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Otolithic Dysfunction in Normal-Hearing Individuals With Tinnitus
Aishwarya Nagarajan1, Sujeet Kumar Sinha2
1Department of Audiology, All India Institute of Speech and Hearing (Recognized Research Centre under University of Mysore), Mysuru, Karnataka, India; and.
Ear and Hearing
|June 9, 2026
Summary
Normal-hearing individuals with tinnitus show vestibular abnormalities, particularly in the peripheral vestibular system. Longer tinnitus duration correlates with increased vestibular deterioration, suggesting vestibular evoked myogenic potentials (VEMPs) as a clinical biomarker.
Area of Science:
- Neuroscience
- Otolaryngology
- Audiology
Background:
- Tinnitus, often experienced by normal-hearing individuals, can indicate underlying cochleovestibular lesions.
- The auditory and vestibular systems are anatomically integrated, necessitating a dual approach to tinnitus assessment.
- Otolith organs, part of the vestibular system, may play a crucial role in tinnitus etiology.
Purpose of the Study:
- To investigate vestibular involvement in normal-hearing individuals with tinnitus.
- To assess sacculo-collic, utriculo-ocular, and vestibulo-masseteric reflex pathways.
- To determine if vestibular evoked myogenic potentials (VEMPs) can identify vestibular abnormalities in tinnitus patients.
Main Methods:
- Compared 35 normal-hearing individuals with unilateral tinnitus (Group I) to 35 normal-hearing controls (Group II).
- Recorded cervical, ocular, and masseter VEMPs in all participants.
- Assessed tinnitus duration and handicap using the Tinnitus Handicap Inventory.
Main Results:
- Group I exhibited significantly reduced VEMP amplitudes in tinnitus ears compared to non-tinnitus ears and Group II.
- Higher interaural amplitude asymmetry ratios for all three VEMP types were observed in Group I.
- A negative correlation was found between tinnitus duration and VEMP amplitudes/asymmetry.
Conclusions:
- Peripheral vestibular apparatus abnormalities are evident in normal-hearing individuals with tinnitus.
- Progressive peripheral vestibular deterioration is linked to longer tinnitus duration.
- Cervical, ocular, and masseter VEMPs serve as reliable clinical biomarkers for peripheral vestibular abnormalities in tinnitus.
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When we hear a sound, our nervous system is detecting sound waves—pressure waves of mechanical energy traveling through a medium. The frequency of the wave is perceived as pitch, while the amplitude is perceived as loudness.
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