人工耳蜗植入对老年性聋伴耳鸣患者的疗效研究

Effectiveness analysis of the cochlear implantation in presbycusis with tinnitus

目的探讨老年性聋伴耳鸣患者人工耳蜗植入术后的听觉和耳鸣康复效果。方法分析42例老年性聋患者资料,耳鸣组23例,对照组19例。记录人工耳蜗植入前、后患者听觉行为分级、言语可懂度分级、言语识别率和耳鸣组患者耳鸣残疾量表和视觉模拟评分法得分,分析可能影响耳鸣预后的因素。结果两组比较,患者听觉行为分级(t=16.47,P<0.01)、言语可懂度分级(t=11.93,P<0.01)和言语识别率W RS均较术前有显著提高(t=25.60,P <0.01)。在相同治疗阶段,两组间比较差异无统计学意义(P>0.05);治疗前、后比较,耳鸣组患者耳鸣残疾量表(t=7.23,P<0.01)和视觉模拟评分法得分(t=5.53,P<0.01)均较术前显著下降,耳鸣时间、重度耳聋时间及是否佩戴助听器对耳鸣预后无影响(P>0.05)。结论人工耳蜗植入可有效提高老年性聋患者的听觉言语能力,改善老年性聋伴耳鸣患者的耳鸣症状。

OBJECTIVE To study the effectiveness of cochlear implantation on auditory and tinnitus outcomes in presbycusis with tinnitus. METHODS The clinical data of 42 presbycusis underwent cochlear implantation between January 2014 and December 2017 were retrospectively analyzed, which include 23 cases with tinnitus and 19 cases with non-tinnitus. The preoperative and postoperative auditory performance were analyzed and compared by the auditory classification criteria(CAP), Speech Intelligibility Rating(SIR) and word recognition score(WRS) between the two groups. The patients with tinnitus were evaluated by using the tinnitus handicap inventory(THI) and the visval analogue scale(VAS) at preoperative and postoperative. Fisher’s exact test were conducted to examine the factors that may affect the prognosis of tinnitus. RESULTS Cochlear implantations were successfully performed in all 42 cases without any complications. The postoperative CAP(t =16.47, P <0.01), SIR(t =11.93, P <0.01) and WRS(t =25.60, P <0.01) scores of t wo g roups were sig n if ica ntly bet ter tha n preoperative, but there was no signif icant difference between two groups. The postoperative THI(t =7.23, P <0.01) and VAS(t =5.53, P <0.01) scores of the patients with tinnitus were significantly better than preoperative. The effects of cochlear implantation on tinnitus were not correlated with the course of tinnitus, severe deafness time and deaf aid(P >0.05). CONCLUSION Cochlear implantation is an effective treatment for presbycusis n speech recognition and auditory performance and can be used to improve the tinnitus symptoms of presbycusis with tinnitus.