The Study Of Clinical Characters Of Tinnitus Patients With Sudden Sensorineural Hearing Loss

Background:Sudden Sensorineural Hearing Loss which be shorted for Sudden Deafness, is a common emergency in Otolaryngology. Its pathogenesis is not clear, and the general clinical common possible causes include:infection, disorders of inner ear circulation, metabolic, psychological factors and so on. The domestic and foreign to determine the effect of treatment of sudden deafness is mainly depending on the outcome of the hearing, and easy to overlook the other symptoms of sudden deafness. Tinnitus is one of the most common symptoms associated of the sudden hearing loss, a significant proportion of patients even been some improvement in hearing symptoms after symptomatic treatment, but no significant improvement in tinnitus symptoms still exist for a long time or a worsening trend. The tinnitus caused the troubles for work, study and life of the majority of patients. Since tinnitus is a subjective feeling of the patients, its pathogenesis is not clearly. Currently clinical treatment have not objective method and in effective drug treatment. But the domestic and foreign describe the relevant characteristics of tinnitus more by tinnitus detection, which have the clinical value to contribute to the further understanding of tinnitus and clinical research.Objectives:Explore the relationship between tinnitus characteristics and audiological characteristics of sudden sensorineural hearing loss with tinnitus patients.Methods:Collect the inpatients of Sudden sensorineural hearing loss with tinnitus who treated in The PLA General Hospital from July2008to July2012as the research object, Analysis the clinical characteristics of tinnitus frequency, the frequency of hearing impairment, tinnitus subjective grading, degree of hearing loss, residual inhibition test results and so on.Results:105case of Sudden Deafness who had tinnitus were included. The average of the patients with61males and44females was44.0±10.3years. The average time elapsed between the onset of hearing loss and the beginning of treatment was18.7±35.6days. The analysis of the degree of hearing loss was30cases of mild,13cases of moderate,28cases of severe and34cases of very severe. The analysis of the hearing impaired frequency was13cases of low-frequency,39cases of middle-high-frequency,53cases of full-range-frequency. The analysis of the tinnitus frequency: low-frequency tinnitus41.9%(44/105), middle-frequency tinnitus21.9%(23/105), high-frequency tinnitus36.2%(38/105).In patients with low-frequency hearing loss, the low-frequency tinnitus accounted for76.9%(10/13), the middle-frequency tinnitus accounted for7.7%(1/13), the high-frequency tinnitus accounted for15.4%(2/13); In patients with middle-high-frequency hearing loss, the low-frequency tinnitus accounted for25.6%(10/39), the middle-frequency tinnitus accounted for28.2%(11/39), the high-frequency tinnitus accounted for46.2%(18/39); In patients with full-range-frequency hearing loss, the low-frequency tinnitus accounted for45.3%(24/53), the middle-frequency tinnitus accounted for20.7%(11/53), the high-frequency tinnitus accounted for34.0%(18/53). The result of the chi-square test is the statistically significant difference between the frequency of the tinnitus frequency hearing loss (P<0.05). The analysis of the tinnitus subjective grading of mild hearing loss patients:4cases of the first-level,16cases of the second-level,9cases of the third-level,1case of the forth-level; the analysis of the tinnitus subjective grading of moderate hearing loss patients:1cases of the first-level,5cases of the second-level,6cases of the third-level,1case of the fifth-level; the analysis of the tinnitus subjective grading of severe hearing loss patients:5cases of the first-level,9cases of the second-level,7cases of the third-level,6cases of the forth-level,1case of the fifth-level; the analysis of the tinnitus subjective grading of very severe hearing loss patients:6cases of the first-level,6cases of the second-level,10cases of the third-level,7cases of the forth-level. By the the spearman rank and correlation analysis between patients with different degree of hearing loss the tinnitus level of difference was statistically significant (P=0.01). Analysis the patients with residual suppress experimental results of72cases, tinnitus masking curve for the convergence type of residual inhibition test positive rate of72.0%, tinnitus masking curve for the separated type of residual inhibition test positive rate of20.0%separated type, tinnitus masking curve for the overlapping type of residual inhibition test positive rate of57.9%, tinnitus masking curve for the spacing type of residual inhibition test positive rate of43.5%. There is a statistically significant difference of the spacing residual inhibition test positive rate among convergence type, separation type and spacing type compared by statistical analysis(P=0.0322, P=0.046).Conclusion:Sudden deafness with tinnitus patients tinnitus characteristics there are individual differences, the tinnitus frequency with hearing impairment frequency tend to have consistency. The more serious of hearing loss have, the more serious the tinnitus subjective grading will be. In the group with different masking curve, converged type test positive rate is higher than the separate type and pitch type, prompt the converged type group patients will be more fit for the tinnitus masking. Therefore, combining the tinnitus detection with the audiological tests, can be more comprehensive understanding of sudden deafness with tinnitus sufferers tinnitus symptoms, audiology symptoms.