence of how these two conditions work when they coexist. Aim: The aim of this paper was to examine how tinnitus affects the Individual perception of hearing handicap in people with presbycusis. Methods: The sample consisted of 100 subjects of both genders with an average age of 67.11. The sample was divided into two groups: E1 – subjects with presbyacusis and tinnitus and E2 – subjects with presbyacusis without tinnitus. Two questionnaires were used for data collection: the Questionnaire for collecting general socio-demographic data and the Hearing Handicap Inventories for the Elderly. Results: The results show that tinnitus significantly affects the individual perception of handicap in persons with presbycusis in both emotional (E1 M=30,58; E2 M – 20.68; p=0,001) and social functioning (E1 M =29.49; E2 M=22; p=0,006), as well as in the overall results (E1 M=60,05 E2 M=42,68; p=0,001). Conclusion: Based on these results, it can be concluded that tinnitus, which is a common entity in presbyacusis, is a very serious phenomenon that significantly affects personal experience of difficulties in the psychosocial functioning of adults.

BACKGROUND: Both tinnitus and hearing loss are multidimensional. The purpose of this study was to identify and determine the degree of mental fatigue in patients with hearing loss and/or tinnitus participating in audiological rehabilitation, and to examine the self-reported mental fatigue scale (MFS) in this patient group. METHODS: Patients undergoing audiological rehabilitation at the Department of Audiology and Neurotology, Karolinska University Hospital, Sweden, between 2011 and 2017 who completed a self-reported MFS questionnaire were investigated. Data on 76 patients were analysed in this pilot study. Patients were also assessed using the Tinnitus Handicap Inventory (THI). RESULTS: The study population had an age range of 38-65 years, and most had normal hearing (37%) or mild to moderate hearing loss (46%). Only 17% had severe to profound hearing loss. A total of 56.5% had tinnitus, of whom 39.5% scored ≥57 on the THI, indicating severe tinnitus, whereas 43.5% reported no tinnitus. The MFS scores, ranging from 13 to 42.5 points, were divided into three severity levels for analysis: 10.5-15, 15.5-20, and ≥20.5. In total, 67% of the patients had MFS scores ≥ 20.5. Importantly, most of the participants (90%) with a THI score ≥ 57 belonged to that group. A significant positive correlation between a high MFS score and severe tinnitus was found. CONCLUSIONS: The study reveals that severe mental fatigue is more common in patients with severe tinnitus than sole hearing loss.

A participatory-based intervention was performed in Sweden, aimed at improving the sound environment in one preschool (n = 20) and one obstetric ward (n = 50), with two controls each (n = 28, n = 66). Measured sound levels, and surveys of noise annoyance, hearing-related symptoms and emotional exhaustion were collected before, and three and nine months after the interventions, comparing intervention and control groups over time. The results of this first implementation in a limited number of workplaces showed significantly worsening of hyperacusis, sound-induced auditory fatigue, emotional exhaustion and increased sound levels in the preschool, and worsening of noise annoyance in both intervention groups. Increased risk awareness, limited implementation support and lack of psychosocial interventions may explain the worsening in outcomes, as might the worse baseline in the intervention groups. The complexity of the demands in human-service workplaces calls for further intervention studies.

The association between silence and powerlessness is one reason behind rape victims’ decision to remain silent about the assault. Rape victims, who most often are traumatized, face a wide array of negative experiences as a consequence of the violence. At the heart of this trauma narrative is the case of a female patient, 70 years old, suffering from tinnitus, for which she was offered psychotherapy. During one of the last therapy sessions the patient disclosed that she was raped at the age of 22 by a man she met when searching for a job. This case study explores the complex relationship between sensory fragments (i.e., hallucinations and tinnitus) and the disclosure of a hidden trauma that occurred half a century earlier. It also illustrates how establishing a confidential therapeutic alliance can contribute to a sustained integration of fragmented experiences of the trauma into a personal history.

