SRF301 - Influence of Tinnitus on Speech Recognition in Quiet and Noise

Abstract:
Tinnitus is a common auditory pathology often associated with hearing loss, aging, and head injuries. Despite frequent complaints of poor speech recognition in noise, studies show mixed results regarding whether tinnitus worsens speech recognition. Here, we examined speech recognition abilities in quiet and noise in thousands of patients with and without tinnitus. Preliminary results suggest tinnitus has little effect on speech recognition in quiet or noise after including hearing loss and age as variables in our model. These results provide vital information for counseling patients with tinnitus and facilitate the routine assessment of speech in noise in clinical practice.

Summary:
Rationale
Tinnitus is among the most prevalent auditory pathologies, affecting approximately 15% of the general population. Tinnitus is commonly associated with hearing loss, increasing age, and concussion or other head injuries. One of the most common complaints of individuals with tinnitus is hearing difficulties, especially poor speech-recognition abilities in noise. To date, however, reports are mixed as to whether speech recognition abilities are worse in individuals with tinnitus, particularly in the presence of background noise. Some investigations have shown deficits in patients who report tinnitus, while others show no difference in auditory abilities between patient groups with and without tinnitus who have similar hearing thresholds. Contributing to this confusion is that many of these studies have small numbers of participants, or are homogenous with regard to the degree of hearing loss. Here, we address these issues by examining speech recognition abilities in quiet and noise in thousands of patients seen in our academic medical center.

Design
We first identified over 100,000 audiograms from patients seen in our facility. All of these patients underwent pure-tone audiometry, and the majority also completed monaural word-recognition in quiet using the NU-6 word lists. A subset of approximately 12,000 audiograms also contained monaural speech in noise performance as measured by the QuickSIN. We then identified patients with a diagnosis of tinnitus using the ICD code H.93, and removed all patients who also presented with a diagnosis of Meniere’s disease or vestibular schwannoma. Performance was subsequently compared between individuals with and without tinnitus on measures of both word-recognition in quiet and the QuickSIN using a generalized linear model that included hearing thresholds and age as additional variables.

Results
Our preliminary results suggest that tinnitus has little to no effect on speech recognition in quiet (0.62), but shows a trend towards impacting performance in noise (0.09), after accounting for hearing sensitivity and age of the patients.

Conclusions
The preliminary results of this ongoing study suggest that deficits in speech recognition are primarily influenced by hearing loss and age, rather than self-reported tinnitus. We plan to expand this work to see whether tinnitus affects speech perception in quiet and noise, when other auditory pathologies (e.g., vestibular schwannoma or Meniere’s disease) are also present.

Brief Summary of Clinical Takeaways:
This investigation provides necessary information for counseling of patients with tinnitus. Furthermore, it provides additional information necessary to further integrate measures of speech in noise into routine practice by demonstrating how they are affected by common auditory pathologies.