Search Results (24)

Background/Objectives: Single-sided deafness (SSD) impairs speech perception, reduces spatial hearing, decreases quality of life, and is frequently accompanied by tinnitus. Cochlear implantation (CI) has become an established treatment option, but long-term prospective evidence across multiple functional and psychological domains remains limited. This study investigated auditory performance, subjective hearing outcomes, tinnitus burden, and psychological well-being over a two-year follow-up in a large SSD cohort. Methods: Seventy adults with SSD underwent unilateral CI. Assessments were conducted preoperatively and at 6 months, 1 year, and 2 years postoperatively. Outcome measures included the Freiburg Monosyllable Test (FS), Oldenburg Inventory (OI), Nijmegen Cochlear Implant Questionnaire (NCIQ), Tinnitus Questionnaire (TQ), Perceived Stress Questionnaire (PSQ), Generalized Anxiety Disorder scale (GAD-7), and General Depression Scale (ADS-L). Longitudinal changes were analyzed using Wilcoxon signed-rank tests with effect sizes; Holm-adjusted p-values were applied for baseline-to-follow-up comparisons. Results: Speech perception improved markedly within the first 6 months and remained stable through 2 years, with large effect sizes. All OI subdomains demonstrated early and sustained improvements in subjective hearing ability. Several hearing-related quality-of-life domains assessed by the NCIQ, particularly social interaction, self-esteem, and activity participation, showed medium-to-large long-term improvements. Tinnitus severity decreased substantially, with marked reductions observed by 6 months and maintained thereafter; the proportion of tinnitus-free patients increased at follow-up, although tinnitus symptoms persisted in a substantial subset of participants. Perceived stress was reduced initially at the early follow-up and remained below baseline thereafter. Anxiety and depressive symptoms mostly stayed within nonclinical ranges, showing no lasting changes after adjusting for multiple comparisons. Conclusions: In this prospective cohort, cochlear implantation was associated with durable improvements in auditory outcomes, tinnitus burden, and selected patient-reported quality-of-life domains over two years. Although significant functional and patient-centered improvements were noted, persistent tinnitus and diverse psychosocial outcomes underscore the need for personalized counseling and comprehensive follow-up that incorporate patient-reported outcomes and psychological assessments. Full article

Background/Objectives: This study aims to explore both the psychosocial outcomes of hearing aid use and the factors that differentiate users from non-users among older adults with sensorineural hearing loss (SNHL) in Romania. Methods: We conducted a cross-sectional, comparative study with follow-up, including 201 patients aged between 49 and 92 years (mean age 70.76 ± 11.86 years), diagnosed with moderate to severe SNHL, evaluated between 1 November 2023, and 30 November 2024, at the Municipal Clinical Hospital Orăștie, Romania. Audiological assessment involved pure-tone audiometry and speech testing. Outcome measures included the Word Recognition Score (WRS), International Outcome Inventory for Hearing Aids (IOI-HA), Hearing Handicap Inventory for Adults (HHIA), Tinnitus Handicap Inventory (THI), and the Self-Esteem Scale (SES). Results: Of the 201 patients, 105 (52.2%) accepted hearing aid (HA) fitting and 96 (47.8%) declined. No significant differences were found in age (p = 0.565) or sex (p = 0.476) between groups. HA users reported significantly lower perceived handicap (HHIA: 46.48 ± 24.83 vs. 77.74 ± 28.02, p = 0.015) and higher self-esteem scores (SES: 35.68 ± 4.88 vs. 23.03 ± 4.90, p < 0.001), while tinnitus-related distress (THI) did not differ significantly (p = 0.785). Word recognition scores improved significantly post-fitting across all degrees of hearing loss: moderate (48.52% → 86.13%), moderately severe (47.47% → 85.31%), and severe (47.55% → 85.46%), all p < 0.001. Conclusions: Hearing aid use in older adults with SNHL was associated with significant improvements in speech perception and reduced perceived hearing handicap. These benefits were consistent across all severity levels and were independent of unilateral or bilateral device use. The difference in self-esteem observed between users and non-users may reflect pre-existing psychological factors influencing HA adoption, underlining the importance of personalized counseling in hearing rehabilitation. Full article

