Department of Otorhinolaryngology, Head and Neck Surgery.
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Otol Neurotol. 2020 Oct;41(9):e1074-e1081. doi: 10.1097/MAO.0000000000002733.
Tinnitus is a prevalent auditory disorder that frequently co-occurs with hearing loss. It is suggested that tinnitus might have negative impact on speech perception. However, studies thus far have not been able to disentangle tinnitus, hearing loss, and speech in noise intelligibility. We therefore investigated whether there is an association between tinnitus and speech understanding in noise, independent of hearing loss.
Of 4,211 participants from the population-based Rotterdam Study (mean age 67.8 [SD 8.9], 57.3% female) data was available on tinnitus, pure-tone audiometry, and digits in noise test. We compared the speech reception threshold in noise (SRTn) in participants with and without tinnitus for the whole population as well as for subgroups stratified for average hearing threshold in 10-dB strata. Additionally, we regressed tinnitus on SRTn with a multivariable regression model, adjusting for sex, age, highest achieved education, and cognitive function.
Participants with tinnitus (20.8%) had a higher SRTn (-3.6 dB [SD 3.7] versus -4.6 dB [SD 3.1]). This difference remained only in the subgroups of participants with hearing loss, between 0.6 and 0.8 dB difference in the SRTn for the different subgroups. In the fully adjusted model tinnitus was associated with 0.2 dB (95% CI 0.00, 0.39) SRTn increase.
We have shown that tinnitus is associated with speech intelligibility in noise, but it is a small effect, only found in people with co-occurring hearing loss.
耳鸣是一种常见的听觉障碍，常与听力损失同时发生。有研究表明，耳鸣可能对言语感知产生负面影响。然而，迄今为止的研究还无法区分耳鸣、听力损失和噪声下言语可懂度。因此，我们研究了在不考虑听力损失的情况下，耳鸣与噪声下言语理解之间是否存在关联。
我们对人群基础的鹿特丹研究中的 4211 名参与者（平均年龄 67.8[8.9]岁，57.3%为女性）的数据进行了分析，这些数据包括耳鸣、纯音听力测试和噪声中数字测试。我们比较了有耳鸣和无耳鸣的参与者的噪声下言语接受阈（SRTn），并对整个人群以及按平均听力阈值分为 10dB 组的亚组进行了比较。此外，我们使用多变量回归模型，调整了性别、年龄、最高学历和认知功能，将耳鸣与 SRTn 进行回归分析。
有耳鸣的参与者（20.8%）的 SRTn 更高（-3.6dB[3.7]与-4.6dB[3.1]）。这种差异仅在听力损失亚组中存在，不同亚组的 SRTn 差异在 0.6 至 0.8dB 之间。在完全调整的模型中，耳鸣与 0.2dB（95%CI 0.00，0.39）的 SRTn 增加相关。
我们已经表明，耳鸣与噪声下的言语可懂度相关，但这是一种小的效应，仅在伴有听力损失的人群中发现。
