个性化切迹音乐治疗主观性耳鸣的初步观察

Preliminary Results of Retraining Using Tailor Made Notch Music in Patients with Subjective Tinnitus

目的探讨个性化切迹音乐对主观性耳鸣的治疗效果,以及耳鸣频率、相关听力学频率特性对治疗效果的影响。方法选取纯音听阈在70d B HL以内的主观性耳鸣患者20名,接受1个月的个性化切迹音乐治疗。以耳鸣致残量表(tinnitus handicap inventory,THI)评价患者治疗前后变化。结果经过个性化切迹音乐治疗后,患者总THI得分明显降低,呈显著差异。治疗有效组中听力损伤患者平均耳鸣频率接近平均边缘频率,两者呈显著相关性;同时,最大听力损伤频率明显高于平均耳鸣频率,存在显著差异。然而,无效组平均耳鸣频率则接近平均最大听力损伤频率,且两者存在显著相关性;另外,无效组平均耳鸣频率明显高于边缘频率,存在显著差异。结论个性化切迹音乐治疗能有效减轻耳鸣带来的困扰,改善主观症状与生活质量。耳鸣频率与相关听力学频率特性之间的关系可能作为反映耳鸣患者中枢机制与预测个性化切迹音乐治疗效果的指标。

Objective To report effectiveness of tailor made notch music training（TMNMT） for patients with subjective tinnitus. Methods A total of 20 patients with subjective tinnitus whose hearing thresholds were less than70 d B HL were recruited to receive TMNMT for one month. Results The mean THI score decreaseed after the one month of TMNMT. In responding patients, the mean tinnitus pitch was close to edge frequency（Fedge） although significantly lower than the maximum hearing loss frequency（Fmax）. However, in non-responding patients, the tinnitus pitch was close to Fmax and significantly higher than Fedge. Significant correlation was found between tinnitus pitch and Fedge at initial examination in responding patients. The tinnitus pitch was correlated with Fmax in non-responding patients. Conclusions TMNMT is effective in patients with subjective tinnitus. The relationships between tinnitus pitch and relevant audiometric characteristics may provide insight into tinnitus generation and the indicator of effectiveness of TMNMT.