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Tinnitus in Canada
Abstract and Figures
Background: Tinnitus, which has no cure, can be a temporary irritant or a life-altering condition. Many factors can precipitate tinnitus, including hearing loss,
exposure to loud noise and other otologic causes, neurological injuries or disease, dental disorders, some medications, and certain infectious diseases. This
study summarizes new tinnitus data from the Canadian Health Measures Survey (CHMS).
Data and methods: Data were collected for individuals aged 19 to 79 years (n=6,571) from 2012 through 2015 as part of the CHMS. Tinnitus is described
as “the presence of hissing, buzzing, ringing, rushing or roaring sounds in your ears when there is no other sound around you.” Bothersome tinnitus refers to
tinnitus affecting sleep, concentration or mood. Factors associated with tinnitus were examined using bivariate and logistic regression analyses.
Results: An estimated 37% of adult Canadians (9.2 million) had experienced tinnitus in the past year; it was bothersome for 7% of the population. Individuals
aged 19 to 29 were significantly more likely to have past-year tinnitus (46%) than those aged 30 to 49 (33%) and 50 to 70 (35%). Tinnitus was associated with
poor self-reported mental health, mood disorder, a weak sense of community belonging, high daily stress and poor quality sleep. People with hearing loss and
tinnitus were twice as likely as those with hearing loss alone to use hearing aids, at 11% compared with 5% respectively.
Interpretation: Tinnitus is a common condition among Canadian adults. Recent exposure to loud noise may contribute to the higher prevalence of past-year
tinnitus at younger ages. Canadians could benefit from greater awareness of tinnitus, prevention strategies and management options.
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... The prevalence of bothersome tinnitus (N ¼ 697) was 2.2% in the total population sample and 9.2% in the tinnitus sample. Many studies found similar prevalence rates (1.2-3%) of bothersome tinnitus in the population (Gallus et al., 2015;Michikawa et al., 2010;Nondahl et al., 2011), while others report higher rates of 5.8-7% (Park et al., 2014;Ramage-Morin et al., 2019). This variance might result from the different study populations as well as from the varying definitions of "bothersome" tinnitus: tinnitus posing a big or very big problem (Gallus et al., 2015), tinnitus interfering with concentration or sleep (Michikawa et al., 2010), tinnitus in its worst form being severe (Nondahl et al., 2011), tinnitus in daily life being annoying (irritating) or severely annoying and causing sleep problems (Park et al., 2014), or tinnitus being bothering by affecting sleep, concentration or mood (Ramage-Morin et al., 2019). ...
... Previous research found that 45% of individuals with bothersome tinnitus report a weak sense of community belonging (Ramage-Morin et al., 2019), highlighting the importance to address social functioning in treatment interventions. The effects of hearing-related difficulties in social situations on bothersome tinnitus were partially mediated by depression (2%), anxiety syndrome (2%), and social anxiety (4%). ...
Abstract
Objective: This study investigates associations of subjective hearing ability, physical comorbidities, and mental comorbidities with bothersome (vs. non-bothersome) tinnitus and mediating effects between these influences.
Methods: The Swedish LifeGene cohort was used to sample cross-sectional survey data (collected 2009–2016) of 7615 participants with tinnitus, 697 (9.2%) of whom rated their tinnitus as bothersome. Associations between bothersome tinnitus and subjective hearing ability, physical and mental comorbidities were investigated by separate age- and gender-adjusted multiple logistic regression models. Interrelationships between these associations were investigated by logistic mediation models.
Results: Compared to non-bothersome tinnitus, bothersome tinnitus was associated with higher age, reduced subjective hearing ability, hearing-related difficulties in social situations, cardiovascular disease, chronic shoulder pain, thyroid disease, Ménière's disease, depression, anxiety syndrome, and social anxiety. Subjective hearing impairment or hearing-related difficulties mediated 13–36% of the effects of mental comorbidities on bothersome tinnitus. Depression or anxiety syndrome mediated 5–8% of most relationships between physical comorbidities and bothersome tinnitus. Depression, anxiety syndrome, or social anxiety mediated 2–4% of the effects of subjective hearing impairment or hearing-related difficulties on bothersome tinnitus.
