Introdução: O saco endolinfático tem sido apontado como o alvo das reações imuno-alérgicas da orelha interna. A prevalência de alergia em pacientes com Doença de Ménière foi estabelecida em torno de 41,6% para inalantes e 26,6% para alimentos, por Derebery em 2000, dados aumentados em relação à prevalência de alergia na população em geral, que, no Brasil, varia de 9% a 30% para inalantes e de 1% a 3% para alimentos. Objetivos: Avaliar a prevalência de reações de hipersensibilidade tipo I a inalantes e alimentos na população do setor de Otoneurologia do Hospital das Clínicas da Faculdade de Medicina de São Paulo e descrever os sintomas vestibulares dos pacientes. Casuística e método: Setenta e cinco pacientes com distúrbios do equilíbrio de origem periférica foram submetidos a questionário de caracterização clínica de sintomas cócleo-vestibulares e teste cutâneo (prick test) para 13 inalantes e 5 alimentos. Resultados: Vinte e cinco (33,3%) pacientes apresentaram prick test positivo a pelo menos um alérgeno inalante e 6 (8%) a pelo menos um alérgeno alimentar. Quatro pacientes apresentaram prick test positivo na ausência de sintomas alérgicos. Prevaleceu a queixa de tontura de caráter rotatório em proporções semelhantes entre os pacientes com prick test positivo e negativo. Conclusão: A prevalência de reações de hipersensibilidade tipo I a inalantes e a alimentos na população avaliada foi maior do que na população em geral. Os sintomas vestibulares não diferiram entre os pacientes da amostra, com prick test positivo ou negativo. No entanto, deve-se obter maior número de amostra para que os dados sejam confiáveis. / Introduction: The endolymphatic sac has been pointed out as the target of immuno-allergic reactions in the inner ear. The prevalence of allergy in patients with Ménières disease was established as approximately 41,6% for inhalants and 26,6% for food by Derebery in 2000, an increase in the data in relation to that of the prevalence of allergy in the general population, which in Brazil varies from 9% to 30% for inhalants and from 1% to 3% for food. Objectives: To evaluate the prevalence of reactions to type I hypersensitivity to inhalants and food in the population of the Otoneurological Section of the Clinics Hospital of the University of São Paulo Medicine School and to describe the vestibular symptoms of the patients. Method: Seventy-five patients with peripheral equilibrium disturbances who had answered a questionnaire of clinical characterization regarding cochlear-vestibular symptoms and undergone prick test for 13 inhalants and 5 types of food. Results: Twenty-five (33,3%) of the patients were positive for the prick test and for at least one allergen inhalant and 6 (8%) for at least one food allergen. Four patients were positive for the prick test in the absence of allergy symptoms. There was a prevalence of the complaint of rotatory dizziness in similar proportions among the patients with positive and negative prick test. Conclusion: The presence of type I hypersensitivity reactions to inhalants and food in the population evaluated was greater than in the general population. The vestibular symptoms did not differ among the patients in the sample, neither with positive or negative prick test results. However, a sample of greater number should be obtained for a higher confidence level of data results.

