300例耳鳴病患之臨床分析

Clinical Analysis of 300 Tinnitus Patients

黃啓原(Chii-Yuan Huang) ； 吳俊良(Jiunn-Liang Wu)

《台灣耳鼻喉頭頸外科雜誌》 38卷5期 (2003/10) Pp. 193-201

https://doi.org/10.6286/2003.38.5.193

摘要

背景：耳鳴雖治療方法眾多但成效不一，國內有系統化之臨床評估模式及數據統計分析亦較缺乏，面對與日俱增之耳鳴問題，急需蒐集較完備之臨床數據；因此，本研究收集耳鳴病例，依其年齡分佈、性別、耳鳴部位、耳鳴期間、分類方式、及各項聽力學檢查與耳鳴嚴重程度等因素，作資料統計分析，以供臨床治療之依據。
方法：自2000年7月至2002年10月間，依Jastreboff與Hazell氏之耳鳴治療分類分成0~Ⅳ型，來統計病患各項臨床表徵。對於病患之耳鳴嚴重程度，則以耳鳴臨床評估問卷之耳鳴影響度(impact of tinnitus: T.I.)作為量化評分依據。
結果：總共有311名耳鳴病例，男性214名，女性97名，平均年齡50歲，耳鳴期間平均5.7年。其中260例屬於聽力異常(83.6%)，51名聽力表現正常(16.4%)。耳鳴期間、年齡與耳鳴影響度(T.I.)之間，不具統計相關性；各頻率之聽閾值與耳鳴嚴重程度之間亦不具有統計相關性；但病側耳與非病耳之聽閾值有顯著差異，其中4k、8kHz組之差異，又更為顯著。
結論：耳鳴因為缺乏客觀的評估量測方法，故研究分析較困難。本研究發現耳鳴病患中約8成以上合併有一定程度之聽力異常，但仍有1成5的病例無明顯之聽力障礙。高頻率區聽閾值異常，特別是4k、8kHz部分，對於其耳鳴之發生，有相當之關聯。

關鍵字

耳鳴 ； 聽閾值 ； 聽力障礙 ； 耳鳴影響度

並列摘要

BACKGROUND: Despite a variety of therapeutic protocols, consistently effective treatment for tinnitus remains elusive. Systemic investigation and evaluation are needed to inform the management of increasing numbers of affected patients. In order to create a clinical database for further analysis, this study systemically set about compiling tinnitus classification, age, gender, les ion site, tinnitus duration and audiological findings in a group of tinnitus sufferers.
METHODS: Tinnitus patients were enrolled and analyzed using Jastreboff and Hazell's tinnitus categories. Using a questionnaire, the severity of tinnitus in patients undergoing TRT was quantified by determining a tinnitus impact value (T.I.).
RESULTS: Three hundred and eleven patients (214 males and 96 females) were enrolled and had a mean age of 50 years and mean tinnitus duration of 5.7 years. Only 51 had normal hearing (16.4%), leaving 260 patients with abnormal hearing (83.6%). Tinnitus severity did not significantly correlate with age, disease duration or hearing thresholds. The difference in hearing thresholds between the affected and unaffected ears was statistically significant, especially in the 4k-Hz and 8k-Hz range.
CONCLUSION: Analysis of tinnitus is complicated by the lack of established, objective evaluation methods. In this study, more than eighty percents of tinnitus patients were found to have abnormal hearing but fifteen percents nevertheless had normal hearing. High frequency hearing loss, particularly between 4k-Hz and 8k-Hz, is an important factor in predicting the occurrence of tinnitus. Patients suffering from long-term tinnitus should also have the possibility of a brain tumor excluded. In order to inform and offer better treatment to tinnitus patients, further investigation and data collection are needed to advance clinical research and our understanding of tinnitus.

並列關鍵字

tinnitus ； hearing threshold ； hearing impairment ； impact of tinnitus