1. Mean audiogram of right ears Mean audiogram of left ears
Incidence of somatic tinnitus in current ENT practice Katharina Ostermann, Marie Paule Thill, Yves Vincent, Marie Emmanuelle Debaty, Philippe Cotton, Philippe Lurquin Department of Otology, CHU Saint Pierre, Bruxelles, Belgium
Summary
Somatic tinnitus and the modulation of tinnitus by somato-sensory inputs has been largely described (Levine 1994, Shore & coll 2007). The hypothesis of its origin seemed to be correlated with activity increase in the Dorsal Cochlear Nucleus (Kaltenbach 2008, Eggermont 2008). In this study we intend to establish the incidence of somatic tinnitus and particularly facial dysesthesis among a group of tinnitus sufferers.
Methods
We present the results of more than 70 patients that followed the Tinnitus Retraining Therapy (TRT) protocol. All patients fulfilled the structured interview (Jastreboff 2002) and were furthermore questioned on the presence of facial dysesthesis or pain, the type of abnormal sensation, the possibility to modulate tinnitus by any somatic modification, the type of modulation obtained, We have evaluated the facial dysesthesis complaint by means of a visual analogic scale.
Hyperactivity of the dorsal cochlear nucleus in absence of auditory stimulation
Mean audiogram of right ears
(bilateral tinnitus)
Mean audiogram of left ears
Results
56 % of all tinnitus patients presented a somatic tinnitus.
● Somatic tinnitus
● Non somatic tinnitus
Population with somatic tinnitus within the whole tinnitus patient sample
● Complaining
● Non complaining
30 % of all tinnitus patients were complaining of their somatic tinnitus.
Population with somatic tinnitus within the whole tinnitus patient sample which had a complaint of facial dysesthesis
Somato-sensory stimulation led in 95 % of cases to an increase of tinnitus perception or tinnitus frequency.
Association between facial dysesthesis and tinnitus
Totally
Frequently
Regularly
A little bit
No, it is independent
80 % of our patients considered that the subjective intensity of tinnitus was directly correlated to the importance of facial dysesthesis.
Conclusion
Somatic tinnitus is a much more frequent condition than earlier believed. There are two types of somatic tinnitus: Tinnitus that can be modulated in intensity and/or frequency by manipulating some regions of the head and neck and tinnitus which is associated with facial pain or dysesthesis. Therefore we suggest a modification of the initial interview questionnaire or the Structured Interview that includes specific questions on somatic tinnitus.