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A participatory-based intervention was performed in Sweden, aimed at improving the sound environment in one preschool (n = 20) and one obstetric ward (n = 50), with two controls each (n = 28, n = 66). Measured sound levels, and surveys of noise annoyance, hearing-related symptoms and emotional exhaustion were collected before, and three and nine months after the interventions, comparing intervention and control groups over time. The results of this first implementation in a limited number of workplaces showed significantly worsening of hyperacusis, sound-induced auditory fatigue, emotional exhaustion and increased sound levels in the preschool, and worsening of noise annoyance in both intervention groups. Increased risk awareness, limited implementation support and lack of psychosocial interventions may explain the worsening in outcomes, as might the worse baseline in the intervention groups. The complexity of the demands in human-service workplaces calls for further intervention studies. [ABSTRACT FROM AUTHOR]

Background: Both tinnitus and hearing loss are multidimensional. The purpose of this study was to identify and determine the degree of mental fatigue in patients with hearing loss and/or tinnitus participating in audiological rehabilitation, and to examine the self-reported mental fatigue scale (MFS) in this patient group. Methods: Patients undergoing audiological rehabilitation at the Department of Audiology and Neurotology, Karolinska University Hospital, Sweden, between 2011 and 2017 who completed a self-reported MFS questionnaire were investigated. Data on 76 patients were analysed in this pilot study. Patients were also assessed using the Tinnitus Handicap Inventory (THI). Results: The study population had an age range of 38–65 years, and most had normal hearing (37%) or mild to moderate hearing loss (46%). Only 17% had severe to profound hearing loss. A total of 56.5% had tinnitus, of whom 39.5% scored ≥57 on the THI, indicating severe tinnitus, whereas 43.5% reported no tinnitus. The MFS scores, ranging from 13 to 42.5 points, were divided into three severity levels for analysis: 10.5–15, 15.5–20, and ≥20.5. In total, 67% of the patients had MFS scores ≥ 20.5. Importantly, most of the participants (90%) with a THI score ≥ 57 belonged to that group. A significant positive correlation between a high MFS score and severe tinnitus was found. Conclusions: The study reveals that severe mental fatigue is more common in patients with severe tinnitus than sole hearing loss. [ABSTRACT FROM AUTHOR]

Objectives: Internet-delivered psychological treatments were developed more than 20 years ago, and tinnitus was among the first target conditions. The aim of this review article is to describe the history of Internet treatments for tinnitus and to comment on the evidence base. Challenges for future research and implementations will be mentioned. Method: A narrative historical review was conducted. Findings: There are now several studies including controlled trials on Internet interventions based on cognitive behavior therapy (ICBT) for tinnitus. Effects in controlled trials are moderate to large with regard to tinnitus annoyance. While the treatment format now exists in four languages, there is a large treatment versus demand gap as very few clients with tinnitus receive ICBT. There is a lack of research on related conditions with the exception of hearing loss. However, there is substantial support for Internet interventions for comorbid conditions such as insomnia and depression but not specifically in association with tinnitus. Conclusions: ICBT is a promising treatment approach for tinnitus and will hopefully increase access to evidence-based treatment to reduce tinnitus distress. More research is needed for related conditions such as hyperacusis and larger trials on tinnitus. [ABSTRACT FROM AUTHOR]

At present there is no validated tinnitus questionnaire available in Norway. The aim of the present study was to psychometrically evaluate and report on a Norwegian translation of the Tinnitus Sample Case History Questionnaire (TSCHQ). Furthermore, the results were compared to those of a recent Swedish validation of TSCHQ. More than two hundred (N = 218) participants with tinnitus participated in the study, of which 78% completed the Norwegian TSCHQ on two occasions so that test‐retest reliability could be evaluated. Results show that the Norwegian TSCHQ has acceptable test‐retest reliability with the exception of 10 items, which is slightly better than the recent Swedish validation of TSCHQ. At the item level, there were both similarities and differences between the Norwegian and Swedish validation studies. It is concluded that the Norwegian TSCHQ is an appropriate measure of patients' history and experience of tinnitus, and while we recommend further validation of the Norwegian TSCHQ, we encourage Norwegian researchers and clinicians to use the Norwegian translation of TSCHQ. [ABSTRACT FROM AUTHOR]

