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Hearing Disorders: HELP
Articles by Richard S. Tyler
Based on 37 articles published since 2009
(Why 37 articles?)
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Between 2009 and 2019, R. Tyler wrote the following 37 articles about Hearing Disorders.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline Clinical practice guideline: tinnitus executive summary. 2014

Tunkel, David E / Bauer, Carol A / Sun, Gordon H / Rosenfeld, Richard M / Chandrasekhar, Sujana S / Cunningham, Eugene R / Archer, Sanford M / Blakley, Brian W / Carter, John M / Granieri, Evelyn C / Henry, James A / Hollingsworth, Deena / Khan, Fawad A / Mitchell, Scott / Monfared, Ashkan / Newman, Craig W / Omole, Folashade S / Phillips, C Douglas / Robinson, Shannon K / Taw, Malcolm B / Tyler, Richard S / Waguespack, Richard / Whamond, Elizabeth J. ·Otolaryngology-Head and Neck Surgery, Johns Hopkins Outpatient Center, Baltimore, Maryland, USA dtunkel@jhmi.edu. · Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA. · Partnership for Health Analytic Research, LLC, Los Angeles, California, USA. · Department of Otolaryngology, State University of New York Downstate Medical Center, Brooklyn, New York, USA. · New York Otology, New York, New York, USA. · Department of Research and Quality Improvement, American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA. · Divisions of Rhinology & Sinus Surgery and Facial Plastic & Reconstructive Surgery, University of Kentucky, Lexington, Kentucky, USA. · Department of Otolaryngology, University of Manitoba, Winnipeg, MB, Canada. · Department of Otolaryngology, Tulane University, New Orleans, Louisiana, USA. · Division of Geriatric Medicine and Aging, Columbia University, New York, New York, USA. · National Center for Rehabilitative Auditory Research, Portland VA Medical Center, Portland, Oregon, USA. · ENT Specialists of Northern Virginia, Falls Church, Virginia, USA. · Ochsner Health System, Kenner, Louisiana, USA. · Mitchell & Cavallo, P.C., Houston, Texas, USA. · Department of Otology and Neurotology, The George Washington University, Washington, DC, USA. · Department of Surgery, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA. · Morehouse School of Medicine, East Point, Georgia, USA. · Department of Head and Neck Imaging, Weill Cornell Medical Center, NewYork-Presbyterian Hospital, New York, New York, USA. · Department of Psychiatry, University of California, San Diego, La Jolla, California, USA. · Department of Medicine, UCLA Center for East-West Medicine, Los Angeles, California, USA. · Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA. · Department of Surgery, University of Alabama School of Medicine, Birmingham, Alabama, USA. · Consumers United for Evidence-based Healthcare, Fredericton, New Brunswick, Canada. ·Otolaryngol Head Neck Surg · Pubmed #25274374.

ABSTRACT: The American Academy of Otolaryngology--Head and Neck Surgery Foundation (AAO-HNSF) has published a supplement to this issue featuring the new Clinical Practice Guideline: Tinnitus. To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose, and key action statements. The 13 recommendations developed address the evaluation of patients with tinnitus, including selection and timing of diagnostic testing and specialty referral to identify potential underlying treatable pathology. It will then focus on the evaluation and treatment of patients with persistent primary tinnitus, with recommendations to guide the evaluation and measurement of the impact of tinnitus and to determine the most appropriate interventions to improve symptoms and quality of life for tinnitus sufferers.

2 Editorial Special issue: cochlear implant research from the University of Iowa. 2010

Gantz, Bruce / Tyler, Richard S. · ·J Am Acad Audiol · Pubmed #20085194.

ABSTRACT: -- No abstract --

3 Review Effect of Transcranial Direct Current Stimulation in Patients With Tinnitus: A Meta-Analysis and Systematic Review. 2018

Wang, Tang-Chuan / Tyler, Richard S / Chang, Ta-Yuan / Chen, Jui-Cheng / Lin, Chia-Der / Chung, Hsiung-Kwang / Tsou, Yung-An. ·1 Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan. · 2 College of Medicine, China Medical University, Taichung, Taiwan. · 3 Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA. · 4 Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan. · 5 Department of Neurology, China Medical University Hospital, Taichung, Taiwan. ·Ann Otol Rhinol Laryngol · Pubmed #29192507.

ABSTRACT: OBJECTIVES: Subjective tinnitus is a phantom sensation experienced without any external source of sound that profoundly impacts the quality of life. Some investigations have claimed that transcranial direct current stimulation (tDCS) reduces tinnitus, but studies on tDCS have demonstrated variable results. This meta-analysis aimed to examine the effect of tDCS on patients with tinnitus. METHODS: We searched for articles published through January 5, 2016, in Medline, Cochrane, EMBASE, and Google Scholar using the following keywords: tinnitus, transcranial direct current stimulation, and tDCS. The study outcomes were change in magnitude estimates of loudness (loudness), tinnitus-related distress (distress), and Tinnitus Handicap Inventory (THI). RESULTS: Pooled results demonstrated that tDCS did not have a beneficial effect on loudness (pooled standardized difference in means = 0.674, 95% CI, -0.089 to 1.437, P = .083). Further, the pooled results demonstrated a greater reduction in distress for the tDCS group (pooled standardized difference in means = 0.634, 95% CI, 0.021-1.247, P = .043). CONCLUSIONS: We conclude that the pooled results demonstrated a greater reduction in distress for groups treated with tDCS as compared with those administered a sham treatment.

4 Review A review of hyperacusis and future directions: part II. Measurement, mechanisms, and treatment. 2014

Pienkowski, Martin / Tyler, Richard S / Roncancio, Eveling Rojas / Jun, Hyung Jin / Brozoski, Tom / Dauman, Nicolas / Coelho, Claudia Barros / Andersson, Gerhard / Keiner, Andrew J / Cacace, Anthony T / Martin, Nora / Moore, Brian C J. · ·Am J Audiol · Pubmed #25478787.

