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与低强度激光疗法诱导的耳鸣暂时抑制相关的听觉电生理反应改变:一项前后病例系列研究。

Alterations in Auditory Electrophysiological Responses Associated With Temporary Suppression of Tinnitus Induced by Low-Level Laser Therapy: A Before-After Case Series.

作者信息

Montazeri Katayoon, Mahmoudian Saeid, Razaghi Zahra, Farhadi Mohammad

机构信息

Laboratory for Auditory Neuroscience, ENT and Head & Neck Research Center, Iran University of Medical Sciences, Tehran, Iran.

Laser Application in Medical Sciences Research Center (LAMSRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Lasers Med Sci. 2017 Summer;8(Suppl 1):S38-S45. doi: 10.15171/jlms.2017.s8. Epub 2017 Aug 27.

Abstract

Tinnitus is the phantom auditory perception of sound in the absence of an external or internal acoustic stimulus. The treatment is difficult due to multiple etiologies and great psychological influence. The purpose of this study was to determine alterations in auditory physiological and electrophysiological responses associated with temporary suppression of tinnitus induced by low-level laser (LLL) irradiation. This study was conducted on 20 subjects with subjective tinnitus. All subjects signed the informed consent form and satisfied all the study eligibility criteria. Visual analog scale (VAS) for loudness, loudness matching of tinnitus (LMT), pitch matching of tinnitus (PMT), Persian-tinnitus questionnaire (P-TQ) and Persian-tinnitus handicap inventory (P-THI) were conducted pre- and post-low level laser therapy (LLLT) for all the subjects. Electrocochleography (ECochG) and distortion product otoacoustic emissions (DPOAEs) were recorded in 11 subjects. Continuous wave diode lasers, including red (630 nm) and infra-red (808 nm) were applied, and were both designed by the Canadian Optic and Laser (COL) Center. Twelve sessions of laser therapy were performed, 2 sessions per week for each subject. Total dose was 120 Joule/ ear/session. LLL irradiation could cause a significant decrease in subjective tests scores consisting of VAS for loudness, PMT, P-TQ, P-THI, but did not result in a significant improvement of objective evaluating parameters except for compound action potential (CAP) amplitude. LLLT might be a subjectively effective treatment for short-term improvement of tinnitus. Defining a new protocol for optimizing LLLT parameters may be an option to improve parameters of objective tests.

摘要

耳鸣是在没有外部或内部声学刺激时出现的幻听。由于病因多样且心理影响较大,治疗较为困难。本研究的目的是确定与低强度激光(LLL)照射引起的耳鸣暂时抑制相关的听觉生理和电生理反应的变化。本研究对20名主观性耳鸣患者进行。所有受试者均签署了知情同意书,并符合所有研究纳入标准。对所有受试者在低强度激光治疗(LLLT)前后进行响度视觉模拟量表(VAS)、耳鸣响度匹配(LMT)、耳鸣音调匹配(PMT)、波斯语耳鸣问卷(P-TQ)和波斯语耳鸣障碍量表(P-THI)评估。对11名受试者记录了耳蜗电图(ECochG)和畸变产物耳声发射(DPOAE)。应用了包括红色(630nm)和红外线(808nm)的连续波二极管激光器,均由加拿大光学与激光(COL)中心设计。每位受试者每周进行2次,共进行12次激光治疗。总剂量为每只耳朵每次治疗120焦耳。LLL照射可使由响度VAS、PMT、P-TQ、P-THI组成的主观测试分数显著降低,但除复合动作电位(CAP)幅度外,客观评估参数未得到显著改善。LLLT可能是一种短期内改善耳鸣主观症状有效的治疗方法。定义一种优化LLLT参数的新方案可能是改善客观测试参数的一个选择。

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