Department of Otorhinolaryngology - Head and Neck Surgery, School of Medicine, Eulji University, Daejeon, South Korea.
Department of Otorhinolaryngology - Head and Neck Surgery, School of Medicine, Eulji University, Daejeon, South Korea.
Am J Otolaryngol. 2019 May-Jun;40(3):400-403. doi: 10.1016/j.amjoto.2019.02.009. Epub 2019 Feb 18.
We aimed to confirm the characteristics of patients with tinnitus in the better-hearing side.
Among the 778 patients who visited the tinnitus clinic complaining of unilateral tinnitus at a local university hospital between March 2014 and December 2017, we recruited 62 patients who showed tinnitus in the better-hearing side on pure-tone audiometry. The mean hearing threshold was calculated using the arithmetic mean of the pure tone thresholds at 1, 2, 3, and 4 kHz. In addition, patients' medical history, tinnitus questionnaires, and other audiologic test results were thoroughly analyzed together for diagnosis.
Fluctuating hearing loss without vertigo or Ménière's disease were the most common etiologies (n = 16, 25.8%), followed by high-frequency hearing loss (n = 13, 21.0%), sudden idiopathic hearing loss (n = 6, 9.7%), and presbycusis (n = 6, 9.7%). Somatosensory tinnitus was also observed in seven patients. Neck pain was associated with tinnitus in five patients (8.1%), and two other patients (3.2%) experienced temporomandibular disorder in the same side as the tinnitus.
Tinnitus was associated with deterioration of hearing even when it occurred in the better-hearing side. Among the possible etiologies, fluctuating hearing loss in the tinnitus side was the most common audiologic finding. Assessment of hearing level at each frequency was more effective in detecting high-frequency hearing loss rather than the use of the mean hearing level. In addition, somatosensory tinnitus should not be ignored.
我们旨在确认听力较好侧耳鸣患者的特征。
在 2014 年 3 月至 2017 年 12 月期间，在当地一所大学医院的耳鸣诊所，我们共招募了 62 名在纯音测听中出现听力较好侧耳鸣的患者，这些患者共 778 名单侧耳鸣患者。平均听力阈值是通过计算 1、2、3 和 4 kHz 的纯音阈值的算术平均值得出的。此外，还对患者的病史、耳鸣问卷和其他听力测试结果进行了全面分析，以明确诊断。
最常见的病因是无眩晕或梅尼埃病的波动性听力损失（n=16，25.8%），其次是高频听力损失（n=13，21.0%）、突发性特发性听力损失（n=6，9.7%）和老年性聋（n=6，9.7%）。7 例患者还伴有体感性耳鸣。5 例患者（8.1%）的耳鸣与颈部疼痛相关，2 例患者（3.2%）在同侧出现颞下颌关节紊乱。
即使耳鸣发生在听力较好的一侧，也与听力下降有关。在可能的病因中，耳鸣侧的波动性听力损失是最常见的听力表现。评估每个频率的听力水平比使用平均听力水平更能有效地发现高频听力损失。此外，体感性耳鸣不应被忽视。
