Makar Sujoy Kumar, Biswas Anirban, Shatapathy Pragati
AYJNIHH, ERC, B.T. Road, Bonhooghly, Kolkata, 700090 West Bengal India.
Indian Otolaryngologist Association, Kolkata, India.
Indian J Otolaryngol Head Neck Surg. 2014 Jan;66(Suppl 1):37-51. doi: 10.1007/s12070-011-0291-x. Epub 2011 Sep 4.
Tinnitus is a very common complain and affects 7% of population and has been associated with a range of physical and emotional disorders (Hallam et al. in Br J Clin Psychol 27:213-222, 1988). Hence to understand the distress caused by tinnitus and its relationship with the nature of tinnitus so as to suggest the appropriate treatment, there is the need to study the impact of tinnitus of a group of tinnitus sufferers. This study could be done on the basis of verbal description of tinnitus, Audiological measurement of tinnitus and psychological characteristics of tinnitus in terms of distress, anxiety, depression and disturbance of personality, to understand the impact of tinnitus on sufferers. Fifty adults in the age range of 18-60 years with subjective tinnitus with bilateral normal hearing or pure SNHL ranging from mild to moderately severe were selected. An audiological profile of each subject was prepared on the basis of brief case history of subject, otoscopic examination, pure tone audiometry, impedance audiometry, frequency (pitch) and intensity (loudness) of tinnitus. A psychometric profile was developed by using Tinnitus Reaction Questionnaire and Nature of Tinnitus Questionnaire. These questionnaires were translated and adopted in Hindi and Bengali language after appropriate standardization procedure. 60% reported that they do not have any idea regarding probable cause of their tinnitus. 74% subjects of this study reported that there is no fluctuation in the pitch of their tinnitus. However, 68% reported loudness of tinnitus is fluctuating. A weak co-relation has been seen between traditional audiological measures like pitch matching, loudness matching and subject's description of pitch and loudness of tinnitus. There was a significant correlation between the impact of tinnitus and disturbance of sleep caused by it with increase in depression and anger (0.483). However, no significant co-relation was seen between distressed caused by tinnitus and duration of tinnitus (-0.034). The multiple nature/sounds of tinnitus had far more devastating effects or serious impact on 'tinnitus sufferers' than the single sound/nature. Gender differences were also found among tinnitus sufferers while assessing the audiological and psychological measures of tinnitus. Female subjects also reported a higher level of emotional reaction with a mean of 35.9 to their tinnitus as compared to males with a mean of 31.7. Tinnitus has resulted in multifold effects/impacts on tinnitus sufferers where it has made them feel unhappy, tense, irritable, depressed, annoyed, distressed and frustrated. It has interfered with their enjoyment, their relaxation, their sleep, and forced them to avoid quiet environmental and social situations. These findings should further help in the overall management of the patient suffering from tinnitus.
耳鸣是一种非常常见的主诉，影响着7%的人口，并且与一系列身体和情绪障碍有关（哈勒姆等人，《英国临床心理学杂志》27:213 - 222，1988年）。因此，为了了解耳鸣所导致的痛苦及其与耳鸣性质的关系，以便提出适当的治疗方法，有必要研究一组耳鸣患者中耳鸣的影响。这项研究可以基于耳鸣的言语描述、耳鸣的听力学测量以及耳鸣在痛苦、焦虑、抑郁和人格障碍方面的心理特征来进行，以了解耳鸣对患者的影响。选取了50名年龄在18 - 60岁之间、患有主观性耳鸣且双侧听力正常或患有轻度至中度重度单纯感音神经性听力损失的成年人。根据受试者的简要病史、耳镜检查、纯音听力测定、声阻抗测听、耳鸣的频率（音高）和强度（响度），为每个受试者制定了听力学概况。通过使用耳鸣反应问卷和耳鸣性质问卷建立了心理测量概况。经过适当的标准化程序后，这些问卷被翻译成印地语和孟加拉语并采用。60%的人表示他们对耳鸣的可能原因一无所知。本研究中74%的受试者报告称他们耳鸣的音高没有波动。然而，68%的人报告耳鸣的响度有波动。在诸如音高匹配、响度匹配等传统听力学测量与受试者对耳鸣音高和响度的描述之间，发现了较弱的相关性。耳鸣的影响与耳鸣导致的睡眠障碍之间存在显著相关性，随着抑郁和愤怒程度的增加（0.483）。然而，耳鸣引起的痛苦与耳鸣持续时间之间未发现显著相关性（-0.034）。耳鸣的多种性质/声音对“耳鸣患者”的破坏性影响或严重影响远比单一声音/性质大。在评估耳鸣的听力学和心理测量指标时，耳鸣患者中也发现了性别差异。女性受试者报告称，与平均为31.7分的男性相比，她们对耳鸣的情绪反应水平更高，平均为35.9分。耳鸣对耳鸣患者产生了多方面的影响，使他们感到不开心、紧张、易怒、抑郁、烦恼、痛苦和沮丧。它干扰了他们的享受、放松和睡眠，迫使他们避开安静的环境和社交场合。这些发现应有助于进一步对耳鸣患者进行全面管理。
