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直流电耳部电刺激与颈椎运动疗法在耳鸣治疗中的应用

The application of direct current electrical stimulation of the ear and cervical spine kinesitherapy in tinnitus treatment.

作者信息

Mielczarek Marzena, Konopka Wieslaw, Olszewski Jurek

机构信息

Department of Otolaryngology and Laryngological Oncology, Medical University of Lodz, 113 Zeromskiego Street, Lodz, Poland.

出版信息

Auris Nasus Larynx. 2013 Feb;40(1):61-5. doi: 10.1016/j.anl.2012.05.006. Epub 2012 Jun 8.

Abstract

OBJECTIVE

The aim of the study was to evaluate the effectiveness of electrical stimulations of the hearing organ in tinnitus treatment adapting the frequency of stimulation according to tinnitus frequency, to assess the influence of cervical spine kinesitherapy on tinnitus, as well as to evaluate hearing after electrical stimulations alone and together with cervical spine kinesitherapy.

METHODS

The study comprised 80 tinnitus, sensorineural hearing loss patients (119 tinnitus ears) divided into two groups. In group I (n - 58 tinnitus ears) electrical stimulation of the hearing organ was performed, in group II (n - 61 tinnitus ears) electrical stimulation together with cervical spine kinesitherapy. Hydrotransmissive, selective electrical stimulations were conducted using direct, rectangular current. The passive electrode was placed on the forehead, the active--a silver probe--was immersed in the external ear canal in 0.9% saline solution. The treatment involved fifteen applications of electrical stimulations (each lasted for 4 min) administered three or four times a week (whole treatment lasted approximately 30 days). The evaluation of the results considered a case history (change from permanent to temporary tinnitus), questionnaires (the increase/decrease of the total points) and the audiometric evaluation of hearing level.

RESULTS

Before the treatment, group I comprised 51 ears (87.93%) with permanent, and 7 ears (12.07%) with temporary tinnitus; group II - 55 ears (90.17%) with permanent and 6 ears (9.83%) with temporary tinnitus. After the treatment, in both groups the number of ears with permanent tinnitus decreased considerably obtaining the pauses or disappearing of tinnitus. Directly after the treatment, group I comprised 25 ears (43.11%) with permanent, and 10 ears (17.24%) with temporary tinnitus, in 23 ears (39.65%) tinnitus disappeared; group II - 33 ears (54.1%) with permanent and 11 ears (18.03%) with temporary tinnitus, in 17 ears (27.87%) tinnitus disappeared. Regarding questionnaires, improvement was observed in group I - in 43.11% of ears, in group II - 32.8%. In both groups audiometric improvement of hearing was recognized.

CONCLUSIONS

(1) Electrical stimulation of the hearing organ, with the application of current frequencies according to tinnitus frequencies (selective electrical stimulation), was an efficient method in severe tinnitus treatment. (2) Cervical spine kinesitherapy in the treatment of tinnitus, using electrical stimulation, did not have any supporting influence.

摘要

目的

本研究旨在评估根据耳鸣频率调整刺激频率的听觉器官电刺激在耳鸣治疗中的有效性,评估颈椎运动疗法对耳鸣的影响,以及评估单独电刺激和联合颈椎运动疗法后的听力情况。

方法

该研究纳入80例耳鸣伴感音神经性听力损失患者(119只耳鸣耳),分为两组。第一组(58只耳鸣耳)进行听觉器官电刺激,第二组(61只耳鸣耳)进行电刺激联合颈椎运动疗法。使用直流电、矩形电流进行水传导性、选择性电刺激。被动电极置于前额,主动电极(银探头)浸入外耳道的0.9%盐溶液中。治疗包括每周进行三次或四次,每次持续4分钟,共15次电刺激应用(整个治疗持续约30天)。结果评估考虑病史(从持续性耳鸣变为暂时性耳鸣)、问卷(总分的增加/减少)以及听力水平的听力测定评估。

结果

治疗前,第一组有51只耳(87.93%)为持续性耳鸣,7只耳(12.07%)为暂时性耳鸣;第二组有55只耳(90.17%)为持续性耳鸣,6只耳(9.83%)为暂时性耳鸣。治疗后,两组中持续性耳鸣耳的数量均显著减少,耳鸣出现间歇或消失。治疗后即刻,第一组有25只耳(43.11%)为持续性耳鸣,10只耳(17.24%)为暂时性耳鸣,23只耳(39.65%)耳鸣消失;第二组有33只耳(54.1%)为持续性耳鸣,11只耳(18.03%)为暂时性耳鸣,17只耳(27.87%)耳鸣消失。关于问卷,第一组43.11%的耳观察到改善,第二组为32.8%。两组均观察到听力测定的听力改善。

结论

(1)根据耳鸣频率应用电流频率的听觉器官电刺激(选择性电刺激)是重度耳鸣治疗的有效方法。(2)在耳鸣治疗中,使用电刺激的颈椎运动疗法没有任何辅助作用。

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