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突发性聋后耳鸣及耳闷预后的临床相关因素。

Clinical Factors Associated With Prognosis of Tinnitus and Aural Fullness After Sudden Sensorineural Hearing Loss.

机构信息

Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.

出版信息

Otol Neurotol. 2023 Jun 1;44(5):432-437. doi: 10.1097/MAO.0000000000003853. Epub 2023 Mar 14.

DOI:10.1097/MAO.0000000000003853
PMID:36922014
Abstract

OBJECTIVES

We evaluated the long-term prognosis and risk factors associated with tinnitus and aural fullness, which occurred with sudden sensorineural hearing loss.

STUDY DESIGN

Retrospective cross-sectional review.

SETTING

Tertiary referral center.

PATIENTS

Those who visited our clinic for sudden hearing loss from January 2016 to May 2020, diagnosed with sudden sensorineural hearing loss based on pure-tone audiometry, and underwent magnetic resonance imaging to rule out other cause of hearing loss. In total, 106 patients were enrolled in this study.

INTERVENTION

All patients were treated with oral glucocorticoids. Salvage intratympanic dexamethasone injection therapy was performed for the patients whose hearing was not fully recovered.

MAIN OUTCOME AND MEASURES

We scored the loudness of tinnitus and the intensity of aural fullness using the numerical rating scale. We used a mixed-effects model for repeatedly measured tinnitus and aural fullness scores.

RESULTS

The time after the onset of sudden sensorineural hearing loss (SSNHL; β = -0.07; 95% confidence interval, -0.09 to -0.05; p < 0.001) and hearing outcome after treatment (overall p = 0.003) were significant factors associated with the prognosis of tinnitus. Concerning aural fullness, the time after the onset of SSNHL was a significant prognosis factor ( β = -0.08; 95% confidence interval, -0.09 to -0.06; p < 0.001), unlike hearing outcome (overall p = 0.261). Pretreatment pure-tone audiometry average threshold and mainly affected frequencies were not significant factors for tinnitus and aural fullness recovery, respectively.

CONCLUSION

The persistence of tinnitus with SSNHL was significantly affected by hearing recovery after treatment, whereas aural fullness was not associated with hearing recovery. However, both symptoms were improved over time after SSNHL.

摘要

目的

我们评估了与突发性聋伴有的耳鸣和耳闷的长期预后及其相关的危险因素。

研究设计

回顾性横断面研究。

地点

三级转诊中心。

患者

2016 年 1 月至 2020 年 5 月期间因突发性听力损失就诊于我院,根据纯音测听诊断为突发性聋,并接受磁共振成像检查以排除其他原因引起的听力损失。本研究共纳入 106 例患者。

干预措施

所有患者均接受口服糖皮质激素治疗。对于听力未完全恢复的患者,行补救性鼓室内地塞米松注射治疗。

主要结局和测量指标

我们使用数字评分量表对耳鸣响度和耳闷强度进行评分。我们使用混合效应模型对重复测量的耳鸣和耳闷评分进行分析。

结果

突发性聋发病后时间(β=-0.07;95%置信区间:-0.09 至-0.05;p<0.001)和治疗后的听力结果(总体 p=0.003)是与耳鸣预后相关的显著因素。对于耳闷,突发性聋发病后的时间是显著的预后因素(β=-0.08;95%置信区间:-0.09 至-0.06;p<0.001),而听力结果(总体 p=0.261)不是。治疗前纯音测听平均阈值和主要受累频率与耳鸣和耳闷的恢复均无显著相关性。

结论

突发性聋伴耳鸣的持续存在与治疗后听力恢复显著相关,而耳闷与听力恢复无关。然而,这两种症状在突发性聋后均随时间推移而改善。

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