Anna Fabijańska

The relationship between distortion product otoacoustic emissions and extended high-frequency audiometry in tinnitus patients. Part 1: Normally hearing patients with unilateral tinnitus

Summary Background The aim of this study was to evaluate distortion product otoacoustic emissions (DPOAEs) and extended high-frequency (EHF) thresholds in a control group and in patients with normal hearing sensitivity in the conventional frequency range and reporting unilateral tinnitus. Material/Methods Seventy patients were enrolled in the study: 47 patients with tinnitus in the left ear (Group 1) and 23 patients with tinnitus in the right ear (Group 2). The control group included 60 otologically normal subjects with no history of pathological tinnitus. Pure-tone thresholds were measured at all standard frequencies from 0.25 to 8 kHz, and at 10, 12.5, 14, and 16 kHz. The DPOAEs were measured in the frequency range from approximately 0.5 to 9 kHz using the primary tones presented at 65/55 dB SPL. Results The left ears of patients in Group 1 had higher median hearing thresholds than those in the control subjects at all 4 EHFs, and lower mean DPOAE levels than those in the controls for almost all primary frequencies, but significantly lower only in the 2-kHz region. Median hearing thresholds in the right ears of patients in Group 2 were higher than those in the right ears of the control subjects in the EHF range at 12.5, 14, and 16 kHz. The mean DPOAE levels in the right ears were lower in patients from Group 2 than those in the controls for the majority of primary frequencies, but only reached statistical significance in the 8-kHz region. Conclusions Hearing thresholds in tinnitus ears with normal hearing sensitivity in the conventional range were higher in the EHF region than those in non-tinnitus control subjects, implying that cochlear damage in the basal region may result in the perception of tinnitus. In general, DPOAE levels in tinnitus ears were lower than those in ears of non-tinnitus subjects, suggesting that subclinical cochlear impairment in limited areas, which can be revealed by DPOAEs but not by conventional audiometry, may exist in tinnitus ears. For patients with tinnitus, DPOAE measures combined with behavioral EHF hearing thresholds may provide additional clinical information about the status of the peripheral hearing.

Effects of tinnitus retraining therapy (TRT) for patients with tinnitus and subjective hearing loss versus tinnitus only.

The patients with tinnitus and/or hyperacusis undergoing an 18-24 month period of TRT are divided into five categories of treatment. Different types of counselling and sound therapy are used in each category. Selection of patients into a specific category depends on such factors as: hyperacusis, subjective hearing loss and long-lasting effect of noise on tinnitus. The 108 cases were evaluated After 1 year of treatment. The results of therapy of 40 patients with tinnitus and subjective hearing loss (category II) were compared with the results of therapy of patients with tinnitus only (categories 0 and I). A special questionnaire, answered before and during the treatment, was used to assess the results. Our data indicate significant improvement in about 70% of patients with tinnitus only and in about 90% of patients with tinnitus and subjective hearing loss after one year of therapy.

Organization of Tinnitus Management in Poland

Spontaneous idiopathic tinnitus is a significant interdisciplinary therapeutic problem. Based on different programs of tinnitus treatment, we organized a team of physicians, psychologists and engineers in order to establish the needs for the first Tinnitus Clinic in Poland. At the same time, together with number of clinical centres, scientific societies and non-governmental organizations, we carried out training and an information campaign throughout the country and initiated the first epidemiological studies/survey about tinnitus in Poland. Over a period of 2 years we have provided care for almost 1000 patients, including them in a 18-24-month therapeutic program at the clinic. As a method of choice, Tinnitus Retraining Therapy (TRT) based on a neurophysiological model of tinnitus origin is used. We present here epidemiological data on tinnitus and hyperacusis in Poland.Spontaneous idiopathic tinnitus is a significant interdisciplinary therapeutic problem. Based on different programs of tinnitus treatment, we organized a team of physicians, psychologists and engineers in order to establish the needs for the first Tinnitus Clinic in Poland. At the same time, together with number of clinical centres, scientific societies and non-governmental organizations, we carried out training and an information campaign throughout the country and initiated the first epidemiological studies survey about tinnitus in Poland. Over a period of 2 years we have provided care for almost 1000 patients, including them in a IS 24-month therapeutic program at the clinic. As a method of choice, Tinnitus Retraining Therapy (TRT) based on a neurophysiological model of tinnitus origin is used. We present here epidemiological data on tinnitus and hyperacusis in Poland.

