To Örebro University

Background and Aim: It is estimated that 10–15% of the general population suffers from tinnitus, including 60% of all otologic patients. Quality of life is reportedly affected in approximately 0.5% of tinnitus patients. The aim of this study is to investigate the role of low-laser therapy in alleviating the symptoms of tinnitus.

Material and Methods: Seventeen tinnitus patients (8 men, 9 women) were included in the study. Tinnitus was identified by the patients either as their sole complaint, or as symptom within the context of other otologic diseases. A 0–5 Visual Analogue Scale (VAS) was used to personally quantify the severity of patients' symptoms. Treatment included the use of an external laser beam in the periauricular area and the external auditory canal, which was produced either by a GaAlAs (808 nm, 450 mW), or by a GaAs (904 nm, 240 mW) laser, for 4 and 2 minutes, respectively. The mean number of sessions for each patient was 17, and the mean duration of therapy was 4 weeks.

Results: With regard to the severity of symptoms, the pretreatment mean score was 4.3, and the respected number after the intervention was 3.2. There was a consistent trend toward symptom improvement; however, the results were not statistically significant due to the small sample size. No side effects or deterioration of symptoms was reported.

Conclusion: Low-laser therapy does seem to have some effect in alleviating tinnitus. However, additional studies are necessary to prove the actual efficacy of this treatment mode and to establish superior outcomes compared with placebo.

Background and Aim: The medial olivocochlear (MOC) system contributes to better sound perception and distinction in noisy environments by causing an inhibitory effect on the cochlear hair cell system. The aim of this study is to search for possible involvement of olivocochlear dysfunction in the generation of tinnitus. The function of the MOC system was evaluated by contralateral suppression (CS) of the TEOAEs and DPOAEs.

Material and Methods: Seventeen patients with bilateral tinnitus (6 men, 11 women; mean age, 46.8 years), 16 patients with left unilateral tinnitus (7 men, 9 women; mean age, 51.1 years), and a control group (CG) of 15 people (7 men, 8 women; mean age, 40.5 years) without tinnitus were included in this study. All the subjects were right-handed with normal pure tone audiogram and without any other underlying pathology. The subjects were evaluated with TEOAEs and DPOAEs without and with the presence of contralateral white noise of 50 dB. The frequencies measured were 1–4 kHz for the TEOAEs and 1–6 kHz for the DPOAEs.

Results: Bilateral tinnitus individuals tended to present less suppression than the CG subjects (presence of suppression 32.3–60%, depending on the frequency, for the tinnitus group vs. 66.6–90% for the CG), and lower volume of suppression than the CG subjects (1.3–2.22 dB vs. 2.47–4.66 dB, depending on the frequency). Similar results were observed in patients with left unilateral tinnitus—presence of suppression in their left ears from 31.2–75% and mean value of suppression 0.62–3.38 dB, whereas 73.3–100% of the left ears of the CG presented suppression with mean value of 2.85–5.38 dB. The differences regarding the right ear were less marked.

Conclusions: Contralateral suppression is lower and less frequent in ears with tinnitus compared with normal ears. This may reflect a disfunction of MOC in patients with tinnitus. Both TEOAEs and DPOAEs seem to be sensitive methods to confirm this relation.

Aims: Vestibular evoked myogenic potentials (VEMPs) are short-latency electromyograms recorded from the ipsilateral tonically contracting sternocleidomastoid muscle in response to loud clicks or tone-bursts. It is reported that this reflex is generated via a disynaptic pathway, beginning in the saccule. The purpose of the study is to investigate the VEMPs in cases of sudden hearing loss.

Materials and Methods: Twelve patients with unilateral idiopathic sudden hearing loss were subjected to pure tone audiometry, acoustic immittance testing, caloric testing, auditory brainstem responses, and VEMP testing. A group of healthy volunteers was also enrolled. VEMP responses were measured and compared to caloric responses.

