OBJECTIVE: To study the clinical characteristics of early tinnitus in patients with sudden deafness. METHOD: Forty-seven patients with sudden deafness and early tinnitus recieved subjective review and filled out classified questionnaire of tinnitus. By pure tone audiometry and tinnitus matching test, we obtain the distribution, quantity and matching loudness of tinnitus patients. RESULT: (1) Objective examination: the most common frequencies of tinnitus were 8000 Hz and 4000 Hz. The most common numbers were two frequencies. The matching loudness was (16.63 ± 8.37) dB. (2) Subjective examination: the tinnitus was monotone (74.0%), sustained (89.0%), third level loudness (45.0%), third level annoying (60.0%), high frequency (83.0%), sound of cicadas (66.7%). The most influencing factors were hearing (28.2%) and mood (29.5%). (3) Relationship between tinnitus and pure tone hearing threshold curve: there was a significant correlation between the frequency of pure tone audiometry and the matching loudness of tinnitus (r = -0. 370, P < 0.01). There was no significant correlation between the frequency of pure tone tinnitus and the matching loudness of tinnitus (r = -0.083, P > 0.05). CONCLUSION (1) The results of subjective examination were consistent with those of objective examination. (2) The tinnitus should be considered in the early treatment of sudden deafness.
Audiometry, Pure-Tone ; Hearing Loss, Sudden ; pathology ; Humans ; Tinnitus ; pathology

We present the case of a patient who developed pulsatile tinnitus that was found to be associated with a petrous carotid aneurysm. The aneurysm was successfully obliterated using stent-assisted coiling, after which the patient was symptom-free. Although aneurysms arising from the petrous segment of the internal carotid artery are rare, this pathology must be considered as a causative factor in patients with pulsatile tinnitus. Endovascular treatment appears to have been successful in resolving the symptoms associated with this pathology.
Aneurysm* ; Carotid Artery, Internal ; Embolization, Therapeutic ; Humans ; Pathology ; Tinnitus*

OBJECTIVE: To analysis the characteristics of sudden sensorineural hearing loss (SSHL) patients with tinnitus, and explore the relationship of characteristics of tinnitus and audiology. METHOD: Patients diagnosed as SSHL with tinnitus were studied in the research. All patients' clinical features were analyzed, such as tinnitus frequency, pure tone audiometry, tinnitus, hearing loss degree, results of residual inhibition test. RESULT: Thirty cases were identified as mild degree hearing loss, 13 cases as moderate degree, 28 cases as severe degree and 34 cases as profound degree. And hearing impaired frequency of 13 cases was ascertained at low-frequency, 39 cases at middle-high-frequency, and 53 cases at full-range-frequency. The incidence of patients with low-frequency was about 41. 9% (44/105), and it was about 21. 9% (23/105) in those with middle-frequency. And it was 36. 2% (38/105) in cases of high-frequency tinnitus. The chi-square test show statistically significant differences between patients with the low-frequency, middle-frequency and high-frequency of the hearing loss (P<0. 05). In tinnitus residual inhibition test, positive rate of convergence type masking curve was about 72.0%, tinnitus separated type masking curve 20.0%, overlapping type was 57.9%, and the spacing type was 43.5%. There was a statistically significant difference among cases with different type masking curve (P<0. 05)with the spacing residual inhibition test positive rate. CONCLUSION There are individual differences of clinical characteristics among SSHL patients with tinnitus. Tinnitus frequency is consistent with the frequency of hearing loss. Patients had the more serious the degree of hearing loss, who had more serious tinnitus grading. Cases with the converged type curve will be fit for tinnitus masking. Therefore, combining the tinnitus detection with the audiological tests, we could obtain the clinical characteristics of SSHL patients with tinnitus.
Audiometry, Pure-Tone ; Deafness ; Hearing Loss ; Hearing Loss, Sensorineural ; complications ; pathology ; Humans ; Tinnitus ; complications ; pathology

OBJECTIVE: To describe the anatomy,radiographic manifestation, and surgical treatment of pulsatile tinnitus due to sigmoid sinus diverticulum. METHOD: The retrospectively study of diagnosis,clinical and radiographic manifestations,and surgical treatment of 2 cases of pulsatile tinnitus caused by sigmoid sinus diverticulum was carried out. RESULT: Bony defect was found in the anterior sigmoid wall in both cases, and one of them was combined with invasion of soft tissues in mastoid cells. Both of them undertook a surgery to reconstruct sinus wall and received a satisfactory results. CONCLUSION Sigmoid sinus diverticulum is one of causes which lead to pulsatile tinnitus. It can be identified by imaging examination and can be cured by sinus wall reconstruction.
Adult ; Diverticulum ; complications ; Female ; Humans ; Male ; Meninges ; Retrospective Studies ; Tinnitus ; etiology ; pathology ; surgery