Background: Mobile phone use and exposure to radiofrequency electromagnetic fields (RF-EMF) from it have been associated with symptoms in some studies, but the studies have shortcomings and their findings are inconsistent. We conducted a prospective cohort study to assess the association between amount of mobile phone use at baseline and frequency of headache, tinnitus or hearing loss at 4-year follow-up.Methods: The participants had mobile phone subscriptions with major mobile phone network operators in Sweden (n = 21 049) and Finland (n = 3120), gave consent for obtaining their mobile phone call data from operator records at baseline, and filled in both baseline and follow-up questionnaires on symptoms, potential confounders and further characteristics of their mobile phone use.Results: The participants with the highest decile of recorded call-time (average call-time >276 min per week) at baseline showed a weak, suggestive increased frequency of weekly headaches at 4-year follow-up (adjusted odds ratio 1.13, 95% confidence interval 0.95-1.34). There was no obvious gradient of weekly headache with increasing call-time (P trend 0.06). The association of headache with call-time was stronger for the Universal Mobile Telecommunications System (UMTS) network than older Global System for Mobile Telecommunications (GSM) technology, despite the latter involving higher exposure to RF-EMF. Tinnitus and hearing loss showed no association with call-time.Conclusions: People using mobile phones most extensively for making or receiving calls at baseline reported weekly headaches slightly more frequently at follow-up than other users, but this finding largely disappeared after adjustment for confounders and was not related to call-time in GSM with higher RF-EMF exposure. Tinnitus and hearing loss were not associated with amount of call-time. [ABSTRACT FROM AUTHOR]

Objective: To study if the antioxidant (AO) N-Acetyl-L-cysteine (NAC) reduces the risk of hearing loss after acoustic accidents in humans. Design: A retrospective, observational study. Study sample: Personnel of the Swedish Armed Forces (SAF) exposed to military acoustic accidents during a 5 year period. Included in the study were 221 cases (mean age: 22.9 years). Most of the exposures, 84%, were weapon related. NAC (400 mg) was given directly after the accident in 146 cases; 75 had not received NAC. Results: The prevalence of hearing thresholds ≥25 dB HL, and the incidence of threshold shifts ≥10 dB, was lower in the NAC group than in the non-NAC group directly after the noise exposure. The deterioration was temporary and not discernable a long time after the accident. The difference was most pronounced in the right ear. The risk reduction to get a temporary hearing loss (TTS), affecting one or both ears was 39% (significant) in the NAC group. Conclusions: The study has demonstrated a significant reduction of the incidence of TTS by the use of NAC. Since cases of both permanent hearing loss (PTS) and noise-induced tinnitus are recruited from cases with TTS, the demonstrated risk reduction indicates a positive effect of NAC. [ABSTRACT FROM AUTHOR]

Background: Tinnitus sufferers commonly report concentration difficulties. Despite several previous studies investigating this, the underlying cause and the role of hearing status remains unclear. Purpose: To investigate whether there are any differences between normal hearing individuals with and without tinnitus in terms of working memory capacity, and whether working memory capacity correlates with high-frequency hearing thresholds. Research Design: Participants had their hearing thresholds measured (0.125-16 kHz) and performed a visual n-back test. All participants completed the Hospital Anxiety and Depression Scale, in addition tinnitus participants filled out the Tinnitus Questionnaire. Study Sample: Sixty-two individuals participated, 31 had tinnitus (tinnitus group) and 31 did not have tinnitus (control group). Groups were age- and sex matched, and all participants had normal hearing thresholds (20 dB HL or better at 0.125-8 kHz). Data Analysis: Friedman test of differences among repeated measures was conducted on the collected data of n-back performance, and Mann-Whitney U-test was used to compare groups. Age-corrected correlations were calculated for high-frequency hearing and each n-back condition. Results: We found no significant differences between the groups in terms of n-back task performances, except for the 2-back condition where the tinnitus group performed significantly better than the controls (p = 0.007). Furthermore, we found high-frequency hearing thresholds of the best ear (10-16 kHz) to correlate with performances at more demanding n-back conditions (p = 0.029 for 1-back and p = 0.015 for 2-back). Conclusion: This suggests that presence of tinnitus might not imply poorer working memory capacity and that deteriorated high-frequency hearing thresholds. [ABSTRACT FROM AUTHOR]

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Objective: The Tinnitus Functional Index (TFI) is a recent self-report instrument for tinnitus with potential advantages over other existing instruments, including a demonstrated high responsiveness. The objectives of this study were to translate and cross-culturally adapt the TFI into Swedish and to investigate its validity and reliability.Design: The development of the Swedish version (TFI-SE) followed published guidelines on cross-cultural adaptation of health questionnaires. Validity and reliability was investigated by correlating responses on the TFI-SE with other tinnitus measures [Tinnitus Handicap Inventory (THI) and visual analogue scale (VAS)] and a scale measuring anxiety and depression (HADS).Study sample: Consecutively recruited tinnitus patients (n = 100) from four Swedish clinics completed the questionnaires. The mean age of the sample was 51 years (SD =17).Results: The internal consistency of the TFI-SE was good (α = 0.95) and the test–retest reliability was high (ICC =0.93). Our results supported the eight-factor structure proposed for the original TFI, and a high correlation between the TFI-SE and the THI (r = 0.8;p < 0.01) and lower correlations between the TFI-SE and the HADS-D (r = 0.60;p < 0.01) and HADS-A (r = 0.59;p < 0.01) confirmed satisfactory convergent and discriminant validity.Conclusions: We found that the Swedish translation and cross-cultural adaptation of the TFI is valid and reliable for use with adult tinnitus patients. [ABSTRACT FROM AUTHOR]

