title: Pre-Treatment Objective Diagnosis and Post-Treatment Outcome Evaluation in Patients with Vascular Pulsatile Tinnitus Using Transcanal Recording and Spectro-Temporal Analysis.
abstract: OBJECTIVE
  Although vascular pulsatile tinnitus (VPT) has been classified as "objective", VPT is not easily recognizable or documentable in most cases. In response to this, we have developed transcanal sound recording (TSR) and spectro-temporal analysis (STA) for the objective diagnosis of VPT. By refining our initial method, we were able to apply TSR/STA to post-treatment outcome evaluation, as well as pre-treatment objective diagnosis.
  
  
  METHODS
  TSR was performed on seven VPT patients and five normal controls before and after surgical or interventional treatment. VPT was recorded using an inserted microphone with the subjects placed in both upright and supine positions with 1) a neutral head position, 2) head rotated to the tinnitus side, 3) head rotated to the non-tinnitus side, and 4) a neutral position with ipsi-lesional manual cervical compression. The recorded signals were analyzed in both time and time-frequency domains by performing a short-time Fourier transformation.
  
  
  RESULTS
  The pre-treatment ear canal signals of all VPT patients demonstrated pulse-synchronous periodic structures and acoustic characteristics that were representative of their presumptive vascular pathologies, whereas those the controls exhibited smaller peaks and weak periodicities. Compared with the pre-treatment signals, the post-treatment signals exhibited significantly reduced peak- and root mean square amplitudes upon time domain analysis. Additionally, further sub-band analysis confirmed that the pulse-synchronous signal of all subjects was not identifiable after treatment and, in particular, that the signal decrement was statistically significant at low frequencies. Moreover, the post-treatment signals of the VPT subjects revealed no significant differences when compared to those of the control group.
  
  
  CONCLUSIONS
  We reconfirmed that the TSR/STA method is an effective modality to objectify VPT. In addition, the potential role of the TSR/STA method in the objective evaluation of treatment outcomes in patients with VPT was proven. Further studies incorporating a larger sample size and more refined recording techniques are warranted.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.|Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medical Center, Seoul, Korea.
authors.forename: Shin Hye
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Music and Audio Research Group, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea.
authors.forename: Gwang Seok
authors.initials: GS
authors.lastname: An
authors.affiliation: Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, United States of America.
authors.forename: Inyong
authors.initials: I
authors.lastname: Choi
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Ja-Won
authors.initials: JW
authors.lastname: Koo
authors.affiliation: Music and Audio Research Group, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea.
authors.forename: Kyogu
authors.initials: K
authors.lastname: Lee
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jae-Jin
authors.identifier: http://orcid.org/0000-0002-6631-3232
authors.initials: JJ
authors.lastname: Song
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005583:Fourier Analysis; D006320:Hearing Tests / Q000295:instrumentation / Q000379:methods / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D013016:Sound; D014012:Tinnitus / Q000175:diagnosis* / Q000628:therapy