G Hesse1, R Andres, H Schaaf, A Laubert. 1. Ohr- und Hör-Institut Hessen, Grosse Allee 3, 34454 Bad Arolsen. drgerhardhesse@googlemail.com
Abstract
INTRODUCTION: According to our audiological data, 90% of tinnitus patients have deficits in inner ear function as a generator of tinnitus, mainly in the outer hair cells (OHC). This can be verified by registration of distortion products of otoacoustic emissions (DPOAE). Thus, the main origin of tinnitus is peripheral, and most patients suffer from accompanying hearing loss, even though it is sometimes mild or subjectively not even felt. Whether or not the tinnitus is disturbing, however, is determined through further auditory processing of the "signal" tinnitus and its psychological validation. With almost 50% of our tinnitus and hyperacusis patients, we find hyperfunctioning of the OHC, possibly originating from reduced or ineffective efferent control in the auditory pathway. Efferent activity can be measured by acoustic stimulation of the contralateral ear, which normally reduces the DPOAE amplitudes via efferent inhibition. METHOD AND PATIENTS: DPOAE were recorded with 67 tinnitus patients (127 ears) with and without contralateral acoustic stimulation. Twenty-one persons (41 ears) served as controls. RESULTS: With 64% of the tinnitus patients, DPOAE amplitudes were not reduced significantly, compared with 34% of the controls. The medium amplitude reduction for controls was 1.76 dB, whereas for the tinnitus patients it was significantly less (0.91 dB). CONCLUSION: For a considerable number of tinnitus patients, efferent control of OHC activity is restricted, but this seems to be confined to a certain type of tinnitus only.
INTRODUCTION: According to our audiological data, 90% of tinnituspatients have deficits in inner ear function as a generator of tinnitus, mainly in the outer hair cells (OHC). This can be verified by registration of distortion products of otoacoustic emissions (DPOAE). Thus, the main origin of tinnitus is peripheral, and most patients suffer from accompanying hearing loss, even though it is sometimes mild or subjectively not even felt. Whether or not the tinnitus is disturbing, however, is determined through further auditory processing of the "signal" tinnitus and its psychological validation. With almost 50% of our tinnitus and hyperacusispatients, we find hyperfunctioning of the OHC, possibly originating from reduced or ineffective efferent control in the auditory pathway. Efferent activity can be measured by acoustic stimulation of the contralateral ear, which normally reduces the DPOAE amplitudes via efferent inhibition. METHOD AND PATIENTS: DPOAE were recorded with 67 tinnituspatients (127 ears) with and without contralateral acoustic stimulation. Twenty-one persons (41 ears) served as controls. RESULTS: With 64% of the tinnituspatients, DPOAE amplitudes were not reduced significantly, compared with 34% of the controls. The medium amplitude reduction for controls was 1.76 dB, whereas for the tinnituspatients it was significantly less (0.91 dB). CONCLUSION: For a considerable number of tinnituspatients, efferent control of OHC activity is restricted, but this seems to be confined to a certain type of tinnitus only.
Authors: Frank E Musiek; Jennifer B Shinn; Robert Jirsa; Doris-Eva Bamiou; Jane A Baran; Elena Zaida Journal: Ear Hear Date: 2005-12 Impact factor: 3.570
Authors: W Arnold; P Bartenstein; E Oestreicher; W Römer; M Schwaiger Journal: ORL J Otorhinolaryngol Relat Spec Date: 1996 Jul-Aug Impact factor: 1.538