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伴有耳鸣与不伴有耳鸣的突发性聋的比较研究:听力学和血液学差异

Comparative study of SSNHL with and without tinnitus: audiologic and hematologic differences.

作者信息

Kim Jung Min, Rim Hwa Sung, Kim Sung Soo, Kim Sang Hoon, Byun Jae Yong, Yeo Seung Geun

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea.

Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Korea.

出版信息

Acta Otolaryngol. 2023 Jul-Aug;143(7):589-595. doi: 10.1080/00016489.2023.2229376. Epub 2023 Jul 12.

Abstract

BACKGROUND AND OBJECTIVES

Tinnitus is one of the most common symptoms of sudden sensorineural hearing loss (SSNHL), with the incidence of tinnitus in patients with SSNHL ranging from 60% to 90%. Little is known, however, about the specific audiologic and hematologic factors that may be associated with the development of tinnitus. To better understand the relationship between tinnitus and SSNHL, the present study compared audiologic and hematologic factors in SSNHL patients with tinnitus and without tinnitus.

SUBJECTS AND METHOD

The present study compared 120 patients with SSNHL with tinnitus and 59 patients with SSNHL without tinnitus at their initial examination. Their audiology and hematologic test results were analyzed, and hearing recovery was determined by comparing the hearing thresholds before and after treatment.

RESULTS

120 patients with tinnitus showed longer III and V latency in auditory brainstem response (ABR) tests, lower signal-to-noise ratios (SNR) at 2 kHz in transient evoked otoacoustic emissions (TEOAE) tests, and lower response rates at 2 kHz in distortion product otoacoustic emissions (DPOAE) tests of the affected ear ( < 0.05 each) than the 59 patients without tinnitus. However, there were no significant between-group differences in the mean hearing threshold and hearing recovery rate of the affected ear. Patients with tinnitus had significantly worse mean hearing thresholds and hearing thresholds at 4 kHz in the nonaffected ear. The percentages of monocytes and large unstained cells (%LUCs) were higher in the group without tinnitus ( < 0.05), although there were no significant between-group differences in inflammatory markers, such as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR).

CONCLUSION

Tinnitus accompanying SSNHL may be associated with baseline hearing level, as well as being an indicator of damage to outer hair cells and auditory nerves. Additional studies are needed to evaluate hematologic data in SSNHL patients with and without tinnitus.

摘要

背景与目的

耳鸣是突发性感音神经性听力损失(SSNHL)最常见的症状之一,SSNHL患者中耳鸣的发生率在60%至90%之间。然而,对于可能与耳鸣发生相关的具体听力学和血液学因素知之甚少。为了更好地理解耳鸣与SSNHL之间的关系,本研究比较了有耳鸣和无耳鸣的SSNHL患者的听力学和血液学因素。

对象与方法

本研究在初次检查时比较了120例有耳鸣的SSNHL患者和59例无耳鸣的SSNHL患者。分析了他们的听力学和血液学检查结果,并通过比较治疗前后的听力阈值来确定听力恢复情况。

结果

与59例无耳鸣的患者相比,120例有耳鸣的患者在听性脑干反应(ABR)测试中III波和V波潜伏期更长,在瞬态诱发耳声发射(TEOAE)测试中2kHz处的信噪比(SNR)更低,在畸变产物耳声发射(DPOAE)测试中患耳2kHz处的反应率更低(均P<0.05)。然而,患耳的平均听力阈值和听力恢复率在两组之间没有显著差异。有耳鸣的患者患耳的平均听力阈值和4kHz处的听力阈值明显更差。无耳鸣组的单核细胞和大未染色细胞百分比(%LUCs)更高(P<0.05),尽管在中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)和血小板与淋巴细胞比值(PLR)等炎症标志物方面两组之间没有显著差异。

结论

伴随SSNHL的耳鸣可能与基线听力水平有关,也是外毛细胞和听神经受损的一个指标。需要进一步研究来评估有耳鸣和无耳鸣的SSNHL患者的血液学数据。

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