人工耳蜗植入对耳鸣影响的问卷调查研究

Questionnaire research on tinnitus changes after cochlear implantation

目的通过问卷调查研究人工耳蜗植入对耳鸣的影响。方法随机调查人工耳蜗植入成年患者人工耳蜗植入术前是否伴有耳鸣以及术后耳鸣改变情况,通过联合应用"视觉模拟评分法(visual analog scale,VAS)"和"耳鸣致残量表(tinnitus handicap inventory,THI)中文版"对耳鸣进行评估。VAS用于评估耳鸣响度,双耳分别打分;THI用于量化耳鸣对日常生活的影响。要求受试者对术前和术后的耳鸣情况分别打分。结果随机调查人工耳蜗植入成人52例,术前伴有耳鸣30例(57.7%)。单侧人工耳蜗植入术后,自觉耳鸣减轻或消失者25例(83.3%),其中,植入耳同侧耳鸣消失5例,这5例患者中2例患者对侧的耳鸣也消失了,即双侧耳鸣均消失;自觉耳鸣较术前无明显变化3例(10.0%);自觉耳鸣加重2例(6.7%)。VAS耳鸣响度得分:耳蜗植入侧术前得分6.5±2.4,术后得分2.8±2.3(t=6.287,P<0.01);术前对侧得分6.2±1.8,术后对侧得分3.3±2.2(t=4.763,P<0.05)。THI得分:术前得分51.9±27.7,术后得分25.3±25.8(t=4.759,P<0.01)。结论耳鸣在人工耳蜗植入候选人群中具有较高的发生率。人工耳蜗植入术后能够显著缓解耳鸣响度,减少耳鸣对患者日常生活的影响。

OBJECTIVE To determine tinnitus changes pre- and post-operatively for cochlear implant patients. METHODS We collected 52 cochlear implant （CI）adults randomly,and asked them wether they had tinnitus before cochlear implant surgery. If the patients experienced tinnitus before surgery, they would be administered the THQ Tinnitus Handicap Inventory （THI）, Visual Analog Scale（VAS）for tinnitus loudness pre- and postoperatively. RESULTS 52 patients were collected. 30 CI users（57.7%）perceived tinnitus before CI surgery. After surgery, 25 subjects（83.3%） had tinnitus relief or completely disappear, 3 subjects （10.0%）reported no change, 2 subjects felt worse （6.7%）. VAS scores for tinnitus loudness： ①ipsilateral ear： pre-surgery 6.5±2.4,post-surgery 2.8±2.3 （t=6.287,P〈0.01）; ②contralateral ear： pre-surgery 6.2±1.8, post-surgery 3.3±2.2（t=4.763, P〈0.05）. THI scores： pre-surgery 51.9±27.7, post-surgery 25.3±25.8 （t=4.759,P〈0.01）. CONCLUSION There is a high tinnitus incidence among CI candidates. Most of these tinnitus patients will benefit from receiving CI.