Background: Tinnitus is a common condition and there is a need to evaluate effects of tinnitus management in relation to moderating factors such as degree of hearing loss. As it is possible that tinnitus influences concentration, and thus is likely to disturb cognitive processing, the role of cognitive functioning also needs to be investigated. Purpose: To compare a group of patients with sensorineural hearing loss and tinnitus to a control group with only sensorineural hearing loss (and no tinnitus). To investigate working memory, sleep, and hearing problems measured before and after hearing rehabilitation. Research Design: A prospective study. Study Sample: The sample consisted of 100 patients, 50 with hearing loss and tinnitus, and 50 controls with hearing loss but no tinnitus. All patients were between 40 and 82 yr old and had a pure-tone average (PTA; average of 0.5, 1, 2, and 4 kHz) <70 dB HL. Intervention: Patients were tested before and after rehabilitation with hearing aids with regard to their working memory capacity, sleep quality, hearing problems, speech recognition, and tinnitus annoyance. Data Collection and Analysis: Eight patients dropped out of the study. Thus, a total of 92 patients were included for analysis, with 46 in each group. As a consequence of unplanned age and PTA differences between the groups, an age-matched subsample (n = 30 + 30) was selected for further analysis. Tests including the Reading Span, Hearing-in-Noise Test (HINT), Tinnitus Handicap Inventory (THI), Hearing Handicap Inventory for the Elderly (HHIE), and Pittsburgh Sleep Quality Index (PSQI) were administered before and after hearing aid rehabilitation. Results: There were no between-group differences at baseline in the full sample (n = 92), with the exception of the THI (p< 0.001) and the PSQI (p< 0.002), on which the hearing loss and tinnitus group had significantly higher scores. Pre/post changes were significant for both groups on the Reading Span, and HHIE. However, these improvements were significantly largerforthe patients in the hearing loss and tinnitus group on the Reading Span test (p < 0.001) and the PSQI (p < 0.001). Patients with tinnitus and hearing loss also exhibited significantly improved THI scores at follow-up, compared to baseline (p < 0.001). We conducted the same analyses for the age-matched subsample (n = 30 + 30). For the baseline data, only the THI (p < 0.001) and the PSQI (p < 0.015) difference remained significant. With regard to the pre/post changes, we found the same differences in improvement in Reading Span (p < 0.001) and the PSQI (p < 0.015) as in the full sample. Conclusions: Patients with tinnitus benefited from hearing aid rehabilitation. The observed differences in cognitive function were unexpected, and there were larger score improvements on the Reading Span test in the hearing loss and tinnitus group than in the hearing loss group. Patients with tinnitus and hearing loss may receive extra benefit in terms of cognitive function following hearing aid rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: Investigate hearing function and headphone listening habits in nine-year-old Swedish children.Design: A cross-sectional study was conducted and included otoscopy, tympanometry, pure-tone audiometry, and spontaneous otoacoustic emissions (SOAE). A questionnaire was used to evaluate headphone listening habits, tinnitus, and hyperacusis.Study sample: A total of 415 children aged nine years.Results: The prevalence of a hearing threshold ≥20 dB HL at one or several frequencies was 53%, and the hearing thresholds at 6 and 8 kHz were higher than those at the low and mid frequencies. SOAEs were observed in 35% of the children, and the prevalence of tinnitus was 5.3%. No significant relationship between SOAE and tinnitus was found. Pure-tone audiometry showed poorer hearing thresholds in children with tinnitus and in children who regularly listened with headphones.Conclusion: The present study of hearing, listening habits, and tinnitus in nine-year old children is, to our knowledge, the largest study so far. The main findings were that hearing thresholds in the right ear were poorer in children who used headphones than in children not using them, which could be interpreted as headphone listening may have negative consequences to children’s hearing. Children with tinnitus showed poorer hearing thresholds compared to children without tinnitus. [ABSTRACT FROM PUBLISHER]