Ocena częstości występowania szumów usznych wśród 7-latków w Polsce Wschodniej

Summary Introduction Tinnitus in children is still rarely mentioned in medical literature. The prevalence of pediatric tinnitus has been reported to range between 3–37% and higher in children with hearing loss. Objectives The objective of this study was to estimate the prevalence of the tinnitus in 7 years old children and to conduct statistical analysis of the relation between tinnitus and hearing loss. Material and methods In this study 60 212 children and their parents were asked about the presence of tinnitus by answering a questionnaire at home. Additionally, children were asked if they can hear noise in their ears or head, before hand hearing screening test at school was conducted. The hearing screening test was performed using screening audiometer with air conduction. Results The results showed that tinnitus was present in group of 8164 children (13.6%). Between children directly asked for tinnitus, 33% mentioned of having it. Over 75% of children did not complained of tinnitus spontaneously to parents. Children with hearing loss reported tinnitus twice more comparing to children with normal hearing. Conclusions Tinnitus is frequent complain among 7 years old children. Children with hearing loss reported tinnitus twice more comparing to children with normal hearing. It is recommended to include to a questionnaire an inquiry about the presence of tinnitus during hearing screening tests performed recently more frequently at primary schools for early detection and diagnosis of tinnitus.INTRODUCTION Tinnitus in children is still rarely mentioned in medical literature. The prevalence of pediatric tinnitus has been reported to range between 3-37% and higher in children with hearing loss. OBJECTIVES The objective of this study was to estimate the prevalence of the tinnitus in 7 years old children and to conduct statistical analysis of the relation between tinnitus and hearing loss. MATERIAL AND METHODS In this study 60 212 children and their parents were asked about the presence of tinnitus by answering a questionnaire at home. Additionally, children were asked if they can hear noise in their ears or head, before hand hearing screening test at school was conducted. The hearing screening test was performed using screening audiometer with air conduction. RESULTS The results showed that tinnitus was present in group of 8164 children (13.6%). Between children directly asked for tinnitus, 33% mentioned of having it. Over 75% of children did not complained of tinnitus spontaneously to parents. Children with hearing loss reported tinnitus twice more comparing to children with normal hearing. CONCLUSIONS Tinnitus is frequent complain among 7 years old children. Children with hearing loss reported tinnitus twice more comparing to children with normal hearing. It is recommended to include to a questionnaire an inquiry about the presence of tinnitus during hearing screening tests performed recently more frequently at primary schools for early detection and diagnosis of tinnitus.

Ocena częstości występowania szumów usznych u dzieci w Polsce

AIM The objective of this study was to estimate the prevalence of the tinnitus in 7- and 12-year-old children in Poland. MATERIAL AND METHODS In this study 118,005, 7-year-old children and 23,339, 12-year-old children and their parents were asked about the presence of tinnitus by answering a questionnaire. 7-year-old children were asked by tester if they can hear noise in their ears or head. RESULTS The results showed that according to parents questionnaire answers tinnitus was present in group of 15,244 (12.9%) 7-year-old children and in group of 3886 (16.6%) 12-year-old children. Between 7-year-old children directly asked for tinnitus 29.3% (34,517) mentioned of having it. Group of 8060 (34.5%) 12-year-old children confirmed in questionnaire hearing tinnitus. Differences in the presence of tinnitus between 7- and 12-year-old children have proven to be statistically significant. CONCLUSIONS Tinnitus is frequent complain among 7- and 12-year-old children. It is recommended to include to a questionnaire an inquiry about the presence of tinnitus during hearing screening tests performed recently more frequently at primary schools for early detection a diagnosis of tinnitus.

Tinnitus as a symptom of acoustic neuroma

Abstract Tinnitus is a common clinical symptom. In Poland, it affects about 20% of our population. Constant tinnitus is present in about 5% of people over 17 years old. In most cases, discordant damage of outer and inner hair cells may be the cause of tinnitus generation. One of the possible, but rarely observed, causes of tinnitus is acoustic neuroma. After medical and audiological evaluation, we found that among 2600 of our patients suffering from unilateral or bilateral tinnitus, 10 patients have acoustic neuroma.