Jährlich erkranken 250.000 Personen in Deutschland neu an Tinnitus (Mazurek, 2011). Die Betroffenen berichten häufig von einem hohen Leidensdruck. In der bisherigen Forschung gibt es kaum Berichte darüber, wie sich verschiedene Verarbeitungsformen auf die Wahrnehmung des Tinnitus auswirken. Die vorliegende qualitative Interviewstudie mit zwölf Tinnitusbetroffenen aus Österreich wurde durchgeführt, um zu untersuchen, inwiefern soziale Beziehungen im Umgang mit dem Tinnitus eine Rolle spielen. Es zeigte sich, dass eine positive Einstellung gegenüber dem Tinnitus, soziale Unterstützung und offene Kommunikation über den Tinnitus einen positiven Einfluss auf die Bewältigung von Tinnitus haben. Zudem kommt es durch den wahrgenommenen Tinnitus zu sozialem Rückzug, welcher mit einem geringeren Wohlbefinden einhergeht. Obwohl die Studie einige Limitationen aufweist und daher zusätzliche Forschung empfohlen wird, lassen sich dennoch praktische Schlussfolgerungen ziehen. Maßnahmen zur Förderung positiver Einstellungen bei Tinnitusbetroffenen und eine Entstigmatisierung von Tinnitus in der Gesellschaft könnten hilfreich für den Umgang mit Tinnitus sein., eingereicht von Nora Glatzel, in englischer Sprache, Masterarbeit Universität Innsbruck 2023

Background: One of the irritating conditions that can drastically lower a patient’s quality of life and productivity is  tinnitus. Even though it is not a life-threatening condition, emotional discomfort, cognitive difficulty, intrusiveness,  auditory and perceptual issues, sleep disturbances, and a variety of somatic ailments are the consequences. Its  frequency and prevalence are increasing daily. Anticonvulsants, anxiolytics, antidepressants, muscle relaxants, and  other pharmacological drugs are now used or being tested for their pacification, but there is little proof that their  benefits outweigh their risks. Also poorly understood is the function of neurostimulation therapies, both invasive and  non-invasive. Cochlear implantation and the development of hearing aids have not shown, particularly clear results. Materials and Methods: Tinnitus and Karnanada-related information were gathered from texts on Ayurveda,  commentaries, and contemporary medicine, respectively. Results: As a result, there is a need to make treatments that are widely recognized, widely successful, and capable of withstanding  systematic replication available. These treatments should be able to significantly reduce the volume and impact of tinnitus. Discussion: Tinnitus has numerous etiologies and unexplained causes, which makes it difficult to determine a  specific treatment plan today. As a result, the prognosis for the condition is also unknown. However, the prognosis  and course of treatment for Karnanada are described in Ayurveda, and we can get better and more satisfied results. Conclusion: Ayurvedic medicine is the most effective treatment for reconstructive ear surgery, and it is best to  combine it with herbal remedies.&nbsp

OBJECTIVES To determine the frequency of tinnitus & hearing impairment in adolescent and young adult earphone users with smartphones and other personal listening devices.METHODOLOGY This prospective & descriptive study involving children with glue ears was conducted in the ENT Department of Medical Teaching Institute, Hayatabad Medical Complex, Peshawar, from Jan 1, 2022, to Sep 30, 2022. Personal listening device (PLD) users aged 12-25 years with complaints of tinnitus and hearing impairment were examined. Conductive hearing loss was excluded by audiological testing. The frequency of resultant hearing loss and tinnitus was calculated. The information obtained was analyzed using SPSS v 26.0 for windows. A Chi square test was performed to determine the significance of tinnitus & hearing impairment in earphones and other PLD users.RESULTS A total of 163 patients were included in the study. The patient’s age range was 12-25 years, with a mean age of 18.03 years and a standard deviation of ± 3.575. There were 117 males and 46 females. The male: female ratio was of 2.54:1.Tinnitus was present in 73% and Hearing impairment in 54.4% of the patients. The chi-square test and p-values determined showed that both tinnitus and hearing loss occurred in many patients using personal listening devices.CONCLUSION Tinnitus and hearing impairment occurs in a significant number of those who use personal listening devices. Their inappropriate use can lead to auditory system damage. It is recommended that PLD users undergo periodic audiological testing to detect early hearing loss and tinnitus to minimize damage to the ear.

Objective: Tinnitus is a symptom that affects people in many ways and can lead to a severe condition of tinnitus-distress. The related distress can be influenced by many factors such as psychological burdens. This two-way relation can create a vicious circle that affects most people with tinnitus-distress. During the Covid-19 pandemic society was changed from one day to another. To prevent the spread of virus, people were forced to adjust to environmental and social changes in areas like work, school, family, and healthcare. It is likely that people with tinnitus-distress was particularly challenged under these new conditions. That’s how the idea for this research came to reality. The thesis ‘Tinnitus at Covid-19 - A systematic review exploring the influence of pandemic related factors on tinnitus’, is aimed to focus on factors that may influence tinnitus during the pandemic. The scientific foundation is a systematic review exploring literature that describes tinnitus from a Covid-19 pandemic perspective. It does not include research that focus on tinnitus caused by Covid-19 virus infection, vaccination, or any other medical treatment. Method: A systematic review was conducted to investigate research, that explores the possible influence of pandemic related factors on tinnitus during the Covid-19 pandemic. 11 studies fulfilled these conditions and were included for analyse and comparison. Results: 7 factors were identified and categorised. Most prominent were factors of emotional state and treatment, as they had a greater foundation of results and could be compared across studies. Emotional state was particularly related to anxiety, stress, and depression. Predominantly results for anxiety revealed a negative impact on tinnitus. To a lesser extent this was revealed for stress. The negative impact could not be concluded for depression. Treatment was challenging to compare because of different aims and methodologies, but a tendency was seen with treatment-met

