Search Results (85)

Background/Objectives: Artificial Intelligence (AI) is increasingly being applied in otolaryngology, including cochlear implants (CIs). This study evaluates the accuracy and completeness of ChatGPT-4 and Microsoft Copilot in determining the appropriate implantation side based on audiological and radiological data, as well as the presence of tinnitus. Methods: Data from 22 CI patients (11 males, 11 females; 12 right-sided, 10 left-sided implants) were used to query both AI models. Each patient’s audiometric thresholds, hearing aid benefit, tinnitus presence, and radiological findings were provided. The AI-generated responses were compared to the clinician-chosen sides. Accuracy and completeness were scored by two independent reviewers. Results: ChatGPT had a 50% concordance rate for right-side implantation and a 70% concordance rate for left-side implantation, while Microsoft Copilot achieved 75% and 90%, respectively. Chi-square tests showed significant associations between AI-suggested and clinician-chosen sides for both AI (p < 0.05). ChatGPT outperformed Microsoft Copilot in identifying radiological alterations (60% vs. 40%) and tinnitus presence (77.8% vs. 66.7%). Cronbach’s alpha was >0.70 only for ChatGPT accuracy, indicating better agreement between reviewers. Conclusions: Both AI models showed significant alignment with clinician decisions. Microsoft Copilot was more accurate in implantation side selection, while ChatGPT better recognized radiological alterations and tinnitus. These results highlight AI’s potential as a clinical decision support tool in CI candidacy, although further research is needed to refine its application in complex cases. Full article

Background/Objectives: This study aimed to (i) cross-culturally adapt the Inventory of Hyperacusis (IHS) into Danish and (ii) assess its usability, validity, and reliability in Danish adults with hyperacusis. Methods: The translation followed established guidelines for adapting hearing-related questionnaires. A two-phase design ensured linguistic and cultural adaptation and evaluated test–retest reliability and construct validity. The IHS, consisting of 25 items, was translated and tested in seven participants through cognitive debriefing. In phase two, temporal consistency was assessed in 32 patients. Results: Thirty-two participants (twenty-eight female; mean age 49.8 years) completed the study over 2–4 weeks (mean 22 days). Eight used hearing aids, and twenty-four reported tinnitus. The Danish IHS showed good reliability (Cronbach’s alpha = 0.95) and acceptable test–retest reliability, except for the General Loudness factor. While no systematic score changes occurred, significant variability in score changes were noted. Conclusions: The Danish IHS appears to be a reliable and valid tool for assessing hyperacusis. Further research is needed, but the IHS-DK shows potential as an effective clinical and research tool for evaluating hyperacusis impact and treatment outcomes. Full article

Objectives: This study aimed to analyse the haematological parameters in relation to subjective tinnitus. We hypothesise that abnormal haematological findings may correlate with increased severity and chronicity of tinnitus. This research could lead to improved diagnostic methods and more targeted treatments. Material and Methods: A total of 439 patients with primary subjective tinnitus and 274 individuals without tinnitus were enrolled. These participants underwent comprehensive laboratory testing, which included haematological parameters. Results: When comparing the white blood cell levels between the tinnitus group and the control group, no statistically significant differences were found (p = 0.743). Similarly, comparisons of red blood cell levels (p = 0.250), haemoglobin levels (p = 0.087), and haematocrit levels (p = 0.066) also revealed no significant differences. The platelet levels showed no significant difference between the two groups (p = 0.782). According to a logistic regression model, lower levels of haemoglobin (p = 0.000) and platelets (p = 0.000) significantly predicted higher scores on the Tinnitus Handicap Inventory, indicating self-reported tinnitus severity. Furthermore, lower haemoglobin levels were significant predictors (p = 0.04) of developing bilateral tinnitus. Using Spearman’s correlation test, a statistically significant negative correlation (p = 0.029) was observed between red blood cell levels and the onset of tinnitus. The frequency of tinnitus demonstrated a significant positive correlation with haemoglobin levels (p = 0.04) and haematocrit levels (p = 0.043). Conversely, platelet levels showed a significant negative correlation with both tinnitus intensity (p = 0.002) and the onset of tinnitus (p = 0.033). Conclusions: While the haematological parameters showed no significant differences between the tinnitus and control groups, further analyses indicated that certain parameters, such as haemoglobin and haematocrit levels, could potentially influence tinnitus, necessitating further investigation. Full article

