Peng X, Zhu X H, Huang B Q, Zhao Z Y, Zhang Q J, Zhu L, Wang F Y, Diao M F, Hou Z H, Zhu Y H
Department of Otolaryngology Head and Neck Surgery, People's Libration Army General Hospital, Beijing 100142, China Department of Otolaryngology Head and Neck Surgery, Hainan Hospital of People's Libration Army General Hospital, Sanya 572013, China.
Laboratory Department of Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Jan 7;58(1):42-46. doi: 10.3760/cma.j.cn115330-20220608-00340.
To clarify the long-term characteristics of tinnitus following treatment of sudden deafness and its long-term physical and mental effects on patients. A retrospective analysis was performed on 88 patients (46 males and 42 females; Age from 11 to 89 years) with sudden deafness treated in Department of Otoscope Surgery of Peoples's Libration Army General Hospital in Beijing from April 2020 to January 2021, and the occurrence of tinnitus and treatment effect of all patients were analyzed. Follow-up was conducted for patients with residual tinnitus after treatment for more than 1 year by the investigation and filling in the survey information collection form, Tinnitus Evaluation Questionnaire (TEQ) and Tinnitus Handicap Inventory (THI). Descriptive statistics and SPSS 22.0 software were used for statistical data analysis. In this study, 93.2% (82/88) of patients with sudden deafness were accompanied by tinnitus at the onset, and the proportion of long-term tinnitus after treatment was 90.2% (74/82). After 1 year of treatment for sudden deafness, the improvement of tinnitus was significant in low-frequency sudden deafness compared with those of high-frequency, flat and total deafness sudden deafness (χ2 value was 6.801, 4.568 and 4.038, all <0.05). In patients with residual tinnitus, 9 (12.2%) patients felt minimal loudness or even no loudness, 34 (46.0%) patients felt slight loudness, 28 (37.8%) patients felt tinnitus was relatively loud, and 3 (4.1%) patients felt tinnitus was loud or noisy. Nine (12.2%) patients's sleep was often affected, 41 (55.4%) patients's sleep was sometimes affected, 9 (12.2%) patients's sleep was rarely affected, 15 (20.3%) patients's sleep was almost not affected. Twenty-eight (37.8%) patients basically completely adapted to tinnitus and 46 (62.2%) patients did not completely adapted to residual tinnitus. Eight (10.8%) patients had no impact on life, 39 (52.7%) patients had slight impact, 22 (29.7%) patients had moderate impact, and the other 5 (6.8%) patients had greater impact. According to tinnitus evaluation questionnaire(TEQ), there were 12 cases (16.2%) of grade Ⅰ, 26 cases (35.1%) of grade Ⅱ, 28 cases (37.8%) of grade Ⅲ, 7 cases (9.5%) of grade Ⅳ and 1 case (1.4%) of grade Ⅴ. According to tinnitus handicap inventory(THI), tinnitus disability was classified into grade Ⅰ, 22 cases (29.7%), grade Ⅱ, 14 cases (18.9%), Grade Ⅲ, 27 cases (36.5%) and grade Ⅳ, 11 cases (14.9%). The rate of residual tinnitus following treatment of sudden deafness is high. Some of the patients can completely adapt residual tinnitus after one year, but some of them will be affected when sleep, work and study. Residual tinnitus can lead to tinnitus disability in different degrees.
为阐明突发性聋治疗后耳鸣的长期特征及其对患者长期的身心影响。对2020年4月至2021年1月在北京解放军总医院耳科手术治疗的88例突发性聋患者（男46例，女42例；年龄11～89岁）进行回顾性分析，分析所有患者耳鸣的发生情况及治疗效果。对治疗后残留耳鸣患者随访1年以上，采用调查并填写调查问卷信息收集表、耳鸣评估问卷（TEQ）和耳鸣致残量表（THI）。采用描述性统计和SPSS 22.0软件进行统计数据分析。本研究中，93.2%（82/88）的突发性聋患者发病时伴有耳鸣，治疗后长期耳鸣的比例为90.2%（74/82）。突发性聋治疗1年后，低频突发性聋耳鸣改善情况与高频、平坦型及全聋型突发性聋相比差异有统计学意义（χ2值分别为6.801、4.568和4.038，均<0.05）。在残留耳鸣患者中，9例（12.2%）患者感觉响度极小甚至无响度，34例（46.0%）患者感觉响度轻微，28例（37.8%）患者感觉耳鸣响度较大，3例（4.1%）患者感觉耳鸣响度大或嘈杂。9例（12.2%）患者睡眠常受影响，41例（55.4%）患者睡眠有时受影响，9例（12.2%）患者睡眠很少受影响，15例（20.3%）患者睡眠几乎不受影响。28例（37.8%）患者基本完全适应耳鸣，46例（62.2%）患者未完全适应残留耳鸣。8例（10.8%）患者对生活无影响，39例（52.7%）患者有轻微影响，22例（29.7%）患者有中度影响，另外5例（6.8%）患者有较大影响。根据耳鸣评估问卷（TEQ），Ⅰ级12例（16.2%），Ⅱ级26例（35.1%），Ⅲ级28例（37.8%），Ⅳ级7例（9.5%），Ⅴ级1例（1.4%）。根据耳鸣致残量表（THI），耳鸣残疾分级为Ⅰ级22例（29.7%），Ⅱ级14例（18.9%），Ⅲ级27例（36.5%），Ⅳ级11例（14.9%）。突发性聋治疗后残留耳鸣发生率较高。部分患者1年后能完全适应残留耳鸣，但部分患者睡眠、工作和学习会受到影响。残留耳鸣可导致不同程度的耳鸣残疾。
