Analysis On The Correlation Factors Of The Severity Of Chronic Subjective Tinnitus

BackgroundTinnitus is defined as a perception of a sound in the head without an externalstimulus, subjective tinnitus is a subjective auditory perception, not including thepulsating blood vessels or muscle spasms and other objective tinnitus, a history of>1year was defined as chronic subjective tinnitus. According to World HealthOrganization statistics, there are about278million worldwide-15%of thepopulation suffers from tinnitus, tinnitus patients is therefore a very large group.Inmany people,tinnitus can their daily lives, such as sleep, work and social activities.Formation mechanism of tinnitus is not very clear, with further research, academiamade a lot of possible formation mechanism and model of tinnitus. Neurophysiologymode of tinnitus on the basis of neurophysiology and psychology proposed byJastreboff is currently widely accepted at home and abroad.the model considers thatthe different planes of the auditory pathway and some non-auditory system (especially the limbic system) are the main parts that produce tinnitus. This modelinvolves the limbic system and the autonomic nervous system, which may explaintinnitus neurological and psychiatric problems caused by tinnitus. Tinnitus can causeanxiety, depression, irritability and sleep disorders and other psychological problems,such as,hyperacusis,too much pressure and other symptoms.For tinnitus, there is no clear objective and effective screening method,so for,scales and questionnaires are mainly used to quantify subjective experience oftinnitus patients to assess the severity and impact on quality of life in patients withtinnitus. Chinese version of the disability scale (tinnitus handicap inventory, THI)translated by QiLan Shi and other researcher has been proved to have good reliability,validity and responsiveness.Tinnitus handicap inventory is an effective tool forassessing tinnitus severity and treatment effect.The influence of tinnitus on patientsis the outcome of tinnitus itself and adverse emotional reactions caused by the tinnitus.In recent years, some scholars have analyze factors of affecting tinnitus severity, suchas gender, age, degree of hearing damage, unilateral or bilateral tinnitus, tinnitusduration, tinnitus psychoacoustics, anxiety, depression, sleep disorder, andhyperacusis, but mostly scholars use single factor analysis method. Due to theseverity of tinnitus is a result of the impact and effects of multiple factors,therefore,the author employs THI scale to analyze the severity of the tinnitus,Possible factors of affecting the severity of tinnitus such as gender, age, hearing loss,tinnitus, match the frequency and loudness, sleep situation, anxiety conditions andthe presence of hyperacusis were analyzed by multivariate ordinal logistic regression,in order to find the key factors of affecting the severity of tinnitus, guidance forclinical treatment in order to achieve better clinical efficacy.Method1.Make the inclusion criteria and exclusion criteria, select120cases of tinnituswho go to the First Affiliated Hospital of Zhengzhou University otology clinic withcomplaints of tinnitus from August2013to December2013for the study.Give eachpatient System specialist examination and detailed medical history, Ask whetherpatients with sleep disorders and hyperacusis. Fill in tinnitus handicap inventory,tinnitus Anxiety Scale questionnaire. Do check for each patient with Pure toneaudiometry, Acoustic immittance and the psychoacoustic characteristics of tinnitusinspection by by the same Professionals and recorded the results.2.Select nine factors: gender,age, tinnitus duration,degree of hearingloss,tinnitus frequency,tinnitus loudness,sleep disorder, Hyperacusis,anxiety.weFirst carry on the t univariate analysis, then carry on the multivariate ordinal Logisticregression when the factor have a statistically significant.choose SPSS19.0 software system for date analysis, P <0.05was considered statistically significant.carry on the multivariate ordinal Logistic regression when the factor have astatistically significant.Result1.120cases of tinnitus patients63males and57females, mean age48.9±14.4,mean tinnitus duration was3.12±1.61years,80cases of tinnitus with hearing loss(66.6%),72cases of tinnitus with sleep disorders (60%),57cases of tinnitus withhyperacusis (47.5%),43cases of tinnitus with anxiety (35.8%), THI score results oftinnitus patients: grade one was eight cases, grader two was50patients, grade threewas40patients, grade four was17cases, grade five was five cases.2.univariate analysis showed that gender, age, degree of hearing damage, tinnitusfrequency and tinnitus loudness have no correlation with the severity of tinnitus (P＞0.05). Whether tinnitus duration， the presence of sleep disorders, hyperacusis andanxiety have correlation with tinnitus severity (P<0.05).3. Multivariate ordinal Logistic regression analysis showed that the presence sleepdisorders, hyperacusis and degree of anxiety have correlation with tinnitus severity (P<0.05), these three factors are the main factors that influence the severity of tinnitus.Conclusion1Severity of tinnitus is affected by many factors, but gender，age,duration oftinnitus and audiology index have no correlation.Therefore we cannot assess theseverity of tinnitus on the basis of objective audiological examination..2, with or without sleep, hyperacusis and degree of the anxiety conditions are themain factors of affecting the severity of tinnitus, treatment of tinnitus should takepsychological counseling, cognitive behavioral therapy, sound therapy, drug treatmentcombined with comprehensive treatment approach.