Different Syndromes Of Otitis Media's Tinnitus Incidence And Tinnitus Characteristics Research

ObjectiveInvetigate detailed tinitus information and collect four diagnostic information of 200 patients with otitis media as to get basic data of the incidence of tinnitus on otitis media patients with different types and different syndromes, and to learn more about tinnitus characteristics of otitis media-related and difference in different syndromes of tinnitus as well as to provide clinical data about the pathogenesis and the TCM differentiation of tinnitus.Contents and methodsCollect cases of out-patients and inpatients with otitis media who were treated in ENT Department of Guangzhou Panyu District Hospital of TCM from March 2010 to December 2010. First, investigate if the patient has tinnitus, if he has tinnitus, investigate the relation between tinnitus and otitis media. If the tinnitus was caused by otitis media, ivestigate thoroughly the severity of tinnitus and analyze its psychology acoustics characteristics. Count the incidence of different syndromes otitis media, and analyze the tinnitus' characteristics.Result1. General information in patients with otitis media:a total of 200 cases of collection cases. Among them, the male are 108 cases (54%), female are 92 cases (46%). Left ear in 86 cases (43.0%), right ear are 114 cases (56.0%). Aged from 14 to 70 years, average for 35.5±13.7 years; course from 1 day to 42 years, the average is 1617.3±262.5 days.112 cases of purulent otitis media,88 cases of secretory otitis media. The sex ratio is similar in TCM syndromes. People of the invasion of the wind-pathogenic syndrome are the youngest in all TCM syndromes, and the people of the kidney-essence deficiency syndrome are the oldest. In the course of disease, the invasion of wind-pathogenic syndrome is the shortest, the kidney-essence deficiency syndromes is the longest. 2. The incidence of tinnitus caused by otitis media:in 200 cases of otitis media by random selected,37 cases(18.5%) have tinnitus which are assoiated with otitis media. Among them,112 cases are purulent otitis media which are associated with 15 tinnitus cases.88 cases of secretory otitis media cases, 22 cases of tinnitus are assoiated with them, accouting for 25.0%.3. The charactrist of otitis media's tinnitus:purulent otitis media and secretory otitis media group are combined of 37 cases which are related to cases of tinnitus. The characteristics are:ringing in the ears as a voice is one kind; the part of tinnitus is in the affected ear or intracranial lateral side near the affected ear; Most of the tinnitus frequency is the middle frequency, the frequency of the purulent otitis media is 800.0±589.7Hz, the average loudness is 4.5±1.3dBSL, residual inhibition test in 11 cases (73.3%) are positive, the average inhibition is 29.1±14.5 seconds; the minimum masking curves are the distance type and the converged type in the majority; the average of tinnitus's severity score is 7.3±2.5 points. The average tinnitus frequence of secretory otitis media group is 1761.4±1335. 1Hz; the tinnitus'loudness is 3.5±1.7dBSL; 17 cases(77.3%) of residual inhibition test are positive, the average inhibition is 30.9±26.3 seconds;the minimum masking curves are the distance type and the converged type in the majority; tinnitus severity average score are 9.5±1.7 points. Most tinnitus patients with stageⅡevaluation, the impact of psychological and living by tinnitus to patients is small, they have not significant mood disorder. Overall, the interference by tinnitus of the working, living, learning, mood, sleep to patients is not big.4. The incidence of different syndromes otitis media's tinnitus:the invasion of wind-pathogenic syndrome is 16.9%, the weakness and wetness of spleen syndrome is 23.6%, the liver and gallbladder damp-heat syndrome is 11.8%, the kidney-essence deficiency syndrome is 22.7%. There is no significant difference in the incidence of different types.5. Tinnitus characteristics of otitis media with different syndromes:the average tinnitus frequency of the invasion of wind-pathogenic syndrome is 750.0±353.6Hz; loudness averaged 3.8±1.4dBSL;the minimum masking curves are the distance type and the converged type in the majority;the positive rate of residual inhibition test is 66.7%, the average second is 32.5±31.8 seconds; tinnitus severity ratings is ClassⅠand ClassⅡin majority.The average tinnitus frequency of the weakness and wetness of spleen syndrome is 2000.0±935.4Hz; loudness averaged 3.8±1.8dBSL; the minimum masking curves are the distance type in majority;the positive rate of residual inhibition test is 76.9%, the average second is 33.0±17.7 seconds; tinnitus severity ratings is Class II in majority.The average tinnitus frequency of the liver and gallbladder damp-heat syndrome is 550.0±233.5Hz; loudness averaged 4.5±1.7dBSL; the minimum masking curves are the overlap type in majority;the positive rate of residual inhibition test is 100%, the average second is 21.3±8.5 seconds; tinnitus severity ratings is ClassⅡin all.The average tinnitus frequency of the kidney-essence deficiency syndrome is 2875.0±1652. OHz; loudness averaged 4.2±1.6dBSL;the minimum masking curves are the distance type in majority; the positive rate of residual inhibition test is 80.0%, the average second is 26.3±11.1 seconds; tinnitus severity ratings is ClassⅡin all.Upon examination, the weakness and wetness of spleen syndrome and the kidney-essence deficiency syndrome's tinnitus frequently is higher than the invasion of wind-pathogenic syndrome and the gallbladder damp-heat syndrome. The wind-pathogenic syndrome and the weakness and wetness of spleen syndrome of tinnitus severity are lower than the other syndromes. The difference of four syndromes among the tinnitus's loudness, the minimum masking curve and the residual inhibition test are not statistically significant. Conclusion1. In this study, investigated 200 cases of otitis media patients, the incidence of tinnitus is 18.5%. The incidence of tinnitus in the secretory otitis media(25%) is a little higher than purulent otitis media(13.4%). It shows tinnitus is not the main symptom in the purulent otitis media and the secretory otitis media.2. Associated with otitis media characterized by tinnitus:ringing in the ears as a voice is one kind; the part of tinnitus is in the affected ear or intracranial lateral side near the affected ear; most of the tinnitus frequency are middle frequency. The sound is not big. The most common type of tinnitus masking curve is the distance type and the converged type; most of the tinnitus residual suppression test is positive. Most of the severity of tinnitus is not more than stageⅡevaluation, purulent otitis media's tinnitus is not so serious as secretory otitis media.3. The incidence of tinnitus between different syndromes occurs is no significant difference (P>0.05). Tinnitus frequency of deficiency syndrome (the weakness and wetness of spleen syndrome, the kidney-essence deficiency syndrome) is higher than the empirical syndrome (the invasion of wind-pathogenic syndrome, the liver and gallbladder damp-heat syndrome). Tinnitus severity of the invasion of wind-pathogenic syndrome and the weakness and wetness of spleen syndrome is lower than the gallbladder damp-heat syndrome and the kidney-essence deficiency syndrome. There is no significant difference among the four syndromes in tinnitus's loudness, the minimum residual inhibition and tinnitus masking curves(P> 0.05).It illustrate that the frequency and severity of tinnitus evaluation may have some reference value for TCM differentiation to otitis media...