Somatosensory Tinnitus Diagnosis: Diagnostic Value of Existing Criteria

Abstract

Background: Tinnitus can be influenced by changes in somatosensory afference from the cervical spine or temporomandibular area, then called somatosensory or somatic tinnitus (ST). In 2018, a new set of diagnostic criteria for ST was agreed upon by a large group of ST experts. Currently, however, it still requires extensive and specific expertise to diagnose ST correctly. The next step in the development of easily applicable diagnostic criteria is to assess the diagnostic value of each individual criterion. Objectives:The aim of this study was, therefore, to further investigate the diagnostic value of these criteria, validate them empirically, and identify their sensitivity and specificity.Methods: An online survey, questioning the presence of 12 diagnostic criteria for ST in a convenience sample of participants with tinnitus, was launched on the online forum Tinnitus Talk, managed by Tinnitus Hub. Participants were divided into three groups: a group with no somatic influence, a group with some somatic influence and a group with large somatic influence on their tinnitus. Chi-square tests were used to calculate differences between these groups. Afterward, sensitivity, specificity, positive and negative likelihood ratios (LR), and pre-and posttest probabilities were calculated for each ST diagnostic criterion. For this analysis, all patients with some and large somatic influence were compared as one group to the group with no somatic influence. Results:In total, 8221 participants filled out the online survey. As expected, the diagnostic criteria for ST are more prevalent in the groups with somatic influence, but the criterium of tinnitus modulation also often occurs in the group with no somatic influence. The simultaneous onset or increase and decrease of both tinnitus and pain complaints have the highest positive LR (6.29 and 10.72, respectively), next to the influence of certain postures on the tinnitus (+LR: 6.04). To rule out ST, the absence of neck pain or tension in the neck extensor muscles are most suited, as they decrease the posttest probability to 18% and 19%, respectively. Conclusion:The simultaneous onset or increase and decrease of tinnitus and neck or jaw pain and the influence of certain postures are most suited to use as a single criterion for identifying patients with a somatic influence on their tinnitus. On the other hand, the absence of neck pain or tension in the neck extensor muscles is valid criterion to rule out a somatic influence. Additional analysis is needed to identify clusters of symptoms and criteria to further aid ST diagnosis.

Hyperacusis: demographic, audiological, and clinical characteristics of patients at the ENT department

“…Furthermore, a higher prevalence of women in the somatic tinnitus population has been reported [37], which raises questions regarding the somatic component in the hyperacusis population. A recent article by Michiels, et al [40] showed a higher prevalence of hyperacusis in a group of patients with a higher degree of somatic tinnitus, which is in line with the earlier study by Schecklmann, et al [8]. However, other studies did not demonstrate this finding [41].…”

A teljes körű kivizsgálás eredményei fülzúgásban szenvedőkön

“…Az elvégzett carotis-vertebralis ultrahangvizsgálat alacsonyabb arányát magyarázhatja a vizsgálat korlátozottabb elérhetősége, illetve a pandémia hatása. A nyakigerinc-röntgenvizsgálat szintén fontos, különösen a szometoszenzoros tinnitusformák esetén [8]. A jelenleg elemzett beteganyagon nyakigerinc-röntgenvizsgálatra nagy arányban került sor (80%), az ábrázolt eltérések közül pedig a spondylosis és a spondyloarthrosis volt messze a leggyakoribb.…”

Tinnitus Perception in Light of a Parietal Operculo–Insular Involvement: A Review

“…Nowadays, the idea that changes in brain regions outside the auditory pathway, in particular the somatosensory pathway, the emotional and the attentional systems, could trigger the development and maintenance of tinnitus is more widely accepted in the community [15]. Additional non-invasive human studies support the involvement of somatosensory pathways in tinnitus [16] and of attentional and limbic networks with possible interactions with the auditory network [17].…”