Chronic tinnitus: analysis of clinical contributions from different audiological evalutions

Moreira, Hélinton Goulart; Bruno, Rúbia Soares; Oppitz, Sheila Jacques; Sanfins, Milaine Dominici; Garcia, Michele Vargas

doi:10.1590/2317-6431-2022-2660en

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Audiology - Communication Research

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Original Article • Audiol., Commun. Res. 27 • 2022 • https://doi.org/10.1590/2317-6431-2022-2660en copy

Chronic tinnitus: analysis of clinical contributions from different audiological evalutions

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

To investigate whether there are differences in peripheral and central audiological findings between individuals with normal hearing thresholds with and without chronic tinnitus, and thereby understand which hearing tests are most important in this population.

Methods

The sample was composed of convenience, including individuals from 18 to 59 years old, divided into two groups: Group 1 (G1) composed of subjects without complaints of chronic tinnitus, and Group 2 (G2) composed of individuals with chronic tinnitus. The evaluation consisted of the following procedures: Anamnesis, High-frequency audiometry (HFA), Transient Otoacoustic emissions (TOAEs), Auditory Brainstem Response (ABR)-click, Frequency Following Response (FFR), and Long Latency Auditory Evoked Potential (LLAEP)-speak.

Results

G2 showed increased values for HFA, with significant differences. For both groups, TOAEs showed a predominance of responses. In ABR there were no statistically significant differences. In FFR, G1 obtained a greater amplitude of wave V and there was a greater absence in LLAEP of P1, N2, and P300 in G2.

Conclusion

The HFA, the analysis of the wave V/I ratio in ABR, the FFR, and the LLAEP identified alterations in individuals with chronic tinnitus, demonstrating that such procedures are promising in the evaluation of this population.

Keywords:
Tinnitus; Evoked potential; Hearing; Adult; Auditory cortex

HFA dBSPL	Group	n	Average	Median	Mín	Max	SD	CI (95%)	p-value
9 kHz	G1	22	13.86	15.00	0.00	20.00	5.96	(4.58; 8.52)	0.001*
9 kHz	G2	22	22.95	22.50	5.00	45.00	10.43	(8.02; 14.90)	0.001*
10 kHz	G1	22	16.59	15.00	5.00	25.00	6.25	(4.80; 8.92)	0.002*
10 kHz	G2	22	25.45	25.00	10.00	50.00	11.12	(8.55; 15.88)	0.002*
11 kHz	G1	22	12.05	12.50	0.00	25.00	9.59	(7.38; 13.71)	<0.001*
11 kHz	G2	22	27.50	27.50	10.00	50.00	9.35	(7.19; 13.36)	<0.001*
12 kHz	G1	22	10.91	5.00	0.00	35.00	11.30	(8.69; 16.14)	<0.001*
12 kHz	G2	22	31.36	30.00	15.00	55.00	10.82	(8.32; 15.46)	<0.001*
13 kHz	G1	22	16.14	12.50	0.00	40.00	12.24	(9.41; 17.49)	<0.001^* * Statistically significant values (p ≤ 0.05)
13 kHz	G2	22	42.27	45.00	20.00	75.00	13.95	(10.73; 19.93)	<0.001^* * Statistically significant values (p ≤ 0.05)
14 kHz	G1	22	28.18	30.00	5.00	45.00	10.86	(8.35; 15.52)	<0.001*
14 kHz	G2	22	53.86	52.50	20.00	90.00	21.15	(16.27; 30.22)	<0.001*
15 kHz	G1	22	32.50	32.50	10.00	55.00	14.62	(11.24; 20.89)	<0.001*
15 kHz	G2	22	59.77	57.50	10.00	100.00	24.42	(18.78; 34.89)	<0.001*
16 kHz	G1	22	38.86	37.50	10.00	60.00	16.03	(12.33; 22.90)	<0.001*
16 kHz	G2	22	68.86	72.50	10.00	100.00	25.82	(19.86; 36.89)	<0.001*
17 kHz	G1	22	50.68	50.00	10.00	90.00	18.34	(14.11; 26.21)	0.001*
17 kHz	G2	22	75.45	82.50	25.00	105.00	24.92	(19.17; 35.61)	0.001*
18 kHz	G1	22	61.36	60.00	5.00	90.00	21.83	(16.79; 31.19)	0.023*
18 kHz	G2	22	77.27	77.50	20.00	105.00	22.98	(17.67; 32.83)	0.023*

Variables	G1	G2	p-value
Number of ears	22	22
Age	40.4	44	0.43
Gender (number)
Male	6	2	0.183
Female	5	9

		Group 1		Group 2		Total		p-value
		n	%	n	%	N	%	p-value
TOAE	No	0	0%	4	18%	4	9%	0.138
TOAE	Yes	22	100%	18	82%	40	91%	0.138

