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What Makes Tinnitus Loud?

Natalia Yakunina1, Eui-Cheol Nam2

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Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
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Summary

Tinnitus loudness perception is influenced by hearing loss for objective measures and by psycho-emotional factors for subjective loudness. Hearing aids may reduce objective tinnitus loudness, while psychological approaches can help with perceived loudness.

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Area of Science:

  • Audiology
  • Otolaryngology
  • Psychology

Background:

  • Tinnitus loudness is a common patient complaint but doesn't always correlate with severity or life impact.
  • Factors influencing tinnitus loudness, a phantom sound perception, are not well understood.
  • Objective and subjective loudness measures may differ significantly in tinnitus patients.

Purpose of the Study:

  • To investigate factors influencing both objective (matched loudness, minimal masking level) and subjective (visual analog scale loudness) measures in chronic tinnitus patients.
  • To analyze the relationship between loudness perception and demographic, audiometric, and psycho-emotional characteristics.
  • To differentiate the drivers of objective versus subjective tinnitus loudness.

Main Methods:

  • Enrolled 299 chronic tinnitus patients.
  • Assessed matched loudness, minimal masking level (MML), and visual analog scale (VAS) loudness.
  • Utilized stepwise multiple regression and bivariate correlations to analyze influencing factors including age, sex, hearing loss (pure-tone average), tinnitus pitch, Tinnitus Handicap Inventory (THI) score, and depression scores.

Main Results:

  • Objective loudness measures (matched loudness, MML) strongly correlated with hearing deficit and tinnitus pitch.
  • Subjective loudness (VAS) showed minimal correlation with objective measures but was significantly related to psycho-emotional factors like THI score, VAS annoyance, daily duration, disturbance, and depression.
  • Psychoacoustic measures were influenced by hearing loss and tinnitus pitch, while self-perceived loudness was linked to psychological distress.

Conclusions:

  • Objective tinnitus loudness is primarily driven by hearing loss and related factors, suggesting hearing aids as a potential intervention.
  • Subjective tinnitus loudness is more closely tied to psycho-emotional factors, indicating that psychological interventions may be more effective for perceived loudness.
  • Differentiating between objective and subjective loudness is crucial for tailoring effective tinnitus management strategies.