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672例耳鸣患者听力曲线特点及其与耳鸣疗效的关系

Characteristics of the Hearing Curves in 672 Tinnitus Patients and Their Relationship With Tinnitus Treatment Outcomes

  • 摘要:
    目的 通过对耳鸣患者的听力曲线类型特点以及不同听力曲线类型耳鸣患者的耳鸣严重程度、疗效差异进行分析,进一步探索耳鸣与听力减退的关系,以期为探索耳鸣的病因及治疗方案提供临床依据。
    方法 对符合纳入标准耳鸣患者的基本信息及耳鸣、听力资料进行采集。耳鸣严重程度参考耳鸣评价量表(tinnitus evaluation questionnaire, TEQ)评分标准进行评估,基于听力曲线分型标准,将耳鸣患者分为“听力正常型、高频下降型、低频下降型、部分下降型、平坦下降型、全聋型”,对不同听力曲线类型患者在初诊时的耳鸣情况以及末诊、随访时的耳鸣疗效等多个方面进行分析。
    结果 纳入本研究的耳鸣患者共672例,其中183例听力正常,489例存在不同程度听力损失。根据TEQ分级标准,初诊时耳鸣患者严重程度主要集中在Ⅱ~Ⅲ级:Ⅰ级86例(12.79%),Ⅱ级309例(45.98%),Ⅲ级161例(23.96%),Ⅳ级87例(12.95%),Ⅴ级29例(4.32%)。耳鸣患者听力曲线类型分布以高频下降型多见。初诊时不同听力曲线类型患者的耳鸣严重程度分布差异有统计学(P<0.01);在高频下降型听力曲线耳鸣患者中,不同耳鸣程度患者的听力损失严重程度分布差异无统计学意义。经过统一治疗后,末诊时和随访时,不同听力曲线类型的耳鸣患者之间的疗效差异均无统计学意义。
    结论 本研究中虽然初诊时不同听力曲线类型耳鸣患者的耳鸣严重程度存在明显差异,但耳鸣疗效与听力曲线类型之间未见明确关联,并且同种听力曲线类型患者的耳鸣与听力损失程度之间亦无明确关联,因此根据听力曲线类型为耳鸣患者选择与突聋相近的治疗方案是否有效还需进一步临床论证。

     

    Abstract:
    Objective  To analyze the characteristics of types of hearing curves in patients with tinnitus and the differences in tinnitus severity and treatment outcomes among patients with different types of hearing curves, to further explore the relationship between tinnitus and hearing loss, and to provide clinical evidence for exploring the etiology and treatment plans for tinnitus.
    Methods  The basic information and the tinnitus and hearing data of the tinnitus patients who met the inclusion criteria were collected. The patients’ severity of tinnitus was assessed on a scale of grades I through V according to the grading standards of the tinnitus evaluation questionnaire (TEQ). According to the classification criteria for the different types of hearing curves, the tinnitus patients were categorized into 6 types, including normal hearing, high-frequency descending type, low-frequency descending type, partial descending type, flat descending type, and total deafness. We analyzed in multiple aspects the tinnitus status identified at the initial diagnosis and the treatment outcomes at the last diagnoses and follow-up in patients with different types of hearing curves.
    Results  A total of 672 patients with tinnitus were included in this study, of which 183 had normal hearing, and 489 had varying degrees of hearing loss. According to the TEQ grading criteria for tinnitus assessment, the patients’ severity of tinnitus at the initial diagnosis was mainly concentrated in grades II and III, with 86 cases (12.79%) classified as grade I, 309 cases (45.98%) as grade II, 161 cases (23.96%) as grade III, 87 cases (12.95%) as grade IV, and 29 cases (4.32%) as grade V. Regarding the distribution of hearing curve types, tinnitus patients had predominantly hearing curves of the high-frequency descending type. There were statistically significant differences in the distribution of tinnitus severity among patients with different types of hearing curves at the initial diagnosis (P<0.01). Among tinnitus patients with high-frequency descending hearing curve, there was no statistically significant difference in the distribution of hearing loss severity among patients with tinnitus of different degrees of severity. After uniform treatment, there was no statistically significant difference in treatment outcomes between patients with different types of audiometry curves at the time of the last diagnosis and the follow-up.
    Conclusion  Despite significant differences in the severity of tinnitus among patients with different types of hearing curves at the initial diagnosis in this study, no clear association was found between tinnitus treatment outcomes and hearing curve types. Furthermore, no clear association was found between tinnitus and the degree of hearing loss in patients with the same type of hearing curve. Hence, further clinical evidence is warranted to assess the efficacy of selecting tinnitus treatment plans that are similar to those for sudden deafness based on the types of hearing curves.

     

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