Bayram Ali UYSAL, Yusuf Çağdaş KUMBUL, Mehmet Emre SİVRİCE, Vural AKIN

Yüksek frekanslı tinnitusu olan hastalarda serum lipid profili

Amaç: Hiperkolesteroleminin; işitme kaybı, tinnitus gibi iç kulak bozukluklarına yol açtığını destekleyen çalışmalar mevcuttur. Bu çalışmada lipid profili düzeylerinin yüksek frekanslı tinnitus üzerine olan etkisini araştırmayı amaçladık. Gereç ve Yöntem: Kulak Burun Boğaz polikliniğine Ekim 2017 – Mayıs 2020 tarihleri arasında tinnitus şikayeti ile başvuran hastalara saf ses odyometrisi, tinnitus pitch eşleme ve tinnitus loudness eşleme testleri uygulandı. Yüksek frekanslarda (2, 4 ve 6 kHz) tinnitus tespit edilen ve lipid paneli bakılmış hastalardan tinnitus grubu oluşturuldu. Kontrol grubu ise kardiyoloji polikliniğine rutin muayene için başvuran hastalardan oluşturuldu. Tinnitus grubu ile kontrol grubunun lipid profili karşılaştırılarak analiz edildi. Bulgular: Gruplar arasında cinsiyet ve yaş açısından istatistiksel fark yoktu. İki grubun HDL-K, LDL-K, trigliserit ve total kolesterol ortalamaları karşılaştırıldığında LDL-K, trigliserit ve total kolesterol arasında istatistiksel olarak anlamlı fark tespit edildi. HDL-K için istatistiksel olarak anlamlı fark yoktu. Tinnitus şiddeti ile HDL-K, LDL-K, trigliserit ve total kolesterol değerleri arasında istatistiksel olarak anlamlı korelasyon bulunamadı. Sonuç: Yüksek frekanslarda tinnitus gelişimi için, LDL-K ve trigliserit düzeyi artışı risk faktörüdür. Lipid parametrelerinin düzeyi ile tinnitus şiddeti arasında ise korelasyon izlenmemiştir. Yüksek frekanslı tinnitus tespit edilen hastaların lipid profili rutin olarak incelenmelidir.

Serum lipid profile in patients with high frequency tinnitus

Purpose: There are several studies supporting that hypercholesterolemia causes inner ear disorders such as hearing loss and tinnitus. Our aim in this study is to investigate the effect of lipid profile levels on high frequency tinnitus. Materials and Methods: Pure tone audiometry, tinnitus pitch matching and tinnitus loudness matching tests were applied to the patients who came to our ENT outpatient clinic with tinnitus complaints between October 2017 and May 2020. The tinnitus group was created from the patients who had tinnitus at high frequencies (2, 4 ve 6 kHz) and whose lipid panel was examined. The control group consisted of patients who applied to the cardiology outpatient clinic for routine examination. The lipid profile of the tinnitus group and the control group was compared and analyzed. Results: There was no statistical difference between the groups in terms of gender and age. When the HDL-C, LDL-C, triglyceride and total cholesterol means of the two groups were compared, a statistically significant difference was found between LDL-C, triglyceride and total cholesterol.. There was no statistically significant difference for HDL-C.. No statistically significant correlation was found between tinnitus loudness and HDL-C, LDL-C, triglyceride and total cholesterol values. Conclusion: Increased LDL-C and triglyceride levels are risk factors for the development of tinnitus at high frequencies. There was no correlation between the level of lipid parameters and the loudness of tinnitus. Lipid profile of patients with high frequency tinnitus should be examined routinely.

Keywords:

