OBJECTIVES: The goal of the present study was to evaluate the reliability and validity of the Korean version of the tinnitus handicap questionnaire (THQ-K). METHODS: A total of 60 patients were included in this study. Patients responded to the THQ-K, the tinnitus handicap inventory (THI), Beck's depression index (BDI), and the visual analogue scale (VAS) for loudness and pitch, loudness match, and minimum masking level (MML) test were performed. RESULTS: Internal consistency of the THQ-K was examined using Cronbach coefficient alpha. Cronbach alpha was 0.96. The THQ-K showed a significant correlation with THI, BDI, VAS for distress, and VAS for loudness, but no significant correlation with psychoacoustic measurement of tinnitus, such as loudness match, pitch match, and MML. CONCLUSION: The THQ-K is a reliable and valid test for evaluating the degree of handicap due to tinnitus for both research and clinical use.
Depression ; Humans ; Masks ; Psychoacoustics ; Reproducibility of Results ; Tinnitus*

BACKGROUND AND OBJECTIVES: Tinnitus retraining therapy (TRT) has been presented as a new approach to tiniutus management. The aim of this paper is to show the clinical implication method of TRT in our clinic and to evaluate the therapeutic efficacy of TRT based on questionnaires and tinnitograms. MATERIALS AND METHODS: Using the clinical implication method of TRT, 60 patients with tinnitus, who visited Tinnitus Clinic, Kangnam St. Mary's Hospital from May, 1999 to July, 2001, and who had received TRT for their tinnitus, were included for the evaluation of therapeutic efficacy of TRT. Their psychoacoustic characteristics of tinnitus and changes of subjective tinnitus were analyzed. RESULTS: Loudness, awareness, annoyance and effect on life of tinnitus decreased after TRT. Tinnitus handicap score also significantly decreased (p<0.05). Forty-eight patients among the sixty patients (80%) showed relief of their tinnitus in more than 2 of 4 subjective parameters (loudness, awareness, annoyance and effect on life of tinnitus). CONCLUSION: TRT has been shown to be effective in the treatment of subjective tinnitus. Modification of TRT may be necessary for easy application of this therapy in Korea.
Humans ; Korea ; Psychoacoustics ; Surveys and Questionnaires ; Tinnitus*

BACKGROUND AND OBJECTIVES: The objective of this study was to observe whether there are differences in detecting ability of pre-pulse gaps between tinnitus patients and normal subjects. SUBJECTS AND METHOD: Ten tinnitus patients and eight normal subjects were recruited. Fifty stimuli composed of a background noise and a pulse noise were presented to the subjects. For certain stimuli, a short gap preceding the pulse noise was inserted but for others, no gaps were inserted. The two groups were subjected to a gap lasting 300 and 200 msec. The subjects were then asked if they detected the gap during the stimulus and the number of correct answers were counted. RESULTS: In the tinnitus patient group, the number of correct answers for gap-stimuli detection was significantly smaller when the gap was shortened to 200 msec. In the control group, however, there was only a slight difference in the score. When the length of the gap was shortened to 200 msec, the score significantly decreased in 50% of the tinnitus patients whereas the score increased in only 12% of the control group. CONCLUSION: The ability to detect pre-pulse gaps is affected by tinnitus in humans just as in the animal models.
Humans ; Models, Animal ; Noise ; Psychoacoustics ; Tinnitus

BACKGROUND AND OBJECTIVES: Hyperacusis is an abnormally strong reaction which occurs within auditory pathways resulting from exposure to moderate sound. More patients are inflicted with it than with tinnitus, accounting for a relatively high proportion of the total tinnitus patients. However, no single test could pass as an objective diagnostic test of hyperacusis. Among various psychoacoustic evaluations, loudness discomfort level (LDL) is frequently used in the evaluation of hyperacusis. Thus, this study aimed to demonstrate a proportion of hyperacusis in tinnitus patients and characterize LDL in hyperacusis and tinnitus patients as a diagnostic test. MATERIALS AND METHOD: Using 186 patients with tinnitus as experiment group and 35 acoustically normal persons as control group, pure tone audiometry (PTA), LDL, and dynamic range (DR) were checked. RESULTS: Amongst the total number of tinnitus patients, there were 10 hyperacusis patients (5.38%). Those hyperacusis patients had much lower LDL (73.50 dB) and DR (41.50 dB) than tinnitus patients without hyperacusis (LDL: 100.90 dB, DR: 67.20 dB) as well as the control group (LDL: 104.86 dB, DR: 93.98 dB). CONCLUSION: Hyperacusis patients consist 5.38% (10/186) and have much lower LDL than tinnitus patients without hyperacusis and the control group. There is a positive correlation between hyperacusis and LDL. Therefore, in a diagnosis of hyperacusis, it is essential to check LDL and take a careful look into the history from patients.
Audiometry ; Auditory Pathways ; Diagnosis ; Diagnostic Tests, Routine ; Humans ; Hyperacusis* ; Psychoacoustics ; Tinnitus*

