The effect of caffeine on tinnitus: Randomized triple-blind placebo-controlled clinical trial

Objective To test the hypothesis that caffeine can influence tinnitus, we recruited 80 patients with chronic tinnitus and randomly allocated them into two groups (caffeine and placebo) to analyze the self-perception of tinnitus symptoms after caffeine consumption, assuming that this is an adequate sample for generalization. Methods The participants were randomized into two groups: one group was administered a 300-mg capsule of caffeine, and the other group was given a placebo capsule (cornstarch). A diet that restricted caffeine consumption for 24 hours was implemented. The participants answered questionnaires (the Tinnitus Handicap Inventory—THI, the Visual Analog Scale—VAS, the profile of mood state—POMS) and underwent examinations (tonal and high frequency audiometry, acufenometry (frequency measure; intensity measure and the minimum level of tinnitus masking), transient otoacoustic emissions—TEOAE and distortion product otoacoustic emissions—DPOAE assessments) at two timepoints: at baseline and after capsule ingestion. Results There was a significant change in mood (measured by the POMS) after caffeine consumption. The THI and VAS scores were improved at the second timepoint in both groups. The audiometry assessment showed a significant difference in some frequencies between baseline and follow-up measurements in both groups, but these differences were not clinically relevant. Similar findings were observed for the amplitude and signal-to-noise ratio in the TEOAE and DPOAE measurements. Conclusions Caffeine (300 mg) did not significantly alter the psychoacoustic measures, electroacoustic measures or the tinnitus-related degree of discomfort.

Ohrgeräusche zutreffend begutachten: Möglichkeit, Plausibilität und Wahrscheinlichkeit

ZusammenfassungOhrgeräusche als subjektive, individuelle Empfindung entziehen sich einem objektiven Nachweis. In der Begutachtungssituation sind sie zudem von physiologischen oder spontanen Hörsensationen abzugrenzen.In Bezug auf die neue Königsteiner Empfehlung und auf die Rechtsprechung des letzten Jahres ist vor dem Hintergrund der unterschiedlichen Kausalitätsbegriffe in der Gesetzlichen und Privaten Unfallversicherung eine stringente Prüfung zur Feststellung, ob eine ausreichend hohe Wahrscheinlichkeit eines unfallbedingten subjektiven Ohrgeräusches vorliegt, bei der Begutachtung erforderlich. Um eine nachvollziehbare und vergleichbare Grundlage zu schaffen, wurde der Vorschlag einer Plausibilitätsprüfung mit der Erfassung von 5 Kriterien – angemessenes Ereignis, Unmittelbarkeit, Reproduzierbarkeit auf der Basis der heutigen Untersuchungsmethoden von Tinnitus-Masking und -Matching, Fortdauer und Fixierung und die Erfassung mit nichtsuggestiven Fragen – einer Überprüfung unterzogen.Die Übersichtsarbeit zeigt, dass sich die Anforderungen an den jeweiligen Beweismaßstab mit den angegebenen Nachweisschritten erfüllen lassen. Die einfache Möglichkeit des Vorliegens von Ohrgeräuschen kann über die Plausibilitätskriterien, die psychoakustische Verfahren beinhalten, sowie offene Fragen systematisch zur Wahrscheinlichkeit des Vorliegens geführt werden. Damit sind die Voraussetzungen für eine nachvollziehbare Kausalbetrachtung zwischen Ereignis und angegebenen Tinnitus nach aktuellen medizinisch-wissenschaftlichen Erkenntnissen geschaffen.

Use of a Smartphone App for Cochlear Implant Patients With Tinnitus

Purpose Smartphone apps for tinnitus relief are now emerging; however, research supporting their use and effectiveness is lacking. Research has shown that Tinnitus Therapy sounds intended for individuals with acoustic hearing provide relief to some patients using cochlear implants (CIs) with tinnitus. Here, we evaluated the use and acceptability of a smartphone app to help CI patients with tinnitus. Method Participants completed a laboratory trial ( n = 19) and an at-home trial ( n = 14) using the ReSound Tinnitus Relief app to evaluate its acceptability and effectiveness in reducing their tinnitus. During the laboratory trial, participants selected a sound that was most acceptable in managing their tinnitus (termed chosen sound ). Word recognition scores in quiet were obtained before and after sound therapy. Participants were randomly assigned to one of two groups for the at-home trial, that is, AB or BA, using (A) the chosen sound for 2 weeks and (B) the study sound (i.e., broadband noise at hearing threshold) for another 2 weeks. Ratings were collected weekly to determine acceptability and effectiveness of the app in reducing tinnitus loudness and annoyance. Results Results indicated that some, but not all, participants found their chosen sound to be acceptable and/or effective in reducing their tinnitus. A majority of the participants rated the chosen sound or the study sound to be acceptable in reducing their tinnitus. Word recognition scores for most participants were not adversely affected using the chosen sound; however, a significant decrease was observed for three participants. All 14 participants had a positive experience with the app during the at-home trial on tests of sound therapy acceptability, effectiveness, and word recognition. Conclusions Sound therapy using a smartphone app can be effective for many tinnitus patients using CIs. Audiologists should recommend a sound and a level for tinnitus masking that do not interfere with speech perception.

