山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (4): 15-18.doi: 10.6040/j.issn.1673-3770.0.2015.126

• 论著 • 上一篇    下一篇

突发性聋伴耳鸣患者耳鸣特征

钟晓声1, 杨海弟2, 郑亿庆2   

  1. 1. 中山大学附属博济医院/增城市人民医院耳鼻喉科, 广东 增城 511300;
    2. 中山大学孙逸仙纪念医院耳鼻喉科, 广东 广州 510120
  • 收稿日期:2015-03-18 修回日期:2015-05-20 出版日期:2015-08-16 发布日期:2015-08-16
  • 通讯作者: 郑亿庆。E-mail：yiqingzheng@hotmail.com E-mail:yiqingzheng@hotmail.com
  • 作者简介:钟晓声。E-mail：masonic@126.com

Characteristics of tinnitus in patients with idiopathic sudden sensorineural hearing loss.

ZHONG Xiaosheng1, YANG Haidi2, ZHENG Yiqing2   

  1. 1. Department of Otolaryngology, Boji-Affiliated Hospital of Sun Yat-sen University(Zengcheng People's Hospital), Zengcheng 511300, Guangdong, China;
    2. Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong, China
  • Received:2015-03-18 Revised:2015-05-20 Online:2015-08-16 Published:2015-08-16

PDF (PC)

551

摘要： 目的 分析研究突发性聋伴耳鸣患者的耳鸣特点、耳鸣与听力损失的关系、耳鸣对患者的影响程度, 探讨突聋患者耳鸣的产生机制。 方法 突发性聋伴有耳鸣患者231例常规采集病史, 填写耳鸣致残量表(THI)及视觉模拟得分表(VAS), 同时进行纯音听阈测试、耳声发射、耳鸣检测及掩蔽试验等检查。分析患者的耳鸣特点、耳鸣与听力的关系、耳鸣的THI及VAS得分以及它们特点。 结果 ①听力损失特点：低中频下降型20例(占8.7%), 中高频下降型60例(占26.0%), 平坦型44例(占19.0%), 全聋型79例(占34.2%), 不规则型28例(占12.1%);②耳鸣频率:低频耳鸣(≤500 Hz)49例(占21.2%), 中频耳鸣(51～2 000 Hz)54例(23.4%), 高频耳鸣(>2 000 Hz)122例(52.8%), 未匹配6例(占2.6%)。其中听力损失类型为低中频下降型的患者中, 低频、中频、高频耳鸣的比例分别为75%、15%、10%;中高频下降型患者中, 低频、中频、高频耳鸣的比例分别为13.3%、26.7%、60.0%;全聋型患者中, 低频、中频、高频耳鸣的比例分别为17.1%、19.0%、63.3%。听力下降最明显的频率对数与耳鸣频率对数呈线性关系, r=0.592, P<0.01;③耳鸣响度:0～30 dB HL 45例(占19.5%), 31～60 dB HL 60例(占26.0%), 60～90 dB HL 102例(占44.2%), 大于90 dB HL 18例(占27.8%), 未匹配6例(占2.6%)。耳鸣响度与听力损失程度(250～4 000 Hz平均听阈)有相关性, 相关系数r=0.216, P=0.001<0.05。④耳鸣致残级别:按照Newman等依据THI得分将耳鸣残疾分级, 其中1级27例(占11.7%), 2级耳鸣44例(占19.0%), 3级66例(占28.6%), 4级94例(占40.7%)。⑤THI及VAS得分特点:THI得分与听力损失程度无相关性r=0.087, P=0.287>0.05。VAS得分与听力损失程度无相关性r=0.002, P=0.982>0.05。THI得分与耳鸣频率对数无相关性, 相关系数r=-0.056, P=0.402>0.05。VAS得分与耳鸣频率对数无相关性, 相关系数r=-0.003, P=0.970>0.05。THI得分与耳鸣响度无相关性, 相关系数r=0.039, P=0.563>0.05。VAS得分与耳鸣响度无相关性, 相关系数r=0.136, P=0.110>0.05。结论 ①突发性聋伴耳鸣患者中高频耳鸣最常见;②耳鸣频率与听力损失类型显著相关, 低中频下降型以低频耳鸣多见, 而中高频下降型及全聋型以高频耳鸣多见;③听力损失最大的频率与耳鸣的频率有较高的一致性;④突发性聋伴耳鸣患者急性期的耳鸣致残程度以3～4级为多;⑤THI及VAS得分与听力损失的程度、耳鸣的频率、耳鸣的响度均无相关性。

