Tinnitus complaint behaviour in long-standing Meniere's disorder: its association with the other cardinal symptoms

Objective: To explore factors that determines tinnitus complaint behaviour in patients with chronic long-standing Meniere's disorder. Design and setting: A questionnaire-based cross-sectional investigation. This included the Oto-neurological questionnaire, the Hearing Disability and Handicap Scale (HDHS), Hearing Measurement Scale (HMS) on sound localisation and the Dizziness Handicap Questionnaire (DHQ). Participants: Randomly selected 183 members of the Finnish Menie` re's Federation. Intervention: Postal questionnaire. Main outcome measure: International Tinnitus Inventory and impact of tinnitus. Results: The 183 patients,[36 men and 147 women; mean age, 63 years] had their Meniere's disorder-like symptoms, with a mean of 18 years [range, 1-43], 19% of patients ranked tinnitus as their most severe symptom, and 10% experienced tinnitus as causing a severe or very severe impact. Regression analysis indicated that 41% of International Tinnitus Inventory variance and 28% of tinnitus impact variance were explained by the cardinal symptoms of Meniere's disorder. Furthermore, 40% of International Tinnitus Inventory and 25% of tinnitus impact variance were explained by symptom-related disabilities (HDHS, HMS and DHQ). Aural pressure, hearing loss and gait problems were the most important predictors of tinnitus complaint. Understanding what people say and limitation of activities because of vertigo were the most important related disabilities. Conclusion: Tinnitus shares a significant variance with the other cardinal symptoms in patients with long-standing Meniere's disorder. As the impact is significantly related to activity limitations based on hearing disability and vertigo, the results suggest that therapeutic efforts to reduce tinnitus in Meniere's disorder should include the alleviation of balance and hearing problems.