Background/Objectives: Tinnitus affects approximately 15% of the population and lacks a universally effective treatment. Tinnitus Retraining Therapy (TRT) is widely used but requires 6–8 h of daily sound exposure for 1–2 years, limiting accessibility and adherence. This study evaluated the clinical feasibility and therapeutic effectiveness of Enriched Acoustic Environment therapy (EAE), a streamlined alternative using individualized sound stimulation with a markedly reduced treatment burden, and compared its time efficiency with published TRT outcomes. Methods: 82 adults with chronic tinnitus received standardized counseling and completed one of two EAE protocols (continuous or sequential). Participants listened to their personalized stimulus for 1 h/day over four months. Tinnitus severity (THI, TFI) and time-efficiency metrics (improvement per 10 listening hours) were assessed and compared with TRT studies reporting baseline and post-treatment THI. Results: EAE produced clinically relevant and statistically significant improvements, with 51.6% THI and 49.8% TFI reduction (p < 0.001). Both stimuli achieved similar outcomes with high responder rates. EAE yielded ~2.3 THI-point improvement per 10 h (~4.3% relative gain), demonstrating substantially greater time efficiency—approximately 20 times higher than values reported for standard TRT protocols. Conclusions: EAE achieved robust symptom reduction with dramatically lower treatment burden, high adherence, and strong clinical feasibility. These findings support EAE as an accessible, time-efficient alternative to TRT. Controlled long-term studies are warranted. Full article

Background/Objectives: Subjective tinnitus, defined as the perception of sound without an external source, is a common and often debilitating condition. In the absence of pharmacotherapy, disease management guidelines recommend counseling interventions to alleviate tinnitus-related distress and improve patient outcome. This study evaluated the benefit of guideline-compliant counseling provided by “Meine Tinnitus App”, a smartphone-based application, for the treatment of subjective tinnitus. Methods: A randomized controlled study was conducted in 204 patients with confirmed chronic subjective tinnitus enrolled at 33 ear, nose and throat (ENT) practices in Germany. Tinnitus improvement was evaluated after 10 weeks of intervention (digital counseling in addition to standard care vs. standard care only). The primary endpoint was the change in tinnitus-related distress (measured by the Mini-TQ-12 validated questionnaire). The secondary endpoint was the change in tinnitus-associated daily burden and coping difficulties (measured by the validated BVB-2000 questionnaire). Treatment effects for the primary and secondary endpoints were represented by the estimated marginal means (EMMs). Results: Patients of the intervention group showed a significant reduction in tinnitus-related distress (EMM [95% CI]: 4.5 [3.3–5.8]; p < 0.001) and a significant improvement in tinnitus-associated daily burden and coping difficulties (EMM [95% CI]: 0.5 [0.2–0.7]; p < 0.001) compared to patients of the control group, with large to moderate effect sizes (Hedges’ g between 1.1. and 0.5). These positive treatment effects were confirmed by responder and sensitivity analyses. Additionally, patients with high vs. low app usage showed a greater improvement in treatment effect for both endpoints (p < 0.05), further supporting the health benefits of digital counseling. Conclusions: This study demonstrated the efficacy of tinnitus counseling provided by “Meine Tinnitus App” to alleviate tinnitus-related distress, daily burden, and coping difficulties in patients with subjective tinnitus (German Clinical Trials Register DRKS00025379). Full article

Background/Objectives: This study evaluated the feasibility and effectiveness of three sound therapies—enriched acoustic environment with random noise (EAERR), enriched acoustic environment with gamma tones (EAEGT), and white noise (WN)—in alleviating tinnitus distress and enhancing emotional well-being. Methods: A total of 125 individuals with tinnitus were recruited, with 92 completing the four-month intervention. Following counseling, participants selected a therapy and listened daily for one hour for four-months at the mixing point intensity. Tinnitus severity and emotional state were assessed at the baseline and post-treatment using the Tinnitus Handicap Inventory (THI), Tinnitus Functional Index (TFI), and Hospital Anxiety and Depression Scale (HADS). Results: All therapies significantly reduced tinnitus distress and improved emotional well-being, with 80.4% of participants reporting benefits. Conclusions: These findings suggest that sound therapies are effective for tinnitus management, though further research with larger and more homogeneous samples is needed to refine their application and optimize treatment for diverse tinnitus profiles. Full article

