耳鸣的掩蔽治疗

耳鸣是耳鼻咽喉科的常见症状，大部分主观性耳鸣尚无特异有效的治疗，掩蔽治疗是一种生理性的疗法，简便、安全、无明显副作用，是治疗耳鸣常用的方法。本就耳鸣掩蔽治疗的原理、效果、方法及研究进展等方面进行综述。     

利多卡因加噪声掩蔽治疗耳鸣

本文对 5 0例耳鸣患者采用利多卡因加噪声掩蔽方法治疗 ,取得一定效果。报道如下。1　资料与方法耳鸣患者 5 0例 ,男 2 0例 ,女 30例 ;年龄 30～70岁。双侧耳鸣 2 2例 ,左耳 1 5例 ,右耳 1 3例。耳鸣无明显听力下降者 2 2例 ,耳鸣伴明显听力下降者 2 8例。病程 2个月～ 5年。均无中耳感染、手术、药物中毒、颅脑外伤、噪音损伤、梅尼埃病及全身疾病史。检查 :耳部均无异常发现。纯音测听 :听力≤ 2 0dB 5例 ,2 1～ 30dB 1 7例 ,31～ 6 0dB 2 2例 ,6 1～ 90dB 6例。抽取 2 %利多卡因 2ml加VitB1、VitB12 各1ml,于颈上神经节封闭 ,每日 1…     

中药加噪声掩蔽对耳鸣的治疗观察

耳呜是指患者自觉耳内有鸣响的感觉而周围环境中并无相应的声源。为一种发生和发展都十分复杂的临床上极为常见的症状。因其发病机制不清,致使临床治疗较为困难。且目前尚无一种治疗方法被公认有确切的疗效。中医对耳鸣的认识有其独特之处,强调辨证施治,注重整体调节,而噪声掩蔽疗法,外界给予声刺激,可以兴奋皮层和皮层下的意识部     

耳鸣掩蔽疗法

耳鸣掩蔽疗法是通过对耳鸣性质的系统测试后，选择与耳鸣音调响度相匹配的特定外界声作为掩蔽声，在医生的指导下聆听掩蔽声以达到抑制耳鸣或缓解耳鸣症状的方法。     

耳鸣掩蔽曲线与掩蔽治疗效果关系的临床观察

目的：观察耳鸣掩蔽曲线与掩蔽治疗效果之间的关系,为合理选择有效的治疗方法提供依据。方法：对108例（137耳）主观性耳鸣患者进行耳鸣测试并给予掩蔽治疗。结果：耳鸣掩蔽曲线中以I型和Ⅲ型所占比例最高。I型和Ⅲ型的残余抑制试验阳性率最高,掩蔽治疗效果最好。残余抑制试验结果与掩蔽治疗效果间存在正相关。结论：不同类型的掩蔽曲线患者对掩蔽治疗的有效性存在差异,应根据掩蔽曲线及残余抑制试验结果筛选掩蔽治疗的适应证,为患者提供个性化的耳鸣治疗方案。     

Mp3改用为耳鸣掩蔽器治疗耳鸣

耳鸣是很难治疗的症状之一,临床实践中对耳鸣病人针对不同具体情况施以不同手段,其中掩蔽疗法为耳鸣治疗中有效的方法之一[1]。掩蔽疗法对显著耳鸣的病人可获得70%的疗效[1]。作者用Mp3下载或直接录制不同窄带噪声后改为耳鸣掩蔽器对38例神经性耳鸣病人(经药物和其他保守治疗无     

耳鸣的掩蔽治疗

耳鸣是耳鼻咽喉科的常见症状,大部分主观性耳鸣尚无特异有效的治疗,掩蔽治疗是一种生理性的疗法,简便、安全、无明显副作用,是治疗耳鸣常用的方法.本文就耳鸣掩蔽治疗的原理、效果、方法及研究进展等方面进行综述.     