Introdução: A perda auditiva causa diversos comprometimentos e pode estar associada, com frequência, ao zumbido. Profissionais da área médica e fonoaudiológica estão cada vez mais envolvidos na busca de instrumentos para melhorar a qualidade de vida do paciente uma vez que há grande dificuldade de mensurar e separar os sintomas do zumbido das queixas auditivas. O Tinnitus and Hearing Survey (THS), foi especialmente desenvolvido com a proposta de identificar a principal queixa desses pacientes. Proposição: Traduzir e adaptar culturalmente o questionário Tinnitus and Hearing Survey (THS) para o português brasileiro. Casuística e Métodos: O estudo foi desenvolvido na Clínica de Fonoaudiologia de Bauru, da Universidade de São Paulo (USP), com a aprovação do Comitê de Ética em Pesquisa e aquiescência do paciente confirmada mediante a assinatura do Termo de Consentimento Livre e Esclarecido. Os pacientes convidados a responder o questionário, passaram previamente pela bateria de exames de diagnóstico audiológico e foram divididos em 4 grupos: audição normal sem zumbido, audição normal com zumbido, perda auditiva sem zumbido e perda auditiva com zumbido. A adaptação cultural do Tinnitus and Hearing Survey (THS) seguiu as etapas indicadas por Guillemin et al. (1993), a avaliação da consistência interna, confiabilidade e reprodutibilidade inter pesquisadores deste questionário. Resultados: a amostra foi composta por 70 pacientes, sendo 36 do sexo feminino e 34 do sexo masculino com média de idade de 51,6 anos. Não houveram grandes modificações no conteúdo das perguntas do questionário, apenas algumas adaptações na questão de Tolerância ao Som foram feitas para facilitar o entendimento. A consistência interna e confiabilidade testada pelo de Cronbach foi considerada boa para todos os domínios. A reprodutibilidade do questionário foi medida pelo coeficiente de Kappa em dois momentos distintos e teve concordância considerada quase perfeita entre os avaliadores 1 e 2, indicando boa reprodutibilidade. Conclusão: O Tinnitus and Hearing Survey foi adaptado culturalmente para o português brasileiro, e os dados de consistência interna, confiabilidade e reprodutibilidade mostraram que o questionário é uma ferramenta útil para auxiliar o profissional a diferenciar qual a principal queixa do indivíduo, possibilitando a escolha de uma intervenção mais adequada. / Introduction: Hearing loss can cause several problems and may be frequently associated with tinnitus. Audiologist and medical professionals are increasingly involved in the search for instruments that improve a patient\'s quality of life as there is great difficulty in measuring and separating the symptoms of tinnitus from hearing complaints. The Tinnitus and Hearing Survey (THS) was specially developed with the purpose of identifying the main complaint of these patients. Proposition: To translate and culturally adapt the Tinnitus and Hearing Survey (THS) for the Brazilian-Portuguese. Methods: The study was developed at the Speech Therapy Clinic of Bauru, University of São Paulo (USP), with the acceptance of the Research Ethics Committee and patient agreement, confirmed by signing the Informed Consent Term. The patients who were invited to answer the questionnaire, previously passed the battery of audiological diagnostic exams and were divided into 4 groups: normal hearing without tinnitus, normal hearing with tinnitus, hearing loss without tinnitus and hearing loss with tinnitus. The cultural adaptation of the Tinnitus and Hearing Survey (THS) followed the steps indicated by Guillemin et al. (1993), and the interresearchers\' reproducibility evaluation, internal consistency, reliability of this questionnaire. Results: The sample consisted of 70 patients, of whom 36 were female and 34 were males, with a mean age of 51.6 years. There were no big changes in the content of the questionnaire questions, only a few adaptations in the issue of Sound Tolerance were made to facilitate understanding. The internal consistency and reliability tested by Cronbach\'s was considered good for all domains. The reproducibility of the questionnaire was measured by the Kappa coefficient at two different moments and the agreement between evaluators 1 and 2 was considered almost perfect, indicating good reproducibility. Conclusion: The Tinnitus and Hearing Survey was culturally adapted to Brazilian Portuguese, and the data of internal consistency, reliability and reproducibility showed that this questionnaire is a useful tool to help professionals differentiate the main complaint of the individual, allowing the choice of a more appropriate intervention.

Syftet med denna litteraturstudie var att sammanfatta vetenskapligt dokumenterade resultat kring vilka psykologiska, sociala och psykosociala konsekvenser som tinnitus kan orsaka. Elva artiklar, tre kvalitativa och åtta kvantitativa, valdes ut vid litteratursökningen och analyserades. Analysen resulterade i tre resultatdelar, primära konsekvenser där psykologiska konsekvenser sorterades in, sekundära konsekvenser där sociala konsekvenser sorterades in och en för psykosociala konsekvenser. Den primära resultatdelen visade att personer med svår tinnitus ofta led av koncentrationsproblem, sömnproblem och psykologiska problem som exempelvis depressioner. Den sekundära resultatdelen visade att personer med svår tinnitus fungerade sämre i det sociala livet och undvek aktiviteter, jämfört med en population som inte har tinnitus. De psykosociala konsekvenserna som fanns dokumenterade var få. En artikel avvek från de övriga och visade liten påverkan på alla områden. Detta togs upp i diskussionen då artikelns författare ansåg att demografiska och kulturella faktorer kunde ha en positiv inverkan. Detta befanns vara intressanta faktorer som liksom hela det psykosociala området kräver ytterligare forskning. I diskussionen påpekades även att man inte kan fastställa om de psykologiska problemen har kommit som en biverkan av tinnitus eller var närvarande innan.