Chapter 1 comprises an overview of current insights into the pathophysiology and consequences of hearing loss and tinnitus, of which specifically the consequences they have for work-related health. It also explains the study design of the Netherlands Longitudinal Study on Hearing (NL-SH). Chapter 2 describes the 10-year change in hearing ability among NL-SH participants, considering factors such as age, education, sex, and lifestyle factors like alcohol use and smoking. The results showed an average decline of 0.89 dB signal-to-noise ratio (SNR) over a decade. The decline was more pronounced in older age groups (51 to 60 and 61 to 70 years) compared to younger ones (i.e. 18 to 30, 31 to 40, and 41 to 50 years). Additionally, participants with a history of smoking experienced a faster decline in speech recognition in noise during the follow-up period. Chapter 3 investigates the association between cardiovascular disease (CVD) risk factors and speech recognition in noise over time. Specifically, interactions between CVD risk factors on the longitudinal change in hearing ability were analyzed. CVD risk factors are known to cluster and interact, increasing the cumulative risk for CVD. However, we found that none of the CVD risk factors or two-way interactions of CVD risk factors were significantly associated with a decline in the speech reception threshold in noise over time. In a cross-sectional analysis using all measurement rounds, obesity, rheumatoid arthritis, and hypertension were associated with overall higher (more unfavorable) speech reception thresholds. In Chapter 4, we analyzed the potential association between beta blocker use and hearing ability in adults and examined whether this effect is dose-dependent. Hearing ability was not affected by beta blockers, but this result is not conclusive for all types of beta blockers as the study involved mostly beta-1 selective agents and no non-selective beta blockers. In Chapter 5 we analyzed the longitudinal associa

Resumen La musicoterapia es el uso profesional, planificado y estructurado de la música como intervención terapéutica, con el objetivo de mejorar la salud y calidad de vida del paciente o el grupo intervenido. Esta herramienta se basa en la evidencia de efectos neuroplásticos, psicológicos y cognitivos de la música en las personas. En las últimas décadas se ha encontrado evidencia de múltiples beneficios de musicoterapia como tratamiento adyuvante en medicina, entre ellos se destacan: reducción del dolor en enfermedades crónicas, oncológicas, procedimientos quirúrgicos y trabajo de parto, disminución de síntomas depresivos y ansiosos en trastornos del ánimo y demencia, mejoría de la sincronización motora y perceptiva en enfermedad de Parkinson, entre otros. La otorrinolaringología se ha establecido, asimismo, como un nicho plausible para musicoterapia. Actualmente existen numerosas líneas de investigación que se han dedicado a generar evidencia científica en torno a musicoterapia y su utilidad en diversos campos de la especialidad; esta revisión pretende recopilar y analizar dicha evidencia. Los resultados obtenidos en los diferentes estudios sugieren, con evidencia de calidad baja a moderada, que existen beneficios significativos en la utilización de esta herramienta en el tratamiento multimodal de tinnitus, manejo del dolor y ansiedad en procedimientos médico-quirúrgicos, y en la rehabilitación de pacientes con hipoacusia e implantes cocleares. Si bien se ha encontrado que la música es una modalidad terapéutica segura, barata y con beneficios que parecen ser prometedores, se requieren más estudios clínicos de buena calidad y validez para recomendar el uso de musicoterapia en otorrinolaringología.

Resumen Una propiedad fundamental de los sistemas sensoriales es su capacidad para detectar estímulos novedosos en el entorno. El sistema nervioso posee neuronas que disminuyen su respuesta a los estímulos sonoros que se repiten a lo largo del tiempo y otras neuronas que aumentan su frecuencia de disparo ante estímulos novedosos, siendo la diferencia entre ambas respuestas conocida como adaptación-específica a estímulos. En las últimas décadas, se ha propuesto que el cerebro establece, continuamente, predicciones de los estímulos novedosos y del entorno basándose en sus experiencias previas y en modelos de representación internos, teoría denominada codificación predictiva. En esta revisión, abordaremos algunos conceptos de la adaptación-específica a estímulos y codificación predictiva, centrándonos principalmente en el sistema auditivo. Por último, propondremos una explicación teórica basada en el marco de la codificación predictiva para algunas disfunciones neuropsiquiátricas, auditivas y vestibulares.