TM3型窄带噪声掩蔽器治疗耳鸣的疗效观察

用TM3窄带噪声掩蔽器治疗耳鸣病人144例,有效率为56％。耳鸣掩蔽治疗安全无明显副作用,优于抗癫痫药物治疗,为治疗耳鸣的一种方法。掩蔽治疗无效者多为重度感觉神经聋或耳鸣声无法匹配者,噪声性聋掩蔽治疗效果较差。耳鸣病程短,有后效抑制者掩蔽疗效较好,延长掩蔽使用时间可能提高疗效。掩蔽声以选择窄带噪声为好。     

不同耳鸣掩蔽曲线与耳鸣治疗效果的关系

目的 观察不同的听力图及掩蔽曲线耳鸣患者掩蔽治疗效果,探讨其相关性.方法 对129例(164耳)耳鸣患者进行纯音测试,根据听力图分为正常听力(40耳)、传导性聋(10耳)和感音神经性聋(114耳)三组.按照弗德曼掩蔽曲线不同分别进行耳鸣测试及掩蔽治疗.结果 129例(164耳)患者中,正常听力组中耳鸣掩蔽曲线以间距型(77.5%)为主;传导性聋组中,以间距型(30.0%)和拮抗型(30.0%)为主;感音神经性聋组中,以汇聚型(43.0%)为主,其次为重叠型(30.7%).残余抑制试验在正常听力、感音神经性聋组中均以汇聚型阳性率高(分别为100.00%和96.00%),与其他类型比较差异有统计学意义(P<0.05).耳呜掩蔽治疗结果在正常听力和感音神经性聋组中以汇聚型有效率高(分别为100.00%和84.00%),与其他类型差异有统计学意义(P<0.05).残余抑制试验与耳鸣掩蔽治疗结果呈正相关(P<0.01).结论 感音神经性聋伴耳鸣患者中以汇聚型耳鸣掩蔽曲线的患者有较好的后效抑制结果和耳呜掩蔽治疗结果.残余抑制试验与耳鸣掩蔽治疗结果呈正相关.     

耳鸣掩蔽结合心理咨询治疗耳鸣的长期康复效果研究

目的:探讨耳鸣掩蔽结合心理咨询治疗耳鸣的长期康复效果。方法:对耳鸣掩蔽结合心理咨询的患者在治疗前、治疗后半年、1年、2年、3年进行随访,填写耳鸣残疾评估量表。结果:共纳入86例患者。半年后应随访82例,失访9例。1年后应随访79例,失访16例。2年后应随访60例,失访26例。3年后应随访44例,失访16例。治疗后半年、1年、2年、3年耳鸣残疾评估量表得分大于等于20分的例数占应随访人数的66%、56%、40%、48%。结论:耳鸣掩蔽结合心理咨询治疗耳鸣随访1年的有效率为66%,但1年以上长期疗效由于失访率高,需进一步研究。     

耳鸣掩蔽治疗结合心理治疗的疗效观察

目的 通过比较单纯耳鸣掩蔽治疗与耳鸣掩蔽治疗结合心理治疗的疗效,探讨耳鸣掩蔽治疗结合心理治疗的临床意义.方法 对158例耳鸣患者先进行耳鸣响度匹配后行掩蔽治疗,其中79例患者辅以心理治疗,比较单纯掩蔽治疗组与掩蔽治疗结合心理治疗组耳鸣残疾度量化表(tinnitus handicapinventory,THI)疗效评分.结果 治疗后单纯掩蔽治疗组(79例)THI得分42.8±23.1,耳鸣治疗结合心理治疗组(79例)THI得分28.3±22.5;两组THI评分结果差异有统计学意义(P=0.019).结论 耳鸣掩蔽治疗结合心理治疗较单纯耳鸣掩蔽治疗可以获得更好的临床效果.     