Background/Objectives:Tinnitus, the perception of sound without an external source, is a prevalent and often distressing condition with complex neurobiological and psychological underpinnings. A growing body of literature suggests a frequent co-occurrence between tinnitus and psychiatric symptoms such as anxiety, depression, and sleep disturbances. However, the extent to which these conditions are associated, and whether treatments targeting one domain impact the other, remains unclear. This scoping review aimed to (1) identify associations between tinnitus and mental health comorbidities, (2) evaluate whether tinnitus treatments affect psychiatric outcomes, and (3) explore whether psychiatric treatments influence tinnitus symptoms. Methods: A comprehensive search of PubMed, MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews, and Google Scholar was conducted for articles published between January 2014 and May 2025. Eligible studies were written in English, French, or Spanish, focused primarily on tinnitus, included at least one co-occurring psychiatric condition, and described how tinnitus was evaluated. A total of 30 studies were included. Data were extracted and synthesized thematically. Study quality was assessed using the Mixed Methods Appraisal Tool and relevant Joanna Briggs Institute checklists. Results: Most studies reported significant associations between tinnitus and psychiatric symptoms, particularly anxiety, depression, stress, insomnia, and, in some cases, psychosis. Treatments aimed at tinnitus, such as eye movement desensitization and reprocessing and cognitive behavioral therapy, were sometimes associated with secondary improvements in mental health. Conversely, limited evidence suggested that psychiatric treatment, including antipsychotic medication and psychotherapy, may reduce tinnitus severity in selected cases. Conclusions: Tinnitus and psychiatric comorbidities frequently co-occur, and early evidence suggests that addressing one may benefit the other. Given the specific inclusion criteria, this review presents a selected subset of the broader literature, focusing only on studies that evaluated tinnitus alongside clinically measured psychiatric symptoms. Future research should prioritize integrated, longitudinal interventions to better understand these complex interactions. Full article

Cognitive behavioural therapy (CBT) is an evidence-based intervention for managing distress associated with tinnitus, hyperacusis, and misophonia. This paper summarises key points from the 2025 Tonndorf Lecture presented at the third World Tinnitus Congress and the 14th International Tinnitus Seminar in Poland. The lecture addressed (1) the theoretical foundations of CBT for these conditions, (2) clinical evidence on CBT delivered by psychologists, audiologists, and digital self-help, and (3) the proportion of patients who may benefit from CBT. Research demonstrates that CBT can effectively reduce distress related to tinnitus, hyperacusis, and misophonia. Both psychologist- and audiologist-delivered CBT approaches have demonstrated significant improvements in reducing the impact of tinnitus, hyperacusis, and misophonia on patients’ quality of life, while guided internet-based CBT also demonstrates positive outcomes. Unguided internet-based CBT is also effective, though it faces challenges such as higher dropout rates. Despite these promising results, not all patients experience the same level of benefit. Some continue to experience distress even after completing CBT, highlighting the need for alternative or complementary interventions and ongoing support. This paper estimates that approximately 1 in 52 individuals with tinnitus require CBT, indicating that while tinnitus is relatively common, the need for intensive therapy is comparatively small. To enhance treatment outcomes, future research should compare the effectiveness of psychologist- and audiologist-delivered CBT, explore hybrid models that combine face-to-face and digital interventions, and address challenges with internet-based CBT, particularly for hyperacusis and misophonia. Furthermore, incorporating neuroimaging and physiological measures in future randomised controlled trials could provide objective insights into the neural mechanisms underlying symptom improvement, ultimately helping to refine CBT interventions. Identifying characteristics of non-responders to CBT may also guide the development of more tailored therapeutic approaches. Full article