A 27-year-old female patient suffering endolymphatic sac tumor with intralabyrinthine hemorrhage was reported. The patient had hearing loss in the left ear with continuous tinnitus, and MRI showed the soft tissue shadow of endolymphatic sac. Considering that the tumor involved semicircular canal and vestibule,endolymphatic cyst tumor resection was performed by labyrinth route. After surgery, there was no cerebrospinal fluid leakage and facial nerve function was normal. More importantly, enhanced MRI of temporal bone showed no tumor recurrence 1 year after surgery.
Female ; Humans ; Adult ; Endolymphatic Sac/surgery* ; Neoplasm Recurrence, Local/pathology* ; Labyrinth Diseases ; Tinnitus ; Ear Neoplasms/pathology* ; Bone Neoplasms ; Hemorrhage

OBJECTIVE: To evaluate the clinical utility of MR imaging of the temporal bone in patients with facial and audiovestibular dysfunction with particular emphasis on the importance of contrast enhancement. MATERIALS AND METHODS: We retrospectively reviewed the MR images of 179 patients [72 men, 107 women; average age, 44 (range, 1-77) years] who presented with peripheral facial palsy (n=15), audiometrically proven sensorineural hearing loss (n=104), vertigo (n=109), or tinnitus (n=92). Positive MR imaging findings possibly responsible for the patients' clinical manifestations were categorized according to the anatomic sites and presumed etiologies of the lesions. We also assessed the utility of contrast-enhanced MR imaging by analyzing its contribution to the demonstration of lesions which would otherwise not have been apparent. All MR images were interpreted by two neuroradiologists, who reached their conclusions by consensus. RESULTS: MR images demonstrated positive findings, thought to account for the presenting symptoms, in 78 (44%) of 179 patients, including 15 (100%) of 15 with peripheral facial palsy, 43 (41%) of 104 with sensorineural hearing loss, 40 (37%) of 109 with vertigo, and 39 (42%) of 92 with tinnitus. Thirty (38%) of those 78 patients had lesions that could be confidently recognized only at contrastenhanced MR imaging. CONCLUSION: Even though its use led to positive findings in less than half of these patients, MR imaging of the temporal bone is a useful diagnostic procedure in the evaluation of those with facial and audiovestibular dysfunction. Because it was only at contrast-enhanced MR imaging that a significant number of patients showed positive imaging findings which explained their clinical manifestations, the use of contrast material is highly recommended.
Adult ; Contrast Media ; Facial Paralysis/*pathology ; Female ; Hearing Loss, Sensorineural/*pathology ; Human ; *Magnetic Resonance Imaging ; Male ; Temporal Bone/*pathology ; Tinnitus/*pathology ; Vertigo/*pathology

Primary meningioma of jugular foramen is extremely rare, while paraganglioma or nerve sheath tumor are relatively common in jugular foramen. We reported a case of primary meningioma of jugular foramen. A 79-year-old female who had left tinnitus and hearing loss for three month came to the department of otorhinolaryngology. Temporal bone computed tomography scan showed sclerotic change and slightly irregular margins of left jugular foramen with relatively preservation of bony architecture. Temporal bone magnetic resonance image showed well defined homogeneous enhancing mass in left jugular foramen with extension to carotid space on gadolinium enhanced T1 weighted image. Prominent dural tail was also noted. On T2 weighted image, this mass showed intermediated signal intensity with no vascular signal voids. Meningioma was confirmed by pathology. In this article, we describe a case of primary en plaque meningioma of jugular foramen and review image findings of differential diagnosis.
Aged ; Diagnosis, Differential* ; Female ; Gadolinium ; Glomus Jugulare Tumor ; Hearing Loss ; Humans ; Meningioma* ; Neurilemmoma ; Otolaryngology ; Paraganglioma ; Pathology ; Tail ; Temporal Bone ; Tinnitus