Introduction Audio-Vestibular (AV) presentation as a consequence of COVID-19 is a less ventured zone. The aim of the study was systematically review the literature (both studies and case reports) published up to August 2021, in order to provide evidence on audio-vestibular symptoms in SARS-CoV-2, COVID-19 patients. Systematic review and meta-analysis was performed for assessment of prevalence of AV symptoms among COVID-19 patients. Materials and Methods A search of existing literature using key words and MeSH (Medical Subject Headings) terms was done. The methods were developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. 36 qualitative studies were narratively synthesized. Meta-analysis was performed on 18 quantitative studies Results Hearing loss was most commonly reported AV manifestation among case series / case reports. In the quantitative studies, the pooled estimate of Hearing loss, Dizziness and Tinnitus was 4.558%, 4.226% and 5.513% respectively. Other reported AV symptoms included ear ache, aural fullness and facial paresis. Conclusion Prevalence of AV symptoms in COVID-19 differs from that of the published literature. This prevalence of hearing loss is less than that reported amongst the world population. Structured community-based studies with homogeneous working definitions have to be conducted to assess the true prevalence.

Taking into account heterogeneity has been highly recommended in tinnitus studies both to disentangle all diverse factors that can contribute to their complexity and to design personalized treatments. To this aim, a heterogeneous sample of 270 tinnitus subjects is analyzed considering the gender (male/female), hearing condition (hearing-impaired/normal-hearing), and tinnitus severity (compensated/decompensated) subgroups. Two categorical variables (tinnitus laterality and tinnitus sound type) and four quantitative variables (average auditory threshold, age of tinnitus onset, tinnitus frequency, and tinnitus severity) are used. The percentages (for categorical variables) and mean values (for quantitative variables) of the whole sample are compared with these of each subgroup. Furthermore, correlational and hypothesis testing is applied to calculate the correlation coefficients and statistical significance, respectively. The results show that the male and female subgroups contrast in the sound type and frequency of their tinnitus, hearing-impaired and normal-hearing individuals differ, in addition, in their average auditory threshold, and the compensated/decompensated tinnitus subgroup provides significantly distinct values in tinnitus laterality and tinnitus sound.

Inspired by Sound Studies and art-based research, I experiment with methods particularly useful for understanding a multiple sensory phenomenon like tinnitus. I ask: How can methods be designed to embed and capture sensory experiences in qualitative studies? Tinnitus is on the rise, and the condition challenges the sense of hearing and how the affected person perceives the everyday sound environment. Tinnitus is present both in the absence and in the presence of other sounds. The sensory system is part of our navigation and adaptation to the world. I use the concept of “attunement” to emphasise how sensory impression is constantly shaped and reshaped in the present moment - depending on all the other entities that are present. In examining hearing impairment from this perspective, I insist that hearing impairment as a phenomenon must be studied in practice and in the sociomaterial context in which it occurs. I work with a range of informants who experience tinnitus to varying degrees. Because of the informants' sensory experiences, I consider them experts with particular auditory knowledge. The informants engage in a process of co-creation with me as the researcher. Here I am inspired by design anthropological methods like design probes, methods from Sound Studies like listening diaries, and a method I call "tinnitus walk alongs". The presentation will explore the potentials of experimental sensory methods in ethnological methodological, analytical, and dissemination work, which will develop the ethnographic everyday life analysis and dissemination strategy.

