Hearing Impairment and Tinnitus Pitch in Patients With Unilateral Tinnitus: Comparison of Sudden Hearing Loss and Chronic Tinnitus

Background: Tinnitus is an annoying problem and until now there is no consensus on its treatment. Aims: In this prospective study, we evaluated the effectiveness of intratympanic lidocaine and dexamethasone (ITLD) injections for the management of subjective idiopathic tinnitus (SIT). Methods: Forty patients with SIT attended the Department of Otorhinolaryngology, Tanta University Hospital, Egypt, between May 2013 and May 2014. The patients were categorized into two groups: group A included 20 patients treated with ITLD injection, and group B included 20 patients treated with intratympanic saline injection as a control. Intratympanic injections were performed four times within 4 weeks in a double-blind manner. At the end of the treatment program, we analyzed the improvement and worsening rates of tinnitus using the following parameters: tinnitus questionnaires, Tinnitus Handicap Index (THI), and loudness matching test. Results: The effectiveness rates of the ITLD group reported in the tinnitus questionnaires, the THI and the loudness matching test were 74.3% in all tests, compared to 26.7, 40.0 and 26.7%, respectively, in the saline group. There was a statistically significant difference between the groups within 2 months after injection. To analyze the therapeutic effect of ITLD on tinnitus of 6 months duration, the improvement rates reported in the tinnitus questionnaires, the THI and the loudness matching test were 78.5% in all tests in the ITLD group, compared to 40.0, 40.0 and 30.0%, respectively, in the saline group. Conclusion: There were statistically significant differences between both groups. ITLD seems to be effective for idiopathic tinnitus.

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“…These findings support the suggestion that damage to cochlear hair cells plays a crucial role in the pathogenesis of tinnitus [3]. …”

Section: Introductionsupporting

confidence: 90%

Tinnitus: Evaluation of Intratympanic Injection of Combined Lidocaine and Corticosteroids

Elzayat

Elsherif

Hegazy

et al. 2016

ORL

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“…[1][2][3] The severity of tinnitus commonly increases with the degree of hearing loss, and the pitch of tinnitus often coincides with the frequency of the lesion or is just below the precipitous edge of the lesion. 4,5 These findings demonstrate that damage to cochlear hair cells plays a crucial role in the pathogenesis of tinnitus. The decreased signal transduction from damaged hair cells may result in a reduction of lateral inhibition at the dorsal cochlear nucleus or inferior colliculus into a characteristic frequency, followed by the development of hyperactivity in auditory neurons at the edge of the frequency.…”

Section: Introductionmentioning

confidence: 93%

Comparison of various treatment modalities for acute tinnitus

et al. 2011

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“…Induction of tinnitus with a 1/3 octave band noise stimulus results in tinnitus frequency at the lower end of the range of loss (Atherley et al, 1968). In humans with unilateral highfrequency sensorineural hearing loss and tinnitus in the same ear, tinnitus frequency corresponds to the lower frequency edge of the range of the hearing loss (Ochi et al, 2003). Kiang et al (1970) suggested that the tonotopic profile of SA in auditory nerve fibers might be a neural correlate of tinnitus.…”

Section: Relationship To Tinnitusmentioning

confidence: 99%

Effect of unilateral noise exposure on the tonotopic distribution of spontaneous activity in the cochlear nucleus and inferior colliculus in the cortically intact and decorticate rat

Imig

Durham

2005

J of Comparative Neurology

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Effects of unilateral noise exposure on spontaneous activity (SA) in the anteroventral and dorsal cochlear nuclei (AVCN and DCN) and the central nucleus of the inferior colliculus (ICc) were studied in cortically intact and decorticate rats. SA was measured 1 week following exposure using uptake of 14C-labeled 2-deoxyglucose (2DG) in quiet. Optical density (OD) measurements were obtained in low- and high-frequency (LF and HF) areas of each nucleus. We refer to the ipsilateral AVCN and DCN (side of the noise-exposed ear) and the contralateral ICc as direct nuclei and to their opposite side counterparts as indirect nuclei. Noise exposure altered the tonotopic profile of SA in the direct pathway by causing a decrease in the ratio of HF OD to LF OD (HF/LF ratio). In intact animals, the decreased HF/LF ratio was due to decreased HF OD. In decorticate animals, it was due to decreased HF OD and increased LF OD, the latter occurring mainly in the DCN and ICc. Decorticate-intact differences may reflect corticofugal feedback inhibition. Lesion of the dorsal acoustic stria caused a substantial decrement of SA in the contralateral ICc. Furthermore, strong positive correlations between HF/LF ratios in the DCN, AVCN, and contralateral ICc suggest that the cochlear nucleus is a major contributor to SA in the ICc. Noise exposure had opposite and weaker effects on 2DG uptake in the indirect pathway that were attributed to crossed inhibition. Noise-induced changes in the tonotopic profile of SA may represent a neural correlate of tinnitus.

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Hearing Impairment and Tinnitus Pitch in Patients With Unilateral Tinnitus: Comparison of Sudden Hearing Loss and Chronic Tinnitus

Abstract: The results suggest that tinnitus is related to hearing impairment in the same frequency region in patients with sudden sensorineural hearing loss with tinnitus or in patients with chronic tinnitus, whereas some instances of chronic tinnitus are caused by reorganization in cortical cells.

Cited by 45 publications

References 20 publications

Tinnitus: Evaluation of Intratympanic Injection of Combined Lidocaine and Corticosteroids

Tinnitus: Evaluation of Intratympanic Injection of Combined Lidocaine and Corticosteroids

Comparison of various treatment modalities for acute tinnitus

Effect of unilateral noise exposure on the tonotopic distribution of spontaneous activity in the cochlear nucleus and inferior colliculus in the cortically intact and decorticate rat

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