A comparative study between tinnitus masking and tinnitus retraining therapy on perceived tinnitus handicap and cognition

<p class="abstract"><strong>Background:</strong> Since last one decade there were no such studies done in India on the efficacy of tinnitus retraining therapy (TRT) on tinnitus treatment. Here, in this study we try to find out whether TRT is an effective tool than tinnitus masking as a treatment procedure of tinnitus in Indian context.</p><p class="abstract"><strong>Methods:</strong> A total of 60 participants (with no prior history of presence of hearing loss) were divided into two groups. Group 1 was consisted of 30 subjects provided tinnitus masking using relief app at the ease of their home environment for 2 months. Group 2 was consisted of another 30 subjects have been provided tinnitus retraining therapy (TRT) for 2months (60 sessions). The design is experimental design. The study was carried out in eight phases. </p><p class="abstract"><strong>Results:</strong> The findings of this study suggested that both the tinnitus masking therapy as well as TRT helped tinnitus sufferers to improve after 60 days of therapy continuation at initial stage. But a significant marked difference was found in terms of performance in participants from group 2 who had undergone TRT i.e., they performed very well after one month of post transfer therapeutic sessions than those who had undergone tinnitus masking therapy.</p><p class="abstract"><strong>Conclusions:</strong> The findings of this study are suggestive of that TRT is more effective than tinnitus masking therapy in tinnitus individuals even after one month of stopping therapy sessions. It also suggests that TRT has a long-term effect on tinnitus management than tinnitus masking.</p>

Comparing Tinnitus Tuning Curves and Psychoacoustic Tuning Curves

Tinnitus masking patterns have long been known to differ from those used for masking external sound. In the present study, we compared the shape of tinnitus tuning curves (TTCs) to psychophysical tuning curves (PTCs), the latter using as a target, an external sound that mimics the tinnitus characteristics. A secondary goal was to compare sound levels required to mask tinnitus to those required to mask tinnitus-mimicking sounds. The TTC, PTC, audiometric thresholds, tinnitus pitch, and level matching results of 32 tinnitus patients were analyzed. Narrowband noise maskers were used for both PTC and TTC procedures. Patients were categorized into three groups based on a combination of individual PTC–TTC results. Our findings indicate that in 41% of cases, the PTC was sharp (V shape), but the TTC showed a flat configuration, suggesting that the tinnitus-related activity in that subgroup does not behave as a regular stimulus-induced activity. In 30% of cases, V-shape PTC and TTC were found, indicating that the tinnitus-related activity may share common properties with stimulus-induced activity. For a masker centered at the tinnitus frequency, the tinnitus was more difficult to mask than the mimicking tone in 72% of patients; this was particularly true for the subset with V-shape PTCs and flat TTCs. These results may have implications for subtyping tinnitus and acoustic therapies, in particular those targeting the tinnitus frequency.

Clinical efficacy of tinnitus retraining therapy and cognitive behavioural therapy in the treatment of subjective tinnitus: a systematic review

Objective:This study aimed to compare the outcomes of two frequently employed interventions for the management of tinnitus: tinnitus retraining therapy and cognitive behavioural therapy.Method:A systematic review of literature published up to and including February 2013 was performed. Only randomised control trials and studies involving only human participants were included.Results:Nine high-quality studies evaluating the efficacy of tinnitus retraining therapy and cognitive behavioural therapy were identified. Of these, eight assessed cognitive behavioural therapy relative to a no-treatment control and one compared tinnitus retraining therapy to tinnitus masking therapy. Each study used a variety of standardised and validated questionnaires. Outcome measures were heterogeneous, but both therapies resulted in significant improvements in quality of life scores. Depression scores improved with cognitive behavioural therapy.Conclusion:Both cognitive behavioural therapy and tinnitus retraining therapy are effective for tinnitus, with neither therapy being demonstrably superior. Further research using standardised, validated questionnaires is needed so that objective comparisons can be made.