ABSTRACT: PURPOSE: Hyperacusis can be extremely debilitating, and at present, there is no cure. In this detailed review of the field, we consolidate present knowledge in the hope of facilitating future research. METHOD: We review and reference the literature on hyperacusis and related areas. This is the 2nd of a 2-part review. RESULTS: Hyperacusis encompasses a wide range of reactions to sounds, which can be grouped into the categories of excessive loudness, annoyance, fear, and pain. Reasonable approaches to assessing the different forms of hyperacusis are emerging, including brain-imaging studies. Researchers are only beginning to understand the many mechanisms at play, and valid animal models are still evolving. There are many counseling and sound-therapy approaches that some patients find helpful, but well-controlled studies are needed to measure their long-term efficacy and to test new approaches. CONCLUSIONS: Hyperacusis can make life difficult in this increasingly noisy world, forcing sufferers to dramatically alter their work and social habits. We believe this is an opportune time to explore approaches to better understand and treat hyperacusis.

5 Review A review of hyperacusis and future directions: part I. Definitions and manifestations. 2014

Tyler, Richard S / Pienkowski, Martin / Roncancio, Eveling Rojas / Jun, Hyung Jin / Brozoski, Tom / Dauman, Nicolas / Dauman, Nicolas / Andersson, Gerhard / Keiner, Andrew J / Cacace, Anthony T / Martin, Nora / Moore, Brian C J. · ·Am J Audiol · Pubmed #25104073.

ABSTRACT: PURPOSE: Hyperacusis can be extremely debilitating, and at present, there is no cure. We provide an overview of the field, and possible related areas, in the hope of facilitating future research. METHOD: We review and reference literature on hyperacusis and related areas. We have divided the review into 2 articles. In Part I, we discuss definitions, epidemiology, different etiologies and subgroups, and how hyperacusis affects people. In Part II, we review measurements, models, mechanisms, and treatments, and we finish with some suggestions for further research. RESULTS: Hyperacusis encompasses a wide range of reactions to sound, which can be grouped into the categories of excessive loudness, annoyance, fear, and pain. Many different causes have been proposed, and it will be important to appreciate and quantify different subgroups. Reasonable approaches to assessing the different forms of hyperacusis are emerging, including psychoacoustical measures, questionnaires, and brain imaging. CONCLUSIONS: Hyperacusis can make life difficult for many, forcing sufferers to dramatically alter their work and social habits. We believe this is an opportune time to explore approaches to better understand and treat hyperacusis.

6 Clinical Trial The contribution of a frequency-compression hearing aid to contralateral cochlear implant performance. 2013

Perreau, Ann E / Bentler, Ruth A / Tyler, Richard S. ·Department of Communication Sciences and Disorders, Augustana College, IL, USA. annperreau@augustana.edu ·J Am Acad Audiol · Pubmed #23357804.

ABSTRACT: BACKGROUND: Frequency-lowering signal processing in hearing aids has re-emerged as an option to improve audibility of the high frequencies by expanding the input bandwidth. Few studies have investigated the usefulness of the scheme as an option for bimodal users (i.e., combined use of a cochlear implant and a contralateral hearing aid). In this study, that question was posed. PURPOSE: The purposes of this study were (1) to determine if frequency compression was a better bimodal option than conventional amplification and (2) to determine the impact of a frequency-compression hearing aid on speech recognition abilities. RESEARCH DESIGN: There were two separate experiments in this study. The first experiment investigated the contribution of a frequency-compression hearing aid to contralateral cochlear implant (CI) performance for localization and speech perception in noise. The second experiment assessed monaural consonant and vowel perception in quiet using the frequency-compression and conventional hearing aid without the use of a contralateral CI or hearing aid. STUDY SAMPLE: Ten subjects fitted with a cochlear implant and hearing aid participated in the first experiment. Seventeen adult subjects with a cochlear implant and hearing aid or two hearing aids participated in the second experiment. To be included, subjects had to have a history of postlingual deafness, a moderate or moderate-to-severe hearing loss, and have not worn this type of frequency-lowering hearing aid previously. DATA COLLECTION AND ANALYSIS: In the first experiment, performance using the frequency-compression and conventional hearing aids was assessed on tests of sound localization, speech perception in a background of noise, and two self-report questionnaires. In the second experiment, consonant and vowel perception in quiet was assessed monaurally for the two conditions. In both experiments, subjects alternated daily between a frequency-compression and conventional hearing aid for 2 mo. The parameters of frequency compression were set individually for each subject, and audibility was measured for the frequency compression and conventional hearing aid programs by comparing estimations of the Speech Intelligibility Index (SII) using a modified algorithm (Bentler et al, 2011). In both experiments, the outcome measures were administered following the hearing aid fitting to assess performance at baseline and after 2 mo of use. RESULTS: For this group of subjects, the results revealed no significant difference between the frequency-compression and conventional hearing aid on tests of localization and consonant recognition. Spondee-in-noise and vowel perception scores were significantly higher with the conventional hearing aid compared to the frequency-compression hearing aid after 2 mo of use. CONCLUSIONS: These results suggest that, for the subjects in this study, frequency compression is not a better bimodal option than conventional amplification. In addition, speech perception may be negatively influenced by frequency compression because formant frequencies are too severely compressed and can no longer be distinguished.

7 Clinical Trial Sequential bilateral cochlear implantation: speech perception and localization pre- and post-second cochlear implantation. 2012

Dunn, Camille C / Tyler, Richard S / Witt, Shelley / Ji, Haihong / Gantz, Bruce J. ·University of Iowa, Iowa City, IA, USA. camille-dunn@uiowa.edu ·Am J Audiol · Pubmed #22846635.

