Skip to main content
Log in

Intermittent tinnitus—an empirical description

Intermittierender Tinnitus – eine empirische Beschreibung

  • Original articles
  • Published:
HNO Aims and scope Submit manuscript

Abstract

Background

Tinnitus is often classified into acute or chronic persistent forms. However, epidemiologic studies have shown that intermittent tinnitus (IT), which does not clearly belong to either category, is the most common form.

Objective

The aim of this study was to further characterize IT empirically.

Materials and methods

We conducted an exploratory cross-sectional interview study among 320 subjects with tinnitus. Sociodemographic and tinnitus characteristics, concomitant complaints, perceived triggers, and help-seeking behavior were assessed. Subjects were classified into continuous (CT), IT, or single-episode tinnitus (SET) if they had experienced tinnitus “continuously,” “temporarily time and again,” or “only once but for several days,” respectively, during the past 12 months.

Results

Of the sample, 62% reported IT, 23% SET, and 16% CT. Mean time since onset was 36 (CT), 28 (IT), and 19 months (SET), respectively. Most subjects with IT experienced episodes lasting a few days, whereas in 25%, episodes lasted 1–4 weeks. Mean duration was 1.6 weeks. The frequency of IT episodes ranged from every few days to half-yearly; mean frequency was every 7 weeks. Leading triggers were occupational and private stress. Asthenia, depression, social isolation, psychiatric disorders, and inner ear disorders were more prevalent among CT than IT subjects. Help-seeking behavior was comparable between CT and IT.

Conclusion

IT is associated with emotional reactions and situational impairment severe enough to trigger multiple treatment attempts, but usually does not result in severe impairment. Inner ear disorders and psychological changes are less frequent than in CT; therefore, treatment response and prognosis might be better. We suggest classification of tinnitus into acute single-episode (<3 months), intermittent, or chronic persistent (>3 months) forms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Andersson G, Vretblad P, Larsen HC et al (2001) Longitudinal follow-up of tinnitus complaints. Arch Otolaryngol Head Neck Surg 127:175–179

    Article  CAS  Google Scholar 

  2. Auerbach BD, Rodrigues PV, Salvi RJ (2014) Central gain control in tinnitus and hyperacusis. Front Neurol 5:206

    Article  Google Scholar 

  3. Bhatt JM, Lin HW, Bhattacharyya N (2016) Prevalence, severity, exposures, and treatment patterns of tinnitus in the United States. Jama Otolaryngol Head Neck Surg 142:959–965

    Article  Google Scholar 

  4. Bruggemann P, Szczepek AJ, Rose M et al (2016) Impact of multiple factors on the degree of tinnitus distress. Front Hum Neurosci 10:341

    Article  Google Scholar 

  5. Cima RF, Maes IH, Joore MA et al (2012) Specialised treatment based on cognitive behaviour therapy versus usual care for tinnitus: a randomised controlled trial. Lancet 379:1951–1959

    Article  Google Scholar 

  6. Cornwell BR, Baas JM, Johnson L et al (2007) Neural responses to auditory stimulus deviance under threat of electric shock revealed by spatially-filtered magnetoencephalography. Neuroimage 37:282–289

    Article  Google Scholar 

  7. Creswell JD, Taren AA, Lindsay EK et al (2016) Alterations in resting-state functional connectivity link mindfulness meditation with reduced Interleukin-6: a randomized controlled trial. Biol Psychiatry 80:53–61

    Article  CAS  Google Scholar 

  8. Drew S, Davies E (2001) Effectiveness of Ginkgo biloba in treating tinnitus: double blind, placebo controlled trial. BMJ 322:73

    Article  CAS  Google Scholar 

  9. Flores LS, Teixeira AR, Rosito LP et al (2016) Pitch and loudness from tinnitus in individuals with noise-induced hearing loss. Int Arch Otorhinolaryngol 20:248–253

    Article  Google Scholar 

  10. Hall DA, Haider H, Kikidis D et al (2015) Toward a global consensus on outcome measures for clinical trials in tinnitus: report from the first international meeting of the COMiT initiative, November 14, 2014, Amsterdam, the Netherlands. Trends Hear 19:1–7

    Google Scholar 

  11. Hall DA, Haider H, Szczepek AJ et al (2016) Systematic review of outcome domains and instruments used in clinical trials of tinnitus treatments in adults. Trials 17:270

    Article  Google Scholar 

  12. Hoekstra CE, Wesdorp FM, Van Zanten GA (2014) Socio-demographic, health, and tinnitus related variables affecting tinnitus severity. Ear Hear 35:544–554

    Article  Google Scholar 

  13. Knippers M, Van DP, Nunes I et al (2013) Advances in the neurobiology of hearing disorders: recent developments regarding the basis of tinnitus and hyperacusis. Prog Neurobiol 111:17–33