Purpose: To test the effects of a brief motivational interviewing (MI) program as an adjunct to hearing aid rehabilitation for patients with tinnitus and sensorineural hearing loss. Research Design: This was a pilot randomized controlled trial. Study Sample: The sample consisted of 50 patients aged between 40 and 82 yr with both tinnitus and sensorineural hearing loss and a pure-tone average (0.5, 1,2, and 4 kHz) < 70 dB HL. All patients were first-time hearing aid users. Intervention: A brief MI program was used during hearing aid fitting in 25 patients, whereas the remainder received standard practice (SP), with conventional hearing rehabilitation. Data Collection and Analysis: A total of 46 patients (N = 23 + 23) with tinnitus were included for further analysis. The Tinnitus Handicap Inventory (THI) and the International Outcome Inventory for Hearing Aids (IOI-HA) were administered before and after rehabilitation. THI was used to investigate changes in tinnitus annoyance, and the IOI-HA was used to determine the effect of hearing aid treatment. Results: Self-reported tinnitus disability (THI) decreased significantly in the MI group (p< 0.001) and in the SP group (p < 0.006). However, there was greater improvement in the MI group (p < 0.013). Furthermore, the findings showed a significant improvement in patients' satisfaction concerning the hearing aids (IOI-HA, within both groups; MI group, p < 0.038; and SP group, p < 0.026), with no difference between the groups (p < 0.99). Conclusion: Tinnitus handicap scores decrease to a greater extent following brief MI than following SP. Future research on the value of incorporating MI into audiological rehabilitation using randomized controlled designs is required. [ABSTRACT FROM AUTHOR]

Objective:The aim of this study was to investigate whether the previously reported differences in cognitive performance as assessed using a Stroop paradigm between individuals with and without tinnitus is present in normal-hearing individuals.Design:Participants completed audiometric evaluation, a visual Stroop test, as well as the Swedish version of the hospital anxiety and depression scale (HADS) questionnaire. In addition individuals with tinnitus participated in a short interview regarding tinnitus characteristics as well as a follow up data collection of the tinnitus questionnaire (TQ).Study sample:Forty individuals participated in this study. Twenty had tinnitus (tinnitus group) and 20 had not (control group). The groups were age- and sex-matched and all participants had normal hearing thresholds (20 dB HL or better).Results:No differences in terms of cognitive performances were found between individuals with tinnitus compared to individuals without tinnitus.Conclusion:In contrast to previous studies of hearing-impaired subjects with tinnitus, the results of the present found no signs of cognitive interference in normal-hearing subjects with tinnitus when assessed using intensive short duration tasks. [ABSTRACT FROM PUBLISHER]

Purpose: The aim of this research forum article was to describe a feasible web-based solution for improving the quality of life of persons with hearing problems, such as hearing loss or tinnitus. The online platform was developed at the Department of Behavioural Sciences and Learning at Linköping University, Sweden, and has been running for a number of years and used in numerous studies and treatments. Method: The security aspects of the platform as well as the process flow for running a study or treatment are described, focusing primarily on the technical and practical considerations. Also presented are the design characteristics and the main features and functions available in the platform. Results: We point out the many advantages of running Internet-assisted intervention treatments, the challenges that we have faced, and some intended developments. Many of our research colleagues, both from Sweden and other countries, have already implemented or intend to implement their own studies on this platform. Conclusions: Audiological rehabilitation can be delivered via the Internet using a stable online platform. Security and usability are important factors to have in mind for the design as well as adaptability to the patients. A next development step is to implement and test blended treatments using video conferencing inside the platform. [ABSTRACT FROM AUTHOR]

Background: Whether handicap due to tinnitus-sound(s) in the ears and/or in the head in the absence of an external auditory source-is best conceived as dimensional or categorical remains an unanswered empirical question. Purpose: The objective was to investigate whether tinnitus severity was best conceptualized as qualitatively distinct subtypes, quantitative differences varying along a single continuum, or as severity differences within subtypes. Methods: Various forms of item response mixture models (latent class models, factor analysis models, and hybrid models) that corresponded to the competing hypotheses were fitted to item responses on the Tinnitus Handicap Inventory in a Swedish sample of individuals with tinnitus ( N = 362). Results: A latent class model could be fitted to the data with a high probability of correctly classifying individuals into three different classes: high-, moderate-, and low-severity classes. However, a comparison of models showed that a unidimensional factor analysis model with a single class provided the best fit to the data. Conclusions: The analysis provided evidence that tinnitus severity varies along a single severity continuum from mild to moderate to severe tinnitus-related handicap. The result that tinnitus severity exists on a continuum rather than as discrete categories has important implications for clinical research. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to examine whether perceived tinnitus severity changes over time, and if so what factors contribute to this change. Design: A modified Swedish version of tinnitus severity questionnaire (MS-TSQ) was used to examine changes in tinnitus severity over a period of time. Study sample: The MS-TSQ questionnaire was completed by 455 subjects visiting an Ear, Nose and Throat (ENT) clinic in Sweden as part of baseline assessment (Sb). The same questionnaire was completed during follow-up assessment (Sf ) by 174 of these subjects to examine changes in tinnitus severity, if any. The difference in scores obtained from the two assessments was calculated and was termed as difference scores (Sd). Results: Results of analyses of variance (ANOVA) indicated significant reduction in tinnitus severity from Sb to Sf scores (p < 0.001). Subjects with noise induced hearing loss showed significantly lower Sd scores than subjects with unspecified sensorineural hearing loss (p < 0.01). The group who received psychological treatment for tinnitus obtained significantly higher Sd than those who did not (p < 0.01). Conclusions: Results provide valuable framework for understanding the factors that affect tinnitus severity over a period of time. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare hyperacusis measurement tools often used in audiological practice in order to determine the most valid measure for assessing hyperacusis. Another aim was to examine the mean value for the Hyperacusis Questionnaire (HQ) in this patient group. Design: This was a cross-sectional study to compare the HQ with loudness discomfort levels (LDL), the Hospital Anxiety and Depression Scale (HADS), and items from a clinical interview dealing with hyperacusis symptoms. Sixty-two patients between the ages of 18 and 61 years were evaluated. All patients were diagnosed with hyperacusis. Results: There were significant negative correlations between the HQ and nearly all LDL scores for the right ear, but no significant correlations could be found for the left ear. LDLs were significantly correlated with the anxiety subscale of the HADS while there were no significant correlations between the HQ and either of the HADS scales. Of the 62 patients, 41 scored above and 21 scored below the previously recommended cut-off for the HQ. Conclusion: We suggest that clinicians should use the HQ and HADS in combination with a clinical interview to diagnose hyperacusis, and propose that the cut-off for the Swedish version of the HQ should be lowered. [ABSTRACT FROM AUTHOR]