(1) Background: The role of air pollutants as risk factors for tinnitus remains unclear. To address this gap in research, we conducted a nationwide retrospective cohort study in Taiwan by integrating patients’ clinical data with daily air quality data to evaluate the environmental risk factors associated with tinnitus. (2) Methods: The Taiwan National Health Research Database (NHIRD) includes medical records for nearly all residents of Taiwan. To assess pollution levels, we used daily air quality data from the Taiwan Environmental Protection Agency regarding SO₂, CO, NO, NO_X, and particulate matter (PM_2.5 and PM₁₀). We merged the NHIRD data with air quality information based on the residents’ locations and the positions of air quality monitoring stations. Pollutant levels were then categorized into quartiles (Q1, Q2, Q3, and Q4). (3) Results: This study included 284,318 subjects. After controlling for covariates, the adjusted HR (95 CI%) for tinnitus increased with increasing SO₂, CO, NO, NO_X, PM_2.5, and PM₁₀ exposure levels, specifically from 1.24 (95 CI% = 1.18, 1.30) to 1.35 (95 CI% = 1.28–1.41); from 1.15 (95 CI% = 1.09, 1.21) to 1.90 (95 CI% = 1.81, 2.00); from 0.86 (95 CI% = 0.82, 0.91) to 1.69 (95 CI% = 1.62, 1.77); from 1.62 (95 CI% = 1.54, 1.71) to 1.69 (95 CI% = 1.60, 1.77); from 0.16 (95 CI% = 0.15, 0.18) to 2.70 (95 CI% = 2.57, 2.84); and from 2.53 (95 CI% = 2.38, 2.69) to 3.58 (95 CI% = 3.39, 3.78), respectively, compared to the Q1 concentrations for all air pollutants. (4) Conclusions: During the 15-year follow-up period, we found a significant positive correlation between air pollutant exposure and the risk of tinnitus. Full article

Background/Objectives: The purpose of this study is to investigate the potential association between tinnitus and benign paroxysmal positional vertigo (BPPV) using large-scale population data to assess the risk of developing one condition in patients who have the other condition. Methods: Using claims data from the National Health Insurance Corporation spanning 2008 to 2021, we conducted a comprehensive analysis to estimate the risk of developing BPPV in patients with tinnitus and vice versa. This study involved 580,531 patients with tinnitus, 572,937 patients with benign paroxysmal positional vertigo, and their corresponding controls. We used propensity score matching and statistical analyses, including Cox proportional hazard models to assess the association between these conditions. Results: The incidence of BPPV in patients with tinnitus was significantly higher (12.3 per 1000 individuals per year) than that of controls (5.1 per 1000 individuals per year), with an adjusted hazard ratio of 2.474. Additionally, the incidence of tinnitus was significantly higher in patients with BPPV (11.7 per 1000 individuals per year) than in controls (5.5 per 1000 individuals per year), with an adjusted hazard ratio of 2.048. Subgroup analysis showed the risk of developing BPPV in people with tinnitus, and vice versa, was higher in young vs. old people (<39 years) and in men vs. women (p<0.0001). These findings remained significant even after adjusting for sex, age, medical benefits, disability, and health habits. Conclusions: This study provides substantial evidence for a bidirectional association between tinnitus and benign paroxysmal positional vertigo, suggesting an interconnected pathophysiology. Further research is warranted to understand the underlying mechanisms. 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