Conclusion: Psychological factors, subjective hearing impairment, and hearing-related difficulties in social situations play key roles in predicting bothersome (vs. non-bothersome) tinnitus in a large population sample. Psychological factors contribute to explaining the impact of physical comorbidities and hearing-related effects on bothersome tinnitus. This highlights their transdiagnostic importance for aggravating varied physical symptom clusters. Interventions to improve or prevent high tinnitus burden should be interdisciplinary/multimodal and target auditory, physical, and psychological factors.
Objectives:
Understanding the association between sleep traits and tinnitus could help prevent and provide appropriate interventions against tinnitus. Therefore, this study aimed to assess the relationship between different sleep patterns and tinnitus.
Design:
A cross-sectional analysis using baseline data (2006-2010, n = 168,064) by logistic regressions was conducted to evaluate the association between sleep traits (including the overall health sleep score and five sleep behaviors) and the occurrence (yes/no), frequency (constant/transient), and severity (upsetting/not upsetting) of tinnitus. Further, a prospective analysis of participants without tinnitus at baseline (n = 9581) was performed, who had been followed-up for 7 years (2012-2019), to assess the association between new-onset tinnitus and sleep characteristics. Moreover, a subgroup analysis was also carried out to estimate the differences in sex by dividing the participants into male and female groups. A sensitivity analysis was also conducted by excluding ear-related diseases to avoid their confounding effects on tinnitus (n = 102,159).
Results:
In the cross-sectional analysis, participants with "current tinnitus" (OR: 1.13, 95% CI: 1.04-1.22, p = 0.004) had a higher risk of having a poor overall healthy sleep score and unhealthy sleep behaviors such as short sleep durations (OR: 1.09, 95% CI: 1.04-1.14, p < 0.001), late chronotypes (OR: 1.09, 95% CI: 1.05-1.13, p < 0.001), and sleeplessness (OR: 1.16, 95% CI: 1.11-1.22, p < 0.001) than those participants who "did not have current tinnitus." However, this trend was not obvious between "constant tinnitus" and "transient tinnitus." When considering the severity of tinnitus, the risk of "upsetting tinnitus" was obviously higher if participants had lower overall healthy sleep scores (OR: 1.31, 95% CI: 1.13-1.53, p < 0.001). Additionally, short sleep duration (OR: 1.22, 95% CI: 1.12-1.33, p < 0.001), late chronotypes (OR: 1.13, 95% CI: 1.04-1.22, p = 0.003), and sleeplessness (OR: 1.43, 95% CI: 1.29-1.59, p < 0.001) showed positive correlations with "upsetting tinnitus." In the prospective analysis, sleeplessness presented a consistently significant association with "upsetting tinnitus" (RR: 2.28, p = 0.001). Consistent results were observed in the sex subgroup analysis, where a much more pronounced trend was identified in females compared with the males. The results of the sensitivity analysis were consistent with those of the cross-sectional and prospective analyses.
Conclusions:
Different types of sleep disturbance may be associated with the occurrence and severity of tinnitus; therefore, precise interventions for different types of sleep disturbance, particularly sleeplessness, may help in the prevention and treatment of tinnitus.