耳鸣训练疗法治疗耳鸣

文中记载了1997年9月至11月间收治的9例耳鸣患者,采用耳鸣训练疗法(tinnitusretrainng therapy,TRT)进行治疗,包括(1)正确的咨询指导;(2)对合并有听力损失者选配助听器;(3)用一个低强度的噪声来掩蔽;(4)松驰练习.结果有7例患者取得了较好的效果,为耳鸣的治疗开拓了另一条途径.     

Small-Group Counseling in a Modified Tinnitus Retraining Therapy for Chronic Tinnitus

Objectives

The authors have treated chronic tinnitus patients using a combination of a simplified tinnitus retraining therapy (TRT) and medications, which we called modified TRT. In this clinical setting, we have attempted small-group counseling to find a time-effective equivalent of individual counseling. The aim of the present study was to evaluate the effectiveness of small-group counseling by comparing the treatment outcomes between individual and small-group counseling.

Methods

The patients who had distressing chronic tinnitus with normal hearing or mild hearing loss were included. The subjects were placed into the small-group (group 1:4) or the individual (group 1:1) counseling group, and underwent a modified TRT composed of a single session of directive counseling and ambient sound stimulation. In addition, alprazolam (0.25 mg) and ginkgo biloba extract (80 mg) were administered orally to the subjects for 3 months. The 3- and 6- month outcomes were assessed using the follow-up rates and tinnitus severity scores: awareness, tinnitus handicap inventory (THI), loudness, annoyance, and effect on life. The treatment responses were classified as improvement, no changes, and worsening.

Results

Of the total 149 patients (77 in group 1:1; 72 in group 1:4), 104 patients completed the protocol at 3 months, and 55 patients at 6 months. The follow-up rates were similar in both groups. Over the period of 6 months, all scores declined significantly except the loudness score at 3 months in both groups. Treatment responses showed no between-group differences. The success rate based on THI was 70% in group 1:1, and 64% in group 1:4 at 6 months.

Conclusion

The small-group counseling of our modified TRT was comparable to the individual counseling for tinnitus relief. We suggest that this protocol can be implemented effectively in any crowded otolaryngology clinics.     

A Comparison of Variability among Measurements of Subjective Tinnitus and Objective Stimuli

8 patients with subjective tinnitus were trained in pitch-matching, loudness-matching, and simultaneous-masking tasks using narrow-band noise and/or pure-tone stimuli. Extensive pitch-matching, loudness-matching and masking measurements were then obtained for their tinnitus, after which the same measurements were obtained for objective stimuli which approximated the frequency and intensity of the tinnitus. Variability for pitch and loudness matching to tinnitus was extremely large relative to the same measurements for objective stimuli. This was particularly true for pitch-matching where even the most consistent patients showed variability for matches to their tinnitus which was an order of magnitude greater than for matches to objective stimuli in the same frequency region. No evidence of frequency-specific masking of tinnitus was seen in any of the patients although such evidence was obtained for the masking of objective stimuli. The results suggest that the large variability in matches to tinnitus, and the lack of normal frequency-specific masking of tinnitus in these patients may reflect interactions at levels higher than the end-organ rather than a degradation in peripheral auditory function.     

白噪声掩蔽效应的临床应用

目的　研究白噪声掩蔽效应试验（Ｌａｎｇｅｎｂｅｃｋ 法） 检测蜗性聋重振现象的敏感性。方法　用德国产ＢＯＳＣＨ 听力计对３０ 例（４４ 耳） 感音神经性听力损失患者作纯音测试和阈上测听（ 包括Ｌａｎｇｅｎｂｅｃｋ ,ＳＩＳＩ和ＡＢＬＢ 试验） ,比较三种试验相对于三种听力曲线及１ ,２ 和４ ｋＨｚ 三频率的阳性结果。结果　纯音听阈曲线：谷形１５ 耳,高频斜坡形下降１６ 耳,高频陡峻形下降１３ 耳。ＳＩＳＩ 得分６０ ％ ～１００ ％ ３６ 耳（８１－８ ％ ） ;ＡＢＬＢ 阳性３５ 耳（７９－５ ％ ） ,两者互有重叠覆盖,未发现两者均阴性者;Ｌａｎｇｅｎｂｅｃｋ 法掩蔽无效３４耳（７７－２ ％ ,其中单纯４ ｋＨｚ 掩蔽无效１５ 耳,４ ｋＨｚ 合并２ ｋＨｚ 掩蔽无效１３ 耳,４ ｋＨｚ 合并１ ｋＨｚ 掩蔽无效６耳） ,与ＳＩＳＩ和ＡＢＬＢ 阳性率８１－８ ％ 和７９－５ ％ 相比,统计学上无显著差异。结论　白噪声掩蔽效应测试也是一种可靠的纯音阈上测试,可用于蜗性聋和蜗后聋的鉴别     