Background and Objectives: The management of chronic tinnitus in patients with otosclerosis presents a considerable clinical challenge, particularly as to those who are either ineligible for or reluctant to undergo surgical interventions. Surgical interventions improve hearing levels and may provide relief from tinnitus; however, medical research is also focused on alternative non-surgical treatments aimed at symptomatic improvement. This is particularly relevant, considering that otosclerosis currently has no definitive cure, despite the existence of various surgical techniques and oral therapies. This study evaluates the effects of oral calcium and fluoride supplementation on tinnitus severity in otosclerosis patients who opted for non-surgical management. Materials and Methods: A total of 128 otosclerosis patients with tinnitus were included in this study, which was conducted over a five-year period. Patients were categorized into three groups based on the severity of their tinnitus (mild, moderate and severe), as assessed by the Tinnitus Handicap Inventory (THI). Patients in all three groups received Florical (Mericon Industries, Inc., Peoria, IL, USA), a calcium and fluoride supplement, and were monitored over three months. The severity of tinnitus was reassessed following supplementation. Statistical analyses were conducted to further investigate patient scores. Results: Evaluating patients based on the severity of their tinnitus, we consistently observed clinically significant reductions in THI scores, specifically a decrease of 10 points or more, among those with mild tinnitus. The moderate group exhibited a lower degree of reduction in their THI scores, while the severe group appeared to be unaffected. Statistical analyses reveal a significant correlation between the reduction of tinnitus and the supplementation of Florical, as the severity of tinnitus decreases. Conclusions: The present study suggests that oral calcium and fluoride supplementation may serve as a promising non-surgical approach for tinnitus management in otosclerosis (particularly in patients with mild symptoms), in addition to its marketing-indicated role, supporting the preservation of hearing levels in otosclerosis. Its efficacy seems to diminish as tinnitus severity increases, further pointing out a potential preventative role of this supplementation. Full article

Background: Meniere’s disease (MD) is a set of rare disorders that affects >4 million people worldwide. Individuals with MD suffer from episodes of vertigo associated with fluctuating sensorineural hearing loss and tinnitus. Hearing loss can involve one or both ears. Over 10% of the reported cases are observed in families, suggesting its significant genetic contribution. The condition is polygenic with >20 genes, and several patterns of inheritance have been reported, including autosomal dominant, autosomal recessive, and digenic inheritance across multiple MD families. Preclinical research using animal models has been an indispensable tool for studying the neurophysiology of the auditory and vestibular systems and to get a better understanding of the functional role of genes that are involved in the hearing and vestibular dysfunction. While mouse models are the most used preclinical model, this review analyzes alternative animal and non-animal models that can be used to study MD genes. Methods: A literature search of the 21 genes reported for familial MD and the preclinical models used to investigate their functional role was performed. Results: Comparing the homology of proteins encoded by these genes to other model organisms revealed Drosophila and zebrafish as cost-effective models to screen multiple genes and study the pathophysiology of MD. Conclusions: Murine models are preferred for a quantitative neurophysiological assessment of hearing and vestibular functions to develop drug or gene therapy. Full article

Background: Jugular foramen syndrome (JFS) is a rare condition characterized by the compression or impairment of one or more terminal cranial nerves passing through the jugular foramen. Although malignancies are the primary cause of JFS. Methods: In this report, we present the first documented case of JFS caused by acute otitis media in an adult patient. Results: A 74-year-old woman presented with ear pain, hoarseness, dysphagia, dizziness, tinnitus, and hearing loss. A physical examination revealed a reddish-bulging tympanic membrane, left-sided hearing loss, right uvula deviation, and cranial nerve palsies affecting the ninth and tenth nerves. Imaging studies confirmed temporal bone inflammation, thrombosis of the sigmoid sinus extending into the internal jugular vein, and signs of thrombophlebitis of the jugular vein. The patient underwent a cortical mastoidectomy, sigmoid sinus decompression, and ventilation tube insertion, along with antibiotic, steroid, and anticoagulant therapy. Postoperatively, the patient’s condition improved significantly. Conclusions: This case highlights the importance of considering complicated acute otitis media in the differential diagnosis of neurological abnormalities associated with JFS. A thorough evaluation of the patient’s medical history and radiological imaging can assist in identifying the cause of the symptoms and guide appropriate surgical or conservative treatment. Further research is essential to gain more comprehensive insights into the pathophysiology and therapeutic interventions of JFS affecting the ears. Full article

