Universidade de São Paulo (USP), Faculdade de Odontologia de Bauru (FOB), Bauru, SP, Brazil.
Universidade de São Paulo (USP), Departamento de Fonoaudiologia, Bauru, SP, Brazil.
Braz J Otorhinolaryngol. 2020 Jan-Feb;86(1):14-22. doi: 10.1016/j.bjorl.2018.07.010. Epub 2018 Aug 23.
Tinnitus is present in a large part of chronic health complaints, and it is considered a public health problem injurious to the individual's quality of life. Considering the increase of the world population associated with an increase of life expectancy, tinnitus remains a cause for medical concern, since during aging the occurrence of auditory impairments due to the deterioration of the peripheral auditory structures and central impairs the quality of life.
The aim of the present study was to analyze the applicability of real ear measurements for audiological intervention of tinnitus through specific evaluation, selection, verification and validation of the hearing aids combined with the sound generator.
Forty individuals of both genders with hearing loss and tinnitus complaints were deemed eligible to compose the sample. They were enrolled according to clinical symptoms and submitted to the following procedures: anamnesis and previous complaint history, high frequency audiometry, immittanciometry and acuphenometry with the research of psychoacoustic thresholds of pitch, loudness and minimum masking threshold, sound generator, in addition to the application of the Tinnitus Handicap Inventory and Visual Analog Scale tools. The entire sample was adapted with Siemens hearing aids and a sound generator, participated in a counseling session with support of digital material and evaluated in two situations: Initial Assessment (before the hearing aids and sound generator adaptation) and Final Assessment (6 months, after adaptation). The statistical analyzes were descriptive and inferential, adopted a significance level of 5% and the T-Paired Test and the Spearman Correlation test were performed.
The results showed that there was a benefit with the use of hearing aids combined with a sound generator from the statistically significant values and strong correlations between the sound generator verification data regarding acuphenometry and the nuisance/severity questionnaires. Regarding the verification of the sound generator, it is important to highlight that the entire sample selected the effective acoustic stimulation based on the comfort levels, which was proved in the present study to be a sufficient intensity for positive prognosis, whereas the users' noises were found below the psychoacoustic thresholds of acuphenometry.
The present study concluded that the audiological intervention with any level of sound stimulus is enough to obtain a positive prognosis in the medium term. Data that specifies that the verification of sound generator was effective at the real ear measurements are important in the evaluation and intervention of the complaint. In addition, it points out that the greater the tinnitus perception, the greater its severity, and the greater the nuisance, the higher the psychoacoustics thresholds of frequency and the minimum threshold of masking.
耳鸣存在于很大一部分慢性健康问题中，被认为是对个人生活质量有害的公共卫生问题。考虑到世界人口的增加与预期寿命的延长，耳鸣仍然是医学关注的原因，因为随着年龄的增长，由于外围听觉结构和中枢听觉的恶化而导致的听觉损伤会降低生活质量。
本研究旨在通过对助听器的特定评估、选择、验证和验证，以及与声音发生器相结合，分析真耳测量在耳鸣听力学干预中的适用性。
符合纳入标准的 40 名听力损失和耳鸣投诉的男女患者被纳入研究。根据临床症状和以下程序进行招募：病史和既往投诉史、高频测听、导抗测听和音叉测听，研究音调、响度和最小掩蔽阈值的心理声学阈值，声音发生器，此外还应用耳鸣残疾量表和视觉模拟量表工具。所有样本均采用西门子助听器和声音发生器进行适配，参加数字材料支持的咨询会议，并在两种情况下进行评估：初始评估（在助听器和声音发生器适配之前）和最终评估（6 个月，在适配之后）。统计分析采用描述性和推断性，采用 5%的显著性水平，进行 T 配对检验和斯皮尔曼相关检验。
结果表明，助听器与声音发生器联合使用具有统计学意义的数值和声音发生器验证数据与音叉测听之间的强相关性，对耳鸣有好处。关于声音发生器的验证，重要的是要强调，整个样本根据舒适度选择了有效的声学刺激，这在本研究中被证明是一个足以获得积极预后的足够强度，而使用者的噪声低于音叉测听的心理声学阈值。
本研究得出结论，任何水平的声音刺激的听力学干预都足以在中期获得积极的预后。在评估和干预投诉时，指定真耳测量中声音发生器验证有效的数据是很重要的。此外，它还指出，耳鸣感知越强，其严重程度越高，干扰越大，频率的心理声学阈值和最小掩蔽阈值越高。