Abstract: Objective: We aimed to describe a large cohort of patients with tinnitus and sensorineural hearing loss (SNHL) in Sweden, and also to explore the possibility of finding potential possible differences between various diagnoses within SNHL. It is also of great interest to see how a multidisciplinary team was used in the different subgroups and the frequency of hearing aids use in patients with tinnitus. Methods: Medical records of all patients who had received the diagnosis SNHL in Östergötland County, Sweden between 2004 and 2007 were reviewed. Patients between 20 and 80 years with tinnitus and a pure tone average (PTA) lower than 70dB HL were included in the study. Patients were excluded from the analyses if they had a cochlear implantation, middle ear disorders or had a hearing loss since birth or childhood. The investigators completed a form for each included patient, covering background facts, and audiograms taken at the yearly check up. Results: Of a total 1672 patients’ medical record review, 714 patients were included. The majority of patients (79%) were in the age group over 50 years. In male patients with bilateral tinnitus, the PTA for the left ear was significantly higher than for the right ear. The results regarding the configuration of hearing loss revealed that 555 patients (78%) had symmetric and 159 (22%) asymmetric hearing loss. Retrocochlear examinations were done in 372 patients and MRI was the most common examination. In all patients, 400 had no hearing aids and out of those 220 had unilateral tinnitus and 180 patients had bilateral tinnitus. 219 patients had a PTA>20dB HL and did not have any hearing aid. Results demonstrated that the Stepped Care model was not used widely in the daily practice. In our study, patients with bilateral-, unilateral hearing loss or Mb Ménière were the most common patients included in the Stepped Care model. Conclusion: In a large cohort of patients with SNHL and tinnitus, despite their hearing loss only 39% had hearing aids. It was observed that the medical record review often showed a lack of information about many background factors, such as; patients’ general health condition, which could be a quality factor that needs improvement. Our results show that the Stepped Care model could be an effective option for providing a better access for tinnitus-focused treatment, although the number of patients in this study who were included in the Stepped Care model was low. [Copyright &y& Elsevier]

Background: Evidence on the association between hearing loss and sick leave or disability pension is to a great extent based on few cross-sectional studies and remains unclear. We aim to assess the associations in a long-term follow-up population study., Methods: We used baseline data from a large population-based hearing study in Norway, the HUNT Hearing study (1996-1998). The sample included 21 754 adults (48.5% men, mean age at baseline 36.6 years). We used register data on sick leave and disability pension (1996-2011). Cox regression was used to assess the association between hearing loss at baseline (Pure tone average/PTA 0.5-4 kHz > 20 dB) and time to first physician-certified sick leave episode, as well as time to first disability pension payment., Results: Hearing loss at baseline (yes/no) was weakly associated with time to first physician-certified sick leave episode: Hazard ratio (HR) 1.2 (95% confidence interval (CI) 1.1-1.3). Restricting the exposed group to people with both hearing loss and tinnitus, the HR was slightly increased: 1.3 (95% CI 1.1-1.6). Hearing loss in 1996-1998 was also associated with time to first received disability pension: HR 1.5 (95% CI 1.3-1.8). Stronger associations were found for disabling hearing loss (PTA > 35). Restricting the exposure to hearing loss and tinnitus, the HR was increased: 2.0 (95% CI 1.4-2.8)., Conclusions: This large population-based cohort study indicates that hearing loss is associated with increased risk of receiving disability pension, especially among younger adults and low educated workers. Hearing loss was weakly associated with sick leave., (© 2022. The Author(s).)