There is a controversy in regards to the efficacy of photobiomodulation (PBM) in the management of tinnitus. The aim was to systematically review randomized controlled trials (RCTs) that assessed the efficacy of PBM (low-level laser therapy) in the management of tinnitus. The focused question was “Is PBM effective in the management of tinnitus?”. Indexed databases were searched up to and including June 2020 using different combinations of the following key words: (a) laser; (b) diode; (c) low-level laser therapy; (d) photobiomodulation; (e) tinnitus; (f) medium-level laser; (g) photo-biomodulation; and (h) low-power laser; and RCTs performed on humans were included. Letters to the editor; case reports/series; commentaries; experimental studies and historic reviews were excluded. The risk of bias was assessed using the modified cochrane collaboration tool. The format of the current systematic review was personalized to summarize the appropriate information. Ten RCTs (2 single-blinded and 8 double-blinded) were included. One study reported 30% and 100% resolution of tinnitus using diode and Neodymium-doped Yttrium Aluminum Garnet lasers; respectively. One study reported that PBM was effective in relieving tinnitus for up to 3 months. Eight studies reported that PBM was ineffective in the management of chronic tinnitus. The risk of bias was high; medium and low in 4; 5 and 1 studies; respectively. The effectiveness of PBM in the management of tinnitus remains debatable. Further power-adjusted and well-designed RCTs with long-term follow-up are needed.
Background:
The psychological effects of hearing aids and auditory training are underinvestigated.
Objective:
To assess the short- and long-term effects of an industry-developed auditory training on tinnitus-related distress, perceived stress, and psychological epiphenomena in patients with chronic tinnitus and mild-to-moderate hearing loss.
Method:
One-hundred-seventy-seven gender-stratified patients were randomized to an immediate [IIG] or delayed [DIG] intervention group. Following binaural hearing aid fitting, participants completed a CD-enhanced 14-days self-study program. Applying a randomized-controlled cross-over design, psychological measures were obtained at four times: pre-treatment/wait [IIG: t1; DIG: wait], post-treatment/pre-treatment [IIG: t2; DIG: t1], follow-up/post-treatment [IIG: t3; DIG: t2], and follow-up [DIG: t3]. Between- and within-group analyses investigated treatment-related effects and their stability at a 70-day follow-up.
Results:
Overall, distress symptom severity was mild. Unlike the DIG, the IIG showed significant improvements in tinnitus-related distress. Some psychological epiphenomena, notably anxiety, slightly improved in both groups. Within-group analyses demonstrated the stability of the tinnitus-distress-related effects, alongside uncontrolled improvements of perceived stress and mood-related symptoms at follow-up.
Conclusions:
The investigated hearing therapy lastingly improves tinnitus-related distress in mildly distressed patients with chronic tinnitus and mild-to-moderate hearing loss. Beneficial psychological knock-on effects deserve further investigation.
There is a controversy in regards to the efficacy of photobiomodulation (PBM) in the management of tinnitus. The aim was to systematically review randomized controlled trials (RCTs) that assessed the efficacy of PBM (low-level laser therapy) in the management of tinnitus. The focused question was "Is PBM effective in the management of tinnitus?". Indexed databases were searched up to and including June 2020 using different combinations of the following key words: (a) laser; (b) diode; (c) low-level laser therapy; (d) photobiomodulation; (e) tinnitus; (f) medium-level laser; (g) photo-biomodulation; and (h) low-power laser; and RCTs performed on humans were included. Letters to the editor; case reports/series; commentaries; experimental studies and historic reviews were excluded. The risk of bias was assessed using the modified cochrane collaboration tool. The format of the current systematic review was person-alized to summarize the appropriate information. Ten RCTs (2 single-blinded and 8 double-blinded) were included. One study reported 30% and 100% resolution of tinnitus using diode and Neodymium-doped Yttrium Aluminum Garnet lasers; respectively. One study reported that PBM was effective in relieving tinnitus for up to 3 months. Eight studies reported that PBM was ineffective in the management of chronic tinnitus. The risk of bias was high; medium and low in 4; 5 and 1 studies; respectively. The effectiveness of PBM in the management of tinnitus remains debatable. Further power-adjusted and well-designed RCTs with long-term follow-up are needed.
