BackgroundThere are a large number of assessment tools for tinnitus, with little consensus on what it is important to measure and no preference for a minimum reporting standard. The item content of tinnitus assessment tools should seek to capture relevant impacts of tinnitus on everyday life, but no-one has yet synthesised information about the range of tinnitus complaints. This review is thus the first comprehensive and authoritative collection and synthesis of what adults with tinnitus and their significant others report as problems in their everyday lives caused by tinnitus.MethodsElectronic searches were conducted in PubMed, Embase, CINAHL, as well as grey literature sources to identify publications from January 1980 to June 2015 in which participants were enrolled because tinnitus was their primary complaint. A manual search of seven relevant journals updated the search to December 2017. Of the 3699 titles identified overall, 84 records (reporting 86 studies) met our inclusion criteria and were taken through to data collection. Coders collated generic and tinnitus-specific complaints reported by people with tinnitus. All relevant data items were then analyzed using an iterative approach to narrative synthesis to form domain groupings representing complaints of tinnitus, which were compared patients and significant others.ResultsFrom the 86 studies analyzed using data collected from 16,381 patients, 42 discrete complaints were identified spanning physical and psychological health, quality of life and negative attributes of the tinnitus sound. This diversity was not captured by any individual study alone. There was good convergence between complaints collected using open- and closed-format questions, with the exception of general moods and perceptual attributes of tinnitus (location, loudness, pitch and unpleasantness); reported only using closed questions. Just two studies addressed data from the perspective of significant others (n = 79), but there was substantial correspondence with the patient framework, especially regarding relationships and social life.ConclusionsOur findings contribute fundamental new knowledge and a unique resource that enables investigators to appreciate the broad impacts of tinnitus on an individual. Our findings can also be used to guide questions during diagnostic assessment, to evaluate existing tinnitus-specific HR-QoL questionnaires and develop new ones, where necessary.Trial RegistrationPROSPERO registration number: CRD42015020629. Protocol published in BMJ Open. 2016;6e009171.Electronic supplementary materialThe online version of this article (10.1186/s12955-018-0888-9) contains supplementary material, which is available to authorized users.

Introduction: Otosclerosis is a common form of conductive hearing loss characterized by abnormal bone remodeling exclusively in the otic capsule. The prevalence of otosclerosis varies in racial populations and is described as being rare in black African populations. In this paper we aim to report five cases of clinical, and surgically confirmed, otosclerosis in black individuals, in São Tomé and Príncipe.Material and Methods: Since February 2011, Ear, Nose and Throat consultations and surgeries specialty have been carried out at Dr. Ayres de Menezes Hospital in cooperation with the project ‘Health for all’. A retrospective analysis was undertaken of the records of all patients subjected either to stapedectomy or partial stapedectomy until February 2014. Information regarding clinical presentation, audiometric data and surgery reports was recorded.Results: Five adult patients underwent stapedectomy or partial stapedectomy. All of them presented with normal otoscopy, conductive or mixed hearing loss on audiogram and normal tympanometry with absent stapedial reflexes. None of the patients had signs of infection or history of head trauma. Three cases showed improvement in the air-bone gap after surgery. The other two were lost to follow-up.Discussion: We documented and surgically confirmed five cases of clinical otosclerosis in this population. A thematic review was carried out and concluded that, despite being described as a rare event in this race, available literature on this topic is not enough to state that there is lower prevalence of otosclerosis amongst the African population.Conclusion: Even if not common, otosclerosis cannot be disregarded as a possible cause for conductive hearing loss among the population of São Tomé and Principe.

A surdez autoimune é uma entidade clínica rara, representando geralmente um desafio diagnóstico, correspondendo muitas vezes à manifestação inicial de um distúrbio autoimune sistémico. Caracteriza-se pela presença de hipoacusia neurossensorial, bilateral e assimétrica de instalação progressiva durante semanas a meses. Em 50% dos casos, associado à surdez, verifica-se a presença de sintomas vestibulares, acufenos ou plenitude auricular. Dada a ausência de testes específicos que permitam a realização de um diagnóstico definitivo, este é baseado na suspeita clínica e na resposta ao tratamento com terapia imunossupressora. O diagnóstico diferencial é realizado através de uma história clínica detalhada com exame objetivo completo, bem como exames audiométricos, laboratoriais e imagiológicos de modo a excluir outras etiologias de surdez neurossensorial. A raridade desta doença, o grande espectro de manifestações clínicas, a ausência de estudos randomizados que demonstrem a eficácia do tratamento, bem como a ausência de resultados a longo prazo, fazem desta doença um desafio. Com este artigo os autores pretendem realizar uma revisão do tema de modo a facilitar a identificação precoce desta patologia e permitir a instituição adequada de tratamento.