Berkiten G, Yildirim G, Topaloglu I, Ugras H
ENT Department, Okmeydani Teaching Hospital, Sişli, Istanbul, Turkey.
B-ENT. 2013;9(2):111-6.
The aim of this study was to determine vitamin B12 levels in patients with non-pulsatile tinnitus and to assess the efficacy of replacement treatment in tinnitus and hearing in patients with vitamin B12 deficiency.
We assessed 100 patients (mean age, 43.87, SD 10.12; 62 females, 38 males) and 20 healthy volunteers (9 females, 11 males). Patients whose blood serum vitamin B12 levels were below 180 pg/mL were deemed to be vitamin B12-deficient. The effect of vitamin B12 replacement treatment on hearing was examined using audiometric tests between 250 and 20000 Hz, and we compared results with a visual analogue scale (VAS) before and after treatment, which helped to produce an objective assessment of the therapeutic results in tinnitus.
Tinnitus was found to be unilateral in 57% of cases (the right ear in 56% and the left ear in 44% of these cases) and bilateral in 43% of cases. Of the patients with tinnitus, 63 had low B12 vitamin levels, and 37 had normal B12 vitamin levels. No statistically significant difference was found with the control group levels (p = 0.80, odds ratio = 1.13). No significant change was observed in tinnitus severity after vitamin B12 therapy. Eight of these patients reported some relief in tinnitus on the VAS, but the rate of improvement was not significant (p > 0.05). In the tinnitus patients with low B12 vitamin levels, audiometric tests conducted after B12 vitamin treatment revealed a significant improvement in hearing levels only at the 250 Hz frequency. No change was observed at other frequencies.
B12 replacement treatment was not effective in these patients with tinnitus. Some patients improved following vitamin B12 supplementation but the results were not significant. More studies are needed to find the reasons for, and effective treatment of, tinnitus since the aetiology of subjective tinnitus is highly variable.
本研究旨在测定非搏动性耳鸣患者的维生素B12水平，并评估维生素B12缺乏患者补充治疗对耳鸣及听力的疗效。
我们评估了100例患者（平均年龄43.87岁，标准差10.12；女性62例，男性38例）和20名健康志愿者（女性9例，男性11例）。血清维生素B12水平低于180 pg/mL的患者被视为维生素B12缺乏。使用250至20000 Hz的听力测试检查维生素B12替代治疗对听力的影响，并在治疗前后用视觉模拟量表（VAS）比较结果，这有助于对耳鸣的治疗效果进行客观评估。
发现57%的病例耳鸣为单侧（其中56%为右耳，44%为左耳），43%的病例为双侧。在耳鸣患者中，63例维生素B12水平低，37例维生素B12水平正常。与对照组水平相比，未发现统计学上的显著差异（p = 0.80，优势比 = 1.13）。维生素B12治疗后耳鸣严重程度未观察到显著变化。这些患者中有8例在VAS上报告耳鸣有所缓解，但改善率不显著（p > 0.05）。在维生素B12水平低的耳鸣患者中，维生素B12治疗后进行的听力测试显示，仅在250 Hz频率时听力水平有显著改善。其他频率未观察到变化。
B12替代治疗对这些耳鸣患者无效。一些患者在补充维生素B12后有所改善，但结果不显著。由于主观性耳鸣的病因高度可变，需要更多研究来找出耳鸣的原因并进行有效治疗。