Wpływ ubytków słuchu w zakresie wysokich częstotliwości na otoemisje produktów zniekształceń nieliniowych ślimaka u osób z szumami usznymi i prawidłowym progiem słyszenia w zakresie 0,25–8 kHz

AIM OF THE STUDY To evaluate the influence of high frequency hearing loss (> 8000 Hz) on distortion product otoacoustic emissions registered in the frequency range from 0,5 to 8 kHz. MATERIAL AND METHODS 280 ears with tinnitus and normal hearing (0.25-8 kHz) divided into 3 groups depending on the degree of high frequency hearing loss: group A--hearing threshold up to 20 dB for 10, 12.5, 14 and 16 kHz (68 ears); group B--hearing threshold 25-40 dB HL for at least one of four EHfs (93 ears); group C--hearing threshold above 40 dB HL for at least one of four EHFs (119 ears). For each group mean audiogram and DP-gram were obtained and statistical analysis was used for comparison across these groups. RESULTS Mean DPOAE values in group C were significantly lower in comparison with group A for the frequency range 2-8 kHz, and in comparison with group B were significantly lower for the frequency range 4-8 kHz. CONCLUSIONS High frequency hearing loss (above 8 kHz) has a relevant influence on distortion product otoacoustic emissions registered at frequencies below 8 kHz in tinnitus patients. The greater is hearing loss above 8 kHz, the lower is DPOAE value below 8 kHz.

Program stosowania implantów ucha środkowego i implantów zakotwiczonych w kości skroniowej na przewodnictwo kostne w leczeniu zaburzeń słuchu

The realization of the biggest surgical program in the world, including several thousand surgical procedures yearly, allowed us to perform progressively implement of different modern treatment solutions. Technological progress was mostly related to first in Poland and in the world applications of various systems of auditory implants. Authors present the history of the implementation and use of subsequent innovative solutions. Current indications for the use of various types of middle ear implants and bone conduction implants are described. They are part of a more extensive program and concept of Skarżyński referring to current possibilities of the treatment of different hearing impairments. Besides the indications authors present their own original surgical solutions applied during implantation.

Audiometria wysokich częstotliwości u pacjentów z szumami usznymi i prawidłowym słuchem. Extended high frequency audiometry in tinnitus patients with normal hearing

Background: Extended high frequency audiometry is not routinely used for diagnostics of tinnitus patients with normal hearing. However, high incidence of high pitch tinnitus in this group of patients naturally inclines to use this diagnostic tool in such cases. Aim of the study: The evaluation of extended high frequency audiometry usefulness in audiological diagnostics of tinnitus patients with normal hearing (0.25–8 kHz). Material and methods: 175 persons with tinnitus and normal audiogram (0.25–8 kHz) and 60 persons in the control group, age up to 40. A high frequency hearing threshold was measured at 10; 12.5, 14 and 16 kHz, by a top-down method. Results: In the unilateral tinnitus group higher values of the hearing threshold for frequencies >8 kHz were observed in ears with tinnitus than in non-tinnitus ears both in the same study group and in comparison with controls. In bilateral tinnitus 17 Prace badawcze

The Influence of High Frequency Hearing Loss on the Distortion Product Otoacoustic Emissions in Tinnitus Subjects with Normal Hearing Thresold (0,25-8kHz)

AIM OF THE STUDY To evaluate the influence of high frequency hearing loss (> 8000 Hz) on distortion product otoacoustic emissions registered in the frequency range from 0,5 to 8 kHz. MATERIAL AND METHODS 280 ears with tinnitus and normal hearing (0.25-8 kHz) divided into 3 groups depending on the degree of high frequency hearing loss: group A--hearing threshold up to 20 dB for 10, 12.5, 14 and 16 kHz (68 ears); group B--hearing threshold 25-40 dB HL for at least one of four EHfs (93 ears); group C--hearing threshold above 40 dB HL for at least one of four EHFs (119 ears). For each group mean audiogram and DP-gram were obtained and statistical analysis was used for comparison across these groups. RESULTS Mean DPOAE values in group C were significantly lower in comparison with group A for the frequency range 2-8 kHz, and in comparison with group B were significantly lower for the frequency range 4-8 kHz. CONCLUSIONS High frequency hearing loss (above 8 kHz) has a relevant influence on distortion product otoacoustic emissions registered at frequencies below 8 kHz in tinnitus patients. The greater is hearing loss above 8 kHz, the lower is DPOAE value below 8 kHz.