BACKGROUND AND OBJECTIVES: Tinnitus retraining therapy (TRT) was introduced as a new method for tinnitus management, and it is currently an efficacious therapy in use. In this article, we would like to show the effectiveness of directive counseling in TRT on tinnitus management. MATERIALS AND METHOD: A total of 1, 100 patients who visited tinnitus clinic at the Severance Hospital from 1999 to 2002 were included in this study. Their characteristics and negative associations of tinnitus were investigated. Forty-six patients who were managed with directive counseling were evaluated with questionnaires about the psychoacoustic characteristics of tinnitus and the subjective changes in tinnitus. RESULTS: Tinnitus was developed after stress (35.6%), fatigue (32.0%) and exposure to noise (21.4%), and it was negatively associated with hearing loss (51.8%), continuation of tinnitus (51.6%) and sleep disorder (17.5%). Factors such as awareness, loudness, annoyance, the effect on life tinnitus had were decreased after directive counseling. And the tinnitus handicap inventory (THI) score was also significantly decreased. CONCLUSION: Directive counseling in TRT which includes explanation of neurophysiology of tinnitus should be tried preferentially before habituation occurs.
Directive Counseling* ; Fatigue ; Hearing Loss ; Humans ; Neurophysiology ; Noise ; Psychoacoustics ; Surveys and Questionnaires ; Tinnitus*

BACKGROUND AND OBJECTIVES: Knowledge about the incidence and clinical characteristics of tinnitus can be useful for diagnostic approach and treatment plan. We analyzed the incidence and clinical characteristics of each case of tinnitus according to the classification of tinnitus. SUBJECTS AND METHOD: The study recruited 211 tinnitus patients who visited tinnitus clinic from March 2009 to August 2009. First, patients were diagnosed and classified as sensorineural tinnitus and somatosounds. Somatosounds were subdivided to vascular tinnitus, muscle origin tinnitus and patulous Eustachian tube. Patients were evaluated by history taking by means of having them fill out tinnitus questionnaires and psychoacoustic questionnaires. Audiologic findings of each type of tinnitus have also been analyzed. RESULTS: Incidences of sensorineural tinnitus and somatosounds were 82.9% and 17.1% respectively. Among somatosounds, vascular tinnitus occupied 7.6%, muscle origin tinnitus, 4.3% and patulous Eustachian tube, 5.2%. The mean age of the patients with sensorineural tinnitus was older than somatosounds. Patients with muscle origin tinnitus had higher scores of tinnitus loudness, effect on life, tinnitus handicap inventory, stress and depression than those with other types of tinnitus. Overall compliance of the treatment was 66.7% and their tinnitus had been significantly improved after treatment. CONCLUSION: With the knowledge of incidence, clinical characteristics and treatment approach for each tinnitus, clinicians can be more confident in providing proper diagnosis and management of patients with tinnitus. Somatosounds, which showed relatively high incidence in this study, should not be neglected but properly treated with early diagnosis.
Compliance ; Depression ; Early Diagnosis ; Eustachian Tube ; Humans ; Incidence ; Muscles ; Psychoacoustics ; Surveys and Questionnaires ; Tinnitus

BACKGROUND AND OBJECTIVES: It is not uncommon in patients with benign vocal fold lesions with voice change to accompany sulcus. The authors postulated that the coexistence of such benign lesions with sulcus would result in numerous problems related with phonation. The aim of this study was to recognize through voice analysis any particular phonation characteristics in patients with benign vocal fold lesions with coexisting sulcus, and to aid in diagnosis and treatment. MATERIALS AND METHOD: The study involved 574 patients who had been diagnosed with benign vocal fold lesions that accompanied voice change from Jan. 2001 through Sept. 2002. The diagnosis was made by videostroboscopy. The benign vocal fold lesions were observed in patients with sulcus and those without sulcus. Also specific benign vocal fold lesions were grouped into pairs determined by the existence of sulcus. Thus, patients with vocal nodules accompanied with sulcus were grouped as group NS and those without sulcus as group N: similarly, patients with vocal polyp and sulcus were grouped as PS and those without sulcus as group P: patients with Reinke's edema and sulcus as group RS and those without sulcus as group R, and patients with laryngeal edema and sulcus were grouped as group LS and without sulcus as group L. Each individual group went through psychoacoustic, acoustic and aerodynamic analyses and were compared against each other. RESULTS: Among patients with benign vocal fold lesions, about 50.2% had sulcus. It was observed that the rate of finding patients with sulcus increased when we began to have keen interest in sulcus. Among patients with benign vocal fold lesions without the accompaniment of sulcus, the most common form of benign vocal fold lesions was the vocal nodule. With coexisting sulcus, the most common form was laryngeal edema. In the psychoacoustic analysis group, the group NS exhibited more hoarseness than the group N: the group R exhibited greater hoarseness than the group RS. However, these results did not have statistical significance. In the acoustic analysis, the group NS had significantly higher shimmer score than the group N. In the aerodynamic analysis, the group NS and PS had exhibited significanlyt higher MFR scores than the groups N and P. CONCLUSIONS: The existence of sulcus in patients with benign vocal fold lesions has a clinical significance regarding treatment and prognosis. Although some acoustic analytic references may be useful in discovering the accompanying sulcus, careful observation of all vocal cords remains the most important component of such discoveries.
Acoustics ; Diagnosis ; Edema ; Hoarseness ; Humans ; Laryngeal Edema ; Phonation ; Polyps ; Prognosis ; Psychoacoustics ; Vocal Cords* ; Voice