Tinnitus, the perception of sound without external source, is a highly prevalent public health problem with about 8% of the population having frequently occurring tinnitus, and about 1-2% experiencing significant distress from it. Population studies, as well as studies on self-selected samples, have reported poor psychological well-being in individuals with tinnitus. However, no study has examined the long-term co-variation between mood and tinnitus prevalence or tinnitus severity. In this study, the relationship between depression and tinnitus prevalence and severity over a 2-year period was examined in a representative sample of the general Swedish working population. Results show that a decrease in depression is associated with a decrease in tinnitus prevalence, and even more markedly with tinnitus severity. Hearing loss was a more potent predictor than depression for tinnitus prevalence, but was a weaker predictor than depression for tinnitus severity. In addition, there were sex differences for tinnitus prevalence, but not for tinnitus severity. This study shows a direct and longterm association between tinnitus severity and depression. [ABSTRACT FROM AUTHOR]

Abstract The aim of this study was to investigate long-term development of hearing in subjects who had received platinum-based chemotherapy in childhood or adolescence. Another aim was to assess the self-reported hearing loss handicap and compare it to audiometric measurements. Medical records from individuals diagnosed with childhood cancer and treated with platinum-based chemotherapy between 1985 and 2000 at the University Hospital in Lund Sweden were reviewed retrospectively. Fifteen subjects, who fulfilled the eligibility criteria set for the study, underwent a thorough audiometric evaluation. The results show that the hearing loss, in subjects with ototoxicity had increased after the end of treatment, to include also the lower frequencies. The largest deterioration in hearing thresholds, up to 55 dB HL, was found at frequencies above 2 kHz. The findings also reveal that the subjects have a considerably greater hearing loss handicap and disability than would be expected from the results of the audiometric evaluations. The conclusion of this study is that children and adolescence treated with platinum-based chemotherapy should have regular audiometric follow-up examinations, also many years after the end of treatment. Furthermore, assessments of self-reported hearing disability should be made during and after chemotherapy. Sumario El objetivo de este estudio fue investigar el desarrollo de la audición a largo plazo en sujetos que recibieron quimioterapia de platino en la niñez o en la adolescencia. Otro objetivo fue evaluar los auto-reportes de discapacidad por la pérdida auditiva y compararlos con las mediciones audiométricas. Se revisaron retrospectivamente los expedientes médicos de individuos diagnosticados con cáncer en la niñez y tratados con quimioterapia con platino entre 1985 y 2000, en el Hospital Universitario de Lund, Suecia. Quince sujetos que cubrieron los criterios de elegibilidad para el estudio, se sometieron a una evaluación audiométrica minuciosa. Los resultados mostraron que la pérdida auditiva en sujetos con ototoxicidad aumentó después de terminar el tratamiento, incluyendo también las frecuencias graves. La mayor pérdida en los umbrales auditivos, hasta de 55 dB HL, se encontró en las frecuencias superiores a 2 kHz. Los hallazgos revelan también que los sujetos presentan una discapacidad y una desventaja auditiva considerablemente mayor que lo que podría esperarse a partir de los resultados de las evaluaciones audiométricas. La conclusión de este estudio es que los niños y adolescentes tratados con quimioterapia con platino deben ser sometidos a un seguimiento en las evaluaciones audiométricas, incluso muchos años después de terminar el tratamiento. Más aún, las evaluaciones de los auto-reportes sobre discapacidad auditiva, deben practicarse durante y después de la quimioterapia. [ABSTRACT FROM AUTHOR]

The aim was to determine the incidence of tinnitus, impaired hearing and musculoskeletal disorders among musicians and the relation to the number of practicing hours and/or the instrument type before the onset of symptoms. Method: The study base consisted of students enroled in the School of Music and Music Education at Göteborg University between the years 1980 and 1995. There were 407 of the 602 original students that answered a questionnaire (response rate of 68%). The questionnaire concerned exposure before and after the enrolment in the Music Academy, as well as onset of symptoms. Results: The highest incidence of symptoms was found for reported tinnitus with a rate of 10.6 per 1000 years of instrumental practice. There was a relationship between exposure to the number of hours of instrumental practice and incidence of impaired hearing. Among the musculoskeletal symptoms the highest incidences per 1000 years of instrumental practice were pain in the neck and in the left shoulder with a rate of 4.4 and 4.6 disorders per 1000 years of instrumental practice, respectively. There was 2.4 times higher incidence for musculoskeletal disorders in the right hand/wrist and a 2.2 times higher incidence in the left elbow/forearm for musicians who practiced for 20 h or more per week before the onset of disorders compared to those who practiced fewer than 20 h per week when controlling for age and gender. Musicians with a violin or a viola as the main instrument had four times the incidence for right elbow/forearm disorder and twice the incidence of neck pain, pain in the right shoulder and the left elbow/forearm compared to those who had piano as the main instrument. [ABSTRACT FROM AUTHOR]