This thesis is an update of the bachelor work entitled "The application of physiotherapeutic tools for some tinnitus types". The original work was complemented with the latest findings in pathogenesis field and in therapy by physiotherapeutic tool. The fundamental of this diploma thesis is a study examining the quality of patients' lives with tinnitus. The study was based upon a research using a modified questionnaire Tinnitus Handicap Inventory by Newman's et. al. (1999). Powered by TCPDF (www.tcpdf.org)

The characteristics of Noise Induced Hearing Loss (NIHL) in gold miners of different ages and occupation types were examined and the incidence of tinnitus, vertigo/balance problems and nausea were determined. The results indicate that as a subject group these had symmetrical bilateral, mild hearing loss in the frequencies below 2000 Hz deteriorating to a moderate sloping hearing loss in the frequencies above 2000 Hz, and the loss did not demonstrate the expected “notch” at 4000 Hz that is usually found in NIHL. The average deterioration in the pure tone thresholds of gold miners was 3.5 dB at 500Hz; 2.75dB at 1000Hz, 15.37 dB at 2000Hz, 19.12 dB at 3000Hz; 20.87dB at 4000 Hz and 14.16dB at 6000 Hz for every ten years of age. The pattern of hearing loss varies for the different occupation types with machine operators being the most severely affected. The majority of tinnitus sufferers were in the age range 30-60 years and 57.8 % were in the under 60 years old category, while in the over 60 years the incidence was 4.8 %. The incidence of vertigo and nausea were found to be 27% in this population. The results of this study will equip the audiologist to better deal with diagnostic testing, successful hearing aid fitting and aural rehabilitation of this population. The study highlights the need for greater awareness and the imparting of detailed information to gold miners about the impact of noise on their hearing. / Dissertation (MCommunication Pathology)--University of Pretoria, 2009. / Speech-Language Pathology and Audiology / unrestricted

Tinnitus is defined as an auditory stimulus that is unrelated to external stimulation. There are many theories as to what causes tinnitus, therefore, there are many treatment options for tinnitus. This paper attempts to increase the audiologist's knowledge of the etiology, as well as, the most appropriate treatment for tinnitus. There are two types of tinnitus, objective and subjective. Subjective tinnitus is more common, although it is more difficult to treat than objective tinnitus. There are many theories as to what causes tinnitus. Several disorders that have tinnitus as a symptom, such as, Meniere's disease, acoustic neuroma, and dysfunction of serotonin levels, are discussed. Before treatment of tinnitus, the patient must undergo a medical and audiologic evaluation. Tests of tinnitus pitch, loudness, residual masking, and minimal masking are included. The implications of these tests on treatment are also discussed. There are many treatment options available for tinnitus, such as, electrical stimulation, medications, stress and psychological therapy, tinnitus maskers, and hearing aids. This paper focuses on mainly the treatments that are most feasible for an audiologist. In addition, included is an empirical study that was conducted to examine the effects of hearing aids and circuit type on tinnitus relief. To conclude, this paper will summarize the steps to follow in order to manage a patient that exhibits tinnitus. Although there are some treatments that seem to be more appropriate for an audiologist to utilize, (i.e., hearing aids, maskers, and Tinnitus Retraining Therapy, none have been proven to be effective in every patient. Research is still needed in this area.

The purpose of this study was to determine the effect(s) of tinnitus maskers and tinnitus instruments on speech discrimination utilizing a population of subjects who currently have tinnitus and are presently wearing these devices. The hypothesis which guided this investigation states that there is no difference between discrimination scores with and without tinnitus maskers. In an attempt to test this hypothesis, speech discrimination scores were obtained from 26 listeners both in quiet and in the presence of cafeteria noise, with and without use of their tinnitus maskers.

