The Role of Manganese, Cadmium, Chromium and Selenium on Subjective Tinnitus

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The Role of Manganese, Cadmium, Chromium and Selenium on Subjective Tinnitus Nihal Efe Atila 1 & Alptug Atila 2 & Zülküf Kaya 3 & Yunus E. Bulut 4 & Fatih Oner 1 & Kübra Topal 5 & Zafer Bayraktutan 6 & Ebubekir Bakan 6 Received: 4 August 2020 / Accepted: 30 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract Elevated levels of heavy metals like cadmium (Cd) and manganese (Mn) are known to lead to oxidative damage-related ototoxicity and decreased levels of chromium (Cr) and selenium (Se) are known to lead to oto-toxicity due to reduced anti-oxidant activity. The aim of the present study was to evaluate serum levels of Cd, Mn, Cr, and Se and their relationship with tinnitus. A total of 48 patients with tinnitus (Group 1) and 40 healthy controls (Group 2) were included in the study. All participants were applied audiology tests. Severity of tinnitus was measured with Tinnitus Severity Index Questionnaire (TSIQ) in group 1. Serum Mn, Cd, Cr, and Se measurements were done by using The Agilent ICP-MS system consisted of a 7700 coupled plasma mass spectrometry (ICP-MS). Serum Cd, Mn, and Cr levels were higher in group 1 and Se level was lower in group 1 than that of group 2. We may conclude that Cd, Mn, Cr, and Se levels could play an important role in etio-pathogenesis of tinnitus, and thereby supplementation or reduction of these elements could be considered as novel therapeutic goals. Keywords Tinnitus . Trace elements . ICP-MS . Serum

Introduction Tinnitus is being aware of the voices coming from an external origin in the ear or in the head. Tinnitus is a symptom, not a disease. Symptoms of tinnitus are usually defined as ringing bells, buzzing, or whistling [1, 2]. It is defined as “objective tinnitus” if the voice can be heard also by the others and “subjective tinnitus” if only the patient can hear it.

* Nihal Efe Atila [email protected] 1

Erzurum Regional Training and Research Hospital, Department of Otorhinolaryngology, 25240 Erzurum, Turkey

2

Department of Analytical Chemistry, Ataturk University Faculty of Pharmacy, 25240 Erzurum, Turkey

3

Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Ataturk University, 25240 Erzurum, Turkey

4

Health Directores, 06560 Ankara, Turkey

5

Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Kastamonu University, 37000 Kastamonu, Turkey

6

Department of Medical Biochemistry, School of Medicine, Ataturk University, 25240 Erzurum, Turkey

Subjective tinnitus is a voice perception resulting from an abnormal neuronal activity. Tinnitus is usually subjective and defined as “chronic tinnitus” if lasts longer than 6 months [1–3]. Prevalence of tinnitus is 10–15% in adult population [4, 5]. Prevalence was reported as 32.9% in a study conducted in Kayseri from Turkey [6]. Tinnitus prevalence tends to increase with age and more common in the age groups of 40– 49 years (23.9%) and 50–59 years (25.6%) [7]. Etiology of tinnitus includes otology disorders, neurologic problems (mu