Category: Brain Injury; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
Few studies have examined auditory complaints in patients with TBI. Herein, we determine patterns of auditory dysfunction in civilians with TBI using patient reported outcomes measures (PROMs) and health quality measures (HQM).
Design : Prospective case-control study.
Setting : Tertiary care rehabilitation hospital.
Participants (or Animals, Specimens, Cadavers) : Mild TBI (mTBI) and moderate-severe TBI (msTBI) patients, and age and gender-matched controls.
Interventions : Consecutive control and patients with mTBI and msTBI were evaluated. Patients with history of prior otologic disorders or noise exposure were excluded. Participants completed Short Form-36 (SF-36) Health Survey, Handicap Inventory for Adults (HHIA), Tinnitus Handicap Inventory (THI), and Hyperacusis Questionnaire (HQ).
Main Outcome Measure(s) : Scores from PROMs.
From 8/2017 to 12/2018, 92 TBI (n=55 mTBI and 37 msTBI) and 55 controls met study criteria. Forty-one mTBI (74.5%) and 17 msTBI (45.9%) had two or more auditory symptoms compared to control group (5.5%, p<.0001). TBI patients also had a higher prevalence of hearing loss (52.2%), tinnitus (51.1%,), hyperacusis (55.4%,), aural fullness (31.5%), and autophony (15.2%,), all p≤.01. Of those complaining of hearing loss, hyperacusis, or tinnitus, TBI patients also had higher mean scores on the HHIA, HQ, and THI compared to controls, all p≤.001. Higher HHIA score was negatively correlated with SF-36, specifically with their vitality, emotional role, social functioning, and general health perception, all p≤.05 .
Conclusions : This is the first study to investigate PROMs of auditory symptoms and associations with HQM in patients with TBI. Findings have implications for screening with goal to enhance quality of life and function.
Seth Herman– Director Brain Injury Medicine Fellowship, Harvard Medical School/Spauding Rehabilitation Hospital, Charlestown, Massachusetts
Rory Lubner– Medical Student Research Assistant, Warren Alpert Medical School of Brown University, Boston, Massachusetts
Renata Knoll– Researcher, Massachusetts Ear and Eye Infirmary/Harvard Medical School, Boston, Massachusetts
Ashwin Babu– Attending Physician, Harvard Medical School/Spauding Rehabilitation Hospital, Boston, Massachusetts
David Jung– Assistant Professor, Harvard Medical School, Boston, Massachusetts
Aaron Remenschneider– Assistant Professor, University of Massachusetts Medical School, Worcester, Massachusetts
Elliott Kozin– Attending Physician, Massachusetts Ear and Eye Infirmary/Harvard Medical School, Boston, Massachusetts