Using pure tone audiometry in 1995, a hearing reassessment was made in 56 classical musicians who participated in Axelsson & Lindgren’s study 16 years earlier, in 1979. This study focuses on hearing development in these classical orchestra musicians, active in Göteborg, Sweden. The aim of the study is to evaluate the risk of progressive hearing loss during work in a classical orchestra. Another aim is to study possible hearing differences in females and males and to compare the high frequency pure-tone average values found in the study with two normal materials. The main findings were that the male, compared to the female musicians, showed a tendency toward a more pronounced, although not significant, hearing reduction in the high frequency region and higher threshold distribution within the 90th percentile than the females. This was found most often in the left ear. The median audiogram for all females showed a notch configuration at 6 kHz, compared to the males who had a high-tone sloping configuration. When comparing high frequency pure-tone average (HFPTA) values with ISO 7029, the females are distributed around the ISO 7029 median and well within the 90th percentile. The average among the males was equal with the median. Comparison with Davis normal population “all the sample, overall occupational group” showed a more even distribution of the HFPTA values around the median for both females and males on both occasions. This follow-up study showed no extended negative progress of the pure-tone hearing threshold values in spite of an additional 16 years of musical noise exposure. [ABSTRACT FROM AUTHOR]

BACKGROUND: Tinnitus occurs with or without prior noise exposure (noise-induced tinnitus (NIT) and spontaneous tinnitus (ST)), and is considered a symptom related to permanent hearing impairment (HI) or temporary hearing threshold shift (TTS). OBJECTIVE: To carry out a cross-sectional interview study on TTS, ST and NIT during a standard audiometric screening of 756 7-year-old children in Gothenburg. RESULTS: 41% out of 756 children reported either NIT or ST on several occasions, 17% reported recurrent TTS and 7% failed the audiometry screening. The probability of ST was 27% for children with no HI or TTS (OR=1.23 (95% CI 1.12 to 1.34)) but 63% (OR=1.16 (95% CI 1.02 to 1.33)) if exhibiting both HI and TTS. CONCLUSION: This study confirms an increased occurrence of spontaneous tinnitus in children with TTS or HI and in children with both TTS and HI, in particular, but also in children with normal hearing. Possibly, tinnitus in young children correlates with stress as in adolescents and adults. [ABSTRACT FROM AUTHOR]

Background: tinnitus is a heterogeneous condition associated with audiological and/or mental disorders. Chronic, severe tinnitus is reported in 1% of the population and it shows a relevant heritability, according to twins, adoptees and familial aggregation studies. The genetic contribution to severe tinnitus is unknown since large genomic studies include individuals with self-reported tinnitus and large heterogeneity in the phenotype. The aim of this study was to identify genes for severe tinnitus in patients with extreme phenotype., Methods: for this extreme phenotype study, we used three different cohorts with European ancestry (Spanish with Meniere disease (MD), Swedes tinnitus and European generalized epilepsy). In addition, four independent control datasets were also used for comparisons. Whole-exome sequencing was performed for the MD and epilepsy cohorts and whole-genome sequencing was carried out in Swedes with tinnitus., Findings: we found an enrichment of rare missense variants in 24 synaptic genes in a Spanish cohort, the most significant being PRUNE2, AKAP9, SORBS1, ITGAX, ANK2, KIF20B and TSC2 (p < 2E -04 ), when they were compared with reference datasets. This burden was replicated for ANK2 gene in a Swedish cohort with 97 tinnitus individuals, and in a subset of 34 Swedish patients with severe tinnitus for ANK2, AKAP9 and TSC2 genes (p < 2E -02 ). However, these associations were not significant in a third cohort of 701 generalized epilepsy individuals without tinnitus. Gene ontology (GO) and gene-set enrichment analyses revealed several pathways and biological processes involved in severe tinnitus, including membrane trafficking and cytoskeletal protein binding in neurons., Interpretation: a burden of rare variants in ANK2, AKAP9 and TSC2 is associated with severe tinnitus. ANK2, encodes a cytoskeleton scaffolding protein that coordinates the assembly of several proteins, drives axonal branching and influences connectivity in neurons., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Purpose: To assess whether working in preschools increases the risk of hearing-related symptoms and whether age, occupational noise, and stressful working conditions affect the risk., Methods: Questionnaire data on hearing-related symptoms were analysed in women aged 24-65 (4718 preschool teachers, and 4122 randomly selected general population controls). Prevalence and risk ratio (RR) of self-reported hearing loss, tinnitus, difficulty perceiving speech, hyperacusis and sound-induced auditory fatigue were assessed by comparing the cohorts in relation to age and self-reported occupational noise and stressful working conditions (effort-reward imbalance and emotional demands). RR was calculated using log-binomial regression models adjusted for age, education, income, smoking, hearing protection, and leisure noise. Incidence rates and incidence rate ratios (IRR) were calculated for retrospectively reported onset of all symptoms except sound-induced auditory fatigue., Results: Compared to the controls, preschool teachers had overall more than twofold RR of sound-induced auditory fatigue (RR 2.4, 95% confidence interval 2.2-2.5) and hyperacusis (RR 2.3, 2.1-2.5) and almost twofold for difficulty perceiving speech (RR 1.9, 1.7-2.0). Preschool teachers had a threefold IRR of hyperacusis (IRR 3.1, 2.8-3.4) and twofold for difficulty perceiving speech (IRR 2.4, 2.2-2.6). Significantly although slightly less increased RR and IRR were observed for hearing loss and tinnitus. RR and IRR were generally still increased for preschool teachers when stratified by age and occupational exposure to noise and stress., Conclusions: This large cohort study showed that working as preschool teacher increases the risk of self-reported hearing-related symptoms, indicating a need of preventative measures.

