Effect of sound and Bone Conduction Ultrasound stimulation on Tinnitus Inhibition

Document Type : Original Articles

Authors

1 Assistant Professor of Audiology, Department of Audiology, School of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Iran

2 Lecturer, Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

3 Assistant Professor, Department of Biostatistics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

10.48305/jrrs.2021.30359

Abstract

Introduction: Tinnitus is a condition where a person perceives a sound without any external source. It is a psychological-auditory phenomenon that affects around 10 to 15% of adults. Due to the complexity of tinnitus and its origins, there are various assumptions and difficulties in treating it. Some treatments include sound stimulation and ultrasonic therapy. This study was conducted to compare the effects of sound stimulation and bone-conducted ultrasound (BCU) stimulation in controlling tinnitus..
Materials and Methods: For this study, 21 patients with persistent tinnitus were selected using convenience sampling method. These patients did not have a curable cause for their tinnitus and did not have conductive hearing loss or retrocochlear lesions. Radiological evaluations were conducted before and after sound and BCU stimulation. These evaluations included audiometry, tympanometry, stapes muscle reflex test, stapes muscle reflex decay test, auditory brainstem responses, and psychoacoustic tinnitus indicators. The psychoacoustic indicators measured included pitch, loudness, maskability, comparison of loudness of tinnitus, and duration of residual inhibition.
Results: The average loudness of tinnitus, measured in dB Sensation level (dBSL), did not significantly decrease (P = 0.080) after receiving sound and BCU stimulation. The mean loudness of tinnitus, as determined by standard-visual criteria, also did not significantly decrease (P = 0.200) after sound and BCU stimulation. However, there was a significant increase in the duration of residual inhibition (RI) after BCU compared to sound stimulation (P = 0.001). The study also found that the maskability of tinnitus and the type of RI did not depend on the type of stimulation used, with a Kappa coefficient of agreement of 0.69.
Conclusion: BCU stimulation of the inner ear may inhibit tinnitus by targeting the basal part of the cochlea, where tinnitus is most likely to occur. BCU stimulation leads to longer inhibition in tinnitus compared to sound stimulation.