Objective To determine tinnitus prevalence and severity in a cohort of unselected first-time cochlear implant (CI) recipients whose primary motive for CI was sensorineural hearing loss (SNHL), and to evaluate the effect of CI on tinnitus after cochlear implantation. Methods Prospective longitudinal study of 45 adult CI recipients with moderate to profound SNHL. Patients completed the Danish version of the Tinnitus Handicap Inventory (THI) and a visual analogue scale (VAS) for tinnitus burden before implantation, 4 months after implantation and 14 months after implantation. Results The study included 45 patients, of which 29 (64%) had pre-implant tinnitus. Median THI score (IQR) significantly decreased from 20 (34) to 12 (24) at first follow-up (p < 0.05) and to 6 points (17) at second follow-up (p < 0.001). Median VAS (IQR) for tinnitus burden decreased from 33 (62) to 17 (40; p = 0.228) and 12 (27, p < 0.05) at the first and second follow-ups, respectively. Tinnitus was totally suppressed in 19% of patients, improved in 48%, remained unchanged in 19% and worsened in 6%. 2 patients reported new tinnitus. At the second follow-up, 74% of patients had slight or no tinnitus handicap, 16% had mild handicaps, 6% had moderate handicaps, and 3% had severe handicaps. High pre-implant THI and VAS scores correlated with greater decrease in THI scores over time. Conclusion 64% of the patients with SNHL had pre-implant tinnitus, which was decreased 4 and 14 months after implantation. Overall, 68% of patients with tinnitus improved their tinnitus handicap after CI. Patients with higher THI and VAS scores had a larger decline and the highest benefits in terms of tinnitus handicap improvement. The study findings demonstrate that the majority of patients with moderate to profound SNHL eligible for cochlear implantation benefit from complete or partial tinnitus suppression and improved quality of life after implantation., Objective: To determine tinnitus prevalence and severity in a cohort of unselected first-time cochlear implant (CI) recipients whose primary motive for CI was sensorineural hearing loss (SNHL), and to evaluate the effect of CI on tinnitus after cochlear implantation. Methods: Prospective longitudinal study of 45 adult CI recipients with moderate to profound SNHL. Patients completed the Danish version of the Tinnitus Handicap Inventory (THI) and a visual analogue scale (VAS) for tinnitus burden before implantation, 4 months after implantation and 14 months after implantation. Results: The study included 45 patients, of which 29 (64%) had pre-implant tinnitus. Median THI score (IQR) significantly decreased from 20 (34) to 12 (24) at first follow-up (p < 0.05) and to 6 points (17) at second follow-up (p < 0.001). Median VAS (IQR) for tinnitus burden decreased from 33 (62) to 17 (40; p = 0.228) and 12 (27, p < 0.05) at the first and second follow-ups, respectively. Tinnitus was totally suppressed in 19% of patients, improved in 48%, remained unchanged in 19% and worsened in 6%. 2 patients reported new tinnitus. At the second follow-up, 74% of patients had slight or no tinnitus handicap, 16% had mild handicaps, 6% had moderate handicaps, and 3% had severe handicaps. High pre-implant THI and VAS scores correlated with greater decrease in THI scores over time. Conclusion: 64% of the patients with SNHL had pre-implant tinnitus, which was decreased 4 and 14 months after implantation. Overall, 68% of patients with tinnitus improved their tinnitus handicap after CI. Patients with higher THI and VAS scores had a larger decline and the highest benefits in terms of tinnitus handicap improvement. The study findings demonstrate that the majority of patients with moderate to profound SNHL eligible for cochlear implantation benefit from complete or partial tinnitus suppression and improved quality of life after implantation.

Substances with modulatory capabilities on certain aspects of human cognition have been revered as nootropics from the dawn of time. The plant kingdom provides most of the currently available nootropics of natural origin. Here, in this systematic review, we aim to provide state-of-the-art information regarding proven and unproven effects of plant-derived nootropics (PDNs) on human cognition in conditions of health and disease. Six independent searches, one for each neurocognitive domain (NCD), were performed in parallel using three independent scientific library databases: PubMed, Cochrane and Scopus. Only scientific studies and systematic reviews with humans published between January 2000 and November 2021 were reviewed, and 256 papers were included. Ginkgo biloba was the most relevant nootropic regarding perceptual and motor functions. Bacopa monnieri improves language, learning and memory. Withania somnifera (Ashwagandha) modulates anxiety and social-related cognitions. Caffeine enhances attention and executive functions. Together, the results from the compiled studies highlight the nootropic effects and the inconsistencies regarding PDNs that require further research.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.2021137.

Neuromodulation treatment effect size for bothersome tinnitus may be larger and more predictable by adopting a target selection approach guided by personalized striatal networks or functional connectivity maps. Several corticostriatal mechanisms are likely to play a role in tinnitus, including the dorsal/ventral striatum and the putamen. We examined whether significant tinnitus treatment response by deep brain stimulation (DBS) of the caudate nucleus may be related to striatal network increased functional connectivity with tinnitus networks that involve the auditory cortex or ventral cerebellum. The first study was a cross-sectional 2-by-2 factorial design (tinnitus, no tinnitus; hearing loss, normal hearing, n = 68) to define cohort level abnormal functional connectivity maps using high-field 7.0 T resting-state fMRI. The second study was a pilot case-control series (n = 2) to examine whether tinnitus modulation response to caudate tail subdivision stimulation would be contingent on individual level striatal connectivity map relationships with tinnitus networks. Resting-state fMRI identified five caudate subdivisions with abnormal cohort level functional connectivity maps. Of those, two connectivity maps exhibited increased connectivity with tinnitus networks-dorsal caudate head with Heschl's gyrus and caudate tail with the ventral cerebellum. DBS of the caudate tail in the case-series responder resulted in dramatic reductions in tinnitus severity and loudness, in contrast to the nonresponder who showed no tinnitus modulation. The individual level connectivity map of the responder was in alignment with the cohort expectation connectivity map, where the caudate tail exhibited increased connectivity with tinnitus networks, whereas the nonresponder individual level connectivity map did not.