Objective:
This study aims to identify gender-specific risk factors associated with the presence of bothersome tinnitus (compared with non-bothersome tinnitus), including sociodemographic and lifestyle factors, tinnitus-associated phenomena (hearing loss, traumatic experiences, sleep disturbances), and physical as well as mental comorbidities.
Methods:
We conducted a cross-sectional study using survey data from the Swedish LifeGene cohort containing information on self-reported tinnitus (N = 7615). We (1) analyzed risk factor and comorbidity frequencies, (2) computed multivariate logistic regression models to identify predictors of bothersome tinnitus within both genders, and (3) moderated logistic regression models to compare effects between genders.
Results:
(1) The majority of factors that differed in frequencies between bothersome and non-bothersome tinnitus were equal for both genders. Women with bothersome tinnitus specifically reported higher rates of cardiovascular disease, thyroid disease, epilepsy, fibromyalgia, and burnout, and men with bothersome tinnitus reported higher rates of alcohol consumption, Ménière's disease, anxiety syndrome, and panic (compared with non-bothersome tinnitus, respectively). (2) Across both genders, multivariate logistic regression analyses revealed significant associations between bothersome tinnitus and age, reduced hearing ability, hearing-related difficulties in social situations, and reduced sleep quality. In women, bothersome tinnitus was specifically associated with cardiovascular disease and epilepsy; in men, with lower education levels and anxiety syndrome. (3) Moderated logistic regression analyses revealed that the effects of low education and anxiety syndrome were present in men, but not in women, whereas the effects of age, reduced hearing ability and related difficulties, cardiovascular disease, epilepsy, and burnout were not gender specific.
Conclusion:
Irrespective of gender, bothersome tinnitus is associated with higher age, reduced hearing ability, hearing-related difficulties, cardiovascular disease, epilepsy, and burnout. Gender-specific effects comprise low levels of education and the presence of anxiety syndrome for men. These findings need to be interpreted with caution, yet they suggest the presence of gender-specific biopsychosocial influences in the emergence or maintenance of bothersome tinnitus. Future studies ought to investigate the underlying mechanisms of the observed relationships.
Background:
Health and safety legislation is designed to protect workers from hazards, including excessive noise. However, some workers are not required to use hearing protection when exposed to loud noise and may be vulnerable to adverse outcomes, including hearing difficulties and tinnitus.
Data and methods:
Data for 19- to 79-year-olds (n=6,571) were collected from 2012 through 2015 as part of the Canadian Health Measures Survey. People exposed to loud workplace noise were defined as those who had to raise their voices to communicate at arm's length. Vulnerable workers were defined as those who were not required to use hearing protection when working in noisy environments and who only used hearing protection sometimes, rarely or never.
Results:
An estimated 11 million Canadians (43%) have worked in noisy environments, and over 6 million of them (56%) were classified as vulnerable to workplace noise. Although the percentage of vulnerable women (72%) was greater than that of men (48%), men outnumbered women in these circumstances at 3.7 million, compared with 2.4 million. The self-employed were more likely than employees to be vulnerable, as were those in white-collar versus blue-collar occupations. Vulnerable workers were more likely to report hearing difficulties and tinnitus than those who had never worked in a noisy environment.
Discussion:
A large percentage of workers exposed to noisy workplaces were vulnerable because hearing protection was neither required nor routinely used. Further work is required to assess whether this reflects gaps in health and safety legislation or its implementation.
