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Objective: This study aimed to investigate the relationship between thyroid function and tinnitus., Study Design: A cross-sectional study., Setting: The Korean National Health and Nutrition Examination Survey from 2013 was used., Patients and Interventions: A total of 1,165 participants ≥ 40 years old who were surveyed for the presence of tinnitus and underwent thyroid function tests were included. The presence of discomfort from tinnitus was defined as annoying tinnitus. The control group included participants with "no tinnitus" or "no discomfort from tinnitus." The participants were divided into the annoying tinnitus group and the control group., Main Outcome Measures: The associations of free thyroxine and thyroid-stimulating hormone (TSH) with annoying tinnitus were analyzed using logistic regression with complex sampling methods. Subgroup analyses were performed according to sex., Results: The low TSH level group had 2.35-fold greater odds of annoying tinnitus than the control group (95% confidence interval  = 1.10-5.12, p = 0.027). Even in patients with a normal free thyroxine level, a low TSH level was related to 2.78-fold higher odds of annoying tinnitus (95% confidence interval  = 1.21-6.38, p = 0.016). In subgroup analyses, this association was apparent in the female subgroup. The male subgroup did not show a relationship between low TSH levels and annoying tinnitus., Conclusions: Subclinical hyperthyroidism was related to an increased risk of annoying tinnitus. This relationship was apparent in the female subgroup., Competing Interests: The authors disclose no conflicts of interest., (Copyright © 2020, Otology & Neurotology, Inc.)

At present, there is no objective method for diagnosing subjective sensorineural tinnitus. Recently, the acoustic change complex (ACC) has been used to evaluate neural detection of sounds. Thus, the present study aimed to examine whether the ACC can reflect cortical detection and discrimination of sounds matched with tinnitus frequencies. We hypothesized that the ACC to change stimuli matched with tinnitus frequencies would be decreased in tinnitus patients because the tinnitus interferes with the perception of acoustic changes. To test the hypothesis, 96 ears of normal-hearing (NH) tinnitus patients and controls were tested. Among the tinnitus patients, 33 ears with a tinnitus frequency of 8 kHz constituted the tinnitus group, and the remaining 63 ears with no experience of tinnitus were allocated to the control group. For the 4 kHz non-tinnitus matched frequency, a subset of tinnitus (n = 17) and NH (n = 47) subjects was tested. The acoustic stimuli were pure tones with a total duration of 500 ms consisting of a 1 kHz tone in the first 250 ms and a second tone of either 8 kHz or 4 kHz in the latter 250 ms. The normalized amplitude of the ACC (naACC) was calculated separately for the amplitude of the N1'-P2' complex evoked by an 8 kHz or 4 kHz change stimulus and for the amplitude of the N1-P2 complex elicited by the initial 1 kHz background stimulus. Our results showed that the naACC to an 8 kHz stimulus in the tinnitus group was significantly smaller than those to 4 kHz and 8 kHz in normal controls. Additionally, in the tinnitus group, the naACC to 4 kHz was greater compared to 8 kHz. The receiver operating characteristic (ROC) curve analysis conducted for naACC to 8 kHz at UCL revealed a fair degree of diagnostic efficacy. Overall, our results indicated that the ACC to a change stimulus matched with the tinnitus frequency can provide an objective measure of frequency-specific tinnitus.