ABSTRACT: PURPOSE: In this study, the authors sought to compare speech perception and localization in subjects who wear 1 cochlear implant (unilateral CI) or 1 cochlear implant and hearing aid (CI+HA) and then receive a second cochlear implant (bilateral CI), and to evaluate the importance of the duration between implant surgeries and duration of deafness. METHOD: Nine subjects were tested on speech perception in quiet, and 13 subjects were tested on speech perception and localization in noise using an array of 8 loudspeakers. All subjects were tested with unilateral CI prior to bilateral implantation and then again with bilateral CI after at least 3 months of bilateral experience. RESULTS: No significant difference was found between bilateral CI and unilateral CI on averaged speech perception in quiet performance. A significant benefit was found for bilateral CI on averaged speech perception in noise and on localization. Nonsignificant correlations were found for duration between surgeries, duration of deafness, and duration of bilateral use. CONCLUSIONS: Improvements for speech perception and localization played in background noise were indicated for most subjects after they received their 2nd implant. The correlations should be reassessed with a larger number of subjects to appropriately evaluate the effects of duration between surgeries, duration of deafness, and duration of bilateral use.

8 Article Tinnitus: How Partners Can Help? 2019

Mancini, Patricia C / Tyler, Richard S / Smith, Sydra / Ji, Helena / Perreau, Ann / Mohr, Anne-Mette. ·Department of Otolaryngology-Head and Neck Surgery, The University of Iowa, Iowa City. · Department of Speech-Language Pathology and Audiology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. · Department of Communication Sciences and Disorders, The University of Iowa, Iowa City. · Department of Communication Sciences and Disorders, Augustana College, Rock Island, IL. · Psykologcentret NV, Copenhagen NV, Denmark. ·Am J Audiol · Pubmed #30938560.

ABSTRACT: Purpose Tinnitus can be distressing for sufferers, but for those who do not have tinnitus, it is difficult to understand what it is like. We attempted to gain an understanding of the knowledge and misconceptions of sufferers and their partners about tinnitus. Method Two different websites were created with surveys, 1 for tinnitus sufferers and the other for their partners. A mass e-mail was sent to employees and students at The University of Iowa inviting people with tinnitus and their significant others to fill out the online surveys. Those with tinnitus were asked to rate how their tinnitus affected their thoughts and emotions, sleep, concentration, and hearing. They were also invited to fill out the Iowa Tinnitus Primary Function Questionnaire (12-item version; Tyler et al., 2014 ). Partners completed a similar survey that asked how tinnitus affected the sufferer in these domains. Open-ended questions were also included to obtain more specific feedback from the participants regarding their experiences and how tinnitus affects their lifestyle and relationships. Results Two hundred twenty-two replies were obtained from 197 tinnitus sufferers and 25 partners of those with tinnitus. Partners and sufferers were not completely in agreement regarding their knowledge about tinnitus or familiar with the impact that this symptom may have on the sufferers. Sufferers showed more confidence in their hearing ability, regardless of tinnitus, than their partners. Furthermore, sufferers and partners do not generally talk about tinnitus to each other. Conclusion We conclude that both sufferers and partners would benefit from receiving counseling to address many misunderstandings regarding tinnitus and its consequences in their everyday life activities.

9 Article Tinnitus Suppression in Cochlear Implant Patients Using a Sound Therapy App. 2018

Tyler, Richard S / Owen, Rachael L / Bridges, Julie / Gander, Phillip E / Perreau, Ann / Mancini, Patricia C. ·Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City. · GN ReSound A/S, Bloomington, MN. · Department of Neurosurgery, University of Iowa, Iowa City. · Department of Communication Sciences and Disorders, Augustana College, Rock Island, IL. · Department of Speech-Language Pathology and Audiology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. ·Am J Audiol · Pubmed #30105356.

ABSTRACT: Purpose: The use of acoustic stimuli to reduce the prominence of tinnitus has been used for decades. Counseling and tinnitus sound therapy options are not currently widespread for cochlear implant (CI) users. The goal of this study was to determine whether tinnitus therapy sounds created for individuals with acoustic hearing may also benefit CI users. Method: Sixteen sounds from the ReSound Relief app (Version 3.0) were selected for the study. Sixteen participants were asked to rate the overall acceptability of each sound and to write the description of the sound they perceived. Sounds were streamed from an Apple™ iPod (6th generation) to the CI using a Cochlear™ Wireless Mini Microphone 2+. Thirteen participants then completed a 5-min trial where they rated their pretrial and posttrial tinnitus and the acceptability of a subset of preferred sounds. Ten out of these 13 participants completed a 2-week home trial with a preferred sound after which they answered an online tinnitus questionnaire and rated the effectiveness of the sound therapy. Results: Individual differences were large. Results from the 5-min trial showed that sounds perceived as rain, music, and waves were rated the most acceptable. For all of the participants, the posttrial tinnitus loudness rating was lower than the pretrial rating, with some participants experiencing greater difference in their tinnitus loudness than others. At the end of the 2-week home trial, 3 of 10 participants rated the effectiveness of sound therapy 70% or higher. Conclusion: The results suggest that the use of tinnitus therapy sounds delivered through a CI can be acceptable and provides relief for some tinnitus sufferers.

10 Article Vagus Nerve Stimulation Paired with Tones for the Treatment of Tinnitus: A Prospective Randomized Double-blind Controlled Pilot Study in Humans. 2017

Tyler, Richard / Cacace, Anthony / Stocking, Christina / Tarver, Brent / Engineer, Navzer / Martin, Jeffrey / Deshpande, Aniruddha / Stecker, Nancy / Pereira, Melissa / Kilgard, Michael / Burress, Chester / Pierce, David / Rennaker, Robert / Vanneste, Sven. ·University of Iowa Department of Otolaryngology-Head and Neck Surgery and Communication Sciences and Disorders, The University of Iowa, Iowa City, IA, USA. rich-tyler@uiowa.edu. · Department of Communication Sciences & Disorders, Wayne State University, Detroit, MI, USA. · Department of Communicative Disorders and Sciences, University at Buffalo, Buffalo, NY, USA. · MicroTransponder, Inc., 2802 Flintrock Trace, Suite 226, Austin, TX, USA. · Callier Center for Communication Disorders, School for Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA. · Department of Speech-Language-Hearing Sciences, Hofstra University, Hempstead, NY, USA. · Texas Biomedical Device Center, University of Texas at Dallas, Richardson, TX, USA. · Lab for Clinical and Integrative Neuroscience, School for Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA. ·Sci Rep · Pubmed #28931943.