Animal studies have discovered that noise, even at levels that produce no permanent threshold shift, may cause cochlear damage and selective nerve degeneration. A hallmark of such damage, or synaptopathy, is recovered threshold but reduced suprathreshold amplitude for the auditory brainstem response (ABR) wave I. The objective of the present study is to evaluate whether the ABR wave I amplitude or slope can be used to diagnose tinnitus in humans. A total of 43 human subjects, consisting of 21 with tinnitus and 22 without tinnitus, participated in the study. The subjects were on average 44 ± 24 (standard deviation) years old and 16 were female; a subgroup of 19 were young adults with normal audiograms from 125 to 8000 Hz. The ABR was measured using ear canal recording tiptrodes for clicks, 1000, 4000 and 8000 Hz tone bursts at 30, 50, and 70 dB nHL. Compared with control subjects, tinnitus subjects did not show reduced ABR wave I amplitude or slope in either the entire group of 21 tinnitus subjects or a subset of tinnitus subjects with normal audiograms. Despite the small sample size and diverse tinnitus population, the present result suggests that low signal-to-noise ratios in non-invasive measurement of the ABR limit its clinical utility in diagnosing tinnitus in humans.

Tinnitus is an auditory sensation in the absence of actual external stimulation. Different clinical interventions are used in tinnitus treatment, but only few patients respond to available options. The lack of successful tinnitus treatment is partly due to the limited knowledge about the mechanisms underlying tinnitus. Recently, the auditory part of the thalamus has gained attention as a central structure in the neuropathophysiology of tinnitus. Increased thalamic spontaneous firing rate, bursting activity and oscillations, alongside an increase of GABAergic tonic inhibition have been shown in the auditory thalamus in animal models of tinnitus. In addition, clinical neuroimaging studies have shown structural and functional thalamic changes with tinnitus. This review provides a systematic overview and discussion of these observations that support a central role of the auditory thalamus in tinnitus. Based on this approach, a neuromodulative treatment option for tinnitus is proposed.

Tinnitus is caused by auditory dysfunction, and it affects about 10 -15% of the adult population. fortunately, in most cases, it is not dangerous however, in 20% of cases it can be life-disturbing especially with aging. Several types of therapies have been found to have a rule in the management of tinnitus including voice therapy, vagus nerve stimulation, hyperbaric oxygen therapy as well as a pharmacological intervention using several medications such as anesthetic, anticonvulsant, antidepressant anxiolytic, and antihistamine. The focus of treatment for tinnitus should include the annoyance associated with the tinnitus. Therefore, tinnitus retraining therapy (TRT) principle which includes meticulous diagnosis, educational counselling, and sound base therapy should be followed in all patients. The optimal results in the management of tinnitus can be achieved by proper counselling and patient education, in addition to providing an acoustic environment and the use of drugs that control some of the symptoms associated with tinnitus.

PurposeBrain herniation into arachnoid granulations (BHAG) of the dural venous sinuses is a recently described finding of uncertain etiology. The purpose of this study was to investigate the prevalence of BHAG in a cohort of patients with pulsatile tinnitus (PT) and to clarify the physiologic and clinical implications of these lesions.MethodsThe imaging and charts of consecutive PT patients were retrospectively reviewed. All patients were examined with MRI including pre- and post-contrast T1- and T2-weighted sequences. Images were reviewed separately by three blinded neuroradiologists to identify the presence of BHAG. Their location, signal intensity, size, presence of arachnoid granulation, and associated dural venous sinus stenosis were documented. Clinical records were further reviewed for idiopathic intracranial hypertension, history of prior lumbar puncture, and opening pressure.ResultsTwo hundred sixty-two consecutive PT patients over a 4-year period met inclusion criteria. PT patients with BHAG were significantly more likely to have idiopathic intracranial hypertension than PT patients without BHAG (OR 4.2, CI 1.5-12, p = 0.006). Sixteen out of 262 (6%) patients were found to have 18 BHAG. Eleven out of 16 (69%) patients had unilateral temporal or occipital lobe herniations located in the transverse sinus or the transverse-sigmoid junction. Three out of 16 (19%) patients had unilateral cerebellar herniations and 2/16 (13%) patients had bilateral BHAG.ConclusionIn patients with PT, BHAG is a prevalent MRI finding that is strongly associated with the clinical diagnosis of IIH. The pathogenesis of BHAG remains uncertain, but recognition should prompt comprehensive evaluation for IIH.