Tinnitus Lipoproteins, Cholesterol, Hyperlipoproteinemia, Cochlea,

PDF

___

1. Jastreboff PJ. Phantom auditory perception (tinnitus): mechanisms of generation and perception. Neurosci Res. 1990;8:221-54.
2. Nondahl DM, Cruickshanks KJ, Wiley TL, Klein BEK, Klein R, Chappell R, et al. The ten-year incidence of tinnitus among older adults. Int J Audiol. 2010;49:580-5.
3. Sismanis A. Pulsatile tinnitus. Otolaryngol Clin N Am. 2003;36:389-402.
4. Vielsmeier V, Lehner A, Strutz J, Steffens T, Kreuzer PM, Schecklmann M, et al. The relevance of the high frequency audiometry in tinnitus patients with normal hearing in conventional pure-tone audiometry. Biomed Res Int. 2015;2015:302515.
5. Fortune DS, Haynes DS, Hall JW 3rd. Tinnitus. Current evaluation and management. Med Clin North Am. 1999;83:153-62.
6. Fox KM, Wang L, Gandra SR, Quek RGW, Li L, Baser O. Clinical and economic burden associated with cardiovascular events among patients with hyperlipidemia: a retrospective cohort study. BMC Cardiovasc Disord. 2016;16:13.
7. Saito T, Sato K, Saito H. An experimental study of auditory dysfunction associated with hyperlipoproteinemia. Arch Otorhinolaryngol. 1986;243:242-5.
8. Feron O, Dessy C, Desager JP, Balligand JL. Hydroxy-methylglutaryl-coenzyme A reductase inhibition promotes endothelial nitric oxide synthase activation through a decrease in caveolin abundance. Circulation. 2001;103:113-8.
9. Öğüt MF. Tinnitusa Multidisipliner Yaklaşım, İstanbul, Medikal Akademi, 2017.
10. Kuk FK, Tyler RS, Russell D, Jordan H. The psychometric properties of a tinnitus handicap questionnaire. Ear Hear. 1990;11:434-45.
11. Meikle MB, Griest SE, Stewart BJ, Press LS. Measuring the negative impact of tinnitus: A brief severity index. Abstr Assoc Res Otolaryngol 1995;167.
12. Newman CW, Jacobson GP, Spitzer JB. Development of the Tinnitus Handicap Inventory. Arch Otolaryngol Head Neck Surg. 1996;122:143-8.
13. Kostek B, Poremski T. A new method for measuring the psychoacoustical properties of tinnitus. Diagn Pathol. 2013;8:209.
14. Henry JA, Meikle MB. Psychoacoustic measures of tinnitus. J Am Acad Audiol. 2000;11:138-55.
15. Kim TS, Yakunina N, Ryu YJ, Chung IJ, Nam EC. Self-Administered Tinnitus Pitch Matching versus a Conventional Audiometric Procedure. Audiol Neurootol. 2017;22:1-8.
16. Kim HJ, Lee HJ, An SY, Sim S, Park B, WS Kim, et al. Analysis of the prevalence and associated risk factors of tinnitus in adults. PLoS One. 2015;10:e0127578.
17. Miller JM, Ren TY, Nuttall AL. Studies of inner ear blood flow in animals and human beings. Otolaryngol Head Neck Surg. 1995;112:101-13.
18. Sidman JD, Prazma J, Pulver SH, Pillsburry HC. Cochlea and heart as endorgans in small vessel disease. Ann Otol Rhinol Laryngol. 1988;97:9-13.
19. Olzowy B, Canis M, Hempel JM, Mazurek B, Suckfüll M. Effect of atorvastatin on progression of sensorineural hearing loss and tinnitus in the elderly: results of a prospective, randomized, double-blind clinical trial. Otol Neurotol. 2007;28.4:455-8.
20. Nguyen TV, Brownell WE. Contribution of membrane cholesterol to outer hair cell lateral wall stiffness. Otolaryngol Head Neck Surg. 1998;119:14- 20.
21. Saito T, Sato K, Saito H. An experimental study of auditory dysfunction associated with hyperlipoproteinemia. Arch Otorhinolaryngol. 1986;243:242-5.
22. Suckfull M. Fibrinogen and LDL apheresis in treatment of sudden hearing loss: a randomised multicentre trial. Lancet. 2002;360:1811-7.
23. Axelsson A, Lindgren F. Is there a relationship between hypercholesterolaemia and noise-induced hearing loss?. Acta Otolaryngol. 1985;100:379-86.
24. Cooper JC, Jr. Health and Nutrition Examination Survey of 1971-75: Part II. Tinnitus, subjective hearing loss, and well-being. J Am Acad Audiol. 1994;5:37-43.
25. Anbari S, Isazadeh D, Safavi A, Alaie M, Azizi F. The role of dyslipidemia in sensorineural hearing loss in children. Int J Pediatr Otorhinolaryngol. 2010;74:32- 6.
26. Kazmierczak H, Doroszewska G. Metabolic disorders in vertigo, tinnitus, and hearing loss. Int Tinnitus J. 2001;7:54-8.
27. Arnold M, Bousser MG, Fahrni G. Vertebral artery dissection: presenting findings and predictors of outcome. Stroke. 2006;37:2499-503.
28. Przewozny T, Gasecki D, Narozny W, Nyka W. Risk factors of sensorineural hearing loss in patients with ischemic stroke. Otol Neurotol. 2008;29:745-50.
29. Qian LQ, Wang B, Niu JY, Gao S, Zhao DY. Assessment of the clinical effect of Chinese medicine therapy combined with psychological intervention for treatment of patients of peri-menopausal syndrome complicated with hyperlipidemia. Chin J Integr Med. 2010;16:124-30.
30. Sutbas A, Yetiser S, Satar B, Akcam T, Karahatay S, Saglam K. Low-cholesterol diet and antilipid therapy in managing tinnitus and hearing loss in patients with noise-induced hearing loss and hyperlipidemia. Int Tinnitus J. 2007;13:143-9.
31. M-Shirazi M, Farhadi M, Jalessi M, Kamrava SK, Behzadi AH, Arami B. Prevalence of dyslipidemia among Iranian patients with idiopathic tinnitus. J Res Med Sci. 2011;16:890-96.
32. Pulec JL, Pulec MB, Mendoza I. Progressive sensorineural hearing loss, subjective tinnitus and vertigo caused by elevated blood lipids. Ear Nose Throat J. 1997;76:716-20.