Tinnitus is related to serious comorbidities such as suicidal ideation and attempts. Body mass index (BMI) is associated with auditory symptoms including hearing loss. The aim of this nationwide, population-based, cross-sectional study was to evaluate the relationship between mental health, body mass index and tinnitus in a Korean premenopausal female population. This study analyzed data from the Korea National Health and Nutrition Examination Surveys in 2010–2012. Data were collected from 4628 19 years or older, premenopausal women. After adjustments, underweight premenopausal women exhibited a higher odds ratio for tinnitus (odd ratio = 1.54; 95% confidence interval = 1.14–2.08) compared with women of normal weight. Moderate and severe tinnitus was highly prevalent in underweight as well as extremely obese women. The prevalence of perceived stress, melancholy, and suicide ideation was significantly higher in women with tinnitus. The prevalence of perceived stress and suicide ideation was significantly higher in underweight women with tinnitus, but that of melancholy was significantly lower. This study demonstrated that underweight premenopausal Korean women had a higher risk of tinnitus, which has grown in importance as a public health issue. Women with tinnitus experience perceived stress and suicide ideation more frequently, but melancholy less frequently than women without.
Objective:
Tinnitus is a common otological condition that affects almost 10% of US adults. Research suggests that college students are vulnerable to tinnitus and hearing loss as they are exposed to traumatic levels of noise on a regular basis. Tinnitus and its influence in daily living continue to be underappreciated in the college-aged population. Therefore, the objective for the present study was to analyze prevalence and associated risk factors of tinnitus and tinnitus-related handicap in a sample of college-aged students.
Design:
A survey was administered to 678 students aged 18-30 years in a cross-section of randomly selected university classes. The survey was adopted from the National Health and Nutrition Examination Survey (2010). It inquired about demographic details, medical and audiological history, routine noise exposure, smoking, sound level tolerance, tinnitus, and tinnitus-related handicap in daily living. Tinnitus-related handicap was assessed by the Tinnitus Handicap Inventory (THI). Participants were divided into four groups: chronic tinnitus (bothersome tinnitus for >1 year), acute tinnitus (bothersome tinnitus for ≤1 year), subacute tinnitus (at least one experience of tinnitus in a lifetime), and no tinnitus (no experience of tinnitus in a lifetime).
Results:
The prevalence of chronic, acute, subacute, and no tinnitus was 8.4%, 13.0%, 37.9%, and 40.7% respectively. Almost 9% of subjects with any form of tinnitus reported more than a slight tinnitus-related handicap (i.e., THI score ≥18). A multinomial regression analysis revealed that individuals with high noise exposure, high sound level tolerance score, recurring ear infections, and self-reported hearing loss had high odds of chronic tinnitus. Females showed higher prevalence of acute tinnitus than males. Individuals with European American ethnicity and smoking history showed high odds of reporting subacute tinnitus. Almost 10% of the subjects reported that they were music students. The prevalence of chronic, acute, and subacute tinnitus was 11.3%, 22.5%, and 32.4%, respectively, for musicians, which was significantly higher than that for nonmusicians. Music exposure, firearm noise exposure, and occupational noise exposure were significantly correlated with tinnitus. Temporal characteristics of tinnitus, self-reported tinnitus loudness, and sound level tolerance were identified as major predictors for the overall THI score.
Conclusions:
Despite the reluctance to complain about tinnitus, a substantial portion of college-aged individuals reported tinnitus experience and its adverse influence in daily living. It was concluded that environmental and health-related factors can trigger tinnitus perception, while self-reported psychoacoustic descriptors of tinnitus may explain perceived tinnitus-related handicap in daily living by college-aged individuals. Future research is required to explore effects of tinnitus on educational achievements, social interaction, and vocational aspects of college students.
Background: There are several established, and an increasing number of putative, therapies using sound to treat tinnitus. There appear to be few guidelines for sound therapy selection and application.
Aim: To review current approaches to personalizing sound therapy for tinnitus.
Methods: A “state-of-the-art” review (Grant and Booth, 2009) was undertaken to answer the question: how do current sound-based therapies for tinnitus adjust for tinnitus heterogeneity? Scopus, Google Scholar, Embase and PubMed were searched for the 10-year period 2006–2016. The search strategy used the following key words: “tinnitus” AND “sound” AND “therapy” AND “guidelines” OR “personalized” OR “customized” OR “individual” OR “questionnaire” OR “selection.” The results of the review were cataloged and organized into themes.
