Section: 
Otiology
OtiologyResidual inhibition of tinnitus of various etiologies by impulse noise
F. A. Syroezhkin (1), S. A. Artyushkin (2), S. R. Ustinov (3), Yu. K. Yanov (4), D. Z. Yumakaev (5)
(1), (2), (3) Mechnikov North-Western State Medical University, Saint Petersburg, 191015, Russian Federation, (1), (4), (5) Kirov Military Medical Academy, Saint Petersburg, 194044, Russian Federation, (1) Saint Petersburg Research Institute of Ear, Throat, Nose and Speech, Saint Petersburg, 190013, Russian Federation
UDK: УДК 616.28-008.14:616.28.12/.23-072.1
DOI: https://doi.org/10.18692/1810-4800-2024-5-83-93
ABSTRACT
Abstract. Residual inhibition of tinnitus is a temporary reduction or cessation of tinnitus noise after acoustic stimulation. The classical method for determining the level of residual inhibition is the presentation of an acoustic signal (tone or noise) at a level of +10 dB above the minimum threshold of tinnitus perception for 30–60 s, after which the time for tinnitus to return to the initial level is recorded. Due to the duration of the test, this method has not received wide application in routine clinical practice. A recently proposed version of acoustic stimulation in the form of a pulsed signal allows for a survey to determine the level of residual inhibition much faster and with a high degree of reproducibility of the results. Objective. To improve the efficiency of differential diagnostics of tinnitus of various etiologies based on comparison of its psychoacoustic characteristics (pitch, loudness, masker threshold, minimum masking level, minimum residual inhibition level) and assessment of the level of noise burden using questionnaires. Patients and methods. The results of application of the main psychoacoustic methods, including determination of residual inhibition level using impulse noise, were analyzed in 29 patients with tinnitus. Depending on the suspected cause of tinnitus, patients were divided into the following groups: acu-/acubarotrauma (1a), use of ototoxic drugs (1b). Patients in whom the cause of tinnitus was not established were divided according to the presence of concomitant hearing loss: patients with isolated tinnitus (2a), patients in whom tinnitus was combined with hearing loss (2b). Results. Most patients (25 people, 86%) achieved complete tinnitus suppression. In 5 of them (20%), a long-term effect was achieved (tinnitus was absent or significantly decreased after a 10-second period of presentation of the acoustic stimulus). A more significant tinnitus suppression effect was shown with the binaural version of presentation of acoustic stimuli. The group of patients with tinnitus combined with hearing loss was characterized by lower thresholds of the studied parameters than the group of patients with isolated tinnitus and the group of patients with tinnitus combined with drug-induced hearing loss in the range above 2 kHz. The minimum threshold levels for the frequency range where the highest hearing thresholds are observed in patients with the consequences of acubarotrauma were within the limits of the greatest hearing loss (4 kHz). An inverse correlation was found between the duration of tinnitus and susceptibility to its suppression in patients with isolated tinnitus. Conclusion. The use of impulse noise in assessing residual inhibition in patients with tinnitus has a number of undeniable advantages over the classical technique, which allows obtaining reproducible and reliable results in studies aimed at solving the issues of differential diagnosis of tinnitus. The obtained results can be used in further work on tinnitus typing depending on its cause, duration, and concomitant hearing loss.
Publication date:
17.10.2024
Keywords:
tinnitus, residual inhibition, impulse noise, acoustic trauma, hearing loss, masking For citation:
Syroezhkin F. A., Artyushkin S. A., Ustinov S. R., Yanov Yu. K., Yumakaev D. Z. Residual inhibition of tinnitus of various etiologies by impulse noise. Russian otorhinolaryngology. 2024;23(5):83-93. (In Russ.) https://doi.org/10.18692/1810-4800-2024-5-83-93