Post/Long COVID (syndrome) is defined as a condition with symptoms persisting for more than 12 weeks after the onset of SARS-CoV-2 infection that cannot be explained otherwise. The prevalence of self-reported otorhinolaryngological Post/Long COVID symptoms is high. The aim of this review was to analyze the current literature regarding the actual prevalence, knowledge of the etiopathology, and evidence-based treatment recommendations of otorhinolaryngology-related Post/Long COVID symptoms. A systematic literature search of articles published since 2019 in PubMed and ScienceDirect was performed and resulted in 108 articles. These were the basis for this review and formed a comprehensive series of consented therapy statements on the most important of otorhinolaryngology-related Post/Long COVID symptoms. Otorhinolaryngological symptoms did not appear isolated but as part of a multi-organ syndrome. Self-reported otorhinolaryngology-related Post/Long COVID symptoms were often not confirmed by objective testing. The confirmed prevalence estimated for anosmia, dysgeusia, cough, facial palsy, hoarseness/dysphonia, acute hearing loss, tinnitus, and vertigo/dizziness was about 4%, 2%, 4–19%, 0%, 17–20%, 8%, 20%, and 5–26%, respectively. There are manifold theoretical concepts of the etiopathology of different symptoms, but there is no clear evidence-based proof. This certainly contributes to the fact that there is no effective specific treatment option for any of the symptoms mentioned. Healthcare pathways must be established so that otorhinolaryngological Post/Long COVID symptoms can be recognized and evaluated and otorhinolaryngologists can provide counseling. This would also help to establish and selectively include patients in clinical trials investigating specific therapeutic concepts. Full article

Ototoxicity is a significant adverse effect associated with second-line anti-tuberculosis (TB) medications, particularly in treating extensively drug-resistant TB (XDR-TB). This study investigated the awareness of ototoxic effects among adults with XDR-TB undergoing treatment in South Africa, specifically exploring the role of information counselling on ototoxic symptoms, the timing of counselling, the content covered, and the management pathways available. This cross-sectional, descriptive qualitative study was conducted at Brooklyn Chest Hospital in the Western Cape. Ten adults with XDR-TB were purposively sampled and participated in semi-structured in-depth interviews. Data were thematically analyzed and the results revealed variability in information counselling on ototoxicity, with only 30% of participants receiving comprehensive counselling that specifically addressed ototoxic symptoms. The timing of counselling was inconsistent: while 70% of participants received some information before treatment, the remainder received counselling only after treatment initiation, which may have impacted early symptom recognition. Participants’ awareness of ototoxic symptoms was generally limited, with most identifying hearing loss but few recognizing other symptoms such as tinnitus or dizziness. Furthermore, only 20% of participants were provided with clear referral pathways for symptom management. These findings highlight a gap in the depth, timing, and specificity of information counselling on ototoxic effects for XDR-TB in this context. Several interventions can be implemented to address this gap. Full article

Background/Objectives: Conventional audiometry assesses hearing in the frequency range of 250–8000 Hz, while humans can detect sounds from 20 to 20,000 Hz. Hearing sensitivity above 8000 Hz can be assessed through “Extended high-frequency audiometry (EHFA)”, which is useful for early detection and monitoring of hearing loss and counseling for tinnitus patients. Despite its usefulness, age significantly affects hearing sensitivity. Currently, there are no standard hearing thresholds in the EHF range categorized by age groups in Thailand. In this study, the aim was to determine normative EHFA data across different age groups in a healthy Thai population. Methods: This study included 134 participants aged 18–70 years, categorized into five age groups. All participants had normal hearing thresholds and type A tympanograms bilaterally. Following this, EHFA measurement was performed. Results: Across all age groups, there was an observed increase in median hearing thresholds as age increased. In comparison, no significant difference in median hearing thresholds was found between individuals aged 18–30 and >30–40 years. However, those over 40 years had significantly higher median thresholds across all frequencies compared to those under 40 years (p < 0.05). Based on these findings, we propose two new subgroups of 18–40 years and >40–70 years. Median hearing thresholds for those aged 18–40 was ≤20 dB HL across most frequencies, except at 16,000 Hz (30 dB HL). In the >40–70 age group, thresholds ranged from 20 dB HL at 9000 Hz to 70 dB HL at 14,000 and 16,000 Hz. However, no significant differences were found in hearing thresholds between sexes and ear sides. Conclusions: In this study, normative EHFA data were established for healthy Thai adults, appropriately divided into two groups (18–40 and >40–70 years) for clinical use. Further studies with more participants per age group are also needed to validate the results. Full article