ABR	Variables	Groups	N	Average	Median	Mín	Máx	SD	CI (95%)	p-value
ms	wave I	G1	22	1.57	1.55	1.4	1.8	0.1	(0.07; 0.14)	0.791
	wave I	G2	20	1.57	1.55	1.4	1.75	0.09	(0.07; 0.13)	0.791
	wave III	G1	22	3.75	3.80	3.45	4	0.2	(0.15; 0.28)	0.338
	wave III	G2	22	3.8	3.79	3.5	4.2	0.18	(0.13; 0.25)	0.338
	Wave V	G1	22	5.68	5.69	5.35	5.98	0.2	(0.15; 0.28)	0.835
	Wave V	G2	22	5.69	5.74	5.33	5.95	0.2	(0.15; 0.28)	0.835
	I-III	G1	22	2.17	2.14	1.75	2.55	0.23	(0.17; 0.32)	0.385
	I-III	G2	19	2.23	2.23	1.9	2.65	0.17	(0.12; 0.25)	0.385
	III-V	G1	22	1.93	1.95	1.5	2.25	0.14	(0.10; 0.20)	0.399
	III-V	G2	22	1.89	1.89	1.7	2.25	0.13	(0.09; 0.18)	0.399
	I-V	G1	22	4.1	4.10	3.72	4.45	0.2	(0.15; 0.28)	0.713
	I-V	G2	19	4.13	4.18	3.73	4.4	0.2	(0.15; 0.30)	0.713
µV	amp I	G1	22	0.3	0.29	0.11	0.63	0.11	(0.08; 0.16)	0.182
	amp I	G2	22	0.25	0.24	0.07	0.45	0.11	(0.08; 0.15)	0.182
	amp V	G1	22	0.47	0.48	0.24	0.77	0.14	(0.11; 0.20)	0.802
	amp V	G2	22	0.46	0.48	0.24	0.74	0.14	(0.10; 0.20)	0.802
	ratio V/I	G1	22	1.77	1.58	0.57	4.27	0.8	(0.61; 1.14)	0.179
	ratio V/I	G2	22	2.14	2.00	0.62	4.43	0.99	(0.76; 1.42)	0.179

	FFR		Average	Median	SD	Min	Max	N	CI	p-value
ms	V	G1	6.08	6.25	0.71	4.5	6.88	11	0.42	0.079
	V	G2	6.89	6.63	1.24	5.88	10.25	10	0.77	0.079
	A	G1	8.2	7.88	1.18	6.38	10.88	11	0.7	0.377
	A	G2	8.67	8.32	1.18	7.5	11.75	10	0.73	0.377
	C	G1	17.16	17.38	1.13	14.88	19	11	0.67	0.935
	C	G2	17.21	17.38	1.42	15.25	20.13	11	0.84	0.935
	D	G1	22.62	22.63	1.68	18.5	25.25	11	0.99	0.377
	D	G2	23.33	22.63	1.66	21.5	26.63	8	1.15	0.377
	E	G1	31.48	31.38	1.5	29	33.38	11	0.89	0.377
	E	G2	31.98	31.94	0.91	30.75	33.25	10	0.56	0.377
	F	G1	39.83	39.88	0.82	38.88	41.5	11	0.48	0.184
	F	G2	40.39	39.94	1.03	39.38	42	10	0.64	0.184
	O	G1	48.5	48.75	0.88	47.38	50.5	11	0.52	0.306
	O	G2	49.15	48.5	1.75	47.87	53.38	9	1.14	0.306
	Slope	G1	0.184	0.184	0.1	0.041	0.38	11	0.059	0.717
	Slope	G2	0.169	0.16	0.067	0.06	0.302	9	0.044	0.717
	V-A	G1	2.12	1.63	1.08	1.25	4.63	11	0.64	0.374
	V-A	G2	1.77	1.63	0.51	1.25	2.87	10	0.32	0.374
	A-C	G1	8.96	9.62	1.86	5.37	11.5	11	1.1	0.744
	A-C	G2	8.74	8.63	1.16	7.25	10.38	10	0.72	0.744
	C-D	G1	5.72	5.25	2.15	2.12	8.5	11	1.27	0.896
	C-D	G2	5.59	5.37	2.15	2.5	8.13	8	1.49	0.896
	D-E	G1	8.55	8.5	2.5	5.62	14.12	11	1.48	0.85
	D-E	G2	8.36	8.87	1.38	5.25	9.37	8	0.95	0.85
	E-F	G1	8.35	8.38	1.48	6.5	11.13	11	0.87	0.903
	E-F	G2	8.41	8.38	0.45	7.75	9.13	10	0.28	0.903
	F-O	G1	8.44	8	0.93	7.25	10.5	11	0.55	0.717
	F-O	G2	8.62	8.31	1.31	7.12	12.13	10	0.81	0.717
	V-O	G1	42.42	42.12	1.37	41.12	45.5	11	0.81	0.206
	V-O	G2	41.52	41.74	1.71	37.75	44.12	9	1.12	0.206
µV	V	G1	0.214	0.19	0.064	0.1	0.3	11	0.038	0.041^* * Statistically significant values (p ≤ 0.05)
	V	G2	0.138	0.11	0.09	0.05	0.34	9	0.059	0.041^* * Statistically significant values (p ≤ 0.05)
	A	G1	-0.133	0.11	0.083	-0.01	-0.32	11	0.049	0.511
	A	G2	-0.157	0.16	0.082	-0.01	-0.29	10	0.051	0.511
	C	G1	-0.136	0.13	0.073	-0.01	-0.27	11	0.043	0.708
	C	G2	-0.15	0.11	0.094	-0.03	-0.3	11	0.056	0.708
	D	G1	-0.119	0.09	0.098	-0.03	-0.31	11	0.058	0.97
	D	G2	-0.118	0.14	0.073	-0.01	-0.19	8	0.05	0.97
	E	G1	-0.195	0.2	0.088	-0.01	-0.33	11	0.052	0.152
	E	G2	-0.249	0.23	0.075	-0.17	-0.43	10	0.046	0.152
	F	G1	-0.196	0.19	0.069	-0.08	-0.28	11	0.041	0.735
	F	G2	-0.232	0.22	0.124	-0.09	-0.48	10	0.077	0.735
	O	G1	-0.123	0.08	0.13	-0.02	-0.47	11	0.077	0.293
	O	G2	-0.176	0.17	0.09	-0.04	-0.35	10	0.056	0.293

