Department of Medical Education and Research, Kaohsiung Veterans General Hospital.
Otol Neurotol. 2024 Jun 1;45(5):e443-e449. doi: 10.1097/MAO.0000000000004196.
To investigate the clinical manifestations and complete auditory function in primary tinnitus patients with and without migraine or vestibular migraine.
Retrospective case-control study.
A tertiary referral center.
This study enrolled 298 patients from the Kaohsiung Veterans General Hospital. All patients were diagnosed with primary tinnitus by a neurotologist between April 2020 and August 2021. Patients were excluded if they had histories of chronic otitis media, idiopathic sudden sensorineural hearing loss, Ménière's disease, skull base neoplasm, or temporal bone trauma.
Twenty-five-item Tinnitus Handicap Inventory (THI), speech audiometry including speech recognition threshold, most comfortable level, uncomfortable loudness levels, dynamic range, and pure-tone audiometry.
Objective hearing loss is defined as a mean threshold greater than 25 dB. Extremely elevated THI is defined as a score greater than 1 standard deviation above the mean THI.
Among the 298 patients with tinnitus, 149 were women and 149 were men, with a mean age of 57.06 (range, 19.22-94.58) years.A total of 125 patients completed the THI questionnaire during their initial visit. The median THI score was 32 (95% confidence interval: 13.98-56.00), and the mean score was 34.99 with a standard deviation of 21.01. The sole contributing factor significantly associated with higher total THI score was the diagnosis of migraine or vestibular migraine (p < 0.001, odds ratio = 19.41).Tinnitus patients with migraine or vestibular migraine exhibited significantly lower mean pure-tone auditory thresholds (right 22.2 versus 29.5, p = 0.002; left 22.5 versus 30.4, p < 0.001), speech recognition threshold (right 20.0 versus 25.2, p = 0.016; left 20.2 versus 25.5, p = 0.019), and most comfortable levels values (right 46.1 versus 51.4, p = 0.007; left 46.9 versus 51.4, p = 0.021) compared with the tinnitus patients without migraine.
In this population-based study, patients with primary tinnitus experienced significantly higher THI scores and exhibited concurrent symptoms, including dizziness/vertigo, cervicalgia, and migraine or vestibular migraine. Among these parameters, the diagnosis of migraine or vestibular migraine was the sole contributor to significant higher THI score.
探讨原发性耳鸣患者伴或不伴偏头痛或前庭性偏头痛的临床表现和完整的听觉功能。
回顾性病例对照研究。
三级转诊中心。
本研究纳入了 2020 年 4 月至 2021 年 8 月期间由神经耳科医生诊断为原发性耳鸣的高雄荣民总医院的 298 名患者。如果患者有慢性中耳炎、特发性突发性聋、梅尼埃病、颅底肿瘤或颞骨外伤病史，则将其排除在外。
采用 25 项耳鸣残疾量表（THI）、言语测听，包括言语识别阈、最舒适水平、不适响度级、动态范围和纯音测听。
客观听力损失定义为平均阈值大于 25dB。极高的 THI 定义为评分高于平均 THI 的标准差 1 个以上。
在 298 例耳鸣患者中，女性 149 例，男性 149 例，平均年龄 57.06（范围：19.22-94.58）岁。共有 125 例患者在初次就诊时完成了 THI 问卷。THI 评分中位数为 32（95%置信区间：13.98-56.00），平均评分为 34.99，标准差为 21.01。唯一与总 THI 评分显著相关的因素是偏头痛或前庭性偏头痛的诊断（p<0.001，优势比=19.41）。伴偏头痛或前庭性偏头痛的耳鸣患者的平均纯音听阈明显更低（右耳 22.2 与 29.5，p=0.002；左耳 22.5 与 30.4，p<0.001），言语识别阈（右耳 20.0 与 25.2，p=0.016；左耳 20.2 与 25.5，p=0.019）和最舒适水平值（右耳 46.1 与 51.4，p=0.007；左耳 46.9 与 51.4，p=0.021）均显著低于无偏头痛的耳鸣患者。
在这项基于人群的研究中，原发性耳鸣患者的 THI 评分明显更高，并伴有头晕/眩晕、颈痛和偏头痛或前庭性偏头痛等症状。在这些参数中，偏头痛或前庭性偏头痛的诊断是导致 THI 评分显著升高的唯一因素。