Tinnitus affects millions of people around the world and causes significant negative impacts on their quality of life (QoL). Tinnitus is rarely examined in Saudi Arabia. This study aimed to estimate the prevalence of tinnitus among adults, explore their experience with tinnitus, investigate the impact of tinnitus on their QoL, and discover their tinnitus management methods. A descriptive cross-sectional study design was performed utilizing a non-probability purposive sampling technique and a face-to-face in-person administered questionnaire. Descriptive statistics and a chi-square test were used to assess the data and find any correlation between the variables. Out of 4860 adults, 320 (males: n = 172; females: n = 148; age range = 18–90 years) had tinnitus, mainly described as a daily, gradual, continuous, whistling, and ringing tinnitus in both ears. Tinnitus prevalence was estimated at 6.54% with a slight predominance in males (6.9%) compared with females (6.2%). Most of the participants were unaware of the cause of their tinnitus. The modal value of the severity of tinnitus signals was severe for both genders. The modal value of the impact of tinnitus on the QoL was moderate for males and severe for females. Sleep, social activities, quiet settings, and concentration were largely affected by tinnitus. Significant associations (p < 0.05) between the impact of tinnitus on the QoL and risk factors, such as gender, age, hearing loss, and hyperacusis were determined. Also, the impact of tinnitus on the QoL was significantly associated (p < 0.05) with the duration of complaints and the severity of tinnitus signals. Approximately, 61% of the participants did not use any tinnitus treatment, while the remaining participants usually used hearing aids, medications, and counseling to manage their tinnitus. By increasing awareness, establishing standard practice, developing guidelines for managing tinnitus, expanding access to suitable interventions, and carrying out additional research, adults living with tinnitus in Saudi Arabia will have better support and, ultimately, an enhancement of their overall well-being. Full article

Hearing aids (HAs), especially those with sound generators (SGs), are used in the management of tinnitus. However, their comparative efficacies and long-term outcomes remain unknown. Therefore, we investigated the efficacy and long-term outcomes of tinnitus therapy using various HA SG models. We retrospectively reviewed 666 patients with chronic tinnitus characterized by persistent symptoms for >6 months. At the initial visit, the patients received educational counselling on tinnitus (Utsunomiya method) and completed a comprehensive questionnaire comprising the tinnitus handicap inventory, a visual analog scale, the state–trait anxiety inventory, and the emotional intelligence scale. The scores were compared among various models of HA SGs and SGs. The patients underwent follow-ups for up to 2 years. Our results indicated that tinnitus retraining therapy using SGs and conventional HAs effectively managed chronic tinnitus. The prolonged use of HAs appeared to exacerbate tinnitus symptoms, emphasizing the superior long-term effectiveness of SG HAs, particularly ZEN (Widex ZEN, WS Audiology, Lynge, Denmark). Our findings indicate that HAs are useful in the first year, but their prolonged use may exacerbate tinnitus symptoms, whereas HA SGs are effective in the long term. Future studies should account for the variations in tinnitus treatment effects based on the type of sound employed. Full article

Counseling can help alleviate tinnitus-caused emotional distress and correct misconceptions, making it an effective rehabilitation option for people with tinnitus. Advances in communication technology have increased the demand for computer-mediated tinnitus counseling; however, the effectiveness of such counseling in reducing tinnitus is unclear. Thus, this study aimed to determine the tinnitus-relieving effects of computer-mediated counseling. Thirty-six participants with tinnitus were randomly assigned to online counseling (15 participants) or video-based counseling (21 participants) groups, defining how remote counseling was conducted. Tinnitus counseling, comprising 100 items, lasted 2 weeks and was separated into six sessions for the online counseling group and 8–9 items daily for 12 days for the video-based counseling group. The effectiveness of counseling was determined based on score changes between baseline and 2-week follow-up using the Korean version of the Tinnitus Primary Function Questionnaire and Visual Analog Scales for annoyance and loudness. While no significant improvements were observed in other domains, average emotional aspect-related scores showed significant improvements in both groups. Regarding individual results, four and seven participants in the online and video-based counseling groups reported significant improvements in the emotional domain, respectively. Overall, computer-mediated educational counseling might be a rehabilitation option for individuals with tinnitus. Full article