急性噪声损伤后耳鸣患者的临床特征分析

目的探讨急性噪声损伤后耳鸣患者的耳鸣特点及预后。方法对61例(75耳)参加打靶训练后2周仍有持续性耳鸣的空军军医大学学员进行耳鸣残疾量表(THI)、耳鸣评价量表(TEQ)调查及耳鸣心理声学检测,并给予耳鸣咨询及金纳多治疗一个月,随访6个月分析结果。结果 61例(75耳)耳鸣者中,左耳45例,右耳2例,双耳14例;耳鸣主调频率主要在4 000~8 000 Hz 65耳(86.67%),平均为5 708±1 568 Hz;耳鸣响度≤10 dB SL 74耳(98.67%),平均为2.714±2.46 dB SL;Feldman掩蔽曲线主要为汇聚型(54耳, 72%)和重叠型(13耳,17.33%);残余抑制试验阳性61耳(81.33%);耳鸣的严重程度多为轻中度(Ⅰ~Ⅲ级);伴耳鸣相应频率听阈下降者61耳(81.33%),听阈正常14耳(18.67%)。随访6个月后耳鸣消失35例(57.38%),减轻24例(39.34%),无变化2例(3.28%),其中耳鸣未消失者打靶后两周的纯音听阈均值(44±18.85 dB HL)及耳鸣频率(6 204.45±1 364.51 Hz)显著高于耳鸣消失者(分别为28.15±14.48 dB HL,5 446.18±1 520.17 Hz)(P<0.05)。结论打靶后2周持续性耳鸣者耳鸣的主调声频率为高频,掩蔽曲线以汇聚型为主,残余抑制试验多为阳性,打靶后6个月仍有持续耳鸣者打靶后2周患耳的纯音听阈及耳鸣频率均高于耳鸣消失者。     

习服疗法与掩蔽疗法对慢性耳鸣疗效的Meta分析

目的 系统评价并比较习服疗法和掩蔽疗法对慢性耳鸣的疗效.方法 从万方数据库、中国期刊全文数据库(CNKI)、维普数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Web of science和Cochrane li-brary等中英文数据库中检索自建库到2020年2月与慢性耳鸣治疗相关的文献,全面收集采...     

Use of Masking for Tinnitus

The use of masking for tinnitus has been a primary method of treatment of patients with severe tinnitus since 1976. Over 5,000 patients have been treated in the Tinnitus Clinic at Oregon Health Sciences University since that time. The paper discusses the results of management of new patients followed for one year from January 1, 1992 through December 31, 1995. Of the 373 patients who could be accurately followed and evaluated for this period of time, 180 patients were recommended for tinnitus maskers or tinnitus instruments, and 83 were provided with masking tapes. The results of this study, along with the overall success of the tinnitus program utilizing masking, are discussed.     

A Test-Retest Reliability Study on Clinical Measurement of Masking Level Differences

Measurement of binaural release from masking was studied in 30 normal and 10 hearing-impaired subjects to determine the test-retest reliability of masking level differences measured with a clinically feasible technique on generally available clinical equipment. The instrumentation/methodology was found to elicit reliable, consistent, rapid measurements for both 500-Hz and speech (spondaic) stimuli which were comparable with those generally reported in the literature as laboratory-conducted experiments.