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慢性耳鸣多年来的进展。

The progression of chronic tinnitus over the years.

机构信息

Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.

University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich, Zurich, Switzerland.

出版信息

Sci Rep. 2021 Feb 18;11(1):4162. doi: 10.1038/s41598-021-83068-5.

Abstract

Little is known about the trajectory of tinnitus over time. This study addressed (1) how often tinnitus remitted in patients with chronic tinnitus; (2) how subjective reported tinnitus characteristics, such as loudness, laterality, and type and measures of burden, such as tinnitus distress, depression, and quality of life, changes over time; (3) how often tinnitus-specific treatments were undertaken and the prevalence of comorbidities, (4) if the number of treatments and comorbidities were associated to changes in tinnitus distress over time. Data from 388 patients with chronic tinnitus who visited a tertiary tinnitus clinic between 2012 and 2017 were interrogated via a mail survey in 2018. Tinnitus characteristics were measured with the Tinnitus Sample Case History Questionnaire and numeric rating scales; tinnitus distress with Tinnitus Handicap Inventory (THI) and the Tinnitus Questionnaire (TQ), depression with the Major Depression Inventory and Quality of life with the World Health Organisation Quality of Life BREF at both time points and the clinical global impression scale. Comorbidities experienced and undertaken treatments were assessed with an in-house survey. Three participants (0.8% of the sample) reported tinnitus remission between both assessments. A decrease in the THI and TQ, and numeric ratings for tinnitus severity, annoyance, unpleasantness, and discomfort was observed, but no differences in tinnitus characteristics, depression, quality of life or overall health status. 64% presented at least one comorbidity, and 88% sought at least on tinnitus-specific treatment. Common comorbidities were psychological and sleeping problems, and the most common interventions were going to the dentist, taking medications, and wearing hearing aids. Our results suggest that full remission of tinnitus is a rare condition, that tinnitus distress on average decreases over time, and that tinnitus characteristics, quality of life, and depression tend to remain unaltered. The high number of interventions and comorbidities displayed minimal association to the changes in tinnitus distress, highlighting the substantial and durable burden of tinnitus sufferers.

摘要

关于耳鸣随时间的变化轨迹,人们知之甚少。本研究旨在:(1) 慢性耳鸣患者耳鸣缓解的频率;(2) 耳鸣的主观报告特征,如响度、侧别、类型和负担的测量指标,如耳鸣困扰、抑郁和生活质量,随时间的变化;(3) 耳鸣特异性治疗的频率和共病的患病率;(4) 耳鸣特异性治疗的频率和共病是否与耳鸣困扰随时间的变化有关。2018 年,通过邮件调查对 2012 年至 2017 年间在一家三级耳鸣诊所就诊的 388 名慢性耳鸣患者的 2012 年至 2017 年间的数据进行了分析。耳鸣特征采用耳鸣样本病史问卷和数字评分量表进行测量;耳鸣困扰采用耳鸣残疾量表(THI)和耳鸣问卷(TQ)进行测量;抑郁采用大抑郁量表进行测量,生活质量采用世界卫生组织生活质量简表进行测量,在两个时间点采用临床总体印象量表进行测量。采用内部调查评估共病经历和接受的治疗。有 3 名患者(样本的 0.8%)在两次评估之间报告耳鸣缓解。THI 和 TQ 以及耳鸣严重程度、烦恼、不愉快和不适的数字评分均下降,但耳鸣特征、抑郁、生活质量或整体健康状况无差异。64%的患者至少存在一种共病,88%的患者至少寻求一种耳鸣特异性治疗。常见的共病是心理和睡眠问题,最常见的干预措施是看牙医、服药和戴助听器。我们的结果表明,耳鸣完全缓解是一种罕见的情况,耳鸣困扰平均随时间降低,而耳鸣特征、生活质量和抑郁往往保持不变。大量的干预措施和共病与耳鸣困扰的变化关联最小,突出了耳鸣患者的实质性和持久负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada0/7892997/cb30fa48722c/41598_2021_83068_Fig1_HTML.jpg

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