Seo Young Joon, Kim Hyun Ji, Moon In Seok, Choi Jae Young
1Department of Otorhinolaryngology, Yonsei University WonJu College of Medicine, Wonju; 2Department of Otorhinolaryngology, Inha University College of Medicine, Incheon; and 3Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea.
Ear Hear. 2015 Nov-Dec;36(6):705-9. doi: 10.1097/AUD.0000000000000187.
Tinnitus is a very common symptom in patients with hearing loss. Several studies have confirmed that hearing restoration using hearing aids or cochlear implants (CIs) has a suppressive effect on tinnitus in users. The aim of this study was to analyze the effect of other hearing restoration devices, specifically the middle ear implant (MEI), on changes in tinnitus severity.
From 2012 to October 2014, 11 adults with tinnitus and hearing loss underwent MEI surgery. Pure-tone audiometry, tinnitus handicap inventory (THI), and visual analog scale scores for loudness, awareness, and annoyance and psychosocial instruments were measured before, immediately after, and 6 months after surgery. Changes in hearing thresholds and THI scores were analyzed and compared with those of 16 CI recipients.
In both MEI and CI groups, significant improvements in tinnitus were found after the surgery. The THI scores improved in 91% of patients in the MEI group and in 56% of those in the CI group. Visual analog scale scores and psychosocial scale scores also decreased after surgery, but there were no statistical differences between the groups.
The results indicate that the MEI may be as beneficial as the CI in relieving tinnitus in subjects with unilateral tinnitus accompanying hearing loss. Furthermore, this improvement may manifest as hearing restoration or habituation rather than a direct electrical nerve stimulation, which was previously considered as the main mechanism underlying tinnitus suppression by auditory implants.
耳鸣是听力损失患者非常常见的症状。多项研究证实，使用助听器或人工耳蜗（CI）恢复听力对使用者的耳鸣有抑制作用。本研究的目的是分析其他听力恢复装置，特别是中耳植入物（MEI）对耳鸣严重程度变化的影响。
2012年至2014年10月，11名患有耳鸣和听力损失的成年人接受了MEI手术。在手术前、术后即刻和术后6个月测量纯音听力测定、耳鸣障碍量表（THI）以及响度、知晓度和烦恼程度的视觉模拟量表评分和心理社会量表。分析听力阈值和THI评分的变化，并与16名CI接受者的变化进行比较。
在MEI组和CI组中，术后耳鸣均有显著改善。MEI组91%的患者THI评分改善，CI组为56%。术后视觉模拟量表评分和心理社会量表评分也有所下降，但两组之间无统计学差异。
结果表明，MEI在缓解伴有听力损失的单侧耳鸣患者的耳鸣方面可能与CI一样有益。此外，这种改善可能表现为听力恢复或习惯化，而不是直接的电神经刺激，后者以前被认为是听觉植入物抑制耳鸣的主要机制。