OBJECTIVES: To evaluate objectively the effect and utility of voice therapy which uses acoustic analysis and aerodynamic assessment, in addition to psychoacoustic analysis, as an initial treatment for patients with vocal nodules. MATERIALS AND METHODS: Eighteen females and 14 males with vocal nodules were treated by voice therapy. The results of pre-treatment and post-treatment were compared with each other after the following analyses: acoustic analysis by measuring relative average pertubation (RAP) and shimmer; aerodynamic assessments by measuring S to Z ratio and maximum phonation time, and psychoacoustic analysis by using the GRBAS scales. RESULTS: All measurements of post-treatment improved significantly. The post-treatment results of children showed better improvement in shimmer, relative average pertubation and MPT, compared to those of adult patients. No significant difference in improvement could be found between male and female patients. CONCLUSION: Voice therapy may serve as one primary treatment modality in vocal nodule patients.
Acoustics ; Adult ; Child ; Female ; Humans ; Male ; Phonation ; Psychoacoustics ; Voice* ; Weights and Measures

OBJECTIVE: Tried to find the relationship between tinnitus and each testing method, provided information for objective diagnosis and treatment for tinnitus patients with sensorineural hearing loss. METHOD: The characteristics of audiology tests, including pure tone audiometric, acoustic immittance, middle ear muscle reflexes, matching test, distortion products otoacoustic emission(DPOAE) were compared in 79 ears of 69 tinnitus patients with sensorineural hearing loss. RESULT: The RI positive rate was higher in Convergence curve in tinnitus patients of sensorineural hearing loss, with the rate being 51.3%. The detection rates of DPOAE were 15.2% in patients of sensorineural hearing loss tinnitus groups, which were significant lower than those in control group. CONCLUSION Psychoacoustic techniques can produce a useful amount of clinical data regarding tinnitus in different aspects, these data can help clinicians design needed based managements. DPOAE test is helpful for the diagnosis of lesions in some tinnitus patients.
Audiometry, Pure-Tone ; Hearing Loss, Sensorineural ; complications ; physiopathology ; Hearing Tests ; methods ; Humans ; Otoacoustic Emissions, Spontaneous ; Psychoacoustics ; Tinnitus ; complications ; physiopathology

OBJECTIVE: To investigate the effect of early scream sound stress on the ability of spatial learning and memory, the levels of norepinephrine (NE) and corticosterone (CORT) in serum, and the morphology of adrenal gland.
 METHODS: Female Sprague-Dawley (SD) rats were treated daily with scream sound from postnatal day 1(P1) for 21 d. Morris water maze was used to measure the spatial learning and memory ability. The levels of serum NE and CORT were determined by radioimmunoassay. Adrenal gland of SD rats was collected and fixed in formalin, and then embedded with paraffin. The morphology of adrenal gland was observed by HE staining.
 RESULTS: Exposure to early scream sound decreased latency of escape and increased times to cross the platform in Morris water maze test (P<0.05). The levels of serum NE was significantly elevated, with an obvious tendency in the increase of CORT level (P<0.05). The morphology of adrenal gland was also influenced. 
 CONCLUSION Newborn female rats subjected to scream sound stress can enhance spatial learning and memory ability in adulthood, which is related to activation of the hypothalamo-pituitary-adrenal axis and sympathetic nervous system.
Adrenal Glands ; anatomy & histology ; Animals ; Corticosterone ; blood ; Female ; Maze Learning ; Memory ; Norepinephrine ; blood ; Psychoacoustics ; Rats ; Rats, Sprague-Dawley ; Stress, Psychological ; Vocalization, Animal