| Objective:In patients with sudden deafness with acute tinnitus who still have hearing loss and tinnitus symptoms after conventional pharmacological treatment.The effectiveness of pharmacological combined with multivariate compound sound therapy in improving hearing and tinnitus symptoms in patients with acute tinnitus in the later stage of treatment was investigated to provide clinical reference for the later stage of treatment of patients with acute tinnitus.Methods:Patients with acute tinnitus admitted to Cangzhou People’s Hospital from October 2021 to January 2023 with the main complaint of"sudden hearing loss with tinnitus"were selected as the study subjects.On the first day of admission,acute tinnitus patients with sudden deafness with tinnitus were asked about their age,gender,tinnitus ear,time of onset of tinnitus,tinnitus triggering factors,whether tinnitus had worsened or decreased,whether tinnitus had been treated,whether they had hearing loss,whether they had a history of chronic diseases,whether they had a history of long-term medication,and their recent emotional state.The patient’s Pure Tone Auditory Threshold Test(PTA)and acoustic conductance test results were collected at the time of admission,and a general physical examination,electronic otoscopy and MRI of the head and internal auditory tract were performed with the patient’s consent(all of the above tests were non-invasive).The patient was given a general introduction to tinnitus and the Tinnitus Disorder Inventory(THI)and the Self-Assessment Scale(SAS)were explained in detail and improved.The patient was given conventional medication with reference to the Guidelines for the Diagnosis and Treatment of Sudden Deafness(2015),the Guidelines for the Clinical Application of Tinnitus,the Guidelines for the Diagnosis and Treatment of Tinnitus(Recommended Case),and the Expert Consensus and Interpretation of Tinnitus 2012.During the course of treatment,medication may be stopped early if the patient’s tinnitus and hearing are cured.At 2 weeks of treatment,patients who still had hearing loss and tinnitus symptoms were selected,and the selected patients were screened for further refinement of the tinnitus refinement and residual suppression test,and the THI score,SAS score and pure tone hearing threshold test were refined again.The patients were randomly divided into a control group and an observation group,and the control group was given pharmacological treatment.The observation group was given drug treatment+multiplexed acoustic therapy.During the continuation of treatment,if the patient’s tinnitus and hearing is cured the treatment can be stopped early and considered effective.Patients were followed up for 2 weeks(i.e.4 weeks of treatment)and 4 weeks(i.e.6 weeks of treatment),and the THI score,SAS score and pure tone hearing threshold test were improved again at 4 weeks of treatment and 6 weeks of treatment.The tinnitus efficacy and hearing efficacy of the two groups were analysed and compared before and after treatment,and whether there was any correlation between the tinnitus efficacy and hearing efficacy.The difference was considered statistically significant at P<0.05.Results:1.The total number of patients with acute tinnitus who completed this study was 79.Among them,44 were male and 35 were female,36 patients had tinnitus on the right side and 43 patients had tinnitus on the left side.53patients(67.09%)had tinnitus with a dominant frequency at high frequencies,and the type of hearing loss curve of the patients was mainly high-frequency hearing loss and flat hearing loss.No statistically significant differences in the distribution of tinnitus severity by patient gender,age at onset,side of tinnitus,duration of illness(days),severity of hearing loss,and type of hearing loss(P>0.05).In the patients,the difference between the distribution of anxiety severity and tinnitus severity was statistically significant(P<0.05),the severity of tinnitus was significantly and positively correlated with the severity of anxiety(r_s=0.464,P<0.05).2.There was no statistically significant difference in tinnitus efficiency between the two groups of patients at 2 weeks of treatment,at 4 weeks of treatment and at 6 weeks of treatment(P>0.05).The mean THI score and mean SAS score of the two groups of patients after treatment were significantly lower than those before treatment,and the difference was statistically significant(P<0.05).The difference between the mean THI score and mean SAS score of the two groups of patients before treatment,at 2weeks of treatment and at 4 weeks of treatment was not statistically significant(P>0.05),and the difference between the mean THI score and mean SAS score at 6 weeks of treatment was Statistically significant(P<0.05).The mean THI score and mean SAS score of patients in the observation group were lower than the mean THI score and mean SAS score of the control group.3.There was no statistically significant difference in the mean values of impaired frequency hearing thresholds between the two groups after treatment(P>0.05).The total hearing efficacy at 6 weeks of treatment was65.79%in the control group and 63.41%in the observation group.4.A univariate analysis of hearing efficacy on tinnitus efficacy at 6weeks of treatment in both groups showed a statistically significant difference in the composition ratio of hearing efficacy to tinnitus efficacy distribution(P<0.05),and a significant positive correlation between hearing efficacy and tinnitus efficacy at 6 weeks of treatment in both groups using the Gamma test(G=0.601,P<0.05).Conclusions:1.In the follow-up treatment of patients with sudden deafness with tinnitus,the combination of medication and polyphonic sound therapy was better than medication alone in reducing the severity of tinnitus in patients with acute tinnitus.2.There was no significant improvement in the hearing of patients with acute tinnitus compared to drug therapy alone,nor was there any negative impact on hearing with polyphonic sound therapy.3.In acute tinnitus patients with sudden deafness and tinnitus,the outcome of tinnitus is positively correlated with the outcome of hearing,i.e.the better the outcome of hearing,the better the outcome of tinnitus will be.4.The severity of tinnitus in tinnitus patients is positively correlated with the patient’s negative emotions. |
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