Single-sided deafness (SSD) leads to difficulties with speech perception in noise, sound localisation, and sometimes tinnitus. Current treatments (Contralateral Routing of Sound hearing aids (CROS) and Bone Conduction Devices (BCD)) do not sufficiently overcome these problems. Cochlear implants (CIs) may help. Our aim was to evaluate these treatments in a Randomised Controlled Trial (RCT). Adult SSD patients were randomised using a web-based randomisation tool into one of three groups: CI; trial period of ‘first BCD, then CROS’; trial period of ‘first CROS, then BCD’. After these trial periods, patients opted for BCD, CROS, or No treatment. The primary outcome was speech perception in noise (directed from the front (S₀N₀)). Secondary outcomes were speech perception in noise with speech directed to the poor ear and noise to the better ear (S_peN_be) and vice versa (S_beN_pe), sound localisation, tinnitus burden, and disease-specific quality of life (QoL). We described results at baseline (unaided situation) and 3 and 6 months after device activation. 120 patients were randomised. Seven patients did not receive the allocated intervention. The number of patients per group after allocation was: CI (n = 28), BCD (n = 25), CROS (n = 34), and No treatment (n = 26). In S₀N₀, the CI group performed significantly better when compared to baseline, and when compared to the other groups. In S_peN_be, there was an advantage for all treatment groups compared to baseline. However, in S_beN_pe, BCD and CROS groups performed worse compared to baseline, whereas the CI group improved. Only in the CI group sound localisation improved and tinnitus burden decreased. In general, all treatment groups improved on disease-specific QoL compared to baseline. This RCT demonstrates that cochlear implantation for SSD leads to improved speech perception in noise, sound localisation, tinnitus burden, and QoL after 3 and 6 months of follow-up. For most outcome measures, CI outperformed BCD and CROS. Trial registration: Netherlands Trial Register (www.trialregister.nl): NTR4580, CINGLE-trial.

Importance: The prevalence of hyperacusis and its relationship with mental and general health is unknown in a nonclinical sample. Therefore, we aimed to determine the prevalence of hyperacusis and its relation with hearing, general and mental health in a population‐based study.Study Design: Prospective population‐based study.Material and Methods: This study uses data from the Busselton Healthy Ageing Study (BHAS). A sample of 5,107 eligible inhabitants aged 45 to 70 years completed a detailed questionnaire and a clinical assessment. A positive answer to “Do you consider yourself sensitive or intolerant to everyday sounds” was used to indicate hyperacusis. Logistic regression was used to examine the association between hearing, mental and general health factors, and hyperacusis.Results: Of 5,107 participants, 775 (15.2%) reported hyperacusis. The majority of participants with hyperacusis reported an occasional effect on daily life (72.0%). Being female, older in age, having a lower income, physical or mental health difficulties, more severe hearing loss, and tinnitus were all associated with the presence of hyperacusis. Individuals who experience hearing impairment, poorer general or mental health have a higher possibility of hyperacusis having an effect on their daily life.Conclusions: In this community population‐based cohort study, we found a prevalence of hyperacusis of 15.2%. Individuals with hearing loss, mental health problems, and lower physical health have a higher possibility of experiencing effects on their daily life associated with their hyperacusis. Unravelling the relationship between hyperacusis hearing, general and mental health can be of major importance for a better understanding of the condition and its consequences.Level of Evidence: 2 Laryngoscope, 131:E2887–E2896, 2021

