Kloostra F J J, Arnold R, Hofman R, Burgerhof J G M, van Dijk P
Department of Otorhinolaryngology and Head and Neck Surgery University Medical Center Groningen Groningen the Netherlands.
Department of Epidemiology University Medical Center Groningen Groningen the Netherlands.
Laryngoscope Investig Otolaryngol. 2018 Dec 14;4(1):138-142. doi: 10.1002/lio2.224. eCollection 2019 Feb.
The effect of cochlear implantation on tinnitus is heterogeneous: implantation does not always reduce tinnitus and may even worsen tinnitus. Therefore, it is important to know which factors influence the consequences of cochlear implantation for tinnitus. To date, no consensus has been reached regarding the factors that influence tinnitus. This study aimed to create prognostic models, using binary logistic regression analyses to predict positive or negative changes in tinnitus after cochlear implantation.
For this study we retrospectively sent two questionnaire packages to 117 cochlear implant patients.
In the binary logistic regression analyses of the responses to the questionnaires, it was not possible to create a significant model to predict a positive effect of cochlear implantation on tinnitus. However, a negative effect of cochlear implantation on tinnitus was predictable, using a backward stepwise selection method in a model including the Abbreviated Profile of Hearing Aid Benefit (APHAB) and Tinnitus Handicap Questionnaire (THQ) ( < .001, Nagelkerke R = 0.529).
Our results suggest that the lower the preoperative tinnitus handicap and the preoperative hearing handicap, the higher the chance that cochlear implantation will worsen tinnitus. More research needs to be done, preferable in a big prospective study, to make this model instrumental for clinical decision making and preoperative patient counselling. However, our results might suggest that preoperative THQ and APHAB screening could be meaningful. Especially in patients who are afraid to develop tinnitus or tinnitus worsening as complication of cochlear implantation.
人工耳蜗植入对耳鸣的影响是异质性的：植入并不总是能减轻耳鸣，甚至可能使耳鸣加重。因此，了解哪些因素会影响人工耳蜗植入对耳鸣的影响很重要。迄今为止，关于影响耳鸣的因素尚未达成共识。本研究旨在建立预后模型，使用二元逻辑回归分析来预测人工耳蜗植入后耳鸣的正向或负向变化。
在本研究中，我们回顾性地向117名人工耳蜗植入患者发送了两个问卷包。
在对问卷回复的二元逻辑回归分析中，无法建立一个能预测人工耳蜗植入对耳鸣有正向影响的显著模型。然而，在一个包含助听器效益简表（APHAB）和耳鸣障碍问卷（THQ）的模型中，使用向后逐步选择法可以预测人工耳蜗植入对耳鸣有负向影响（<0.001，Nagelkerke R = 0.529）。
我们的结果表明，术前耳鸣障碍和术前听力障碍越低，人工耳蜗植入使耳鸣加重的可能性越高。需要进行更多研究，最好是大规模前瞻性研究，以使该模型有助于临床决策和术前患者咨询。然而，我们的结果可能表明术前THQ和APHAB筛查可能是有意义的。特别是对于那些担心因人工耳蜗植入并发症而出现耳鸣或耳鸣加重的患者。
4级。