    Article  Google Scholar 

  14. Krauss P, Tziridis K, Metzner C et al (2016) Stochastic resonance controlled upregulation of internal noise after hearing loss as a putative cause of tinnitus-related neuronal hyperactivity. Front Neurosci 10:597

    Article  Google Scholar 

  15. Landgrebe M, Azevedo A, Baguley D et al (2012) Methodological aspects of clinical trials in tinnitus: a proposal for an international standard. J Psychosom Res 73:112–121

    Article  Google Scholar 

  16. Leaver AM, Turesky TK, Seydell-Greenwald A et al (2016) Intrinsic network activity in tinnitus investigated using functional MRI. Hum Brain Mapp 37:2717–2735

    Article  Google Scholar 

  17. Maron-Katz A, Vaisvaser S, Lin T et al (2016) A large-scale perspective on stress-induced alterations in resting-state networks. Sci Rep 6:21503

    Article  CAS  Google Scholar 

  18. Mazurek B, Haupt H, Olze H et al (2012) Stress and tinnitus-from bedside to bench and back. Front Syst Neurosci 6:47

    Article  Google Scholar 

  19. Mazurek B, Szczepek AJ, Hebert S (2015) Stress and tinnitus. HNO 63:258–265

    Article  CAS  Google Scholar 

  20. Mccormack A, Edmondson-Jones M, Somerset S et al (2016) A systematic review of the reporting of tinnitus prevalence and severity. Hear Res 337:70–79

    Article  Google Scholar 

  21. Moller AR (2011) Introduction. In: Moller AR, Langguth B, DeRidder D, Kleinjung T (eds) Textbook of tinnitus. Springer, New York, pp 3–7

    Chapter  Google Scholar 

  22. Oiticica J, Bittar RS (2015) Tinnitus prevalence in the city of Sao Paulo. Braz J Otorhinolaryngol 81:167–176

    Article  Google Scholar 

  23. Probst T, Pryss R, Langguth B et al (2016) Emotional states as mediators between tinnitus loudness and tinnitus distress in daily life: results from the “TrackYourTinnitus” application. Sci Rep 6:20382

    Article  CAS  Google Scholar 

  24. Rauschecker JP, Leaver AM, Muhlau M (2010) Tuning out the noise: limbic-auditory interactions in tinnitus. Neuron 66:819–826

    Article  CAS  Google Scholar 

  25. Seydel C, Haupt H, Szczepek AJ et al (2010) Long-term improvement in tinnitus after modified tinnitus retraining therapy enhanced by a variety of psychological approaches. Audiol Neurootol 15:69–80

    Article  Google Scholar 

  26. Shargorodsky J, Curhan GC, Farwell WR (2010) Prevalence and characteristics of tinnitus among US adults. Am J Med 123:711–718

    Article  Google Scholar 

  27. Shore SE, Roberts LE, Langguth B (2016) Maladaptive plasticity in tinnitus – triggers, mechanisms and treatment. Nat Rev Neurol 12:150–160

    Article  Google Scholar 

  28. Simonetti P, Oiticica J (2015) Tinnitus neural mechanisms and structural changes in the brain: the contribution of neuroimaging research. Int Arch Otorhinolaryngol 19:259–265

    Article  Google Scholar 

  29. Stein A, Wunderlich R, Lau P et al (2016) Clinical trial on tonal tinnitus with tailor-made notched music training. Bmc Neurol 16:38

    Article  Google Scholar 

  30. Tunkel DE, Bauer CA, Sun GH et al (2014) Clinical practice guideline: tinnitus. Otolaryngol Head Neck Surg 151:S1–S40

    Article  Google Scholar 

  31. Zenner HP (2015) S3-Leitlinie 017/064: Chronischer Tinnitus

    Google Scholar 

  32. Zenner HP, Vonthein R, Zenner B et al (2013) Standardized tinnitus-specific individual cognitive-behavioral therapy: a controlled outcome study with 286 tinnitus patients. Hear Res 298:117–125

    Article  Google Scholar 

Download references

Funding

This research was funded by Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to B. Mazurek.

Ethics declarations

Conflict of interest

B. Mazurek is director and M. Burkart, P. Brueggemann, and A.J. Szczepek are full-time employees of organizations offering tinnitus treatments. D. Frank is managing director of ISM Global Dynamics, the organization conducting the study.

The study was conducted in accordance with the International Code on Market and Social Research of the International Chamber of Commerce/European Society for Opinion and Market Research and current BVM (Berufsverband Deutscher Markt- und Sozialforscher e. V.) guidelines. All respondents gave their consent.

The supplement containing this article is not sponsored by industry.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Burkart, M., Brueggemann, P., Szczepek, A.J. et al. Intermittent tinnitus—an empirical description. HNO 67 (Suppl 2), 51–58 (2019). https://doi.org/10.1007/s00106-019-0623-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00106-019-0623-9

Keywords

Navigation