ABSTRACT: The aim of the pilot study was to evaluate the effect of Vagus Nerve Stimulation (VNS) paired with sounds in chronic tinnitus patients. All participants were implanted and randomized to a paired VNS (n = 16) or control (n = 14) group. After 6 weeks of home therapy, all participants received paired VNS. The device was used on 96% of days with good compliance. After 6 weeks, the paired VNS group improved on the Tinnitus Handicap Inventory (THI) (p = 0.0012) compared to controls (p = 0.1561). The between-group difference was 10.3% (p = 0.3393). Fifty percent of the participants in the paired VNS group showed clinically meaningful improvements compared to 28% in controls. At one year, 50% of participants had a clinically meaningful response. The therapy had greater benefits for participants with tonal and non-blast induced tinnitus at the end of 6 (24.3% vs. 2%, p = 0.05) and 12 weeks (34% vs. 2%, p = 0.004) compared to controls with 80% and 70% responding at 6 months and 1 year, respectively. Adverse effects were mild and well-tolerated and the therapy had a similar safety profile to VNS for epilepsy. VNS paired with tones may be effective for a subgroup of tinnitus patients and provides impetus for a larger pivotal study.

11 Article Development of a Shortened Version of the Spatial Hearing Questionnaire (SHQ-S) for Screening Spatial-Hearing Ability. 2017

Ou, Hua / Perreau, Ann / Tyler, Richard S. ·Department of Communication Sciences and Disorders, Illinois State University, Normal. · Department of Communication Sciences and Disorders, Augustana College, Rock Island, IL. · Department of Communication Disorders and Sciences, University of Iowa, Iowa City. ·Am J Audiol · Pubmed #28738135.

ABSTRACT: Purpose: The Spatial Hearing Questionnaire (SHQ) was developed to address how to measure spatial-hearing ability in complex listening situations (Tyler, Perreau, & Ji, 2009). It has been translated and validated into various languages, including Chinese, Dutch, French, and Persian. Although the SHQ contains only 24 items, it could be time-consuming in a busy clinic to administer. The purposes of this study were to develop and validate a shortened version of the SHQ (SHQ-S) and to compare self-perceived spatial-hearing ability across adults with normal hearing (NH), hearing loss (HL), and cochlear implants (CIs). Method: This was a retrospective study. The full version of the SHQ was administered to measure self-perceived spatial-hearing ability for 51 adults with NH at Augustana College, 47 adults with essentially mild to moderately severe sensorineural HL at Illinois State University, and 72 adult CI users at the University of Iowa. Exploratory factor analysis was performed for the full version for the data collected from adults with NH and HL. Appropriate items were chosen to develop the SHQ-S from the results of the exploratory factor analysis. Confirmatory factor analysis was then applied to test the factor structure of the SHQ-S for all participants. One-way analysis of variance was used to compare the self-perceived spatial-hearing performance scores between the 3 groups. Results: The exploratory factor analysis revealed scores loaded on 2 factors. Six items from the full version were chosen accordingly. The results of the confirmatory factor analysis indicated that that a shortened version of 6 items is sufficient to measure spatial-hearing ability. The internal consistency reliability of the SHQ-S was high. The main effect of the one-way analysis of variance was significant for the groups, F(2, 167) = 36.0, p < .0001. The comparisons with the Tukey adjustment indicated that the NH group reported significantly better spatial-hearing ability than either the HL or the CI group (both adjusted p values < .05). There was no significant difference between the participants with HL and CI users. Conclusions: The psychometric characteristics of the 6-item SHQ-S were similar to those of the full version of the SHQ. We conclude that the SHQ-S is a reliable and valid tool for measuring spatial-hearing ability and screening for spatial-hearing difficulties. Participants with NH reported better spatial-hearing ability than those with HL or with CIs, whereas the CI users and participants with HL perceived similar spatial-hearing ability in the present study.

12 Article The Effectiveness of the Progression of Widex Zen Tinnitus Therapy: A Pilot Study. 2017

Tyler, Richard S / Deshpande, Aniruddha K / Lau, Chi C / Kuk, Francis. ·Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City. · Department of Communication Sciences and Disorders, University of Iowa, Iowa City. · Department of Speech-Language-Hearing Sciences, Hofstra University, Hempstead, NY. · Widex ORCA-USA, Lisle, IL. ·Am J Audiol · Pubmed #28614844.

ABSTRACT: Purpose: The aim of this study was to measure the progression of benefits to individuals with tinnitus from providing informational counseling, hearing aids, a brief tinnitus activities treatment and Zen therapy. Method: Several magnitude estimation scales and tinnitus handicap scales were administered for the duration of the study to 20 participants. Results: Results indicated that all participants benefited from this sequential approach of providing different components of this tinnitus treatment. Large benefits were observed following the tinnitus activities treatment and the Zen treatments. Conclusion: We conclude that the progressive approach of treatment demonstrated here should be of benefit to most individuals with tinnitus and that the Widex Zen sound therapy is a worthwhile treatment for many tinnitus sufferers.

13 Article Survey on the Effectiveness of Dietary Supplements to Treat Tinnitus. 2016

Coelho, Claudia / Tyler, Richard / Ji, Haihong / Rojas-Roncancio, Eveling / Witt, Shelley / Tao, Pan / Jun, Hyung-Jin / Wang, Tang Chuan / Hansen, Marlan R / Gantz, Bruce J. ·University of Iowa, Iowa City. ·Am J Audiol · Pubmed #27681261.

