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Vibrant Soundbridge 对伴有感音神经性听力损失的耳鸣的影响。

Effects of Vibrant Soundbridge on tinnitus accompanied by sensorineural hearing loss.

机构信息

Department of Otorhinolaryngology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.

Department of Otorhinolaryngology, Incheon St. Mary's Hospital, The Catholic University of Korea, Bupyeong, Incheon, Korea.

出版信息

PLoS One. 2020 Feb 4;15(2):e0228498. doi: 10.1371/journal.pone.0228498. eCollection 2020.

Abstract

OBJECTIVES

Tinnitus is a common symptom among patients with hearing loss, and many studies have reported successful tinnitus suppression with hearing devices. Active middle ear implantation of the Vibrant Soundbridge (VSB) is a good alternative to existing hearing devices. This study evaluated the effects of VSB implantation on tinnitus and sought to identify the main audiological factor that affects tinnitus suppression.

METHODS

The study participants were 16 adults who had tinnitus with sensorineural hearing loss, and who underwent VSB implantations. Pure-tone audiometry; word recognition test; tinnitus handicap inventory (THI); and visual analog scale (VAS) assessment of loudness, awareness, and annoyance were performed before and 12 months after surgery. Changes in hearing threshold, word recognition scores (WRS), THI scores, and VAS scores were analyzed.

RESULTS

VAS scores for loudness (mean difference: 1.9, 95% CI: 0.6, 3.1), awareness (mean difference: 1.6, 95% CI: 0.4, 2.8), and annoyance (mean difference: 1.7, 95% CI: 0.7, 2.8) showed significant improvements from baseline to 12 months after surgery. In addition, THI scores showed a significant decrease (mean difference: 13.8, 95% CI: 2.9, 24.9). The average hearing threshold level, WRS, and most comfortable level (MCL) also showed significant improvements at 12 months after surgery (mean difference: 17.3, 95% CI: 13.3, 21.3; mean difference: -7.6, 95% CI: -15.1, -0.1; mean difference: 26.3, 95% CI: 22.9, 29.6, respectively). Among the aforementioned factors, changes in MCL were best correlated with those in THI scores (mean difference: 2.55, 95% CI: 0.90, 4.21).

CONCLUSION

A VSB implant is beneficial to subjects with tinnitus accompanied by sensorineural hearing loss. The changes in THI scores best correlated with those in MCL. This improvement may represent a masking effect that contributes to tinnitus suppression in patients with VSB implants.

摘要

目的

耳鸣是听力损失患者常见的症状,许多研究报道使用听力设备可成功抑制耳鸣。主动式中耳植入 Vibrant Soundbridge(VSB)是现有听力设备的良好替代品。本研究评估了 VSB 植入对耳鸣的影响,并试图确定影响耳鸣抑制的主要听力学因素。

方法

研究对象为 16 名患有感音神经性听力损失并接受 VSB 植入的成年人。在手术前和手术后 12 个月进行纯音测听、言语识别测试、耳鸣残疾量表(THI)和视觉模拟量表(VAS)评估,评估响度、意识和烦恼程度。分析听力阈值、言语识别评分(WRS)、THI 评分和 VAS 评分的变化。

结果

手术后 12 个月时,VAS 评分的响度(平均差值:1.9,95%置信区间:0.6,3.1)、意识(平均差值:1.6,95%置信区间:0.4,2.8)和烦恼(平均差值:1.7,95%置信区间:0.7,2.8)较基线显著改善。此外,THI 评分显著下降(平均差值:13.8,95%置信区间:2.9,24.9)。手术后 12 个月时,平均听力阈值水平、WRS 和最舒适水平(MCL)也显著改善(平均差值:17.3,95%置信区间:13.3,21.3;平均差值:-7.6,95%置信区间:-15.1,-0.1;平均差值:26.3,95%置信区间:22.9,29.6)。在上述因素中,MCL 的变化与 THI 评分的变化相关性最好(平均差值:2.55,95%置信区间:0.90,4.21)。

结论

VSB 植入对伴有感音神经性听力损失的耳鸣患者有益。THI 评分的变化与 MCL 的变化相关性最好。这种改善可能代表一种掩蔽效应,有助于 VSB 植入患者的耳鸣抑制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b67/6999863/0a71bf44edbf/pone.0228498.g001.jpg

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