Objectives/hypothesis: Postoperative tinnitus and taste disturbances after myringoplasty are more common than previously reported., Study Design: This study was a retrospective analysis of prospectively collected data from the Swedish National Quality Registry for Myringoplasty., Methods: The analysis was performed on extracted data from all counties in Sweden collected from database A from 2002 to 2012 and database B from 2013 to 2016. Tinnitus and taste disturbance complications 1 year after myringoplasty were analyzed in relation to gender, age, procedure, and success rate. In database A, physicians reported tinnitus and taste disturbances. In database B, patients reported the complications., Results: A major difference was found when the complications were reported by physicians compared to when the complications were reported by patients. In database A, tinnitus was reported in 1.2% of the patients and taste disturbances in 0.5%. In database B, the frequencies were 12.3% and 11.2%, respectively. Tinnitus and taste disturbances were more frequent after conventional myringoplasty compared to those after fat grafting and were more frequent after primary compared to those after revision surgery when reported by physicians. Patients, however, reported the same frequency of tinnitus after fat graft myringoplasty compared to that after conventional myringoplasty (12.0% vs. 12.6%) and fewer taste disturbances after revision surgery. In follow-up assessments, complications persisted after surgery over a long time period., Conclusion: Tinnitus and taste disturbances are more common after myringoplasty when patients report their symptoms than when physicians report the symptoms., Level of Evidence: 2b Laryngoscope, 129:209-215, 2019., (© 2018 The American Laryngological, Rhinological and Otological Society, Inc.)

A correction is presented to the article “A Swedish cross-cultural adaptation and validation of the Tinnitus Functional Index” which appeared in the issue.

The article looks at several international studies on health and medicine as of June 18, 2016. Topics covered include the experiences of people dying in palliative care in Edinburgh, Scotland, how often myocardial infection occur without being picked up at the time, and the phenomenon of music-induced goosebumps or frisson.

Purpose: To study the quality of life (QoL) and psychosocial consequences in terms of sick leave and audiological rehabilitation given to patients with severe to profound hearing impairment., Method: A retrospective study of data on 2319 patients with severe to profound hearing impairment in The Swedish Quality Register of Otorhinolaryngology, followed by a posted questionnaire including The Hospital Anxiety and Depression Scale (HADS)., Results: The results indicate greater levels of anxiety and depression among patients with severe or profound hearing impairment than in the general population, and annoying tinnitus and vertigo had strong negative effects on QoL. The proportion of sick leave differed between the studied dimensions in the study. The proportion of patients who received extended audiological rehabilitation was 38% in the present study., Conclusions: Treatment focused on anxiety, depression, tinnitus and vertigo must be given early in the rehabilitation process in patients with severe or profound hearing impairment. Because sick leave differs greatly within this group of patients, collaboration with the regional Social Insurance Agency is crucial part of the rehabilitation. The study also shows that presently, only a small proportion of patients in Sweden with severe to profound hearing impairment receive extended audiological rehabilitation. Implications for Rehabilitation Greater levels of anxiety and depression have been found among patients with severe or profound hearing impairment than in the general population, and annoying tinnitus and vertigo have strong negative effects on QoL in this group of patients. Only a small proportion of patients with severe to profound hearing impairment receive extended audiological rehabilitation today, including medical, technical and psychosocial efforts. Extended audiological rehabilitation focused on anxiety, depression, tinnitus and vertigo must be given, together with technical rehabilitation, early in the rehabilitation process in patients with severe or profound hearing impairment.