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The aim of this work is to study the characteristics of tinnitus both in normal hearing subjects and in patients with hearing loss. The study considered tinnitus sufferers, ranging from 21 to 83 years of age, who were referred to the Audiology Section of Palermo University in the years 2006-2008. The following parameters were considered: age, sex, hearing threshold, tinnitus laterality, tinnitus duration, tinnitus measurements and subjective disturbance caused by tinnitus. The sample was divided into Group1 (G1), 115 subjects with normal hearing, and Group2 (G2), 197 subjects with hearing loss. Especially for G2, there was a predominance of males compared to females (P = 0.011); the highest percentage of tinnitus resulted in the decades 61-70 and >70 with a significant difference for G2 demonstrating that the hearing status and the elderly represent the principal tinnitus-related factors (P < 0.0001). The hearing impairment resulted in most cases of sensorineural hearing loss (SNHL) type and was limited to the high frequencies; the 72.1% of the patients with SNHL had a high-pitched tinnitus, while the 88.4% of the patients with a high-frequency SNHL had a high-pitched tinnitus (P < 0.0001). As to the subjective discomfort, the catastrophic category was the most representative among G1 with a significant difference between the two groups; no correlation was found between the level of tinnitus intensity and the tinnitus annoyance confirming the possibility that tinnitus discomfort is elicited by a certain degree of psychological distress as anxiety, depression, irritability and phobias.

The aims of this study were to determine the distribution of risk factors associated with tinnitus analysing their role in the development of tinnitus and the effects of their interaction; to evidence the importance of a suitable and adequate clinical and audiologic assessment to avoid those modifiable risk factors responsible for cochlear dysfunction and tinnitus onset. 46 subjects with tinnitus and 74 controls were studied according to: age, sex, Body Mass Index (BMI), neck circumference, tobacco smoking, feeling fatigue or headache, self reporting snoring, hypertension, diabetes, coronary heart disease, and/or hyperlipidemia, and laboratory finding as lipid profile and levels of reactive oxygen metabolites (d-ROM). Audiological assessment was performed by multi-frequency audiometry (PTA 0.5-16 kHz ) and transient-evoked otoacoustic emissions (TEOAE diagnostic). Univariate analysis was performed to examine the association between determinants and occurrence of tinnitus; Mantel-Haenszel test (G.or) was used to investigate the joint effect of determinants on tinnitus. Tinnitus was more frequent among males with age [50 years; BMI [30 kg/m 2 , neck circumference [40 cm, headache, hypertension, hypercholesterolemia resulted significant risk factors for tinnitus (P \ 0.0001). Tinnitus group had more comorbidity (P \ 0.0001) and worse audiometric thresholds (60.87 Vs 21.62 % hearing loss; P \ 0.0001) with respect to control group. The interaction between hypertension-BMI C 30 kg/m 2 (G.or = 8.45) and smoking-hypercholesterolemia (G.or = 5.08) increases the risk of tinnitus (P \ 0.0001). Our results underline that several factors either individually or jointly contribute to tinnitus onset; a comprehensive knowledge about tinnitus risk factors and associated clinical conditions could contribute to minimizing this disorder.

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The objective of this study is to identify the prevalence of otitis media with effusion (OME) in primary school children and to value the possible predisposing factors focusing on relationship between allergy and OME in Western Sicily. 2,097 children attending primary school were screened from September 2006 to June 2007 in Sciacca. Children underwent pneumatic otoscopy, skin tests, tympanogram and acoustic reflex tests. Audiogram was performed if the child had a type B or a type C tympanogram. The criteria for diagnosis of OME were: documented persistent middle ear effusion by otoscopic examination for a minimum of 3 months, presence of B or C tympanogram, absence of ipsilateral acoustic reflex and a conductive hearing loss greater than 25 dB at any one of the frequencies from 250 Hz to 4 kHz. OME was identified in 143 children, in 61 of whom OME was unilateral and in 82 of whom it was bilateral. The overall prevalence of OME was 6.8%, with a maximum prevalence of 12.9% between 5 and 6 years of age. By increasing age, the prevalence of OME decreased. Also, we found a higher prevalence rate of OME in children with positive skin tests (62.9%) than those with negative skin tests (37.1%). The present study evidences the high social impact of OME, whose prevalence is directly correlated to age and atopy. Moreover, our finding supports the literature data that climatic and environmental factors may also have a role in the occurrence of OME.