ABSTRACT: PURPOSE: We surveyed the benefit of dietary supplements to treat tinnitus and reported adverse effects. METHOD: A website was created for people with tinnitus to complete a variety of questions. RESULTS: The 1,788 subjects who responded to questionnaires came from 53 different countries; 413 (23.1%) reported taking supplements. No effect on tinnitus was reported in 70.7%, improvement in 19.0%, and worsening in 10.3%. Adverse effects were reported in 6% (n = 36), including bleeding, diarrhea, headache, and others. Supplements were reported to be helpful for sleep: melatonin (effect size, d = 1.228) and lipoflavonoid (d = 0.5244); emotional reactions: melatonin (d = 0.6138) and lipoflavonoid (d = 0.457); hearing: Ginkgo biloba (d = 0.3758); and concentration Ginkgo biloba (d = 0.3611). The positive, subjective reports should be interpreted cautiously; many might have reported a positive effect because they were committed to treatment and expected a benefit. Users of supplements were more likely to have loudness hyperacusis and to have a louder tinnitus. CONCLUSIONS: The use of dietary supplements to treat tinnitus is common, particularly with Ginkgo biloba, lipoflavonoids, magnesium, melatonin, vitamin B12, and zinc. It is likely that some supplements will help with sleep for some patients. However, they are generally not effective, and many produced adverse effects. We concluded that dietary supplements should not be recommended to treat tinnitus but could have a positive outcome on tinnitus reactions in some people.

14 Article Manganese and Lipoflavonoid Plus(®) to Treat Tinnitus: A Randomized Controlled Trial. 2016

Rojas-Roncancio, Eveling / Tyler, Richard / Jun, Hyung-Jin / Wang, Tang-Chuan / Ji, Haihong / Coelho, Claudia / Witt, Shelley / Hansen, Marlan R / Gantz, Bruce J. ·Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, IA. · Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA. ·J Am Acad Audiol · Pubmed #27564443.

ABSTRACT: BACKGROUND: Several tinnitus sufferers suggest that manganese has been helpful with their tinnitus. PURPOSE: We tested this in a controlled experiment where participants were committed to taking manganese and Lipoflavonoid Plus(®) to treat their tinnitus. RESEARCH DESIGN: Randomized controlled trial. STUDY SAMPLE: 40 participants were randomized to receive both manganese and Lipoflavonoid Plus(®) for 6 months, or Lipoflavonoid Plus(®) only (as the control). DATA COLLECTION AND ANALYSIS: Pre- and postmeasures were obtained with the Tinnitus Handicap Questionnaire, Tinnitus Primary Functions Questionnaire, and tinnitus loudness and annoyance ratings. An audiologist performed the audiogram, the tinnitus loudness match, and minimal masking level. RESULTS: Twelve participants were dropped out of the study because of the side effects or were lost to follow-up. In the manganese group, 1 participant (out of 12) showed a decrease in the questionnaires, and another showed a decrease in the loudness and annoyance ratings. No participants from the control group (total 16) showed a decrease in the questionnaires ratings. Two participants in the control group reported a loudness decrement and one reported an annoyance decrement. CONCLUSIONS: We were not able to conclude that either manganese or Lipoflavonoid Plus(®) is an effective treatment for tinnitus.

15 Article Validation of the Chinese Translation of the Spatial Hearing Questionnaire and Its Short Form. 2016

Ou, Hua / Wen, Bei / Perreau, Ann / Kim, Elaine / Tyler, Richard. · ·Am J Audiol · Pubmed #26934713.

ABSTRACT: PURPOSE: Few questionnaires address how to measure spatial hearing ability in complex listening situations. The purpose of the study was (a) to validate the Chinese translation of the Spatial Hearing Questionnaire (C-SHQ) among Chinese participants and (b) to provide a shortened version for the purpose of clinical screening. METHOD: This was a cross-sectional study. The C-SHQ was developed from the process of translation and back-translation of the original 24-item, English version (Tyler, Perreau, & Ji, 2009). The C-SHQ was administered to 146 patients at the Department of Otolaryngology Clinic of Sichuan Provincial People's Hospital between October 2013 and May 2014 at Sichuan, China. Exploratory factor analysis and reliability tests were performed for the full version, and confirmatory factor analysis was applied for the shortened version of the C-SHQ. RESULTS: The exploratory factor analysis revealed scores loaded on 3 similar factors compared with the original SHQ. The internal consistency reliability was high (Cronbach's α = 0.99). The confirmatory factor analysis indicated that a shortened version of 12 items is sufficient to measure spatial hearing abilities. CONCLUSIONS: The C-SHQ and its short form are both reliable and valid questionnaires, which are suitable for both research and clinical settings to measure spatial hearing ability in the Chinese population.

16 Article Differences Among Patients That Make Their Tinnitus Worse or Better. 2015

Pan, Tao / Tyler, Richard S / Ji, Haihong / Coelho, Claudia / Gogel, Stephanie A. · ·Am J Audiol · Pubmed #26649850.

ABSTRACT: PURPOSE: Our objective was to identify activities that influence tinnitus and to determine if conditional probabilities exist among such variables. METHOD: Two hundred fifty-eight patients were asked the following two questions: "When you have your tinnitus, which of the following makes it worse?" and "Which of the following reduces your tinnitus?" RESULTS: Things that made tinnitus better included noise (31%) and relaxation (15%). Things that made tinnitus worse included being in a quiet place (48%), stress (36%), being in a noisy place (32%), and lack of sleep (27%). Almost 6% of patients suggested coffee/tea and 4% said certain foods made their tinnitus worse. Conditional probabilities indicated that for those whose tinnitus is not worse in quiet, it is usually not reduced by noise. For those whose tinnitus is not worse in noise, it is usually not reduced in quiet. CONCLUSION: There are dramatic differences among patients. Such differences need to be considered in planning treatments.

17 Article A Series of Case Studies of Tinnitus Suppression With Mixed Background Stimuli in a Cochlear Implant. 2015

Tyler, Richard S / Keiner, A J / Walker, Kurt / Deshpande, Aniruddha K / Witt, Shelley / Killian, Matthijs / Ji, Helena / Patrick, Jim / Dillier, Norbert / van Dijk, Pim / Lai, Wai Kong / Hansen, Marlan R / Gantz, Bruce. · ·Am J Audiol · Pubmed #26001407.