Background: Vestibular schwannoma (VS) is a benign tumor of the eighth cranial nerve formed from neoplastic Schwann cells. Although VS can cause a variety of symptoms, tinnitus is one of the most distressing symptoms for patients and can greatly impact quality of life. The objective of this systematic review is to comprehensively examine and compare the outcomes related to tinnitus in patients undergoing treatment for VS. Specifically, it evaluates patient experiences with tinnitus following the removal of VS using the various surgical approaches of traditional surgical resection and gamma knife radiosurgery (GKS). By delving into various aspects such as the severity of tinnitus post-treatment, the duration of symptom relief, patient quality of life, new onset of tinnitus after VS treatment, and any potential complications or side effects, this review aims to provide a detailed analysis of VS treatment on tinnitus outcomes. Methods: Following PRISMA guidelines, articles were included from PubMed, Science Direct, Scopus, and EMBASE. Quality assessment and risk of bias analysis were performed using a ROBINS-I tool. Results: Although VS-associated tinnitus is variable in its intensity and persistence post-resection, there was a trend towards a decreased tinnitus burden in patients. Irrespective of the surgical approach or the treatment with GKS, there were cases of persistent or worsened tinnitus within the studied cohorts. Conclusion: The findings of this systematic review highlight the complex relationship between VS resection and tinnitus outcomes. These findings underscore the need for individualized patient counseling and tailored treatment approaches in managing VS-associated tinnitus. The findings of this systematic review may help in guiding clinicians towards making more informed and personalized healthcare decisions. Further studies must be completed to fill gaps in the current literature. Full article

Single sided deafness (SSD) is characterized by significant sensorineural hearing loss, severe or profound, in only one ear. SSD adversely affects various aspects of auditory perception, including causing impairment in sound localization, difficulties with speech comprehension in noisy environments, and decreased spatial awareness, resulting in a significant decline in overall quality of life (QoL). Several treatment options are available for SSD, including cochlear implants (CI), contralateral routing of signal (CROS), and bone conduction devices (BCD). The lack of consensus on outcome domains and measurement tools complicates treatment comparisons and decision-making. This narrative overview aims to summarize the treatment options available for SSD in adult and pediatric populations, discussing their respective advantages and disadvantages. Rerouting devices (CROS and BCD) attenuate the effects of head shadow and improve sound awareness and signal-to-noise ratio in the affected ear; however, they cannot restore binaural hearing. CROS devices, being non-implantable, are the least invasive option. Cochlear implantation is the only strategy that can restore binaural hearing, delivering significant improvements in speech perception, spatial localization, tinnitus control, and overall QoL. Comprehensive preoperative counseling, including a discussion of alternative technologies, implications of no treatment, expectations, and auditory training, is critical to optimizing therapeutic outcomes. Full article

Vestibular schwannoma (VS) are equally common in men and woman. A number of epidemiological studies have reported on sex-specific aspects of incidence, tumor size, tinnitus and hearing loss. However, data on sex-specific, pre- and post-surgically quality of life (QoL) are rare. The objective of the present study was to determine sex-specific aspects on QoL in VS. Health-related QoL was analyzed in 260 patients (112 male/148 female) with unilateral sporadic VS using general (SF-36: general Short-Form Health Survey), disease-specific (PANQOL: Penn Acoustic Neuroma Quality-of-Life Scale, PANQOL) and symptom-specific (DHI: Dizziness Handicap Inventory; HHI: Hearing Handicap Inventory; THI: Tinnitus Handicap Inventory; FDI: Facial Disability Index) QoL questionnaires. Sex differences were evaluated pre- and postoperative by multi- and univariate analyses based on 200 preoperative and 88 postoperative questionnaires. Female patients were significantly more affected by dizziness, headaches, reduced energy and anxiety. Energy and balance changed similarly in both sexes after surgery. However, postoperative women tended to be more affected by facial palsy and headaches than men. Despite the greater physical impairment, general health improved equivalently or even more in female patients than in males. In conclusion, self-rated QoL in VS is significantly affected by sex and surgery. This should be taken into account when counseling VS patients regarding observation, radiotherapy, and surgery. Full article

Subjective tinnitus is a highly prevalent sound sensation produced in most cases by persistent neural activity in the auditory pathway of the patient. Audiologists should be confident that they can employ elements of sound therapy and related counseling to support patients in coping. However, patients with bothersome tinnitus may be challenged by mental health complications, and they struggle to find adequate care when tinnitus and psychological distress co-occur. Audiologists in many cases lack the confidence to provide in-depth counseling while mental health providers lack basic understanding of tinnitus, its mechanisms, and the elements of audiologic management that could support patients in coping. At the very least, audiologists should be able to explain the mechanisms involved in and contributing to negative tinnitus effects, conduct valid measures of these effects, and offer reasonable options for managing the consequences linked by the patient to bothersome tinnitus and sound-related sensations. This brief communication summarizes the current state of tinnitus-related opportunities offered in US audiology training programs, and the substantial need to improve both the education of practitioners and the delivery of services to patients in need. Full article