University Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium.
Otol Neurotol. 2013 Jun;34(4):662-6. doi: 10.1097/MAO.0b013e31828779f0.
The influence of tinnitus on speech reception is under debate. A few previous studies addressed this issue and compared speech reception in groups with and without tinnitus, with tinnitus arising in both ears or in the same test ear. Recently, we demonstrated that loudness of tinnitus in single-sided deafness (SSD) could be reduced dramatically by implanting and activating a cochlear implant (CI).
The aim of the study was to evaluate whether changing the level of tinnitus in the SSD ear by disenabling or enabling the CI changes the speech reception in noise in the non-tinnitus ear.
Fifteen CI users (MED-EL multichannel) with SSD and incapacitating tinnitus participated. They had an initial score of 6 or greater out of 10 on the Visual Analogue Scale (VAS) and an average total score of 58.05 (standard deviation [SD], 13.68) on the Tinnitus Questionnaire. The outcome measure, speech reception threshold (SRT) in noise using an adaptive procedure was measured in the nontinnitus ear using insert earphones. The measurements were performed with a high tinnitus level and a low tinnitus level in the SSD ear, realized by switching the CI off or on. Tinnitus loudness was assessed on a VAS, and tinnitus loudness was also matched using an audiometer.
Speech reception in noise is significantly worse in case of high tinnitus loudness. The mean difference in SRT in the nontinnitus ear between the 2 conditions (SRTCI off-SRTCI on) of the 15 subjects was 1.98 dB SNR (SD, 3.01 dB SNR). The mean tinnitus loudness on the VAS was 7.2 (SD, 2.6) in the CI-off condition. In the CI-on condition, the mean VAS score significantly declined to 3.4 (SD, 2.5). Also, the tinnitus loudness match improved from 22 dB SL (SD, 14.4 dB SL) to 10 dB SL (SD, 10.1 dB SL) in the CI-on condition.
Unilateral tinnitus can significantly decrease speech reception in noise in the nontinnitus ear.
耳鸣对言语感知的影响仍存在争议。一些先前的研究已经探讨了这个问题，并比较了双耳或同测耳存在耳鸣的患者的言语感知情况。最近，我们发现单侧聋（SSD）患者的耳鸣响度可以通过植入和激活人工耳蜗（CI）显著降低。
本研究旨在评估通过使 CI 失能或启用来改变 SSD 耳中的耳鸣水平是否会改变非耳鸣耳的噪声下言语感知。
15 名使用 MED-EL 多通道人工耳蜗的 SSD 伴失能性耳鸣患者参与了研究。他们的视觉模拟量表（VAS）评分初始得分为 6 分或更高，耳鸣问卷平均总得分为 58.05（标准差 [SD]，13.68）。使用自适应程序测量非耳鸣耳的言语感知阈（SRT）作为主要观察指标，采用插入式耳机进行测量。在 SSD 耳中通过关闭或开启 CI 来实现高和低的耳鸣水平，分别进行测量。使用 VAS 评估耳鸣响度，也使用听力计进行匹配。
在高耳鸣响度时，噪声下的言语感知明显更差。15 名受试者的两种条件（CI 关闭时的 SRT 减去 CI 开启时的 SRT）下非耳鸣耳的 SRT 均值差异为 1.98 dB SNR（SD，3.01 dB SNR）。CI 关闭时 VAS 上的平均耳鸣响度为 7.2（SD，2.6）。在 CI 开启时，VAS 评分显著下降至 3.4（SD，2.5）。此外，CI 开启时，耳鸣响度匹配从 22 dB SL（SD，14.4 dB SL）改善至 10 dB SL（SD，10.1 dB SL）。
单侧耳鸣会显著降低非耳鸣耳的噪声下言语感知。