Background: Tinnitus is a common condition in adults; however, the pathophysiology of tinnitus remains unclear, and no large population-based study has assessed the associated risk factors. The aim of this study was to analyze the prevalence and associated risk factors of tinnitus., Methods: We conducted a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey, with 19,290 participants ranging in age from 20 to 98 years old, between 2009 and 2012. We investigated the prevalence of tinnitus using a questionnaire and analyzed various possible factors associated with tinnitus using simple and multiple logistic regression analysis with complex sampling., Results: The prevalence of tinnitus was 20.7%, and the rates of tinnitus associated with no discomfort, moderate annoyance, and severe annoyance were 69.2%, 27.9%, and 3.0%, respectively. The prevalence of tinnitus and the rates of annoying tinnitus increased with age. The adjusted odds ratio (AOR) of tinnitus was higher for females, those with a smoking history, those reporting less sleep (≤ 6 h), those with more stress, those in smaller households, those with a history of hyperlipidemia osteoarthritis, rheumatoid arthritis, asthma, depression, thyroid disease, an abnormal tympanic membrane, unilateral hearing loss, bilateral hearing loss, noise exposure from earphones, noise exposure at the workplace, noise exposure outside the workplace, and brief noise exposure. Additionally, unemployed individuals and soldiers had higher AORs for tinnitus. The AOR of annoying tinnitus increased with age, stress, history of hyperlipidemia, unilateral hearing loss, and bilateral hearing loss., Conclusions: Tinnitus is very common in the general population and is associated with gender, smoking, stress, sleep, hearing loss, hyperlipidemia, osteoarthritis, rheumatoid arthritis, asthma, depression, and thyroid disease history.

The muscular tinnitus due to an extrinsic auricular myoclonus is an extremely rare disorder which demonstrates a semirhythmic involuntary movement of the ear. We report a 33-year-old man with clicking tinnitus caused by focal myoclonic jerks of bilateral posterior auricularis muscle and bilateral temporalis muscle. This muscular tinnitus persisted except for when he was sleeping or breath holding. His symptom responded poorly to medical therapy but was controlled by botulinum toxin type A injection under electromyography monitoring with favorable outcome. Previous reports of this condition and possible therapeutic approaches are discussed., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Background: Tinnitus in children and adolescents is known to be as common as in adults. However, tinnitus in this young population is often overlooked, and a large population-based study designed to adjust for various risk factors for tinnitus is lacking., Methods: A cross-sectional study was conducted using data from the Korea National Health and Nutrition Examination Survey, with 3047 participants aged 12 to 19 years, from 2008 through 2011. We investigated the tinnitus prevalence by questionnaire and analyzed risk factors for tinnitus of three types: personal, otologic, and parental factors., Results: The prevalence of tinnitus in the young population was 17.7%, although only 0.3% of subjects reported severe discomfort caused by tinnitus. The tinnitus prevalence increased with age (adjusted odds ratio [AOR], 1.087). Female gender (AOR, 1.401), sleeping less than 9 hours (sleep 7 or 8 h: AOR, 1.437; sleep 6 h or less: AOR, 1.737), noise exposure in other places (AOR, 6.395), and momentary noise exposure (AOR, 5.504) increased the risk of tinnitus. Participants whose mother had a history of tinnitus showed higher AORs. However, high body mass index, alcohol consumption, stress, monthly household income, having an abnormal tympanic membrane, unilateral or bilateral hearing loss, noise exposure caused by earphone, and noise exposure in the workplace, all reported risk factors for tinnitus, showed no statistically significant difference. A tinnitus history in the father was also not associated with tinnitus in children., Conclusion: We believe that understanding the influences of these factors will help in preventing tinnitus.

