Michiba Takahiro, Kitahara Tadashi, Hikita-Watanabe Noriko, Fukushima Munehisa, Ozono Yoshiyuki, Imai Ryusuke, Inohara Hidenori
Department of Otolaryngology-Head and Neck Surgery, Osaka Rosai Hospital, Japan.
Auris Nasus Larynx. 2013 Apr;40(2):162-6. doi: 10.1016/j.anl.2012.06.007. Epub 2012 Jul 26.
Some patients with sudden sensorineural hearing loss (SSNHL) are frustrated by residual tinnitus even after accomplishment of the treatment for SSNHL. In the present prospective study, we examined patients' backgrounds of sex, laterality and age together with changes in hearing level and the tinnitus score after the onset of SSHNL to determine the prognostic factors of residual tinnitus after the final day of medical treatment for SSNHL.
Forty-four patients with SSNHL were all treated with systemic administration of steroids for 2 weeks and oral intake of vasoactive drugs and vitamin B12 for 6 months before accomplishment of the treatment for SSNHL. The hearing improvement rate (HIR) was determined by comparing the hearing level before and 6 months after the start of treatment. Tinnitus was subjectively evaluated by the tinnitus scoring questionnaire before, 6 and 24 months after the start of treatment. The score of a five-step evaluation of subjective tinnitus feelings, "loudness", "duration" and "annoyance", was recorded.
HIR was significantly correlated with tinnitus score improvement (TSI) in "duration" at 6 months after the start of treatment compared with before treatment. The tinnitus score of all 3 items was significantly improved 6 months after the start of treatment compared with that before treatment but it was not significantly changed between 6 and 24 months after the start of treatment. TSI in "duration" between 6 and 24 months was significantly correlated with the patients' age and HIR using multiple regression analysis.
According to the tinnitus scoring questionnaire, "duration" is the most reliable item for subjective evaluation of tinnitus accompanied by SSNHL. Generally, subjective feelings for residual tinnitus 6 months after the start of treatment for SSNHL are supposed to be almost the same, even at the 24th post-treatment month. Especially, younger patients with better hearing improvement are predicted to achieve further improvement of tinnitus between 6 and 24 months after the start of treatment.
一些突发性感音神经性听力损失（SSNHL）患者即使在完成SSNHL治疗后仍受残余耳鸣困扰。在本前瞻性研究中，我们研究了患者的性别、患侧性和年龄背景，以及SSNHL发病后听力水平和耳鸣评分的变化，以确定SSNHL药物治疗最后一天后残余耳鸣的预后因素。
44例SSNHL患者在完成SSNHL治疗前均接受了2周的全身类固醇给药，并口服血管活性药物和维生素B12 6个月。通过比较治疗开始前和开始后6个月的听力水平来确定听力改善率（HIR）。在治疗开始前、开始后6个月和24个月，通过耳鸣评分问卷对耳鸣进行主观评估。记录主观耳鸣感受“响度”“持续时间”和“烦恼程度”的五步评估得分。
与治疗前相比，治疗开始后6个月时，HIR与“持续时间”方面的耳鸣评分改善（TSI）显著相关。与治疗前相比，治疗开始后6个月时所有3项耳鸣评分均显著改善，但治疗开始后6个月至24个月之间无显著变化。使用多元回归分析，6至24个月之间“持续时间”的TSI与患者年龄和HIR显著相关。
根据耳鸣评分问卷，“持续时间”是对SSNHL伴发耳鸣进行主观评估最可靠的项目。一般来说，SSNHL治疗开始后6个月时残余耳鸣的主观感受即使在治疗后第24个月也应大致相同。特别是，听力改善较好的年轻患者预计在治疗开始后6至24个月之间耳鸣会进一步改善。