Hearing loss and tinnitus are the two most common service-connected disabilities in Veterans. Patients with a chief complaint of hearing loss and/or tinnitus typically undergo a hearing evaluation to determine the severity and type of hearing loss. The standard treatment for sensorineural hearing loss is the fitting of personal amplification.Up to 95% of tinnitus patients have an underlying hearing loss and could benefit from hearing aids for both improved communication and as an effective treatment to reduce the impact of tinnitus, ((Shargorodsky, Curhan, & Farwell, 2010). It is not uncommon, however, for some of these patients to decline hearing aids although they elect to undergo tinnitus counseling. The observation that some of these patients elected to obtain hearing aids following tinnitus counseling compelled an investigation of tinnitus counseling’s role in the patient’s revised decision to accept hearing aid fitting. An electronic medical records review (2015- 2020) identified Veterans meeting the following criteria: (1) diagnosis of sensorineural hearing loss and tinnitus, (2) declined hearing aids at the time of the hearing evaluation, (3) received tinnitus counseling, (4) elected to obtain hearing aids following tinnitus counseling, and (5) affirmed regular use of the hearing aids for more than one year. 30 qualified veterans provided informed consent to participate. Enrolled participants were interviewed using a brief survey that allowed patients to report a variety of tinnitus and hearing-related challenges. Participants also completed a validated tinnitus intake form, the tinnitus handicap inventory (THI), which reports a patient’s self-assessed tinnitus handicap. A total of six Veterans (white males, average age of 60 years, with bilateral sensorineural hearing loss and bothersome tinnitus) participated. The number of hours of daily hearing aid use was related to the self-perceived benefit of hearing aids for the management of tinnitus, as the 5 participants who wore their hearing aids >5 hours/day reported benefit in contrast to the single participant who wore their hearing aids /day. The reported benefit of tinnitus counseling, however, was not reflected as a significant improvement in the post-counseling THI score. All participants reported the counseling was useful and recommended that other veterans experiencing tinnitus and hearing loss undergo a trial with hearing aids . A narrative analysis of additional information provided by participants was made to identify counseling elements that supported the use of hearing aids for tinnitus management. In general, the analysis indicated that when patients were provided accurate information regarding tinnitus management strategy options, then they might be more likely than uninformed patients to accept and act upon hearing aid recommendations in a timely manner. All participants suggested that the provision of more information regarding tinnitus and management options at the time of the hearing evaluation would have likely expedited hearing aid acceptance. The preliminary findings of this survey suggest that patients with a diagnosis of sensorineural hearing loss and tinnitus might benefit from some form of tinnitus management counseling at the time of the initial hearing evaluation, and that the counseling might facilitate uptake of hearing aids.

FFifteen to thirty-five percent of the population in the United States experience tinnitus, a subjective "ringing in the ears". Up to 10% of tinnitus patients report their symptoms are severe and disabling. Tinnitus was induced in FBN rats using 116 dB (SPL) unilateral octave-band sound exposures centered at 16 kHz for one hour in an anesthetized preparation. Rats were assessed behaviorally by an operant conditioning paradigm as well as a gap detection method to verify the development of tinnitus. Both young (7 mos.) and aged (30 mos.) sound exposed rats showed significant elevated auditory brainstem-evoked response (ABR) thresholds for clix and all tested frequencies immediately after the sound exposure. Eighty days post-exposure, ABR thresholds for the young exposed rats were significantly close to the initial young control values while aged exposed rats showed residual thresholds shifts relative to aged controls. Sixteen weeks following sound exposure, young exposed rats showed significantly reduced gap detection at 24 and 32 kHz, suggestive of high frequency tinnitus. Aged exposed animals showed significant tinnitus-related behavioral changes near 10 kHz by both behavior methods. Message and protein levels of &alpha1-3 glycine receptor subunits (GlyRs), gephyrin, BDNF and its receptor TrkB were assessed in dorsal cochlear nucleus (DCN) fusiform cells 4 months post exposure utilizing quantitative in situ hybridization and immunocytochemistry. Young exposed rats showed significant decreases of GlyR &alpha1 protein at middle and high frequency regions in DCN unlike the contrasting increase of their message levels. Aged exposed rats showed higher &alpha1 subunit protein levels in the same high and middle DCN frequency regions. The GlyR anchoring protein, gephyrin, was significantly increased in both young and aged exposed rats, suggesting an intracellular receptor trafficking change following acoustic trauma. BDNF and TrkB were also increased over fusiform cells in both young and aged exposed rats. [3H] strychnine binding was used to evaluate DCN GlyR pharmacology and function following sound exposure. The age-related decrease in GlyR α1 protein was reflected in the significant age-related down-regulation of GlyR (Bmax). Tinnitus-related changes in GlyR &alpha1 protein level was reflected in the decline of the GlyR (Bmax) in young exposed rats and up-regulated GlyRs in aged exposed animals. The GlyRs in DCN of young exposed animals also demonstrated an increase in affinity, further suggesting a post-exposure receptor composition change. These findings suggest that both aging and/or sound exposure/tinnitus are associated with GlyR changes capable of altering alter the output of the DCN. Detailed characterization of these GlyR modifications could advance the development of novel selective drugs for tinnitus and age-related hearing loss.

Tinnitus has been bothering humanity since Ancient Babylon, plaguing everyone from Leonardo da Vinci to Charles Darwin. Today, roughly one in seven people worldwide experiences this auditory sensation. So what exactly is tinnitus, and where does this persistent sound come from? Marc Fagelson travels into the auditory system to explore the loss of silence.