Abstract
Purpose
Although tinnitus patients have different audiometric configuration, we evaluated them using the same approach. Thus we analyzed the clinical features of patients with subjective tinnitus classified according to audiometric configuration.
Materials and methods
The study cohort consisted of 123 patients with subjective tinnitus who visited the tinnitus clinic from April 2013 to April 2014. Patients with a previous history of otologic disease or migrainous vertigo were excluded. Factors evaluated included pure tone audiometry, tinnitogram, auditory brainstem response (ABR), distortion product otoacoustic emissions (DPOAEs) and transient evoked otoacoustic emissions (TEOAEs).
Results
Tinnitus patients could be divided into three groups: Flat, high frequency gently sloping (HFGS) and high frequency steeply sloping (HFSS). HFGS showed female predominance and HFSS male predominance (p < 0.05 each). THI score was higher in the HFGS than in the other groups (p < 0.05). Tinnitus pitch and occupations varied, but showed specific tendencies in each group. On ABR, the HFSS group showed significant prolongation of wave I, III, and V latencies (p < 0.05 each). On DPOAEs, the HFSS group showed significantly lower response rates at 3, 4, and 6 kHz (p < 0.05 each). TEOAE normal rates were significantly higher in the Flat than in the HFGS and HFSS groups (p < 0.05).
Conclusions
Average pure tone thresholds were similar, but threshold values at high frequencies, ABR, DPOAEs, and TEOAEs differed among the groups. Therefore, different access to tinnitus patients could be required according to audiometric shape.
1
Introduction
Tinnitus is a phenomenon in which a person senses the presence of sound in the ear without an outside auditory stimulus . Its incidence in adults has been reported to range from 10–30%. For example, a cross-sectional population survey from 2009 to 2011 in South Korea found that 19.7% of individuals surveyed complained of tinnitus, with the incidence increasing with age . The actual rates of tinnitus may be even higher, since it is likely that many individuals with this condition do not visit the hospital .
Tinnitus can be classified as subjective or objective. Subjective tinnitus generally occurs in the cochlea and auditory nerve system and is not audible to the tester. In contrast, objective tinnitus is audible to the tester, with determination of the cause suggesting the type of treatment . Although subjective tinnitus occurs much more frequently than objective tinnitus, its causes, pathogenesis and treatment remain unclear. In addition, the heterogeneity observed in subjects with distressing tinnitus suggests that the mechanism of origin of tinnitus may differ among individuals. Indeed, multiple mechanisms may be at work within one individual .
Most individuals develop tinnitus after their hearing decreases, suggesting a correlation. However, the pitch and loudness of tinnitus may differ among patients with similar hearing thresholds . Moreover many tinnitus patients have normal hearing, but their threshold values at high frequency are decreased. Therefore, tinnitus patients can be categorized based on the shape of a graph of their threshold values at each frequency rather than on their mean hearing threshold .
We therefore analyzed the clinical features of patients with subjective idiopathic tinnitus classified according to audiometric configuration.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
