The Impact of Acute Tinnitus on Listening Effort: A Study Based on Clinical Observations of Sudden Sensorineural Hearing Loss Patients

Abstract

This study investigates the relationship between listening effort and acute tinnitus over the clinical course of sudden sensorineural hearing loss (SSNHL) before and after treatment. Thirty SSNHL patients with acute tinnitus were enrolled in this prospective study. Each patient was evaluated before treatment and after 1 and 3 months of follow-up. Listening effort was evaluated in the unaffected ears in two conditions (with and without background noise) using a dual-task paradigm, which included a primary (speech recognition) task and a secondary (visual reaction time) task. Tinnitus severity was assessed with the Tinnitus Handicap Inventory (THI). It was observed that background noise significantly increased listening effort in SSNHL patients with acute tinnitus before and after treatment. THI scores and listening effort in quiet conditions (** p = 0.009) were significantly decreased three months after treatment. In an analysis of the relation between tinnitus severity and listening effort, it was found that the THI total score was significantly correlated with listening effort in quiet (* p = 0.0388) and noisy conditions (* p = 0.044) before treatment. We concluded that SSNHL patients with acute tinnitus exerted greater listening effort in the presence of background noise than in quiet conditions. Furthermore, listening effort was reduced as tinnitus improved in SSNHL patients during the three months after treatment. Both before and after 3 months of treatment, patients who were more affected and emotionally distressed by tinnitus tended to exert more listening effort in both quiet and noisy environments.

Keywords: listening effort; sudden sensorineural hearing loss; tinnitus.

Figure A1

Scatter plots showing the correlation of THI total (T) and subscale scores (C: catastrophic; E: emotional; F: functional) with reaction time (RT); r: Spearman correlation coefficient; * p < 0.05, ** p < 001.

Figure A1

Scatter plots showing the correlation of THI total (T) and subscale scores (C: catastrophic; E: emotional; F: functional) with reaction time (RT); r: Spearman correlation coefficient; * p < 0.05, ** p < 001.

Figure A2

The correlation between tinnitus loudness and reaction time (a) before treatment, T0; (b) 1 month after treatment, T1; and (c) 3 months after treatment, T3. (d) Scatter plots of tinnitus loudness and the differences in reaction time between noise and quiet at T0, T1, and T3. RT: reaction time; r: Spearman correlation coefficient; * p < 0.05.

Figure A3

Comparison of Listening effort between male (14) and female (14) subjects. Quiet male: 260.62 ± 55.82 ms, Quiet female: 238.97 ± 39.98 ms, (p = 0.25); Noise male: 267.40 ± 69.69 ms, Quiet female: 247.15 ± 47.12 ms, (p = 0.38).

Figure A4

Histograms of reaction time (RT) distribution in quiet and noisy conditions before treatment (T0), 1 month after treatment (T1) and 3 months after treatment (T3).

Figure 1

Schematic illustration of a dual-task paradigm composed of a primary task-speech recognition task in quiet (noise−) or noise (noise+) and a secondary task-visual reaction time task.

Figure 2

(a) Mean THI total score and (b) mean reaction time in quiet and with noise at pretreatment (T0), 1 month after treatment (T1) and 3 months after treatment (T3). THI = Tinnitus Handicap Inventory; RT-Quiet = mean reaction time in quiet conditions; RT-Noise = mean reaction time with noise. * p < 0.05. ** p < 0.01.

Figure 3

Tinnitus loudness as measured by a visual analog scale before treatment (T0, range 1 to 10, median 4), 1 month after treatment (T1, range 1 to 7, median 1) and 3 months after treatment (T3, range 1 to 7, median 1). Red lines represent median values.

Figure 4

(a) The trends in each patient’s THI score over time. (b) THI grading before and after treatment; (T0) before treatment, (T1) 1 month after treatment, and (T3) 3 months after treatment. THI = Tinnitus Handicap Inventory.