42例耳鸣伴听觉过敏患者特征分析

目的 探讨耳鸣伴听觉过敏患者的临床、听力及心理声学特征以及对患者的影响。 方法 对2015年3月至2017年3月在广州医科大学附属第二医院耳鼻咽喉科门诊就诊的42例耳鸣合并听觉过敏患者进行纯音测听、耳鸣心理声学特征、响度不适阈(LDL)检测,并对耳鸣及听觉过敏严重程度进行评估。 结果 42例中,24例以耳鸣为第一主诉(A组),18例以听觉过敏为第一主诉(B组)。耳鸣主调以纯音为主,频率以高频为主,响度多数≤5 dB SL。患者听觉过敏表现为对正常环境声过分关注或刻意回避,伴烦躁、心悸、惊慌、恐惧,戴耳塞、不敢出门。分别检测0.125~8 kHz频率的LDL,两组在同一频率的LDL差异无统计学意义(P>0.05)。 结论 不能以响度不适阈判断听觉过敏的严重程度;临床上耳鸣与听觉过敏常相伴随,要重视其对患者工作、生活、睡眠与情绪的影响,应制定和使用适合中国国情的评估量表。

Characteristics of 42 patients with tinnitus and hyperacusis

Objective To explore the clinical, auditory and psychoacoustic characteristics of patients with tinnitus accompanied by auditory hypersensitivity and to explore its effects on patients. Methods Forty-two patients with tinnitus and hyperacusis who were admitted to the Department of Otorhinolaryngology, Second Affiliated Hospital of Guangzhou Medical University from March 2015 to March 2017, were detected the pure tone audiometry, tinnitus psychoacoustic characteristics, loudness discomfort level(LDL). Results There were 24 cases of tinnitus as the first chief complaint group(group A)and 18 cases of hyperacusis as the first main complaint group(group B). Tinnitus tone was given priority to with pure tone, frequency was given priority to with high frequency, and the loudness is mostly ≤5dB SL. Patients with hyperacusis is characterized by excessive attention or deliberate avoidance of normal environmental sounds, accompanied by irritability, palpitations, panic, fear, wearing earplugs, and dare not going out. LDL at frequencies between 0.125 and 8kHz were detected, and there was no significant difference in LDL between the two groups at the same frequency(P>0.05). Conclusion The severity of auditory hyperacusis cannot be judged by the loudness discomfort threshold; clinical tinnitus and auditory allergy are often accompanied, and attention should be paid to its influence on the work, life, sleep and mood of patients. The evaluation scale suitable for China's national conditions should be formulated and used.