Applied relaxation (AR) is a behavioral coping technique consisting of seven steps and taught like a course, where each new step builds on the previous. The aim is that the patient learns a rapid relaxation skill that can be applied in natural anxiety-arousing situations. A meta-analysis of 66 randomized controlled studies showed a large within-group effect size which was maintained at follow-up. AR was significantly better than no or placebo treatment and did not differ from other active treatments. AR is recommended for anxiety disorders and menopausal symptoms since the effects were better for these than for pain and tinnitus.

OBJECTIVE: This study was designed to gain insights regarding patterns of social representations (values, ideas, beliefs) of tinnitus and their relation to demographic and clinical factors. METHOD: A cross-sectional survey design was used including 399 adults seeking help and reporting interest in internet-based cognitive behavior therapy for tinnitus. Data were collected using a free association task and analysis used qualitative (content analysis) and quantitative (cluster analysis and chi-square analysis) using the Iramuteq software. RESULTS: The social representations identified the negative impact of tinnitus and included the way it sounded (descriptions of the way tinnitus sounds (18%), annoyance (13.5%), and persistence (8%)). Four clusters were identified representing four levels of tinnitus severity, namely debilitating tinnitus (24%), distressing tinnitus (10%), annoying tinnitus (46%), and accepting tinnitus (20%). Cluster identity was associated with demographic and clinical variables. DISCUSSION: The identified clusters represented tinnitus severity experience in four stages, ranging from debilitating tinnitus to acceptance of tinnitus. These findings are important for clinical practice where tinnitus descriptions can indicate the stage of the tinnitus experience and which intervention pathway may be most appropriate.

Tinnitus is a symptom of disturbed auditory perception and in more than 90% connected to a hearing loss of different expression. Many people experience tinnitus and seek for treatment, but suffering and burden through the tinnitus is individually very different. With many patients it vanishes after a certain time even without treatment. This process is called habituation, tinnitus is perceived less disturbing. Up to date there is no therapy that can completely switch off the tinnitus, mainly because origin and expression of tinnitus is individual and very different.This review summarizes scientific findings about tinnitus, its origin and comorbidities and describes and evaluates modern therapies. It is based on the just new elaborated and in September 2021 published S3-Guideline "Chronic Tinnitus", under the lead management of the German Society of ENT, Head and Neck-Surgery., Tinnitus ist ein Symptom gestörter Hörwahrnehmung und in über 90% der Fälle mit einem mehr oder weniger stark ausgeprägten Hörverlust vergesellschaftet. Zwar klagen sehr viele Menschen über Ohrgeräusche und suchen entsprechende Behandlungsangebote, tatsächlich aber sind Ausprägung und Belastung der Beschwerden sehr unterschiedlich und verschwinden bei vielen Menschen auch ohne Therapie wieder bzw. werden habituiert, d.h. nicht mehr störend wahrgenommen. Therapieansätze, die Ohrgeräusche vollständig abschalten können, sind nicht verfügbar, zumal die Ausprägung und Entstehung des Tinnitus individuell sehr unterschiedlich sind.In diesem Review sollen die wissenschaftlichen Erkenntnisse zum Tinnitus zusammengefasst und Therapieformen beschrieben und bewertet werden. Die Übersicht stützt sich dabei auf die unter Federführung der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Halschirurgie gerade neu erstellte und im September 2021 veröffentlichte S3-Leitlinie "Chronischer Tinnitus".

OBJECTIVE: To ensure the safety and quality of vaccines, especially the newest RNA-vaccines against COVID-19, is one of the World Health Organization's current highest priorities. DESIGN: Case description. STUDY SAMPLE: We report three cases of sudden unilateral tinnitus following BNT162b2 mRNA-vaccine injection, which rapidly resolved in 2 out of 3 cases. RESULTS: The mechanism responsible for its development remains unclear. A hypersensitivity reaction with an abnormal autoimmune response or a vasculitic event may be implicated. CONCLUSIONS: Large-scale and well-designed studies are needed to improve surveillance of the COVID-19 vaccine and better define possible adverse reactions involving the cochleo-vestibular system and/or immunisation anxiety-related reactions.