OBJECTIVES: The aim of the present study was to evaluate the internal auditory canal (IAC) and the nerves inside it to define possible structural differences in cases with subjective tinnitus of unknown origin. METHODS: Cases applying to the ear, nose and throat department with the complaint of tinnitus with unknown origin and having normal physical examination and test results were included in the study (n=78). Patients admitted to the radiology clinic for routine cranial magnetic resonance imaging (MRI) and whose MRI findings revealed no pathologies were enrolled as the control group (n=79). Data for the control group were obtained from the radiology department and informed consent was obtained from all the patients. Diameters of the IAC and the nerves inside it were measured through enhanced images obtained by routine temporal bone MRIs in all cases. Statistical evaluations were performed using Student t-test and statistical significance was defined as P<0.05. RESULTS: Measurements of IAC diameters revealed statistically significant differences between the controls and the tinnitus group (P<0.05). Regarding the diameters of the cochlear nerve, facial nerve, inferior vestibular nerve, superior vestibular nerve, and total vestibular nerve, no statistically significant difference was found between the controls and the tinnitus group. CONCLUSION: Narrowed IAC has to be assessed as an etiological factor in cases with subjective tinnitus of unknown origin.
Cochlear Nerve ; Ear ; Facial Nerve ; Humans ; Informed Consent ; Magnetic Resonance Imaging ; Nose ; Pathology ; Pharynx ; Physical Examination ; Temporal Bone ; Tinnitus* ; Vestibular Nerve

BACKGROUND: Infections and vascular disorders are the two most widely accepted probable causes of sudden hearing loss. Tumor necrosis factor alpha (TNF-alpha) is major pro-inflammatory cytokine that is thought to be important in the pathogenesis of sudden deafness. However, the functions of genetic polymorphism in this cytokine have not been throughly examined in the context of sudden deafness pathology. In an effort to discover polymorphism in genes whose variants have been implicated in sudden deafness phenotypes, we examined the genetic effects of TNF-alpha polymorphisms in Koreans with sudden deafness. METHODS: Two common single nucleotide polymorphism (SNP) in TNF-alpha gene were genotyped in a Korean sudden deafness. Ninety nine patients with sudden deafness (45 males and 54 females) were selected from Keimyung University Dongsan Medical Center. The control subjects consisted of healthy 285 males and 319 females. RESULTS: Human genomic DNA was extracted from peripheral blood sample. The SNP at position -863 C/A and -857 C/T of TNF-alpha promoter were analyzed by PCR and pyrosequencing. Genotype distribution and allele frquencies in subjects were in Hardy-Weinberg equilibrium (p>0.05). No significant association was found between TNF-alpha -863 C/A and -857 C/T polymorphism and sudden deafness. We examined whether the relation between TNF-alpha polymorphism and sudden deafness varied according to tinnitus. Statistical analysis of TNF-alpha polymorphism at -857 C/T showed that there was a significant difference between SD without tinnitus and the control in both genotype distribution (p<0.05) and allele frequency [OR (95% CI)=2.63 (1.29-5.34)], but not between SD with tinnitus. CONCLUSION: These findings suggest TNF-alpha polymorphisms at -863C/A, -857 C/T are likely to play a role in SD.
Alleles ; DNA ; Female ; Gene Frequency ; Genotype ; Hearing Loss, Sudden* ; Humans ; Male ; Pathology ; Phenotype ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide* ; Tinnitus ; Tumor Necrosis Factor-alpha*

BACKGROUND AND OBJECTIVES: Tinnitus is one of the most obscure otological pathologies. There is no universally proved treatment modality for tinnitus. Intratympanic lidocaine injection is one of the therapeutic trials. In this study, authors investigated the effects of intratympanically delivered lidocaine on the auditory system in humans. MATERIALS AND METHODS: Two percent of 0.25 cc lidocaine was delivered intratympanically to the affected ears in 5 normal hearing patients with unilateral tinnitus. We assessed auditory function by pure tone audiometry, tympanometry, tinnitus study, auditon evoked otoacoustic emissions, and ABR to observe possible druge Rects in the auditory system. In all five patients, saline was injected to the other intact ear for control purposes. RESULTS: Saline injection did not create significant changes in any of the measures. Intratympanic lidocaine injection did not make any differences between pre- and post-injection audiologic tests except otoacoustic emissions and tinnitus study. It suppressed otoacoustic emmisions and reduced loudness of tinnitus by 10 dB. Lidocaine injection did not cause any changes in latencies or amplitudes in the auditory brainstem response (ABR). CONCLUSION: These results suggest that intratympanically delivered lidocaine has an effect on the organ of Corti structures in human subjects without significantly affecting the auditory nerve or the central auditory pathways. Further investigations on the concentration and volume of intratympanically delivered lidocaine should be made in order to manage patients with tinnitus clinically.
Acoustic Impedance Tests ; Audiometry ; Auditory Pathways ; Cochlear Nerve ; Ear ; Evoked Potentials, Auditory, Brain Stem ; Hearing ; Humans ; Lidocaine* ; Organ of Corti ; Pathology ; Tinnitus* ; Tympanic Membrane