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45 例人工耳蜗植入患者前瞻性队列中的耳鸣抑制:发生率、程度和相关因素。

Tinnitus suppression in a prospective cohort of 45 cochlear implant recipients: occurrence, degree and correlates.

机构信息

Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.

Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

出版信息

Eur Arch Otorhinolaryngol. 2023 Sep;280(9):4073-4082. doi: 10.1007/s00405-023-07921-1. Epub 2023 Apr 26.

Abstract

OBJECTIVE

To determine tinnitus prevalence and severity in a cohort of unselected first-time cochlear implant (CI) recipients whose primary motive for CI was sensorineural hearing loss (SNHL), and to evaluate the effect of CI on tinnitus after cochlear implantation.

METHODS

Prospective longitudinal study of 45 adult CI recipients with moderate to profound SNHL. Patients completed the Danish version of the Tinnitus Handicap Inventory (THI) and a visual analogue scale (VAS) for tinnitus burden before implantation, 4 months after implantation and 14 months after implantation.

RESULTS

The study included 45 patients, of which 29 (64%) had pre-implant tinnitus. Median THI score (IQR) significantly decreased from 20 (34) to 12 (24) at first follow-up (p < 0.05) and to 6 points (17) at second follow-up (p < 0.001). Median VAS (IQR) for tinnitus burden decreased from 33 (62) to 17 (40; p = 0.228) and 12 (27, p < 0.05) at the first and second follow-ups, respectively. Tinnitus was totally suppressed in 19% of patients, improved in 48%, remained unchanged in 19% and worsened in 6%. 2 patients reported new tinnitus. At the second follow-up, 74% of patients had slight or no tinnitus handicap, 16% had mild handicaps, 6% had moderate handicaps, and 3% had severe handicaps. High pre-implant THI and VAS scores correlated with greater decrease in THI scores over time.

CONCLUSION

64% of the patients with SNHL had pre-implant tinnitus, which was decreased 4 and 14 months after implantation. Overall, 68% of patients with tinnitus improved their tinnitus handicap after CI. Patients with higher THI and VAS scores had a larger decline and the highest benefits in terms of tinnitus handicap improvement. The study findings demonstrate that the majority of patients with moderate to profound SNHL eligible for cochlear implantation benefit from complete or partial tinnitus suppression and improved quality of life after implantation.

摘要

目的

确定一组初次接受人工耳蜗植入(CI)的未选择的患者的耳鸣患病率和严重程度,这些患者的主要动机是感音神经性听力损失(SNHL),并评估 CI 对植入后耳鸣的影响。

方法

对 45 名患有中度至重度 SNHL 的成年 CI 接受者进行前瞻性纵向研究。患者在植入前、植入后 4 个月和植入后 14 个月时完成丹麦版耳鸣残疾量表(THI)和耳鸣负担视觉模拟量表(VAS)。

结果

该研究包括 45 名患者,其中 29 名(64%)有植入前耳鸣。THI 评分中位数(IQR)在第一次随访时从 20(34)显著降低至 12(24)(p < 0.05),第二次随访时降低至 6 分(17)(p < 0.001)。耳鸣负担的 VAS 中位数(IQR)从 33(62)降低至 17(40;p = 0.228)和 12(27,p < 0.05),分别在第一次和第二次随访时。19%的患者耳鸣完全抑制,48%的患者耳鸣改善,19%的患者耳鸣无变化,6%的患者耳鸣恶化。2 名患者报告出现新的耳鸣。在第二次随访时,74%的患者有轻度或无耳鸣障碍,16%的患者有轻度障碍,6%的患者有中度障碍,3%的患者有重度障碍。高植入前 THI 和 VAS 评分与随时间推移 THI 评分的更大降低相关。

结论

64%的 SNHL 患者在植入前有耳鸣,植入后 4 个月和 14 个月时耳鸣减轻。总体而言,68%的耳鸣患者在接受 CI 后改善了耳鸣障碍。THI 和 VAS 评分较高的患者耳鸣障碍改善程度更大,受益最大。研究结果表明,大多数有中度至重度 SNHL 的患者适合接受人工耳蜗植入,植入后可完全或部分抑制耳鸣,并提高生活质量。

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