Results: In total 165 articles were reviewed in full, 83 contained sufficient details to contribute to answering the study question. The key themes identified were hearing compensation, pitched-match therapy, maskability, reaction to sound and psychosocial factors. Although many therapies mentioned customization, few could be classified as being personalized. Several psychoacoustic and questionnaire-based methods for assisting treatment selection were identified.
Conclusions: Assessment methods are available to assist clinicians to personalize sound-therapy and empower patients to be active in therapy decision-making. Most current therapies are modified using only one characteristic of the individual and/or their tinnitus.
Objective
The aim of this study was to estimate the prevalence of hearing loss (HL), self-reported occupational noise exposure, and hearing protection usage among Canadians.
Methods
In-person household interviews were conducted with 3666 participants, aged 16 to 79 years (1811 males) with 94% completing audiometry and distortion-product otoacoustic emission (DPOAE) evaluations. Occupational noise exposure was defined as hazardous when communicating with coworkers at an arm's length distance required speaking in a raised voice.
Results
An estimated 42% of respondents reported hazardous occupational noise exposure; 10 years or more was associated with HL regardless of age, sex or education. Absent DPOAEs, tinnitus, and the Wilson audiometric notch were significantly more prevalent in hazardous workplace noise-exposed workers than in nonexposed. When mandatory, 80% reported wearing hearing protection.
Conclusions
These findings are consistent with other industrialized countries, underscoring the need for ongoing awareness of noise-induced occupational HL.
In rodents, exposure to high-level noise can destroy synapses between inner hair cells and auditory nerve fibers, without causing hair cell loss or permanent threshold elevation. Such “cochlear synaptopathy” is associated with amplitude reductions in wave I of the auditory brainstem response (ABR) at moderate-to-high sound levels. Similar ABR results have been reported in humans with tinnitus and normal audiometric thresholds, leading to the suggestion that tinnitus in these cases might be a consequence of synaptopathy. However, the ABR is an indirect measure of synaptopathy and it is unclear whether the results in humans reflect the same mechanisms demonstrated in rodents. Measures of noise exposure were not obtained in the human studies, and high frequency audiometric loss may have impacted ABR amplitudes. To clarify the role of cochlear synaptopathy in tinnitus with a normal audiogram, we recorded ABRs, envelope following responses (EFRs), and noise exposure histories in young adults with tinnitus and matched controls. Tinnitus was associated with significantly greater lifetime noise exposure, despite close matching for age, sex, and audiometric thresholds up to 14 kHz. However, tinnitus was not associated with reduced ABR wave I amplitude, nor with significant effects on EFR measures of synaptopathy. These electrophysiological measures were also uncorrelated with lifetime noise exposure, providing no evidence of noise-induced synaptopathy in this cohort, despite a wide range of exposures. In young adults with normal audiograms, tinnitus may be related not to cochlear synaptopathy but to other effects of noise exposure.
Perceived hearing difficulty (HD) and/or tinnitus in the presence of normal audiometric thresholds present a clinical challenge. Yet, there is limited data regarding prevalence and determinant factors contributing to HD. Here we present estimates generalized to the non-institutionalized population of the United States based on the cross-sectional population-based study, the National Health and Nutrition and Examination Survey (NHANES) in 2176 participants (20-69 years of age). Normal audiometric thresholds were defined by pure-tone average (PTA4) of 0.5, 1.0, 2.0, 4.0 kHz ≤ 25 dBHL in each ear. Hearing difficulty (HD) and tinnitus perception was self-reported. Of the 2176 participants with complete data, 2015 had normal audiometric thresholds based on PTA4; the prevalence of individuals with normal PTA4 that self-reported HD was 15%. The percentage of individuals with normal audiometric threshold and persistent tinnitus was 10.6%. Multivariate logistic regression adjusting for age, sex, and hearing thresholds identified the following variables related to increased odds of HD: tinnitus, balance issues, noise exposure, arthritis, vision difficulties, neuropathic symptoms, physical/mental/emotional issues; and for increased odds or reported persistent tinnitus: HD, diabetes, arthritis, vision difficulties, confusion/memory issues, balance issues, noise exposure, high alcohol consumption, neuropathic symptoms and analgesic use. Analyses using an alternative definition of normal hearing, pure-tone thresholds ≤25 dBHL at 0.5, 1.0, 2.0, 4.0, 6.0, and 8.0 kHz in each ear, revealed lower prevalence of HD and tinnitus, but comparable multivariate relationships. The findings suggest that prevalence of HD is dependent on how normal hearing is defined and the factors that impact odds of reported HD include tinnitus, noise exposure, mental/cognitive status, and other sensory deficits.
