Preyer S, Bootz F
Universitäts-HNO-Klinik Tübingen.
HNO. 1995 Jun;43(6):338-51.
Tinnitus models are an integral part of tinnitus counselling. In cases with compensated tinnitus, counselling represents the only therapeutic measure necessary. In contrast, patients with uncompensated tinnitus require further therapy in the form of medication, tinnitus-maskers or psychotherapy. Sound processing along the peripheral and central auditory pathways is achieved by functional loops that direct mechanical, electrical or chemical information to various points in the pathway. Minor damage to a loop can cause destabilization of this finely balanced system and can induce tinnitus. Current peripheral tinnitus models are reviewed and discussed with respect to in vitro data from isolated outer hair cells of the guinea pig cochlea. Audiological findings of a patient with central tinnitus after brainstem surgery are discussed in view of central tinnitus models. Specific models for common hearing disorders, such as tinnitus with normal hearing, noise trauma, sudden hearing loss, toxic cochlear lesions, presbyacusis, acoustic neurinoma and Menière's disease are presented for the ENT-surgeon involved with tinnitus-counselling.
耳鸣模型是耳鸣咨询不可或缺的一部分。对于代偿性耳鸣患者，咨询是唯一必要的治疗措施。相比之下，失代偿性耳鸣患者需要药物治疗、耳鸣掩蔽器治疗或心理治疗等进一步治疗。沿着外周和中枢听觉通路的声音处理是通过功能回路实现的，这些回路将机械、电或化学信息导向通路中的各个点。回路的轻微损伤会导致这个精细平衡的系统不稳定，并引发耳鸣。本文回顾并讨论了当前基于豚鼠耳蜗分离外毛细胞体外数据的外周耳鸣模型。结合中枢耳鸣模型，讨论了一名脑干手术后出现中枢耳鸣患者的听力学检查结果。本文还为从事耳鸣咨询的耳鼻喉科医生介绍了常见听力障碍的特定模型，如听力正常的耳鸣、噪声性创伤、突发性听力损失、中毒性耳蜗病变、老年性聋、听神经瘤和梅尼埃病。