Objectives To determine if, and to what extent, published clinical practice guidelines for the treatment of chronic tinnitus vary in their recommendations. Design Systematic review of guidelines. Data sources PubMed, EMBASE and GIN electronic databases were searched in March 2022 and the search was updated in June 2023. Eligibility criteria We included clinical practice guidelines that gave recommendations on the treatment of tinnitus. No language restrictions were applied. Data extraction and synthesis Two independent reviewers extracted the data and used the AGREE checklist to report on reporting. Results A total of 10 guidelines were identified and included, published between 2011 and 2021. Recommendations for 13 types of tinnitus treatments were compared. Large differences in guideline development and methodology were found. Seven of the 10 guidelines included a systematic search of the literature to identify the available evidence. Six of the 10 guidelines used a framework for the development of the guideline. Reporting was poor in multiple guidelines. Counselling and cognitive behavioural therapy were the only treatments that were recommended for treating tinnitus associated distress by all guidelines that reported on these topics. Tinnitus retraining therapy, sound therapy, hearing aids and cochlear implantation were not unanimously recommended either due to the lack of evidence, a high risk of bias or judgement of no beneficial effect of the specific treatment. Conclusions There were notable differences with respect to whether guidelines considered the available evidence sufficient enough to make a recommendation. Notably, we identified substantial differences in the rigour of guideline design and development. Reporting was poor in many guidelines. Future guidelines could benefit from the use of reporting tools to improve reporting and transparency and the inclusion of guideline experts and patients to improve the quality of clinical practice guidelines on tinnitus.

Objectives This systematic review summarises the evidence on the correlation between recurrent acute otitis media (rAOM) or chronic suppurative otitis media (CSOM) and sensorineural hearing loss (SNHL). Research methods PubMed, Embase and Cochrane Library databases were searched from inception to 15 January 2021. Two authors independently identified articles, extracted data and performed quality assessment for included studies. Studies comparing the sensorineural hearing levels of patients with a history of rAOM/CSOM for >3 months to a control group were included. Results Screening of 4168 articles lead to inclusion of two case-control studies (control-group: patients non-OM) and seven cohort-studies (control group: contralateral ear). Quality assessment indicated considerable risk of bias in all studies. Reported populations varied (sample size 13–607, mean age 22–41.5 years, mean duration of disease 6.1–12.4 years). The OR for SNHL in the OM-group was 3.30–7.86 (95% CI 1.16 to 9.40, p<0.05) in cohort studies (n=2), and 0.05 (95% CI 0 to 0.78, p<0.05) in a case-control study. Mean/median bone conduction thresholds were respectively 1.19–32.21/0–10 dB higher on all frequencies (0.5–4 kHz) for the OM-group in four cohort studies (p<0.05). Two other studies reported no statistical test outcomes. Conclusion Due to the high risk of bias of included studies, effect estimates heterogeneity and suboptimal research designs, no conclusion on the correlation between OM and SNHL can be made. It emphasises the need for future prognostic studies.

Objectives: In this systematic review, we aim to evaluate the evidence regarding the correlation between tinnitus distress and the severity of depressive symptoms in patients with chronic tinnitus. Also, the prevalence of clinically relevant depressive symptoms scores in patients with chronic tinnitus was evaluated. Methods: We performed a systematic review in PubMed, EMBASE, and the Cochrane library in June 2021 using the terms “depression” and “tinnitus,” and their synonyms, following PRISMA guidelines. Studies were selected on relevance and critically appraised regarding risk of bias using the Newcastle–Ottowa Quality Assessment Scale. Results: A total of 1,912 articles were screened on title and abstract after the removal of the duplicates. Eventually, 33 (1.5%) articles were included for the final analysis. Only cross-sectional cohort studies and case–control studies with a low level of evidence and a high risk of bias due to the study design and patient selection were found. Statistically significant correlations between the experienced tinnitus distress and depressive symptoms were reported in 31 out of 33 studies. Clinically relevant depression scores had a prevalence of 4.6–41.7%. Conclusions: In this systematic review, in which mostly cross-sectional studies were included, a statistically significant correlation was found between the experienced tinnitus distress and the reported severity of symptoms of depression in patients with chronic tinnitus. A wide range of clinically relevant depression scores were reported in included studies. Due to the high risk of bias of included studies it is not possible to provide a definite answer on the existence of this relationship. Future population-based studies are necessary to provide more clarity.