ABSTRACT: PURPOSE: Background sounds provided by a wearable sound playback device were mixed with the acoustical input picked up by a cochlear implant speech processor in an attempt to suppress tinnitus. METHOD: First, patients were allowed to listen to several sounds and to select up to 4 sounds that they thought might be effective. These stimuli were programmed to loop continuously in the wearable playback device. Second, subjects were instructed to use 1 background sound each day on the wearable device, and they sequenced the selected background sounds during a 28-day trial. Patients were instructed to go to a website at the end of each day and rate the loudness and annoyance of the tinnitus as well as the acceptability of the background sound. Patients completed the Tinnitus Primary Function Questionnaire (Tyler, Stocking, Secor, & Slattery, 2014) at the beginning of the trial. RESULTS: Results indicated that background sounds were very effective at suppressing tinnitus. There was considerable variability in sounds preferred by the subjects. CONCLUSION: The study shows that a background sound mixed with the microphone input can be effective for suppressing tinnitus during daily use of the sound processor in selected cochlear implant users.

18 Article Speech, Spatial and Qualities of Hearing Scale (SSQ) and Spatial Hearing Questionnaire (SHQ) Changes Over Time in Adults With Simultaneous Cochlear Implants. 2015

Zhang, Juan / Tyler, Richard / Ji, Haihong / Dunn, Camille / Wang, Ningyu / Hansen, Marlan / Gantz, Bruce. · ·Am J Audiol · Pubmed #25934950.

ABSTRACT: PURPOSE: The purpose of the present study is to evaluate the changes over time of the Spatial Hearing Questionnaire (SHQ; Tyler, Perreau, & Ji, 2009) and the Speech, Spatial and Qualities of Hearing Scale (SSQ; Gatehouse & Noble, 2004) in adults with simultaneous bilateral cochlear implants by collecting data for 2 years after implantation. METHOD: Nineteen postlingual subjects participated in this study. Average age at implant was 63 years. The subjects' data were included in this retrospective analysis only if they completed both questionnaires. We compared subjects' SSQ and SHQ scores to word recognition and sound localization performances. RESULTS: The study showed SHQ and SSQ scores continuously improved up to 1 year postimplantation, with the most improvement occurring within the first 6 months of implantation. After 1 year, the scores reached a plateau. This is consistent with laboratory tests from the same 19 subjects, and they showed high correlations (p < .05). The present study also showed a high degree of correlation between SHQ and SSQ scores. CONCLUSIONS: Both the SSQ and SHQ scores improved up to 12 months postimplantation, with the most improvement during the first 6 months of implantation. Both were consistent with laboratory tests. There was a high degree of correlation between SHQ and SSQ scores.

19 Article Clinical practice guideline: tinnitus. 2014

Tunkel, David E / Bauer, Carol A / Sun, Gordon H / Rosenfeld, Richard M / Chandrasekhar, Sujana S / Cunningham, Eugene R / Archer, Sanford M / Blakley, Brian W / Carter, John M / Granieri, Evelyn C / Henry, James A / Hollingsworth, Deena / Khan, Fawad A / Mitchell, Scott / Monfared, Ashkan / Newman, Craig W / Omole, Folashade S / Phillips, C Douglas / Robinson, Shannon K / Taw, Malcolm B / Tyler, Richard S / Waguespack, Richard / Whamond, Elizabeth J. ·Otolaryngology-Head and Neck Surgery, Johns Hopkins Outpatient Center, Baltimore, Maryland, USA dtunkel@jhmi.edu. · Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA. · Partnership for Health Analytic Research, LLC, Los Angeles, California, USA. · Department of Otolaryngology, State University of New York at Downstate Medical Center, Brooklyn, New York, USA. · New York Otology, New York, New York, USA. · Department of Research and Quality Improvement, American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA. · Divisions of Rhinology & Sinus Surgery and Facial Plastic & Reconstructive Surgery, University of Kentucky, Lexington, Kentucky, USA. · Department of Otolaryngology, University of Manitoba, Winnipeg, Manitoba, Canada. · Department of Otolaryngology, Tulane University, New Orleans, Louisiana, USA. · Division of Geriatric Medicine and Aging, Columbia University, New York, New York, USA. · National Center for Rehabilitative Auditory Research, Portland VA Medical Center, Portland, Oregon, USA. · ENT Specialists of Northern Virginia, Falls Church, Virginia, USA. · Ochsner Health System, Kenner, Louisiana, USA. · Mitchell & Cavallo, P.C., Houston, Texas, USA. · Department of Otology and Neurotology, The George Washington University, Washington, DC, USA. · Department of Surgery, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA. · Morehouse School of Medicine, East Point, Georgia, USA. · Department of Head and Neck Imaging, Weill Cornell Medical Center, New York-Presbyterian Hospital, New York, New York, USA. · Department of Psychiatry, University of California, San Diego, La Jolla, California, USA. · Department of Medicine, UCLA Center for East-West Medicine, Los Angeles, California, USA. · Department of Otolaryngology-Head and Neck Surgery, The University of Iowa, Iowa City, Iowa, USA. · Department of Surgery, University of Alabama School of Medicine, Birmingham, Alabama, USA. · Consumers United for Evidence-Based Healthcare, Fredericton, New Brunswick, Canada. ·Otolaryngol Head Neck Surg · Pubmed #25273878.

