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持续性耳鸣的心理声学分类。

Psychoacoustic classification of persistent tinnitus.

机构信息

Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Otorrinolaringologia e Cirurgia Cabeça e Pescoço, São Paulo, SP, Brazil.

Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Otorrinolaringologia e Cirurgia Cabeça e Pescoço, São Paulo, SP, Brazil.

出版信息

Braz J Otorhinolaryngol. 2018 Sep-Oct;84(5):583-590. doi: 10.1016/j.bjorl.2017.07.005. Epub 2017 Aug 1.

Abstract

INTRODUCTION

Tinnitus is a difficult to treat symptom, with different responses in patients. It is classified in different ways, according to its origin and associated diseases.

OBJECTIVE

to propose a single and measurable classification of persistent tinnitus, through its perception as sounds of nature or of daily life and its comparison with pure tone or noise, of high or low pitch, presented to the patient by audiometer sound.

METHODS

A total of 110 adult patients, of both genders, treated at the Tinnitus Outpatient Clinic, were enrolled according to the inclusion and exclusion criteria. Otorhinolaryngologic and Audiological, Pitch Matching and Loudness, Visual Analog Scale, Tinnitus Handicap Inventory and Minimum Masking Level assessments were performed.

RESULTS

In these 110 patients, 181 tinnitus complaints were identified accordingly to type and ear, with 93 (51%) Pure Tone, and 88 (49%) Noise type; 19 at low and 162 at high frequency; with a mean in the Pure Tone of 5.47 in the Visual Analog Scale and 12.31 decibel in the Loudness and a mean in the Noise of 6.66 and 10.51 decibel. For Tinnitus Handicap Inventory and Minimum Masking Level, the 110 patients were separated into three groups with tinnitus, Pure Tone, Noise and multiple. Tinnitus Handicap Inventory higher in the group with multiple tinnitus, of 61.38. Masking noises such as White Noise and Narrow Band were used for the Minimum Masking Level at the frequencies of 500 and 6000Hz. There was a similarity between the Pure Tone and Multiple groups. In the Noise group, different responses were found when Narrow Band was used at low frequency.

CONCLUSION

Classifying persistent tinnitus as pure tone or noise, present in high or low frequency and establishing its different characteristics allow us to know its peculiarities and the effects of this symptom in patients' lives.

摘要

简介

耳鸣是一种难以治疗的症状,不同患者的反应也不同。它可以根据其起源和相关疾病进行不同的分类。

目的

通过将持续性耳鸣的感知归类为自然或日常生活的声音,并将其与通过听力计声音呈现给患者的纯音或噪声进行比较,提出一种单一且可衡量的持续性耳鸣分类方法,该分类方法涉及到声音的音调高低。

方法

共纳入符合纳入和排除标准的 110 名成年患者,这些患者均来自耳鸣门诊。对他们进行了耳鼻喉科和听力评估、音调匹配和响度评估、视觉模拟评分、耳鸣残疾评估和最小掩蔽级评估。

结果

在这 110 名患者中,根据类型和耳朵共识别出 181 种耳鸣主诉,其中 93 种(51%)为纯音型,88 种(49%)为噪声型;19 种为低频,162 种为高频;纯音型的平均视觉模拟评分为 5.47,响度平均为 12.31 分贝,噪声型的平均视觉模拟评分为 6.66,响度平均为 10.51 分贝。对于耳鸣残疾评估和最小掩蔽级,将 110 名患者根据耳鸣类型(纯音、噪声和多种)分为三组。在多种耳鸣组中,耳鸣残疾评估得分较高,为 61.38。对于最小掩蔽级,在 500Hz 和 6000Hz 频率下使用白噪声和窄带噪声等掩蔽噪声。在纯音和多种耳鸣组之间存在相似性。在噪声组中,当在低频使用窄带噪声时,会发现不同的反应。

结论

将持续性耳鸣分为纯音或噪声、高频或低频,并确定其不同特征,可以帮助我们了解其特殊性以及该症状对患者生活的影响。

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本文引用的文献

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Clinical practice guideline: tinnitus.临床实践指南:耳鸣
Otolaryngol Head Neck Surg. 2014 Oct;151(2 Suppl):S1-S40. doi: 10.1177/0194599814545325.
10
Acupuncture for tinnitus immediate relief.针灸治疗耳鸣,立竿见影。
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