Results: VEMPs were present in all normal subjects and ipsilaterally normal on the unaffected side in all patients with sudden hearing loss. Five out of 12 patients displayed abnormal VEMPs (41.6%) on the affected side (in 4 cases were absent, in 1 case delayed) and 4 of them demonstrated decreased canal paresis, while the fifth had normal caloric responses. In 5 patients both electronystagmographic findings and VEMPs were normal, while the remaining 2 patients showed normal VEMP test results but abnormal caloric responses.

Conclusion: Most of the patients displayed normal VEMPs. However, in a considerable number of cases they were abnormal. Also, in the majority of patients, VEMPs correlated to the caloric responses, although in 3 patients either the superior or the inferior vestibular nerve was involved.

Background and Aim: Stapes surgery, the first-choice treatment for otosclerosis, restores the ossicular chain mobility. Otoacoustic emissions, particularly transient-evoked (TEOAEs) and distortion product (DPOAEs), are capable of noninvasively recording both conductive hearing and cochlear function.

Aim: The aim of this study was to process the effects of otosclerosis pre- and postoperatively, using otoacoustic emissions as an objective method of hearing evaluation.

Material and Methods: Thirty patients (23 women and 7 men) who were candidates for surgery were included in the study. The same patients were asked to be evaluated 2 and 5 months after surgery. All of the patients were evaluated with the use of pure tone audiometry, stapedial reflexes, tympanometry, TEOAE, and DPOAE recordings.

Results: Preoperatively, tympanometry showed type A or As tympanogram, and no stapedial reflexes were detected. Pure tone audiometry showed conductive hearing loss and mean air-bone gaps for frequencies 500 Hz to 4000 Hz between 15.167 dB and 33.167 dB. In 10% of the patients, TEOAEs were measured, whereas DPOAEs were detected in no cases (0%) before surgery. Two months after surgery, only 21 out of 30 patients were re-examined. Air-bone gaps were decreased for speech frequencies (500–4000 Hz), ranging from 8.1dB to 14.05 dB. In 52.4% of the patients who took the reappraisal, TEOAEs were measured, whereas DPOAEs were detected in 28 (57%) of them. Five months after surgery, air-bone gaps decreased even more, ranging between 4.32 dB and 13.4 dB. The presence of both TEOAEs and DPOAEs was increased in the 21 patients who underwent this re-examination, with TEOAEs detected in 54.55% and DPAOEs in 50% of them.

Conclusions: Despite hearing improvement and sufficient air-bone gap closing, OAEs are not always detected postoperatively. It seems that OAEs can be—in addition to an objective tool for testing ossicular chain's restoration—an approach to cochlear function after surgery.

Background and Aim: Vestibular involvement in cases of idiopathic sudden hearing loss (ISHL) is common and is reported to be an important prognostic factor. The aim of this study was to evaluate the extent of inner ear lesion in ISHL and to correlate it with the severity of hearing loss and the degree of short-term recovery.

Material and Methods: Ninety-six patients with unilateral ISHL were subjected to a standard protocol of neurotological evaluation. All subjects were hospitalized and treated similarly. A group of 35 healthy volunteers was also enrolled in the study. The results of the VEMP test and the caloric test were measured and compared with the initial and final audiograms of each patient. Each inner ear lesion was ranked into one of three groups according to the results of vestibular tests: complete (group A), partial (group B), and cochlear lesion only (group C). A statistical analysis was done to correlate severity of inner ear damage with severity of hearing loss and early recovery rate.

Results: In total, 22 patients were ranked in group A, 35 in group B, and 39 in group C. Profound hearing loss appeared in 54%, 23%, and 23% of cases in each group, respectively. However, early recovery was shown in 74% of patients of group C, 54% of cases of group B, and in only 5% of subjects included in group A.

Conclusions: Our study results revealed a significant positive correlation between the extent of inner ear lesion and severity of hearing loss and a significant negative correlation between the extent of inner ear lesion and the grade of early recovery. This means that, in ISHL cases, the more the inner ear is affected the less chance there is for recovery.