Objective:
Tinnitus is a common disorder that may cause psychological distress and anxiety. The aim of this study was to investigate the association between anxiety disorders (ADs) and tinnitus in a large population.
Method:
We conducted a cross-sectional study using the National Health Insurance Research Database in Taiwan. Study subjects included 14,772 patients with tinnitus and 709,963 people in the general population who sought treatment in 2005. Distributions in ADs, age, sex, and medical comorbidities were compared between groups using chi-squared tests. Multivariate logistic regression models adjusted for age, sex, and medical comorbidities were used to analyze the association between tinnitus and ADs.
Results:
Prevalence of ADs in tinnitus and general population groups was 3.9% and 1.5%, respectively, and this difference was significant (P<0.001). Diabetes mellitus, hypertension, hyperlipidemia, concussion or head injury, Meniere's disease, sensorineural hearing impairment, renal disease, coronary artery disease, and cerebrovascular disease were significantly more prevalent in the tinnitus group (all P-values<0.001). Multivariate logistic regression model demonstrated that patients with tinnitus were significantly associated with increased risk of ADs (adjusted OR=1.99; 95% CI=1.81-2.19; P<0.001).
Conclusion:
Because the risk of ADs was significantly higher in patients with tinnitus than in the general population, physicians should be aware of the importance of psychological factors in tinnitus management.
Objectives:
To review literature on the link between depression and anxiety in patients suffering from tinnitus.
Method:
A systematic review of published English-language literature was performed using PubMed, Ovid, and Cochrane databases.
Results:
Of the 56 eligible abstracts 15 were chosen to be included in the review. All articles showed an association of depression and anxiety in tinnitus patients.
Conclusions:
Because of the strong association between tinnitus, depression, and anxiety- all tinnitus patients should be screened for psychiatric disorders. Treatment for these complex conditions should involve a multidisciplinary team with cognitive behavioral therapy and possible pharmacological therapy.
Objective:
The aim of this study is to develop a diagnostic-therapeutic algorithm for those suffering from tinnitus who seek emergency aid.
Materials and methods:
A literature review has been performed on articles from the last 30 years.
Results:
It is important to activate medical or surgical diagnostic and therapeutic strategies, in order to safeguard and rehabilitate the various functions affected. Psychiatric comorbidity is the most frequent pathological condition of those with serious or catastrophic tinnitus. In these cases, mortality risk is linked to suicide, morbidity to tinnitus-correlated distress.
Conclusions:
Tinnitus, mainly linked to loss of hearing, is a frequent symptom among the population at large. About 7% of those affected by tinnitus turn to their doctor to solve their problem, while between 0.5 and 2% request urgent medical assistance. Their cry for help may be the result of an acute onset of tinnitus or the rapid impairment of an already chronic condition. Tinnitus is not considered an urgent ear, nose and throat (ENT) condition by the Associazione Otorinolaringologi Ospedalieri Italiani (AOOI) [Italian Association of Hospital ENT], even though there are many pathological conditions, sometimes serious, associated with tinnitus and emergency action is necessary to reduce the risk of morbidity and mortality.