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    Is chirp more effective than click and tone-burst during oVEMP test?
    (2020) Bas, Banu; Keseroglu, Kemal; Er, Serap; Ozdek, Ali; Korkmaz, Mehmet Hakan
    Aim: We aimed to show the effectivity of chirp stimulus and to compare with tone-burst and click stimulus during ocular VEMP (oVEMP) and also to exhibit same stimulation response pattern in utricle as seen in cochlea. Material and Methods: A total of 85 healthy volunteers without any vestibular and otologic disease history were enrolled in this study. Three different types of air conduction stimuli (tone-burst, click and chirp) were used for the oVEMP test. N1, P1 latencies, N1P1 amplitudes and asymmetry ratios were investigated for each stimulus type according to age subgroups and sex.Results: The ratio of presence of oVEMP response was found to be 94.1%, 82.1% and 98.8% with tone-burst, click and chirp stimuli respectively. The latencies were significantly shorter in chirp stimulus with respect to others in both ears. The amplitudes were also significantly larger in chirp stimulus with respect to other in both ears. According to analysis of N1P1 asymmetry ratios, N1 and P1 latency asymmetry, there were no statistically significant difference in these values within each stimulus types.Conclusion: oVEMP is more practical, easier, faster and less invasive method. oVEMP results with chirp stimulus have shorter latency and higher amplitude and more clear waveform morphology with higher ratio of response when compared to click and tone-burst stimulus. As a result, chirp is a reliable and suitable stimulus type for oVEMP analysis. In the light of these unique results with chirp stimulus, utricular hair cells may have similar frequency specific tonotopic organization as seen in cochlea.
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    Multivariate Analysis of the Factors Affecting Tinnitus Severity in Old Age: A Multi-Center Cross- Sectional Study
    (Gazi Univ, Fac Med, 2023) Ozer, Fulya; Cabuk, Goezde Bayramoglu; Mutlu, Meryem; Er, Serap; Simsek, Agit; Erbek, Selim Sermed
    Aim: The purpose of this study was to analyze the factors affecting tinnitus severity in the population aged 60 and over with a multi-central data and with multivariate analysis. Materials: This prospective study was composed of 130 subjects aged 60 years or older with clinical complaint of tinnitus and administered to five different otorhinolaryngology clinics in four different cities in our country. All participants have been tested with pure tone audiometry. Tinnitus loudness and pitch mapping were determined for all participants. All participants also interviewed individually to complete Tinnitus Handicap Inventory (THI) and asked to characterize their tinnitus symptoms using a visual analog scale (VAS) measuring severity, annoyance of tinnitus. Results: Tinnitus loudness increases significantly in the group over the age of 79, but there is no significant difference between the groups formed according to age in terms of VAS or THI values. Systemic disease does not make a significant difference that increases the severity of tinnitus. risk factors that increase tinnitus severity are included in the logistic regression analysis; High level of education and advanced age over 79 years were determined as independent risk factors. Increasing education level is an independent risk factor for increasing tinnitus severity with an odds ratio of 2.46 (95% CI, 1.080-5.624). At the same time, advanced age over 79 years is an independent risk factor with an odds ratio of 5.4 (95% CI, 1,385-21.197), which causes tinnitus severity to be felt more. Conclusion: In old age population, the incidence of tinnitus does not increase with increasing age, but tinnitus severity increases. As hearing loss increases, tinnitus severity and VAS score increase. According to the results of this study, the most important risk factors that increase the perception of tinnitus in the elderly population were determined as very advanced age and high education level. It is reasonable to think that one of the reasons for this is that the elderly in the vulnerable group for the Covid 19 pandemic should stay away from hospitals unless their tinnitus complaints are very serious. Re-performing our study in elderly individuals after the pandemic is important to see the effect of the pandemic period more clearly in these individuals.