双侧对称高频SNHL伴耳鸣患者耳鸣特征分析

Characteristics of Tinnitus in Patients with Bilateral Symmetrical High Frequency SNHL

目的探讨双侧对称高频感音神经性聋(Sensorineural Hearing Loss,SNHL)伴耳鸣患者的一般特征和耳鸣的特点。方法选20例听力正常耳鸣患者作为对照组,20例双侧对称高频SNHL耳鸣患者作为试验组,进行纯音测听、声导抗、耳鸣残疾评估量化表(Tinnitus Handicap Inventory,THI)以及耳鸣声类型、频率、强度等一系列测试,再比较分析两组数据特征。结果①平均听阈:对照组为左耳16.43±4.61dB HL、右耳16.31±3.16dB HL,试验组为左耳26.61±3.62dB HL、右耳29.11±6.38dB HL,且两组受试者声导抗测试均为A型;②THI两组得分:对照组为38.09±26.64,试验组为33.42±21.99,耳鸣声强度:对照组为24.88±10.34dB HL,试验组为33.57±14.63dB HL,两组之间均P>0.05,;③耳鸣声类型:对照组为纯音:窄带噪声:脉冲纯音=7:2:1、试验组为纯音:窄带噪声:白噪声=15:3:2,耳鸣声频率:对照组为低频(<500Hz):中频(500-2000Hz):高频(>2000Hz)=2:13:5,试验组为中频(500-2000Hz):高频(>2000Hz)=3:7,双侧对称高频SNHL患者,单侧耳鸣及双侧耳鸣患者各占11例、9例。结论①双侧对称高频SNHI耳鸣患者THI得分、耳鸣声强度与听力正常耳鸣患者均相差不大,无明显统计学差异;②双侧对称高频SNHI与听力正常耳鸣患者的耳鸣声类型均以纯音为主,耳鸣声频率前者以高频居多,后者以中频占多数;③双侧对称高频SNHI耳鸣患者,其耳鸣频率分布并不一定与听力损失频率完全一致。

Objective To report general characteristics and characteristics of tinnitus in patients with bilateral symmetrical high frequency sensorineural hearing loss(SNHL).Methods Twenty patients with bilateral symmetrical high frequency SNHL and tinnitus were selected with 20 tinnitus patients with normal hearing used as controls.Pure tone audiometry,acoustic immittance testing and the tinnitus handicap inventory(THI),as well as tinnitus type,pitch and loudness,were assessed and compared between patients with SNHL and normal hearing.Results 1)Average hearing threshold was 16.43+4.61 dB HL on left and 16.31+3.16 dB HL on right in normal hearing patients,and 26.61+3.62 dB HL on left and 29.11+6.38 dB HL on right in patients with SNHL,all showing type A tympanograms;2)The THI score was 38.09+26.64 in normal hearing patients and 33.42+21.99 in patients with SNHL,with tinnitus loudness matched at 24.88+10.34 dB HL in normal hearing patients and 33.57+14.63 dB HL in patients with SNHL;3)Tinnitus was matched to pure tone(n=7),narrowband noise(n=2)and pulse tone(n=1)in normal hearing patients,and to pure tone(n=15),narrowband noise(n=3)and white noise(n=2)in patients with SNHL;tinnitus was matched to low frequencies(<500 Hz)in 2,mid frequencies(500-2000 Hz)in 13 and high frequencies(>2000 Hz)in 5 of patients with SNHL,and to mid frequencies in 3 and high frequencies in 7 of patients with normal hearing;tinnitus was bilateral in 9 and unilateral in 11 of patients with symmetrical high frequency SNHL.Conclusion 1)THI scores and tinnitus loudness in patients with bilateral symmetrical high frequency SNHI are not significantly different from tinnitus patients with normal hearing;2)Tonal tinnitus is the most type of tinnitus in both patients with bilateral symmetrical high frequency SNHI and tinnitus patients with normal hearing,with tinnitus pitch more likely in mid frequency range in tinnitus patients with normal hearing and in high frequency range in those with bilateral symmetrical high frequency SNHI;3)The distribution of tinnitus pitch is not necessarily consistent with the frequency feature of hearing loss.