ABSTRACT: OBJECTIVE: Tinnitus is the perception of sound without an external source. More than 50 million people in the United States have reported experiencing tinnitus, resulting in an estimated prevalence of 10% to 15% in adults. Despite the high prevalence of tinnitus and its potential significant effect on quality of life, there are no evidence-based, multidisciplinary clinical practice guidelines to assist clinicians with management. The focus of this guideline is on tinnitus that is both bothersome and persistent (lasting 6 months or longer), which often negatively affects the patient's quality of life. The target audience for the guideline is any clinician, including nonphysicians, involved in managing patients with tinnitus. The target patient population is limited to adults (18 years and older) with primary tinnitus that is persistent and bothersome. PURPOSE: The purpose of this guideline is to provide evidence-based recommendations for clinicians managing patients with tinnitus. This guideline provides clinicians with a logical framework to improve patient care and mitigate the personal and social effects of persistent, bothersome tinnitus. It will discuss the evaluation of patients with tinnitus, including selection and timing of diagnostic testing and specialty referral to identify potential underlying treatable pathology. It will then focus on the evaluation and treatment of patients with persistent primary tinnitus, with recommendations to guide the evaluation and measurement of the effect of tinnitus and to determine the most appropriate interventions to improve symptoms and quality of life for tinnitus sufferers. ACTION STATEMENTS: The development group made a strong recommendation that clinicians distinguish patients with bothersome tinnitus from patients with nonbothersome tinnitus. The development group made a strong recommendation against obtaining imaging studies of the head and neck in patients with tinnitus, specifically to evaluate tinnitus that does not localize to 1 ear, is nonpulsatile, and is not associated with focal neurologic abnormalities or an asymmetric hearing loss. The panel made the following recommendations: Clinicians should (a) perform a targeted history and physical examination at the initial evaluation of a patient with presumed primary tinnitus to identify conditions that if promptly identified and managed may relieve tinnitus; (b) obtain a prompt, comprehensive audiologic examination in patients with tinnitus that is unilateral, persistent (≥ 6 months), or associated with hearing difficulties; (c) distinguish patients with bothersome tinnitus of recent onset from those with persistent symptoms (≥ 6 months) to prioritize intervention and facilitate discussions about natural history and follow-up care; (d) educate patients with persistent, bothersome tinnitus about management strategies; (e) recommend a hearing aid evaluation for patients who have persistent, bothersome tinnitus associated with documented hearing loss; and (f) recommend cognitive behavioral therapy to patients with persistent, bothersome tinnitus. The panel recommended against (a) antidepressants, anticonvulsants, anxiolytics, or intratympanic medications for the routine treatment of patients with persistent, bothersome tinnitus; (b) Ginkgo biloba, melatonin, zinc, or other dietary supplements for treating patients with persistent, bothersome tinnitus; and (c) transcranial magnetic stimulation for the routine treatment of patients with persistent, bothersome tinnitus. The development group provided the following options: Clinicians may (a) obtain an initial comprehensive audiologic examination in patients who present with tinnitus (regardless of laterality, duration, or perceived hearing status); and (b) recommend sound therapy to patients with persistent, bothersome tinnitus. The development group provided no recommendation regarding the effect of acupuncture in patients with persistent, bothersome tinnitus.

20 Article Self-reported spatial hearing abilities across different cochlear implant profiles. 2014

Perreau, Ann E / Ou, Hua / Tyler, Richard / Dunn, Camille. · ·Am J Audiol · Pubmed #25093507.

ABSTRACT: PURPOSE: The goal of this study was to determine how self-reported spatial hearing abilities differ across various cochlear implant (CI) profiles and to examine the degree of subjective benefit following cochlear implantation across different groups of CI users. METHOD: This was a retrospective study of subjective spatial hearing ability of CI recipients. The subjects consisted of 99 unilateral CI users, 49 bilateral CI users, 32 subjects with a CI and contralateral hearing aid (bimodal users), and 37 short-electrode CI users. All subjects completed the Spatial Hearing Questionnaire (Tyler, Perreau, & Ji, 2009), a questionnaire assessing spatial hearing ability, after implantation, and a subset of the subjects completed the questionnaire pre- and postimplantation. RESULTS: Subjective spatial hearing ability was rated higher for the bilateral and short electrode CI users compared to the unilateral and bimodal users. There was no significant difference in subjective spatial hearing performance between the bilateral and short electrode CI users and the unilateral CI and bimodal users. A separate analysis of pre- and postimplant performance revealed that all CI groups reported significant improvements in spatial hearing ability after implantation. CONCLUSION: This study suggests that there are substantial differences in perceived spatial hearing ability among unilateral and bimodal CI users compared with bilateral and short electrode CI users.

21 Article Amplitude modulated S-tones can be superior to noise for tinnitus reduction. 2014

Tyler, Richard / Stocking, Christina / Secor, Carrie / Slattery, William H. · ·Am J Audiol · Pubmed #25026936.

ABSTRACT: PURPOSE: Recent evidence has suggested that amplitude modulated tones might have some advantages over broadband noise. METHOD: Fifty-six subjects listened to S-Tones at a carrier frequency matched at the tinnitus pitch (amplitude modulation rate of 40 Hz) and to broadband noise. Subjects rated their tinnitus loudness before, during, and after a 120-s duration masker. RESULTS: The results suggested that S-Tones were generally more effective at reducing tinnitus loudness than noise. In about one third (21/56) of the subjects, there was no significant effect from any masker. In other subjects, 54.3% (19/35) showed a greater reduction for the S-Tones, 20% (7/35) showed a greater reduction with the noise, and 25.7% (9/35) showed similar performance between the 2 stimuli. The S-Tones showed a statistically significant benefit ( p < .01) versus noise at reducing the patient's tinnitus perception. Using low-level stimuli that were rated much softer than the subjects' baseline tinnitus, the S-Tones reduced the tinnitus loudness by 1.9 times the amount that noise did (about 28% on average, whereas the noise reduced the tinnitus by about 15%). CONCLUSION: S-Tones at the tinnitus pitch-match frequency are more likely to be effective than broadband noise at reducing tinnitus loudness.

22 Article Development and validation of the tinnitus primary function questionnaire. 2014

Tyler, Richard / Ji, Haihong / Perreau, Ann / Witt, Shelley / Noble, William / Coelho, Claudia. · ·Am J Audiol · Pubmed #24811293.

