Functional Impact of Tinnitus in Patients with Hearing Loss

Abstract

Introduction Tinnitus, which is considered the third worst symptom for humans, is a common complaint among people living with hearing loss and may negatively affect the quality of life of those who have it. Objective To analyze the perception of the handicap in patients with tinnitus and hearing loss as well as the possible associations between the variables hearing loss, loudness, onset, frequency and annoyance by tinnitus, and the correlation between the visual analogue scale (VAS) and the Tinnitus Handicap Inventory (THI). Methods A total of 30 patients with complaints of tinnitus and the presence of sensorineural hearing impairment were selected for this cross-sectional, observational, and descriptive study. The loudness of the tinnitus was measured by a VAS and classified as mild, moderate, or severe. The THI was classified as slight, mild, moderate, severe, and catastrophic. Data were submitted to statistical analysis using the Fisher exact test and Spearman correlation coefficient. Results Eleven male (36.7%) and 19 female (63.3%) subjects with a mean age of 56.5 years old were evaluated. There was no significant association between loudness, annoyance, time and frequency of tinnitus, nor between hearing loss and tinnitus. There was a significant association between the variables hearing loss and loudness, and a weak correlation between VAS and THI. Conclusion Tinnitus has a practical impact in the lives of patients with hearing loss in terms of catastrophic, functional, and emotional aspects, regardless of loudness, frequency, or time of onset. Hearing loss was a factor that had an impact on the loudness of tinnitus. There was no statistically significant correlation between VAS and THI.

Effect of Tinnitus on Sleep Quality and Insomnia

“…These findings are similar to those of another study, 27 in which most participants were females and reported symptoms of bilateral tinnitus, and a mean time of symptom perception of 7.8 years. Data in the present study also corroborate findings from a study by Mantello et participants reported bilateral tinnitus, 28 as well as the findings of studies by other authors studies, with $ 60% of the sample comprising females. 28,29 It should be noted that it is not usual for females to be more prevalent among samples of tinnitus patients, although there are some studies with that distribution.…”

“…Data in the present study also corroborate findings from a study by Mantello et participants reported bilateral tinnitus, 28 as well as the findings of studies by other authors studies, with $ 60% of the sample comprising females. 28,29 It should be noted that it is not usual for females to be more prevalent among samples of tinnitus patients, although there are some studies with that distribution. 1,4,6,8 Most participants were identified with hearing loss (76.5% in the left ear and 82.4% in the right ear), corroborating a study that indicated tinnitus as being associated with subjects with a diagnosis of hearing loss.…”

“…These results did not conform to a study with a sample comprising only partic-ipants diagnosed with hearing loss (n ¼ 30), in which 46.5% reported mild tinnitus handicap, 10% reported moderate handicap, and 43.5% reported severe/catastrophic tinnitus handicap, by means of the THI. 28 On the other hand, the study by Nascimento et al, using the THI, observed that most of the sample reported mild tinnitus handicap, followed by moderately severe tinnitus, results that corroborate the ones found in the present study. The difference in tinnitus severity among the studies was explained by Nascimento et al as being due to the low degree of anxiety, common to the participants in their study, implying that the severity of the symptom may be related or even be aggravated by psychological issues.…”

Caracterización de los pacientes con tinnitus y hallazgos audiométricos

“…Es importante aclarar, que se registraron los datos de pacientes con sensación de hipoacusia y con hipoacusia objetiva. Los primeros, fueron pacientes que referían sentir hipoacusia unilateral o bilateral en concomitancia al inicio de su tinnitus, independiente de los resultados de su audiometría y la hipoacusia objetiva fue definida como una audiometría de transmisión, neurosensorial o mixta, con una pérdida mayor o igual a 20 decibeles 11 . El 33% de los pacientes refiere sentir hipoacusia concomitante a su tinnitus.…”

“…En relación a la frecuencia, en dos tercios de los pacientes, el tinnitus fue continuo y en un tercio intermitente, esto no se relaciona con la literatura donde la mayor frecuencia es en el patrón intermitente con 60% 14 . Sin embargo, en un estudio del año 2020, llevada a cabo por Mantello y colaboradores en un hospital general de Sao Paulo, Brasil, encontraron un patrón bilateral en el 60% de los casos y un patrón continuo en el 80%, siendo similares valores en relación al presente estudio, pero debido a que su muestra solo eran 30 pacientes puede no ser representativo ni generalizable a la población 11 . En relación a las comorbilidades del tinnitus, en la literatura se encuentran amplias asociaciones, pero sin un sustento evidente, se cree que su causa es multifactorial.…”