人工耳蜗对语后聋患者双侧耳鸣的影响

Effect of cochlear implantation on bilateral perceived tinnitus of postlingually deafened patients

目的 观察人工耳蜗植入对语后聋患者双侧耳鸣的影响,探讨人工耳蜗植入治疗耳鸣的可行性.方法 对32例（64耳）术前双侧耳鸣语后聋人工耳蜗植入者（男13例,女19例;31例单侧植入,1例双侧植入）进行术前、术后耳鸣问卷调查评估.测试材料采用耳鸣残疾评估量表（Tinnitus Handicap Inventory,THI）,同时记录患者耳鸣的特征,分析植入同侧及对侧耳鸣术前术后响度的变化情况,并观察人工耳蜗开机工作和关机两种状态对耳鸣响度的影响.采用SPSS18.0软件进行数据统计分析.结果 22例患者（71.0％）术后THI得分比术前下降≥20分.术前THI总分平均为（56.4±18.1）分,术后THI总分平均为（24.7±22.7）分,经配对t检验分析,得分手术前后差异具有统计学意义（t=8.037,P＜0.05）.患者术后未开机情况下,同侧耳鸣81.9％（27/33）减弱或消失,18.2％（6/33）响度未变,无响度加重情况出现;对侧耳鸣71.0％（22/31）术后减弱或消失,16.1％（5/31）响度未变,12.9％（4/31）响度加重.在开机状态下,同侧耳鸣97.0％（32/33）减弱或消失,对侧耳鸣83.9％（26/31）减弱或消失.结论 人工耳蜗植入对语后聋耳鸣患者的耳鸣症状具有较好的抑制作用,但也存在耳鸣加重的风险。

Objective The aim of the study was to evaluate the effects of cochlear implantation on bilateral perceived tinnitus of postlingually deafened patients.Method Total of 32 postlingually deafened cochlear implant recipients （13 males,19 females;31 unilateral,1 bilateral cochlear implantation） with bilateral tinnitus were assessed by Tinnitus Handicap Inventory （THI） before and after implantation.Furthermore,characteristics information of tinnitus were recorded to analyze the variety of tinnitus.Intensity of tinnitus in ispilateral and contralateral ears was investigated when cochlear implant was switched on and off.Statistical analysis was performed by SPSS 18.0.Results Twenty-two patients （71.0%） got a decreased THI score of more than 20 points after the operation.The average THI score of pre-operation was 56.4 ± 18.1,and post-operation score was 24.7 ±22.7.A paired-samples t test analysis showed a significant difference of the THI total scores（t =8.037,P 〈0.05）.Tinnitus in the ipsilateral ear improved in 81.9% （27/33）patients and 18.2% （6/33） unchanged.Tinnitus in the contralateral ear improved in 71.0% （22/31）patients,16.1% （5/31） unchanged and 12.9% （4/31） worsen.Tinnitus of ipsilateral ears improved or abolished in 97.0% （32/33）patients,while 83.9% （26/31）of contralateral ear got reduction or absence of loudness when cochlear implant was switched on.Conclusions As an electrical stimulation treatment method,cochlear implant has the inhibitory effect on tinnitus.However,cases of tinnitus aggravation were found,further data is still necessary before considering CI as a treatment of tinnitus.