From Acute to Chronic Tinnitus: Pilot Data on Predictors and Progression

Abstract

Little is known about the transition from acute tinnitus to chronic tinnitus. By means of this study, we are attempting to close this gap by presenting prospective pilot data of patients with acute tinnitus, followed by tracking their condition's trajectory over a period of 6 months. Forty-nine patients presenting with acute tinnitus (duration < 28 days) were recruited in two clinics. We recorded demographic and clinical tinnitus-related data as well as data on personality, health, treatments, and life-style, during patients' first appearance in the clinic and again three and 6 months thereafter. Standard audiograms were performed at the first and the second visit. Nine (18.4%) patients showed full remission of their tinnitus. These patients differed from patients with a chronic course of tinnitus by shorter tinnitus duration, lower fear-related hyperacusis, higher proportion of female gender, increased ear pressure, and lower levels of alcohol consumption. Among the patients with a chronification of tinnitus, there was no change in tinnitus characteristics. However, their tinnitus distress improved moderately over time. These preliminary data are in line with earlier studies that have shown that only a small proportion of those patients presenting in the clinic with acute tinnitus experience a full remission. The results of this study can be of service in deducing hypotheses for the transition from acute to chronic tinnitus and in developing designs for interventional studies.

Co-occurrence of Hyperacusis Accelerates With Tinnitus Burden Over Time and Requires Medical Care

“…We here suggest that the confounding factor in the T-group is a gradual increase in hyperacusis characteristics. Before we discuss this aspect in more detail, it is important to note that two recent trials also investigated the transition of tinnitus from acute to chronic over a period of 6 months ( 29 , 30 ) and found that the average tinnitus distress moderately improved over time. Neither of these studies, however, analyzed tinnitus over longer durations or separated its features from the co-occurrence of hyperacusis.…”

“…A hitherto, largely unexplored, factor is the duration of chronic tinnitus. In three recent publications, the transition from acute to chronic tinnitus was examined (28)(29)(30). One study included normal hearing subjects with tinnitus lasting longer than 6 months (28) and classified patients into 3 categories according to the tinnitus duration: (i) acute, < 1 month (ii) chronic, > 6 months, (iii) subacute, between 1 and 6 months.…”

Methodological Aspects of Randomized Controlled Trials for Tinnitus: A Systematic Review and How a Decision Support System Could Overcome Barriers

“…Relatively little is known about the course of tinnitus over time [ 7 , 105 , 106 , 107 ]. There are a lot of factors contributing to this.…”

Cerebral Blood Flow Difference Between Acute and Chronic Tinnitus Perception: A Perfusion Functional Magnetic Resonance Imaging Study

“…A recent longitudinal study found that 18.4% of acute tinnitus patients had complete remission of tinnitus within 6 months. There was no change in tinnitus characteristics in patients with their tinnitus persistent ( Vielsmeier et al, 2020 ). However, the exact mechanism of the chronization of tinnitus remains a mystery.…”