BackgroundTinnitus distress is related to both the loudness and intrusiveness of the tinnitus percept. Treatment approaches targeting both attentional/limbic and auditory systems may better alleviate tinnitus distress than approaches targeting the auditory system alone.Materials and methodsTen subjects with chronic tinnitus received sequential rTMS treatment involving: 1) excitatory stimulation administered to the left dorsolateral prefrontal cortex (DLPFC) or inhibitory stimulation administered to the right DLPFC, followed by 2) inhibitory stimulation administered to primary auditory cortex (Heschel's gyrus or HG). A systematic literature review was performed to evaluate the existing literature on sequential repetitive Transcranial Magnetic Stimulation (rTMS) treatment approaches for tinnitus. Results of the case series are interpreted in the context of tinnitus neurobiology and the extant literature.ResultsSubjects experienced a significant decrease (average 21.7%) in symptoms on the Tinnitus Functional Index (TFI). Those with tinnitus alone experienced a greater mean symptom reduction than those with comorbid MDD (27.7 vs. 17.0%, respectively). Adverse effects were transient and minor. Literature review confirmed that sequential approaches had some advantages compared to single site rTMS; in general, the addition of 1 Hz treatment at DLPFC was superior to single site rTMS in the short term (1-12 weeks), while the addition of 20 Hz treatment at DLPFC appeared superior in the long term (90-180 days).ConclusionsSequential rTMS approaches for the treatment of tinnitus-particularly those administering low-frequency treatment at left DLPFC-merit further investigation.

Migraine headaches frequently coexist with vestibular symptoms such as vertigo, motion sickness, and gait instability. Migraine-related vasospasm can also damage the inner ear, which results in symptoms such as sudden sensorineural hearing loss and resultant tinnitus. The pathophysiology of these symptoms is not yet fully understood, and despite their prevalence, there is no universally approved management. This review summarizes the data on complementary and integrative medicine in treating patients with migrainous ear disorders.

Purpose of reviewThe purpose of this narrative review is to discuss current literature about vestibular migraine and other cochleovestibular symptoms related to migraine.Recent findingsVestibular migraine affects 2.7% of the US population. Misdiagnosis is common. The pathophysiology is currently unknown but new research shows that calcitonin gene-related peptide, which is implicated in migraine headaches, is expressed in the audiovestibular periphery. A recent large-scale placebo-controlled trial looking at metoprolol for vestibular migraine was terminated early due to poor recruitment; however, at study completion, no differences were seen between treatment arms. Many other audiovestibular symptoms have been shown to be associated with migraine, including tinnitus, hearing loss, aural fullness, otalgia, and sinus symptoms. Migraine is also associated with risk for developing numerous otologic conditions, including Meniere's disease, vestibular loss, Benign Paroxysmal Positional Vertigo, and sudden sensorineural hearing loss. There is now some evidence that patients may experience fluctuating hearing loss and aural fullness without vertigo in association with migraine, which is called cochlear migraine.SummaryMigraine can cause a variety of audiologic and vestibular symptoms, and further research is required to understand how migraine affects the inner ear.

While noninvasive brain stimulation is convenient and cost effective, its utility is limited by the substantial distance between scalp electrodes and their intended neural targets in the head. The tympanic membrane, or eardrum, is a thin flap of skin deep in an orifice of the head that may serve as a port for improved efficiency of noninvasive stimulation. Here we chose the cochlea as a target because it resides in the densest bone of the skull and is adjacent to many deep-brain-stimulation structures. We also tested the hypothesis that noninvasive electric stimulation of the cochlea may restore neural activities that are missing in acoustic stimulation. We placed an electrode in the ear canal or on the tympanic membrane in 25 human adults (10 females) and compared their stimulation efficiency by characterizing the electrically-evoked auditory sensation. Relative to ear canal stimulation, tympanic membrane stimulation was four times more likely to produce an auditory percept, required eight times lower electric current to reach the threshold and produced two-to-four times more linear suprathreshold responses. We further measured tinnitus suppression in 14 of the 25 subjects who had chronic tinnitus. Compared with ear canal stimulation, tympanic membrane stimulation doubled both the probability (22% vs. 55%) and the amount (-15% vs. -34%) of tinnitus suppression. These findings extended previous work comparing evoked perception and tinnitus suppression between electrodes placed in the ear canal and on the scalp. Together, the previous and present results suggest that the efficiency of conventional scalp-based noninvasive electric stimulation can be improved by at least one order of magnitude via tympanic membrane stimulation. This increased efficiency is most likely due to the shortened distance between the electrode placed on the tympanic membrane and the targeted cochlea. The present findings have implications for the management of tinnitus by offering a potential