Guo Ping, Sun Wenfang, Wang Wuqing
Department of Otolaryngology, Fudan University Eye Ear Nose and Throat Hospital, 83 Fenyang Rd, Shanghai, 200031, People's Republic of China.
Eur Arch Otorhinolaryngol. 2018 Jan;275(1):39-45. doi: 10.1007/s00405-017-4742-1. Epub 2017 Oct 24.
The purpose of this study is to investigate what characteristics of tinnitus in patients with chronic otitis media was reduced after tympanoplasty and to assess the relationship between post-operative tinnitus reduction and pre-operative tinnitus tone, tinnitus duration, post-operative hearing recovery, and tympanogram. Medical records were prospective between March 2013 and May 2016. Audiologic evaluation by pure tone audiometry and acoustic impedance and tinnitus assessment using scores on the Tinnitus Handicap Inventory (THI) was conducted preoperatively and 6 months post-operatively. The data were analyzed using the Wilcoxon test, Student's and paired t test, and ANOVA. The pre-operative incidence of tinnitus in patients with COM was 47%. There was a very significant difference between pre-operative and post-operative mean THI scores (p < 0.05). Tinnitus was reduced or alleviated in 83% of tinnitus patients. Pre-operative low-tone tinnitus was significantly reduced 6 months after surgery. After surgery, air-conducted hearing improvement at 250, 500, and 1000 Hz in the tinnitus significant recovery group was greater than the tinnitus non-significant recovery group (p < 0.05). Tinnitus reduction in tympanogram A was significantly greater than in tympanograms B or C (p < 0.05). There was no statistically significant correlation between tinnitus duration and tinnitus reduction (p > 0.05). There was no significant effect of presence cholesteatoma and dry period on the gain THI (p > 0.05). The types of tympanoplasty had no effect on tinnitus improvement (p > 0.05). No patients experienced new tinnitus after surgery. Following tympanoplasty, most patients experienced a reduction in tinnitus. Pre-operative low-tone tinnitus is easier to reduce after tympanoplasty. Post-operative normal tympanogram and improved low-frequency AC hearing were important to tinnitus reduction.
本研究的目的是调查慢性中耳炎患者鼓室成形术后耳鸣的哪些特征有所减轻,并评估术后耳鸣减轻与术前耳鸣音调、耳鸣持续时间、术后听力恢复以及鼓室图之间的关系。2013年3月至2016年5月期间进行了前瞻性病历记录。术前及术后6个月采用纯音听力计进行听力学评估、声阻抗测试,并使用耳鸣障碍量表(THI)评分进行耳鸣评估。采用Wilcoxon检验、Student's检验、配对t检验和方差分析对数据进行分析。慢性中耳炎患者术前耳鸣发生率为47%。术前和术后平均THI评分之间存在非常显著的差异(p<0.05)。83%的耳鸣患者耳鸣减轻或缓解。术前低音调耳鸣在术后6个月显著减轻。术后,耳鸣显著恢复组在250、500和1000Hz处气导听力的改善大于耳鸣无显著恢复组(p<0.05)。鼓室图A型患者的耳鸣减轻程度显著大于B型或C型(p<0.05)。耳鸣持续时间与耳鸣减轻之间无统计学显著相关性(p>0.05)。胆脂瘤的存在和干耳期对THI增益无显著影响(p>0.05)。鼓室成形术的类型对耳鸣改善无影响(p>0.05)。术后无患者出现新的耳鸣。鼓室成形术后,大多数患者的耳鸣有所减轻。术前低音调耳鸣在鼓室成形术后更容易减轻。术后正常鼓室图和低频气导听力改善对耳鸣减轻很重要。