A Systematic Review and Meta-Analysis of Extended High-Frequency Hearing Thresholds in Tinnitus With a Normal Audiogram

Jafari, Zahra; Baguley, David; Kolb, Bryan E.; Mohajerani, Majid H.

Abstract

OBJECTIVES: Current evidence supports the growing application of extended high-frequency (EHF: 9 to 20 kHz) audiometry in hearing research, which likely results from the high vulnerability of this frequency region to damage induced by known auditory risk factors. The present systematic review and meta-analysis were performed to investigate whether adults with a normal audiogram and tinnitus show increased EHF hearing thresholds relative to control peers. DESIGN: A comprehensive search was undertaken on electronic databases consisting of PubMed, ScienceDirect, Wiley, and Google Scholar using combined keywords: "tinnitus," "extended high frequency," "normal audiogram," and "hidden hearing loss." RESULTS: From 261 articles found by searching databases, nine studies met the inclusion criteria for the meta-analysis. A significant difference was observed between tinnitus and control groups in the effect size analysis of hearing thresholds at 10, 12.5, 14, 16, and 18 kHz ( p ≤ 0.001), and the I-square heterogeneity analysis was below 50% in all studies ( p ≥ 0.131). Visual inspection by the Funnel plot and Egger's regression test ( p ≥ 0.211) also exhibited no publication bias in the meta-analyses. CONCLUSIONS: Our findings are in support of the idea that in most cases, tinnitus is associated with some degree of cochlear mechanical dysfunction, which may not be detected by conventional audiometry alone. This finding underscores the significance of EHF audiometry in clinical practice, which may help both early identification of individuals susceptible to developing tinnitus and reduce the number of new cases through preventive counseling programs.

Citation

Jafari, Z., Baguley, D., Kolb, B. E., & Mohajerani, M. H. (2022). A Systematic Review and Meta-Analysis of Extended High-Frequency Hearing Thresholds in Tinnitus With a Normal Audiogram. Ear and Hearing, 43(6), 1643-1652. https://doi.org/10.1097/AUD.0000000000001229

• Journal Article Type: Article
• Acceptance Date: Mar 25, 2022
• Online Publication Date: May 13, 2022
• Publication Date: Nov 1, 2022
• Deposit Date: Apr 25, 2022
• Publicly Available Date: May 14, 2023
• Journal: Ear and hearing
• Print ISSN: 0196-0202
• Electronic ISSN: 1538-4667
• Publisher: Lippincott, Williams & Wilkins
• Peer Reviewed: Peer Reviewed
• Volume: 43
• Issue: 6
• Pages: 1643-1652
• DOI: https://doi.org/10.1097/AUD.0000000000001229
• Keywords: Speech and Hearing; Otorhinolaryngology
• Public URL: https://nottingham-repository.worktribe.com/output/7831154
• Publisher URL: https://journals.lww.com/ear-hearing/Citation/2022/11000/A_Systematic_Review_and_Meta_Analysis_of_Extended.4.aspx