Keywords

  1. De Ridder D, Schlee W, Vanneste S, Londero A, Weisz N, Kleinjung T, et al. Tinnitus and tinnitus disorder: Theoretical and operational definitions (an international multidisciplinary proposal). Prog Brain Res 2021; 260: 1-25.
  2. McCormack A, Edmondson-Jones M, Somerset S, Hall D. A systematic review of the reporting of tinnitus prevalence and severity. Hear Res 2016; 337: 70-9.
  3. Langguth B, Kreuzer PM, Kleinjung T, De Ridder D. Tinnitus: Causes and clinical management. Lancet Neurol 2013; 12(9): 920-30.
  4. Kaltenbach JA. Neurophysiologic mechanisms of tinnitus. J Am Acad Audiol 2000; 11(3): 125-37.
  5. Eggermont JJ, Roberts LE. The neuroscience of tinnitus. Trends Neurosci 2004; 27(11): 676-82.
  6. Poremski T, Kostek B. Tinnitus therapy based on high-frequency linearization principles-preliminary results. Archives of Acoustics 2012; 37(2): 161-70.
  7. Tucker K. The efficacy of ultra-high frequency bone conduction stimulation for the treatment of tinnitus. London, ON, Canada: University of Western Ontario, School of Communication Sciences and Disorders. 2010.
  8. Labree B, Hoare DJ, Gascoyne LE, Scutt P, Del Giovane C, Sereda M. Determining the effects of transcranial direct current stimulation on tinnitus, depression, and anxiety: A systematic review. Brain Sci 2022; 12(4): 484.
  9. Martins ML, Souza DDS, Cavalcante MEOB, Barboza HN, de Medeiros JF, Dos Santos Andrade SMM, et al. Effect of transcranial Direct Current Stimulation for tinnitus treatment: A systematic review and meta-analysis. Neurophysiol Clin 2022; 52(1): 1-16.
  10. Jastreboff PJ, Hazell JWP. Tinnitus retraining therapy: Implementing the neurophysiological model. Cambridge, UK: Cambridge University Press; 2008.
  11. Henry JA, Meikle MB. Psychoacoustic measures of tinnitus. J Am Acad Audiol 2000; 11(3): 138-55.
  12. Koizumi T, Nishimura T, Yamashita A, Yamanaka T, Imamura T, Hosoi H. Residual inhibition of tinnitus induced by 30-kHz bone-conducted ultrasound. Hear Res 2014; 310: 48-53.
  13. Roberts LE, Moffat G, Baumann M, Ward LM, Bosnyak DJ. Residual inhibition functions overlap tinnitus spectra and the region of auditory threshold shift. J Assoc Res Otolaryngol 2008; 9(4): 417-35.
  14. Roberts LE, Moffat G, Bosnyak DJ. Residual inhibition functions in relation to tinnitus spectra and auditory threshold shift. Acta Otolaryngol Suppl 2006; (556): 27-33.
  15. Lenhardt ML. Ultrasonic hearing in humans: Applications for tinnitus treatment. Int Tinnitus J 2003; 9(2): 69-75.
  16. Nishimura T, Okayasu T, Uratani Y, Fukuda F, Saito O, Hosoi H. Peripheral perception mechanism of ultrasonic hearing. Hear Res 2011; 277(1-2): 176-83.
  17. Nishimura T, Nakagawa S, Sakaguchi T, Hosoi H. Ultrasonic masker clarifies ultrasonic perception in man. Hear Res 2003; 175(1-2): 171-7.
  18. Dieroff HG, Ertel H. Some thoughts on the perception of ultrasonics by man. Arch Otorhinolaryngol 1975; 209(4): 277-90.
  19. Hosoi H, Imaizumi S, Sakaguchi T, Tonoike M, Murata K. Activation of the auditory cortex by ultrasound. Lancet 1998; 351(9101): 496-7.
  20. Imaizumi S, Hosoi H, Sakaguchi T, Watanabe Y, Sadato N, Nakamura S, et al. Ultrasound activates the auditory cortex of profoundly deaf subjects. Neuroreport 2001; 12(3): 583-6.
  21. Corso JF. Erratum: Bone-conduction thresholds for sonic and ultrasonic frequencies [J. Acoust Soc Am; 1963: 35(11): 1738-43
  22. Shulman A, Strashun AM, Avitable MJ, Lenhardt ML, Goldstein BA. Ultra-high-frequency acoustic stimulation and tinnitus control: A positron emission tomography study. Int Tinnitus J 2004; 10(2): 113-25.
  23. Nascimento IDP, Almeida AA, Diniz JJ, Martins ML, Freitas TMMW, Rosa MRDD. Tinnitus evaluation: Relationship between pitch matching and loudness, visual analog scale and tinnitus handicap inventory. Braz J Otorhinolaryngol 2019; 85(5): 611-6.
  24. Ryota S. Hearing aids. In: Stavros H, Andrea C, editors. An excursus into hearing loss. Rijeka, Croatia: IntechOpen; 2018.
  25. Lenhardt ML, Richards DG, Madsen AG, Goldstein BA, Shulman A, Guinta R. Measurement of bone conduction levels for high frequencies. Int Tinnitus J 2002; 8(1): 9-12.
  26. Lenhardt ML, Goldstein BA, Shulman A, Guinta R. Use of high-frequency and muscle vibration in the treatment of tinnitus. Int Tinnitus J 2003; 9(1): 32-6.
  27. Goldstein BA, Lenhardt ML, Shulman A. Tinnitus improvement with ultra-high-frequency vibration therapy. Int Tinnitus J 2005; 11(1): 14-22.
  28. Goldstein BA, Shulman A, Lenhardt ML. Ultra-high-frequency ultrasonic external acoustic stimulation for tinnitus relief: A method for patient selection. Int Tinnitus J 2005; 11(2): 111-4.
  29. Carrick DG, Davies WM, Fielder CP, Bihari J. Low-powered ultrasound in the treatment of tinnitus: A pilot study. Br J Audiol 1986; 20(2): 153-5.
  30. Rendell RJ, Carrick DG, Fielder CP, Callaghan DE, Thomas KJ. Low-powered ultrasound in the inhibition of tinnitus. Br J Audiol 1987; 21(4): 289-93.