目的:分析突发性聋伴耳鸣患者的耳鸣特点,探讨其与听力学特征之间的关系。方法:选择105例突发性聋伴耳鸣患者为研究对象,分析其耳鸣频率、听力受损频率、耳鸣主观分级、听力损失程度、残余抑制试验结果等临床特点。结果:听力损失程度:轻度30例,中度13例,重度28例,极重度34例;听力受损频率:低频13例,中高频39例,全频53例;伴发耳鸣频率:低频耳鸣41.9%(44/105),中频耳鸣21.9%(23/105),高频耳鸣36.2%(38/105)。在低频听力损失患者中,低、中、高频耳鸣患者所占比例分别为76.9%(10/13)、7.7%(1/13)、15.4%(2/13);在中高频听力损失患者中,低、中、高频耳鸣患者所占比例分别为25.6%(10/39)、28.2%(11/39)、46.2%(18/39);在全频听力损失患者中,低、中、高频耳鸣患者所占比例分别为45.3%(24/53)、20.7%(11/53)、34.0%(18/53);听力损失频率与耳鸣频率具有较高的一致性(P〈0.05),听力损失程度和耳鸣主观分级具有一定的相关性(r=0.24,P〈0.05)。对其中72例可行残余抑制实验的患者的结果进行分析,耳鸣掩蔽曲线为汇聚型者阳性率为72.0%,分离型为20.0%,重叠型为57.9%,间距型为43.5%;汇聚型与分离型、间距型间差异有统计学意义(P〈0.05)。结论:突发性聋伴耳鸣患者的耳鸣特点存在个体差异,耳鸣频率多出现在听力受损频率;听力损失程度越严重的患者其耳鸣主观分级越严重;不同掩蔽曲线患者中汇聚型与间距型、分离型相比残余抑制试验阳性率更高,提示汇聚型患者耳鸣掩蔽治疗效果更好。因此,耳鸣检测与听力学检查相结合,可以更全面地了解突发性聋伴耳鸣患者的耳鸣症状与听力学改变,对其治疗有着指导性作用。
Objective: To analysis the characteristics of sudden sensorineural hearing loss (SSHL) patients with tinnitus, and explore the relationship of characteristics of tinnitus and audiology. Method:Patients diagnosed as SSHL with tinnitus were studied in the research. All patients clinical features were analyzed, such as tinnitus frequency, pure tone audiometry, tinnitus, hearing loss degree, results of residual inhibition test. Result:Thirty cases were identified as mild degree hearing loss, 13 cases as moderate degree, 28 cases as severe degree and 34 cases as profound degree. And hearing impaired frequency of 13 cases was ascertained at low-frequency, 39 cases at middle-high-frequency, and 53 cases at full-range-frequency. The incidence of patients with low-frequency was a- bout 41.9% (44 /105), and it was about 21.90% (23 /105) in those with middle-frequency. And it was 36.2% (38/105) in cases of high-frequency tinnitus. The chi-square test show statistically significant differences between patients with the low-frequency, middle-frequency and high-frequency of the hearing loss (P〈0. 05). In tinnitus residual inhibition test, positive rate of convergence type masking curve was about 72.0%, tinnitus separated type masking curve 20.0%, overlapping type was 57.9%, and the spacing type was 43.5%, There was a statistically significant difference among cases with different type masking curve (P〈0.05)with the spacing residual inhibitiontest positive rate. Conclusion: There are individual differences of clinical characteristics among SSHL patients with tinnitus. Tinnitus frequency is consistent with the frequency of hearing loss. Patients had the more serious the degree of hearing loss, who had more serious tinnitus grading. Cases with the converged type curve will be fit for tinnitus masking. Therefore, combining the tinnitus detection with the audiological tests, we could obtain the clinical characteristics of SSHL patients with tinnitus.