ABSTRACT: PURPOSE: To create a questionnaire focused on the primary activities impaired by tinnitus and therefore more sensitive to treatments. METHOD: Questions were developed on (a) emotions, (b) hearing, (c) sleep, and (d) concentration. A 20-item questionnaire was administered to 158 patients. First, confirmatory factor analysis was used to select 3 questions per domain. Second, factor analysis was used to evaluate the appropriateness of the 12-item questionnaire. RESULTS: The analysis indicated that the selected questions successfully represented 4 independent domains. Scores were correlated with the Tinnitus Handicap Questionnaire ( r = .77, p < .01) and loudness ( r = .40, p < .01). The Sleep subscale correlated with the Pittsburgh Sleep Index ( r = .68, p < .01); the Emotion subscale correlated with the Beck Inventory ( r = .66, p < .01) and the Trait Anxiety questionnaire ( r = .67, p < .01). The average scores went from 51% to 38% following treatment. CONCLUSION: The Tinnitus Primary Function Questionnaire is valid, reliable, and sensitive and can be used to determine the efficacy of clinical trials.

23 Article The spatial hearing questionnaire: data from individuals with normal hearing. 2014

Perreau, Ann E / Spejcher, Bryn / Ou, Hua / Tyler, Richard. · ·Am J Audiol · Pubmed #24687018.

ABSTRACT: PURPOSE: Although a number of questionnaires are available to assess hearing aid benefit and general hearing disability, relatively few investigate spatial hearing ability in more complex listening situations. The aim of this study was to document the performance of individuals with normal hearing using the Spatial Hearing Questionnaire (SHQ; Tyler, Perreau, & Ji, 2009) and to compare performance with published data from cochlear implant (CI) users. METHOD: Fifty-one participants with normal hearing participated. All participants completed the 24-item SHQ. Also, a factor analysis and reliability tests were performed. RESULTS: Performance on the SHQ was high (87%) for the participants with normal hearing. Subjective ratings varied across different listening situations: Understanding speech in quiet (98%) was rated higher than sound localization (84%) and understanding speech in a background of noise (85%). Compared with previously published data (Tyler, Perreau, & Ji, 2009), listeners with normal hearing rated their spatial hearing ability significantly better than bilateral and unilateral CI users. Results confirmed that the SHQ is a reliable measure of spatial hearing ability for listeners with normal hearing. CONCLUSIONS: Overall, results indicated that the SHQ is able to capture expected differences between individuals with normal hearing and CI users. These new data can be used as targets following the provision of hearing devices.

24 Article Zinc to treat tinnitus in the elderly: a randomized placebo controlled crossover trial. 2013

Coelho, Claudia / Witt, Shelly A / Ji, Haihong / Hansen, Marlan R / Gantz, Bruce / Tyler, Richard. ·Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa 52242, USA. claudiabarroscoelho@gmail.com ·Otol Neurotol · Pubmed #23598691.

ABSTRACT: OBJECTIVE: Several reports suggest that zinc, which is involved in several neural transmissions systems throughout the auditory pathway, might help some tinnitus patients. However, previous studies used inadequate experimental designs. Therefore, we tested the effectiveness of zinc to reduce tinnitus. STUDY DESIGN: Randomized, prospective double-blind placebo-controlled design. SETTING: Tertiary referral center. PATIENTS: Tinnitus subjects older than 60 years, who are more likely to have a zinc deficiency. INTERVENTION(S): In Phase 1, 58 subjects were randomized to receive 50 mg of zinc per day for 4 months, and 58 subjects received a placebo. After a 1-month washout period, the 2 groups were crossed over to receive the alternative regime (Phase 2). MAIN OUTCOME MEASURE: Difference scores between before and after measures of the Tinnitus Handicap Questionnaire. Changes on the difference scores 20 or greater were considered as a statistically significant and, therefore, clinically meaningful improvement for THQ. RESULTS: Five percent (5 of 93 patients) had an improvement of 20 points or greater in THQ scores after zinc treatment, whereas 2% (2 of 94 patients) had an improvement of 20 or greater in THQ scores after placebo. The difference between 2 proportions is 5/93 - 2/94 = 0.03, the estimate of relative improvement is (5/93) / (2/94) = 2.53, with 95% confidence interval from 0.5 to 12.7. From chi-square independent test, there was no significant evidence that patients treated by zinc improved better than those treated by placebo (X2 (1) = 1.4, p > 0.05). The observed power in THQ for zinc is 0.16, and that for placebo is 0.06. CONCLUSION: Zinc is not an effective treatment for tinnitus in this subgroup of patients.

25 Article Willingness to accept and pay for implantable tinnitus treatments: a survey. 2013

Engineer, Navzer D / Rosellini, Will M / Tyler, Richard S. ·MicroTransponder, Inc., 2802 Flintrock Trace, Suite 225, Austin, TX, USA. navzer@microtransponder.com ·Neuromodulation · Pubmed #22849609.

ABSTRACT: OBJECTIVES: At present, there is no cure for tinnitus. Neurostimulation techniques have shown great promise, but it is uncertain whether they will gain acceptance because of their invasive nature. We have previously demonstrated that pairing acoustic stimuli with vagus nerve stimulation (VNS) also has potential as a viable tinnitus treatment approach. METHODS: We conducted a survey on tinnitus sufferers that emphasized questions related to a willingness to pay for the treatment of tinnitus, including VNS. Four hundred thirty-nine individuals responded to an Internet survey modeled after a recent study by Tyler. RESULTS: The average age was about 47 years. Ninety-four percent reported that they had health insurance. Almost 40% had spent between $500 and $10,000 on tinnitus therapies. Almost three-fourths said that they would be willing to have a device implanted if it reduced tinnitus annoyance by half. About 70% of those with very loud tinnitus would be willing to have a temporary implant, and about 60% would be willing to have a permanent implant even if the device suppressed their tinnitus by only half of its annoyance. Only 10% of patients with SOFT tinnitus would be willing to have a permanent implant if the therapy suppressed their tinnitus by only half of its annoyance. CONCLUSIONS: We conclude that implanted devices, such as a VNS, will be an acceptable form of tinnitus treatment for many who suffer from tinnitus. The results of this survey indicate that VNS tone pairing would be an acceptable therapeutic solution for individuals with moderate to severe tinnitus and should be developed for the market.

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