Teleaudiology and Screening Department.
Oto-Rhino-Laryngology Surgery Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany.
Otol Neurotol. 2019 Jun;40(5):578-583. doi: 10.1097/MAO.0000000000002240.
To determine whether stapedotomy was effective in reducing tinnitus severity. In addition, the relationship between reduction in tinnitus and improvement in hearing after stapedotomy was analyzed.
Prospective clinical study.
Tertiary referral center.
A group of 168 otosclerosis patients diagnosed with chronic tinnitus.
Stapedotomy.
The Tinnitus Functional Index questionnaire (TFI) was used to assess tinnitus severity before surgery, and at 3 and 6 months postoperatively. Pure-tone audiometry was conducted before surgery and 6 months postoperatively.
The TFI Total score before the operation was M = 34.5 (standard deviation [SD] = 1.6) points, and decreased 3 months after stapedotomy to M = 17.5 (SD = 1.7), a statistically significant change (T = -8.200; p < 0.001). A weak correlation was found between the pre- and postoperative difference of TFI Total score and air-conduction thresholds (r = 0.21; p = 0.013) as well as between the TFI Total score and the size of the air-bone gap (r = 0.21; p = 0.013). Preoperatively, 86 patients tinnitus was a not or small problem, and for 82 it was moderate to very big. After stapedotomy, 93 (55%) of patients experienced a significant reduction in tinnitus severity. Of the whole group, 62 patients (37%) reported complete disappearance of their tinnitus. No change in tinnitus severity was reported by 63 patients (38%), and an increase was observed by 12 patients (7%).
Stapedotomy not only improves hearing but also reduces tinnitus severity. The current results extend knowledge of postoperative results in terms of tinnitus severity, and might benefit patients undergoing tinnitus counseling. It might also be useful to otolaryngologists when making decisions regarding qualification criteria.
确定镫骨切除术是否能有效减轻耳鸣严重程度。此外，还分析了镫骨切除术后耳鸣减轻与听力改善之间的关系。
前瞻性临床研究。
三级转诊中心。
一组 168 例诊断为慢性耳鸣的耳硬化症患者。
镫骨切除术。
手术前和术后 3 个月及 6 个月使用耳鸣功能指数问卷（TFI）评估耳鸣严重程度。手术前和术后 6 个月进行纯音听阈测试。
术前 TFI 总分 M=34.5（标准差[SD]=1.6）分，镫骨手术后 3 个月降至 M=17.5（SD=1.7），有统计学意义（T=-8.200；p<0.001）。TFI 总分术前与术后差值与气导听阈（r=0.21；p=0.013）以及 TFI 总分与气骨导差（r=0.21；p=0.013）之间呈弱相关。术前 86 例患者耳鸣为轻度或不严重，82 例为中度或非常严重。镫骨手术后，93 例（55%）患者耳鸣严重程度明显减轻。在整个研究组中，62 例（37%）患者报告耳鸣完全消失。63 例（38%）患者耳鸣严重程度无变化，12 例（7%）患者耳鸣严重程度加重。
镫骨切除术不仅改善听力，还减轻耳鸣严重程度。目前的结果扩展了术后耳鸣严重程度的研究结果，可能使接受耳鸣咨询的患者受益。对于耳鼻喉科医生来说，在决定资格标准时，这可能也是有用的。