Simple Summary: The principle of Bayesian inference provides a theoretical framework for stable perception in numerous tasks, including sensory–perceptual tasks, sensorimotor, and motor tasks. Efference copy (EC) signals enable organisms to reduce cognitive loading by decreasing the sensory processing of their own actions. In the auditory domain, the sensorimotor prediction error is responsible for false perceptions, such as auditory hallucinations in schizophrenia, while sensory prediction error also leads to auditory phantom perception such as tinnitus. Attenuation of the N1 component in event-related potentials has been suggested as evidence for the integrity of the EC mechanism. The current study investigated the EC mechanism in auditory false perception and phantom perception as a consequence of sensory prediction errors. N1 attenuation failures were present in tinnitus patients with significant hearing impairment and in those with schizophrenia, indicating that phantom perception after sensory deprivation might lead to impairment in the EC mechanism. However, the corresponding neural representation with spatiotemporal patterns presented differently between patients with schizophrenia and tinnitus. Although the present study had several constraints, the results provide a new perspective on neurobiological aspects of abnormal auditory perception resulting from deficits in predictive coding. In this study, we hypothesized that top-down sensory prediction error due to peripheral hearing loss might influence sensorimotor integration using the efference copy (EC) signals as functional connections between auditory and motor brain areas. Using neurophysiological methods, we demonstrated that the auditory responses to self-generated sound were not suppressed in a group of patients with tinnitus accompanied by significant hearing impairment and in a schizophrenia group. However, the response was attenuated in a group with tinnitus accompanied by mild hearing impairment, similar to a healthy control group. The bias of attentional networks to self-generated sound was also observed in the subjects with tinnitus with significant hearing impairment compared to those with mild hearing impairment and healthy subjects, but it did not reach the notable disintegration found in those in the schizophrenia group. Even though the present study had significant constraints in that we did not include hearing loss subjects without tinnitus, these results might suggest that auditory deafferentation (hearing loss) may influence sensorimotor integration process using EC signals. However, the impaired sensorimotor integration in subjects with tinnitus with significant hearing impairment may have resulted from aberrant auditory signals due to sensory loss, not fundamental deficits in the reafference system, as the auditory attention network to self-generated sound is relatively well preserved in these subjects. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to examine the difference between self-reported hearing status and hearing impairment assessed using conventional audiometry. The associated factors were examined when a concordance between self-reported hearing and audiometric measures was lacking. Methods: In total, 19,642 individuals ≥20 years of age who participated in the Korea National Health and Nutrition Examination Surveys conducted from 2009 through 2012 were enrolled. Pure-tone hearing threshold audiometry (PTA) was measured and classified into three levels: <25 dB (normal hearing); ≥25 dB <40 dB (mild hearing impairment); and ≥40 dB (moderate-to-severe hearing impairment). The self-reported hearing loss was categorized into 3 categories. The participants were categorized into three groups: the concordance (matched between self-reported hearing loss and audiometric PTA), overestimation (higher self-reported hearing loss compared to audiometric PTA), and underestimation groups (lower self-reported hearing loss compared to audiometric PTA). The associations of age, sex, education level, stress level, anxiety/depression, tympanic membrane (TM) status, hearing aid use, and tinnitus with the discrepancy between the hearing self-reported hearing loss and audiometric pure tone threshold results were analyzed using multinomial logistic regression analysis with complex sampling. Results: Overall, 80.1%, 7.1%, and 12.8% of the participants were assigned to the concordance, overestimation, and underestimation groups, respectively. Older age (adjusted odds ratios [AORs] = 1.28 [95% confidence interval = 1.19–1.37] and 2.80 [2.62–2.99] for the overestimation and the underestimation groups, respectively), abnormal TM (2.17 [1.46–3.23] and 1.59 [1.17–2.15]), and tinnitus (2.44 [2.10–2.83] and 1.61 [1.38–1.87]) were positively correlated with both the overestimation and underestimation groups. Compared with specialized workers, service workers, manual workers, and the unemployed were more likely to be in the overestimation group (1.48 [1.11–1.98], 1.39 [1.04–1.86], and 1.50 [1.18–1.90], respectively), and service workers were more likely to be in the underestimation group (AOR = 1.42 [1.01–1.99]). Higher education level (0.77 [0.59–1.01] and 0.43 [0.33–0.57]) and hearing aid use (0.36 [0.17–0.77] and 0.23 [0.13–0.43]) were negatively associated with being in the underestimation group (0.43 [0.37–0.50]). Compared with males, females were less likely to be assigned to the underestimation group (0.43 [0.37–0.50]). Stress (1.98 [1.32–2.98]) and anxiety/depression (1.30 [1.06–1.59]) were associated with overestimation group. Conclusion: Older age, lower education level, occupation, abnormal TM, non-hearing aid use, and tinnitus were related to both overestimation and underestimation groups. Male gender was related to underestimation, and stress and anxiety/depression were correlated with overestimation group. An understanding of these factors associated with the self-reported hearing loss will be instrumental to identifying and managing hearing-impaired individuals. [ABSTRACT FROM AUTHOR]