Kochilas Helen L, Cacace Anthony T, Arnold Amy, Seidman Michael D, Tarver W Brent
North Atlanta Ears, Nose, Throat & Allergy, Alpharetta Georgia.
Present address: North Atlanta Ears, Nose, Throat & Allergy Alpharetta Georgia.
Laryngoscope Investig Otolaryngol. 2020 Mar 24;5(2):286-296. doi: 10.1002/lio2.364. eCollection 2020 Apr.
In individuals with chronic tinnitus, our interest was to determine whether daily low-level electrical stimulation of the vagus nerve paired with tones (paired-VNS) for tinnitus suppression had any adverse effects on motor-speech production and physiological acoustics of sustained vowels. Similarly, we were also interested in evaluating for changes in pure-tone thresholds, word-recognition performance, and minimum-masking levels. Both voice and hearing functions were measured repeatedly over a period of 1 year.
Longitudinal with repeated-measures.
Digitized samples of sustained frontal, midline, and back vowels (/e/, /o/, /ah/) were analyzed with computer software to quantify the degree of , , and contained in these waveforms. Pure-tone thresholds, monosyllabic word-recognition performance, and MMLs were also evaluated for VNS alterations. Linear-regression analysis was the benchmark statistic used to document change over time in voice and hearing status from a baseline condition.
Most of the regression functions for the vocal samples and audiometric variables had slope values that were significantly different from zero. Four of the nine vocal functions showed a significant improvement over time, whereas three of the pure tone regression functions at 2-4 kHz showed some degree of decline; all changes observed were for the left ear, all were at adjacent frequencies, and all were ipsilateral to the side of VNS. However, mean pure-tone threshold changes did not exceed 4.29 dB from baseline and therefore, would not be considered clinically significant. In some individuals, larger threshold shifts were observed. No significant regression/slope effects were observed for word-recognition or MMLs.
Quantitative voice analysis and assessment of audiometric variables showed minimal if any evidence of adverse effects using paired-VNS over a treatment period of 1 year. Therefore, we conclude that paired-VNS is a safe tool for tinnitus abatement in humans without significant side effects.
Level IV.
对于患有慢性耳鸣的个体，我们感兴趣的是确定每日将迷走神经的低水平电刺激与音调配对（配对迷走神经刺激）以抑制耳鸣是否会对运动言语产生和持续元音的生理声学产生任何不利影响。同样，我们也有兴趣评估纯音阈值、单词识别性能和最小掩蔽水平的变化。在1年的时间里对语音和听力功能进行了多次测量。
重复测量的纵向研究。
使用计算机软件分析持续的前位、中线和后位元音（/e/、/o/、/ah/）的数字化样本，以量化这些波形中所含的、和的程度。还评估了纯音阈值、单音节单词识别性能和最小掩蔽水平以检测迷走神经刺激的改变。线性回归分析是用于记录语音和听力状态相对于基线条件随时间变化的基准统计方法。
大多数语音样本和听力测量变量的回归函数的斜率值与零有显著差异。九个语音功能中的四个随时间显示出显著改善，而2 - 4千赫兹处的三个纯音回归函数显示出一定程度的下降；观察到的所有变化都发生在左耳，都在相邻频率，并且都与迷走神经刺激的一侧同侧。然而，平均纯音阈值变化相对于基线不超过4.29分贝，因此，不会被认为具有临床意义。在一些个体中，观察到了更大的阈值变化。对于单词识别或最小掩蔽水平未观察到显著的回归/斜率效应。
在1年的治疗期内，定量语音分析和听力测量变量评估显示，使用配对迷走神经刺激即使有不利影响也微乎其微。因此，我们得出结论，配对迷走神经刺激是一种用于减轻人类耳鸣的安全工具，无明显副作用。
四级。