关键词: 突发性聋, 视觉模拟得分表, 耳鸣致残量表, 耳鸣

Abstract: Objective To analyze the characteristics of tinnitus, correlation between tinnitus and hearing loss, effects of tinnitus, and mechanism of tinnitus in patients with sudden sensorineural hearing loss. Methods Clinical data of 231 tinnitus patients with idiopathic sudden sensorineural hearing loss were retrospectively reviewed. Results of Tinnitus Handicap Inventory (THI), visual analogue scale (VAS), pure tone audiometry, acoustic emission, tinnitus test and masking test were analyzed. Results ① Characteristics of hearing loss: Low-intermediate frequency hearing loss (rise type) was 8.7%, high-frequency hearing loss (fall type) was 26%, flat-type was 19%, total-deafness type was 34.2%, irregular type was 12.1%. ② Frequency of tinnitus: Low-frequency (<500 Hz) tinnitus was 21.2%, medium-frequency (51-2 000 Hz) tinnitus was 23.4%, high-frequency (>2 000 Hz) tinnitus was 52.8%, unmatched tinnitus was 2.6%. Of hearing loss with low-intermediate frequency, low, medium and high frequency tinnitus was 75%, 15% and 10% respectively. Of hearing loss with medium-high frequency, low, medium and high frequency tinnitus was 13.3%, 26.7% and 60.0% respectively. Of total deafness, low, medium and high frequency tinnitus was 17.1%, 19.0% and 63.3% respectively. There was an linear relationship between the frequency hearing loss and tinnitus frequency (r=0.590, P<0.01). ③ Tinnitus volume: Tinnitus volume was 0-30 dB HL(19.5%), 31-60 dB HL(26%), 60-90 dB HL(44.2%), >90 dB HL (27.8%), and unmatched (2.6%). Tinnitus volume was correlated with the degree of hearing loss (r=0.216, P<0.05). ④ Tinnitus disability level: According to THI scores, the tinnitus disability level was: grade 1 (11.7%), grade 2 (19%), grade 3 (28.6%), and grade 4 (40.7%). ⑤ The characteristics of THI and VAS scores: there was no correlation between THI scores and degree of hearing loss (r=0.087, P=0.287), no correlation between VAS score and degree of hearing loss (r=0.002, P=0.982), no correlation between THI and the logarithm of tinnitus frequency (r=-0.056, P=0.402), no correlation between VAS score and frequency of tinnitus (r=-0.003, P=0.970), no correlation between THI score and tinnitus volume, r=0.03, P=0.563), no correlation between VAS score and tinnitus volume (r=0.136, P=0.110). Conclusion ① High-frequency tinnitus with idiopathic sudden deafness is the most common among all types of hearing loss. ② There is a significant correlation between tinnitus frequency and type of hearing loss. ③ The frequency of the greatest hearing loss is consistent with the frequency of tinnitus. ④ Tinnitus disability level is grade 3-4 during the acute period of idiopathic sudden sensorineural hearing loss. ⑤ THI and VAS scores are not correlated with degree of hearing loss, tinnitus, tinnitus volume and frequency.

Key words: Tinnitus handicap inventory, Visual analogue scale, Tinnitus, Idiopathic sudden deafness

中图分类号: 

