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[降低耳鸣强度:使用个体频谱优化的近阈值噪声减轻音调性耳鸣的初步研究]

[Reducing tinnitus intensity : Pilot study to attenuate tonal tinnitus using individually spectrally optimized near-threshold noise].

作者信息

Schilling A, Krauss P, Hannemann R, Schulze H, Tziridis K

机构信息

Experimentelle HNO-Heilkunde, HNO-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Waldstraße 1, 91054, Erlangen, Deutschland.

WSAudiology, Sivantos GmbH, R&D AAA SA ERL, Erlangen, Deutschland.

出版信息

HNO. 2021 Nov;69(11):891-898. doi: 10.1007/s00106-020-00963-5. Epub 2020 Nov 13.

Abstract

BACKGROUND

Around 15% of the general population is affected by tinnitus, but no real cure exists despite intensive research. Based on our recent causal model for tinnitus development, we here test a new treatment aimed at counteracting the perception. This treatment is based on the stochastic resonance phenomenon at specific auditory system synapses that is induced by externally presented near-threshold noise.

OBJECTIVE

This pilot study will investigate whether individually spectrally adapted noise can successfully reduce chronic tonal/narrow-band tinnitus during stimulation.

MATERIALS AND METHODS

Hearing loss (HL) as well as tinnitus pitch (TP) and loudness (TL) were audiometrically measured in 22 adults (46.6±16.3 years; 4 women) with tinnitus. Based on these measurements, up to eight different noise stimuli with five intensities (-20 to +20 dB SL) were generated. These were presented for 40 s each via audiologic headphones in a soundproof chamber. After each presentation, the change in TL was rated on a five-level scale (-2 to +2).

RESULTS

We found patients (n = 6) without any improvement in their TL perception as well as patients with improvement (n = 16), where stimulation around the TP was most effective. The groups differed in post-hoc analysis of their audiograms: the effectiveness of our new therapeutic strategy obviously depends on the individual HL, and was most effective in normal-hearing tinnitus patients and those with mild HL.

CONCLUSION

Subjective TL could be reduced in 16 out of 22 patients during stimulation. For a possible success of a future therapy, the HL seems to be of relevance.

摘要

背景

约15%的普通人群受耳鸣影响,尽管进行了深入研究,但尚无真正的治愈方法。基于我们最近提出的耳鸣发生因果模型,我们在此测试一种旨在对抗耳鸣感知的新疗法。该疗法基于特定听觉系统突触处的随机共振现象,由外部呈现的近阈值噪声诱发。

目的

这项初步研究将调查个体频谱适配噪声在刺激过程中能否成功减轻慢性音调/窄带耳鸣。

材料与方法

对22名患有耳鸣的成年人(46.6±16.3岁;4名女性)进行听力测定,测量听力损失(HL)以及耳鸣音高(TP)和响度(TL)。基于这些测量结果,生成多达八种不同强度(-20至+20 dB SL)的噪声刺激。这些刺激通过听力耳机在隔音室内每次呈现40秒。每次呈现后,TL的变化按五级量表(-2至+2)进行评分。

结果

我们发现有些患者(n = 6)的TL感知没有任何改善,而有些患者(n = 16)有改善,其中在TP附近进行刺激最为有效。两组在听力图的事后分析中存在差异:我们新治疗策略的有效性明显取决于个体HL,在听力正常的耳鸣患者和轻度HL患者中最为有效。

结论

22名患者中有16名在刺激过程中主观TL有所降低。对于未来治疗可能取得成功而言,HL似乎具有相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/865b/8545742/db51247aaa66/106_2020_963_Fig1_HTML.jpg

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