Background/Objectives: Tinnitus, often described as a ringing in the ears, affects a significant portion of the population, varying in perception and severity. Methods: This systematic review investigates the correlation between tinnitus and temporomandibular joint disorders (TMDs) within a PRISMA-compliant framework, ensuring methodological transparency and rigor. Using databases, such as PubMed, Scopus, and Web of Science, we analyzed studies from the past decade to evaluate clinical and observational evidence. Results: A significant association between TMD and tinnitus was found, with somatosensory and neuroplastic mechanisms contributing to this relationship. Key therapeutic approaches identified include manual therapy and multidisciplinary treatments, demonstrating potential clinical efficacy. Conclusions: However, the available evidence remains inconsistent, emphasizing the need for further research with standardized methodologies to improve understanding and refine therapeutic strategies. This review provides a foundation for future studies aiming to enhance tinnitus management by addressing underlying TMD-related mechanisms. Full article

Background: This study investigates electrophysiological distinctions in auditory evoked potentials (AEPs) among individuals with chronic subjective tinnitus, with a specific focus on the impact of treatment response and tinnitus localisation. Methods: Early AEPs, known as Auditory Brainstem Responses (ABR), and middle AEPs, termed Auditory Middle Latency Responses (AMLR), were analysed in tinnitus patients across four clinical centers in an attempt to verify increased neuronal activity, in accordance with the current tinnitus models. Our statistical analyses primarily focused on discrepancies in time–domain core features of ABR and AMLR signals, including amplitudes and latencies, concerning both treatment response and tinnitus laterality. Results: Statistically significant differences were observed in ABR wave III and V latencies, ABR wave III peak amplitude, and AMLR wave Na and Nb amplitudes when comparing groups based on their response to treatment, accompanied by varying effect sizes. Conversely, when examining groups categorised by tinnitus laterality, no statistically significant differences emerged. Conclusions: These results provide valuable insights into the potential influence of treatment responses on AEPs. However, further research is imperative to attain a comprehensive understanding of the underlying mechanisms at play. Full article

Juniperus sabina L., a species within the Juniperus genus, is broadly distributed across Southern Europe and Central Asia. In China, its berries, branches, and leaves are traditionally employed in Uyghur medicine to address conditions such as rheumatoid arthritis, itchy skin, tinnitus, deafness, and urinary discomfort. Notably, the plant’s primary bioactive constituents are terpenoids, lignans, and flavonoids. Contemporary pharmacological studies have revealed that J. sabina exhibits a range of bioactivities, including insecticidal, antimicrobial, antioxidant, anti-inflammatory, and antitumor effects. These diverse therapeutic properties can be attributed to its rich chemical profile, which comprises 279 distinct compounds such as terpenoids, lignans, flavonoids, coumarins, and others, isolated to date. This comprehensive review systematically organizes and summarizes the botanical characteristics, traditional uses, chemical composition, pharmacological activities, toxicity, limitations, and future prospects of J. sabina. It aims to offer a valuable scientific reference and fresh perspectives for further research, development, and application of this plant. Full article

Background: Somatic tinnitus (ST) is a type of tinnitus that is influenced by changes in somatosensory input from the cervical spine or temporomandibular area. Although traditional physiotherapy has been shown to reduce ST symptoms, in-clinic treatment is not always available, and adherence to home exercise programs is often low. This study aims to investigate the effectiveness of an app-based physiotherapy program to enhance the compliance and availability of treatment for ST patients. Methods: This pilot randomised controlled trial included 38 adult patients with chronic somatic tinnitus. Participants were randomly assigned to a treatment group receiving a 9-week app-based cervical spine exercise program or a control group. The primary outcome was tinnitus distress measured using the Tinnitus Handicap Inventory (THI). As a secondary outcome we used the Mini-Tinnitus Questionnaire (Mini-TQ). Results: Participants in the treatment group showed significant reductions in tinnitus distress, with a large effect size for both the THI and Mini-TQ groups (Cohen’s d = 1.71 and 1.02, respectively). The control group showed no significant changes. Conclusions: This study provides evidence that an app-based physiotherapy intervention is a feasible and effective treatment for ST. Further research with larger sample sizes and comparisons to traditional in-clinic treatments is needed to confirm these findings. Additional studies on personalised treatment might further improve the treatment. Full article