  • R764.437
[1] 刘敏, 陈锡辉, 汪广理, 等. 性别、年龄和听力损害程度与突发性聋患者耳鸣症状相关性分析[J] . 中华耳鼻咽喉头颈外科杂志, 2007, 15(3):174-176. LIU Min, CHEN Xihui, WANG Guangli, et al. Association of sex, age and hearing loss severity with tinnitus among cases with sudden sensorineural hering loss[J]. Chin J Otorhinolarynol Head Neck Surg, 2007, 15(3):174-176.
[2] Psifidis A D, Psillas G K, Daniilidis J C H. Sudden sensorineural hearing loss: Long- term follow- up results[J]. Otolaryngol Head Neck Surg, 2006, 134(5):809-815.
[3] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会.突发性聋的诊断和治疗指南(2005年.济南).中华耳鼻咽喉头颈外科杂志, 2006, 41(8): 569-569. Chinese Otorhinolaryngology Head and Neck Surgery Society of Chinese Medical Association, Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery. Guideline of diagnosis and treatment of sudden deafness (2005, Jinan) [J]. Chin J Otorhinolarynol Head Neck Surg, 2006, 41(8):569-569.
[4] Jastreboff P J, Gray W C, Gold S L. Neurophysiological approach to tinnitus patients[J]. Am J Otol, 1996, 17(2):236-240.
[5] Newman C W, Sandridge S A, Bolek L. Development and psychometric adequacy of the screening versin of the tinitus hadicap inventory[J]. Otol Neurotol, 2008, 29(3):276-281.
[6] 朱亚骄, 薛飞, 王秋萍. 90例耳鸣患者心理声学特征研究[J]. 山东大学耳鼻喉眼学报, 2014, 28(5): 14-17. ZHU Yajiao, XUE Fei, WANG Qiuping. Psychoacoustic characteristics of 90 tinnitus patients[J]. J Otolaryngol Ophthalmol Shandong Univ, 2014, 28(5):14-17.
[7] 杨海弟, 郑亿庆, 张志钢, 等. 主观性耳鸣的掩蔽及习服治疗效果分析[J]. 临床耳鼻咽喉头颈外科杂志, 2010, 24(10):442-446 . YANG Haidi, ZHENG Yiqing, ZHANG Zhigang, et al. Analysis and comparison of the masking and TRT for patients with subjective tinnitus[J]. Clin J Otorhinolarynol Head Neck Surg, 2010, 24(10):442-446.
[1] 廖礼兵,刘绮明,宗凌,翟锦明,张建国. 42例耳鸣伴听觉过敏患者特征分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 31-36.
[2] 许明,罗兴谷,唐洪波,江青山. 儿童突发性聋的临床特征及预后相关因素分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 41-44.
[3] 陈伟,胡中南,童钊君,李湘宇,刘文君. 青中年无眩晕、心脑血管疾病病史的突发性聋患者高刺激率听性脑干反应特征分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 45-49.
[4] 朱文燕,金新,佘万东,马永驰. 突发性聋30例精神心理状况分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 50-52.
[5] 侯小兵,任同力,张毅博. 69例梅尼埃病伴耳鸣的发病特点及影响因素[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 37-40.
[6] 黄娟,庞宇峰,龚静蓉,董玥辉. 耳鸣声学特征与扩展高频听阈的关系[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 7-10.
[7] 张玉波,岳丽艳,尹晓妍,吕哲,单春光. 耳鸣治疗仪联合银杏叶提取物注射液治疗突聋伴耳鸣的疗效分析[J]. 山东大学耳鼻喉眼学报, 2017, 31(5): 50-53.
[8] 朱江彬,南兵卫,陈涛, 郝宗生. 低中频下降型突发性聋听阈恢复后残留耳鸣治疗体会[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 5-7.
[9] 刘阳云,张彩霞,江文,陈琼,常恩格,赵花香,杨会. 突发性聋患者血脂分析[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 1-4.
[10] 马荣峰,朱富高,孙美红,付涛,张晓恒,曹琳. 突发性聋预后的相关因素分析及疗程选择[J]. 山东大学耳鼻喉眼学报, 2016, 30(4): 69-74.
[11] 衡伟伟,后婕,魏先梅,佘万东. TNF-α和IL-8在突发性聋患者血清及外周血单个核细胞中的表达及其意义[J]. 山东大学耳鼻喉眼学报, 2016, 30(2): 40-45.
[12] 狄国华, 刘俊茹, 赵延祥, 高英恺. 利多卡因联合天麻素耳后注射治疗特发性耳鸣[J]. 山东大学耳鼻喉眼学报, 2015, 29(6): 5-7.
[13] 王坛, 安丰伟, 陈剑秋, 林家峰, 侯晓智, 解翠丽, 王英, 林娟. 腭肌电图引导下治疗腭肌阵挛性耳鸣[J]. 山东大学耳鼻喉眼学报, 2015, 29(1): 12-14.
[14] 张彩霞, 刘阳云, 陈志喜, 江文, 李正贤, 陈琼, 常恩格. 鼓室激素注射为初始治疗的突发性聋听力恢复的时间规律[J]. 山东大学耳鼻喉眼学报, 2015, 29(1): 15-18.
[15] 江朝勇, 蔡永明, 殷亚磊. 耳后药物注射治疗突发性聋32例[J]. 山东大学耳鼻喉眼学报, 2014, 28(6): 18-20.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发