儿童耳鸣特点的初步分析

A Preliminary Study of Tinnitus Characteristics in Children

目的探讨儿童耳鸣的临床特点。方法分析33例儿童耳鸣患者的病因、年龄分布、就诊目的及烦恼程度。结果①病因:2例肌源性及1例血管源性客观性耳鸣;中耳病变:分泌性中耳炎6例,外伤性鼓膜穿孔1例;内耳病变:膜迷路积水2例,高频听力损失17例,纯音听阈正常、耳声发射异常4例;②主动诉说耳鸣的儿童最小年龄4.5岁,6岁以下主要病因为分泌性中耳炎,8～14岁主要病因为内耳病变;③就诊的目的和动机:27例为对耳内新出现的声音好奇,向家长反映"耳内有噪声",3例因耳鸣而难以集中注意力,3例对耳鸣有不同程度的担心而求助于家长;④烦恼程度:3例感觉耳鸣较响,轻度烦恼及担心,1例感觉耳鸣很响、很烦、非常担心,其余患儿无担心及烦恼感。结论儿童耳鸣的病因以中、内耳病变为主,是否主动就医与其主诉能力及家长的重视程度有关;儿童耳鸣很少有心理因素参与,预后较成人好。

Objective To study the characteristics of tinnitus in children. Methods 33 cases of children with tinnitus were analyzed for the etiologies, age, intention of seeing doctor and the annoyance scales. Results 2 cases were myo-source objective tinnitus and 1 case was related to blood vessel; 6 cases were associated with secretory otitis media （SOM） and 1 case with traumatic tympanic membrane perforation. 23 cases were due to inner-ear diseases, such as 2 cases of endolymphatic hydrops, 17 cases with high frequency sensorineural hearing loss and 4 cases with normal hearing but abnormal distortion product otoacoustic emission. The youngest one complaining of tinnitus was 4.5 years old. The major cause of tinnitus was SOM for children younger than 6 years old, and inner-ear diseases for the group of 8～14 years old. 27 patients actively looked for professional advice and interested in knowing the noise in the ear. 3 cases were difficult to concentrate their attention because of tinnitus while the other 3 cases were worried about their tinnitus. Regarding annoyance scales, only 3 cases felt moderate tinnitus and somewhat annoyed. 1 case complained of very loud tinnitus and was severely annoyed. The rest reported no annoyance. Conclusion The authors believed the reasons that the children actively seek professional consultation are the follows： the older the child is , the more possible he can complain of tinnitus, followed by the guardian＇s attitude towards tinnitus and the degree of hearing loss. The tinnitus in children hardly have psychological factors participation and the prognosis is better than the adult＇s.