‘Is It Brain Talking to the Ear’: Neuro-otological Evaluation of Tinnitus Using Auditory Brainstem Response Audiometry

Tinnitus is hypothesized to be an auditory phantom phenomenon resulting from spontaneous neuronal activity somewhere along the auditory pathway. The neural abnormalities underlying tinnitus are largely unknown. We evaluated the functional characteristics and the auditory system synchronization using Auditory Brainstem Response (ABR) in normal hearing tinnitus patients. In this observational comparative cross-sectional study, patients with chief complaints of Tinnitus and equal number of age and sex matched controls without hearing loss and tinnitus were enrolled. All patients underwent a full ENT assessment, pure tone audiometry and Brainstem evoked response audiometry (BERA) tests. The study population consisted of 100 patients with tinnitus, 55 controls without tinnitus and 45 controls with tinnitus. Statistical analysis showed significant relation (p < 0.05) between hearing loss and tinnitus between cases and controls with tinnitus, between absolute latency of wave III amongst cases and controls without tinnitus, Interpeak Latency between wave III and V amongst cases and controls with tinnitus and interpeak latency of wave I and wave III amongst controls without and with tinnitus. Brainstem evoked response audiometry results that we obtained from the patients of tinnitus and controls with and without tinnitus are different from one person to another. This suggests impaired neural firing synchronization and transmission in the central auditory pathway in tinnitus patients. These findings also indicate that the pathology underlying tinnitus is not the same in every individual, with possible brainstem involvement in some cases.