LLAEP	Variable	Group	n	Average	Median	Mín	Máx	SD	CI (95%)	p-value
ms	P1	G1	22	53.55	52	50	67	4.64	(3.56; 6.62)	0.141
	P1	G2	12	56.5	52.5	50	67	6.76	(4.79; 11.48)	0.141
	N1	G1	22	100.45	98.5	80	116	9.54	(7.34; 13.63)	0.529
	N1	G2	22	102.23	102	86	121	8.96	(6.89; 12.80)	0.529
	P2	G1	22	183.32	181.5	153	222	19.37	(14.90; 27.68)	0.312
	P2	G2	22	189.64	189.5	153	217	21.49	(16.53; 30.71)	0.312
	N2	G1	22	257.77	257.5	212	297	26.58	(20.44; 37.98)	0.734
	N2	G2	15	253.67	268	192	302	46.32	(33.91; 73.05)	0.734
	P3	G1	22	312.14	315.5	253	371	33.52	(25.78; 47.90)	0.003^* * Statistically significant values (p ≤ 0.05)
	P3	G2	12	307.33	319.5	229	355	39.93	(28.28; 67.79)	0.003^* * Statistically significant values (p ≤ 0.05)
µV	P1-N1	G1	22	4.89	4.96	2.23	7.9	1.83	(1.40; 2.61)	0.061
	P1-N1	G2	8	6.64	6.25	3.63	10.97	2.97	(1.96; 6.04)	0.061
	N1-P2	G1	22	7.89	7.82	3.05	13.36	3.25	(2.50; 4.64)	0.699
	N1-P2	G2	17	8.3	6.88	4.1	14.9	3.27	(2.43; 4.98)	0.699
	P2-N2	G1	22	5.03	4.82	1.37	7.49	1.34	(1.02; 1.91)	0.913
	P2-N2	G2	13	4.94	4.05	1.01	11.17	3.52	(2.52; 5.80)	0.913
	P3	G1	22	6.02	4.45	3.01	14.4	3.3	(2.54; 4.72)	0.246
	P3	G2	11	7.87	5.56	3	20.42	5.73	(4.00; 10.05)	0.246

LLAEP (ms)		G1		G2		Total		p-value
LLAEP (ms)		n	%	n	%	n	%	p-value
P1	Absence	0	0%	10	45%	10	22.72%	<0.001*
P1	Presence	22	100%	12	55%	34	72.27%	<0.001*
N1	Absence	0	0%	0	0%	0	0%	NA
N1	Presence	22	100%	22	100%	44	100%	NA
P2	Absence	0	0%	0	0%	0	0%	NA
P2	Presence	22	100%	22	100%	44	100%	NA
N2	Absence	0	0%	7	31.81%	7	15.90%	0.003^* * Statistically significant values (p ≤ 0.05)
N2	Presence	22	100%	15	68.18%	37	84.09%	0.003^* * Statistically significant values (p ≤ 0.05)
P3	Absence	0	0%	10	45%	10	22.72%	<0.001*
P3	Presence	22	100%	12	55%	34	72.27%	<0.001*

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[1] Conflict of interests: No.