| Part Ⅰ:Analysis of clinical characteristics and influencing factors of severity of acute tinnitusObjective:Tinnitus can be divided into acute tinnitus,subacute tinnitus,and chronic tinnitus according to the course of the disease.Acute tinnitus refers to tinnitus with a course of disease within 3 months.Currently,the research on acute tinnitus mainly focuses on tinnitus associated with sudden deafness and tinnitus secondary to noise damage,while there are few studies on other types of acute tinnitus.This study aims to analyze the clinical characteristics of patients with acute tinnitus and the factors that affect the severity of acute tinnitus,thereby providing evidence for the treatment of acute tinnitus.Methods:A retrospective analysis was conducted of 495 patients with acute tinnitus diagnosed in the Department of Otolaryngology,First Affiliated Hospital of the Air Force Military Medical University from December 2019 to April 2022.All patients had detailed medical history data,including:patient’s basic information,tinnitus side,course of disease,tinnitus acoustic properties,hearing loss,headache,dizziness,ear tightness,earache,and other associated diseases or symptoms;All completed the tinnitus disorder scale,including Tinnitus Handicap Inventory(THI),Hyperacusis Questionnaire(HQ),Generalized Anxiety Disorder(GAD-7),Depression Screening Scale(PHQ-9),Pittsburgh sleep quality scale(PSQI)and Type D personality scale-14(DS-14).The moderate to severe tinnitus group was determined based on a THI score of≥38,and the mild tinnitus group was determined based on a THI score of ≤36.Using the THI grouping as the dependent variable and the above factors as the independent variables,the correlation between each factor and the severity of acute tinnitus was analyzed using binary logistic regression.Results:There were 235 cases(47.47%)in the mild tinnitus group and 260 cases(52.53%)in the moderate to severe tinnitus group among 495 patients with acute tinnitus.1.Analysis of social demography factors:the proportion of patients with physical labor and the proportion of patients with junior high school education and below in the moderate to severe tinnitus group were higher than those in the mild tinnitus group,and the difference was statistically significant(P<0.05).2.Analysis of auditory and acoustic factors:There was no statistically significant difference between the mild tinnitus group and the moderate to severe tinnitus group in terms of tinnitus frequency,tinnitus loudness,hearing loss,tinnitus location,and disease course distribution(P>0.05).3.Analysis of common clinical symptoms:The proportion of moderate to severe tinnitus combination with hyperacusis,headache,dizziness,ear tightness,and earache was higher than that of mild tinnitus group,and the difference was statistically significant(P<0.05).4.Analysis of combined sleep disorders,emotional disorders,and D-type personality:The results showed that the proportion of moderate to severe tinnitus combined with sleep disorders,anxiety,depression,and D-type personality was higher than that of the mild tinnitus group,and the difference was statistically significant(P<0.05).5.Analysis of common clinical diseases:The proportion of moderate to severe tinnitus combination with pharyngolaryngeal reflux was significantly higher than that of mild tinnitus group,and the difference was statistically significant(P<0.05);There was no statistically significant difference in the combination of other diseases between the two groups of patients(P>0.05).6.Binomial logistic regression analysis of the severity of acute tinnitus:The THI group was used as the dependent variable,and gender,age,education level,occupation,ear tightness,earache,pharyngolaryngeal reflux,auditory hypersensitivity,anxiety,depression,headache,dizziness,D-type personality,and sleep disorders were used as independent variables for binary logistic regression analysis.The results showed education level(OR=0.689),hyperacusis(OR=3.991),anxiety(OR=3.043),and depression(OR=2.605)sleep disorders(OR=1.788)were associated with the severity of acute tinnitus(P<0.05).Conclusion:Educational background,hyperacusis,anxiety,depression,etc.may be the factors that affect the severity of acute tinnitus.Therefore,high attention should be paid when treating patients with acute tinnitus.Part Ⅱ:Prognosis and influencing factors of acute tinnitusObjective:Chronic decompensated tinnitus is a difficult problem in clinical treatment,which significantly affects the quality of life of patients.In recent years,studies on chronic tinnitus have shown that hearing loss,insomnia,anxiety and depression,hyperacusis,headache,chronic pain and other factors may be common factors affecting tinnitus compensation.Chronic tinnitus develops from acute tinnitus.Therefore,studying the prognosis and influencing factors of acute tinnitus has guiding significance for the prevention and treatment of chronic tinnitus.This study aims to analyze the prognosis of acute tinnitus and possible influencing factors,follow up the process of tinnitus occurrence and development,so as to better predict the prognosis of tinnitus.Methods:From March 2022 to September 2022,121 patients with acute tinnitus were diagnosed in the Department of Otolaryngology,Head and Neck Surgery,the First Affiliated Hospital of the Air Force Military Medical University.The examination and evaluation contents of all patients at initial diagnosis were the same as those in the first part.All patients received individualized treatment based on tinnitus consultation and medication,and were followed up 6 months after the occurrence of tinnitus.The THI scale was filled out to analyze tinnitus compensation and its influencing factors.Result:1.Prognosis of patients with acute tinnitus:Comparison between the severity of tinnitus after 6 months and the acute phase:After 6 months,the THI score was significantly lower than the acute phase THI score(Z=-9.017,P<0.001).Among 121 patients with acute tinnitus,15(12.40%)had tinnitus disappear,97(80.17%)developed chronic compensatory tinnitus,and 9(7.44%)developed chronic decompensated tinnitus.2.Social demography factor analysis:the social demography factor analysis of patients with different prognosis showed that there was no statistically significant differences in gender,education level,occupation,marriage,and residence among the groups(P>0.05).3.Analysis of auditory and acoustic characteristics of different prognosis groups in the acute phase:There was no statistically significant difference in hearing loss,tinnitus frequency,and tinnitus site distribution among different prognosis groups in the acute phase(P>0.05).4.Comparison of various scores in different prognosis groups during the acute phase:Patients who converted to chronic decompensated tinnitus after 6 months had higher THI and hyperacusis score in the acute phase,with statistically significant differences(P<0.05).5.Correlation between the severity of tinnitus after 6 months and various indicators in the acute phase:Acute hyperacusis score,acute tinnitus severity are related to the severity of tinnitus after 6 months,while acute anxiety and depression scores are weakly correlated with the severity of tinnitus after 6 months,with statistically significant differences(P<0.05).6.The relationship between different prognosis groups and D-type personality:There was no statistically significant difference in the distribution of D-type personality among different prognosis groups(P>0.05).Conclusion:1.As the duration of tinnitus increases,the pain level of tinnitus gradually decreases.2.The severity of acute tinnitus and hyperacusis are factors that affect the prognosis of tinnitus.Anxiety and depression in acute phase are weakly correlated with the prognosis of tinnitus. |
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