耳鸣治疗研究进展

耳鸣是指在无外源性声音刺激时耳内或颅内感知到的声音,是临床常见症状。耳鸣可分为客观性耳鸣和主观性耳鸣,普通人群中大概有12%~30%的人会出现耳鸣。因耳鸣的发病机制目前尚不清楚,故耳鸣的治疗成为一个世界性的难题。现就耳鸣治疗的研究现状做一综述。     

乙状窦憩室致搏动性耳鸣手术治疗的疗效分析CSCD

目的探讨乙状窦憩室引起的搏动性耳鸣手术治疗的效果。方法通过对2010年3月~2014年6月期间在我院诊断为乙状窦憩室引起的搏动性耳鸣并接受手术治疗的32例患者的临床资料进行回顾性总结和分析,评价乙状窦憩室回纳术对搏动性耳鸣的治疗效果。结果 32例患者中女性29例,年龄30~62岁,男性3例,年龄32~47岁;左侧4例,右侧28例。术前颞骨高分辨率CT检查,32例患者中均有不同程度乙状窦憩室。术前综合检查排除患耳中耳炎及肿瘤,患耳无手术、外伤史,无高血压病、甲状腺疾病及糖尿病等基础病病史。全部患者均行乙状窦憩室回纳术,术后均无眩晕、恶心呕吐、脑脊液漏等并发症,1例患者因鼓室积血引起短期的低调耳鸣,经对症处理后症状消失,7例耳鸣明显减轻,24例患者耳鸣消失。随访6~36个月,32例患者搏动性耳鸣均完全消失,无反复。结论乙状窦憩室致搏动性耳鸣的手术治疗风险较小,疗效显著,是一种有效的治疗手段,值得临床推广、应用。     

耳鸣研究进展

耳鸣仅为一种症状,可对患者带来无尽的烦恼。目前有关耳鸣的研究文章发表不少,虽然取得一定进展,但许多问题仍未被认识。本文就近年来有关耳鸣产生机制、检测方法及治疗手段等国外研究资料进行综述,以供同道参考。     

乙状窦憩室致搏动性耳鸣手术治疗的疗效分析

目的　探讨乙状窦憩室引起的搏动性耳鸣手术治疗的效果。方法　通过对2010年3月～2014年6月期间在我院诊断为乙状窦憩室引起的搏动性耳鸣并接受手术治疗 的32例患者的临床资料进行回顾性总结和分析,评价乙状窦憩室回纳术对搏动性耳鸣的治疗效果。结果　32例患者中女性29例,年龄30～62岁,男性3例,年龄32～47岁;左侧4例,右侧28例。术前颞骨高分辨率CT检查,32例患者中均有不同程度乙状窦憩室。术前综合检查排除患耳中耳炎及肿瘤,患耳无手术、外伤史,无高血压病、甲状腺疾病及糖尿病等基础病病史。全部患者均行乙状窦憩室回纳术,术后均无眩晕、恶心呕吐、脑脊液漏等并发症,1例患者因鼓室积血引起短期的低调耳鸣,经对症处理后症状消失,7例耳鸣明显减轻,24例患者耳鸣消失。随访6～36个月,32例患者搏动性耳鸣均完全消失,无反复。结论　乙状窦憩室致搏动性耳鸣的手术治疗风险较小,疗效显著,是一种有效的治疗手段,值得临床推广、应用。     

迷路切除及经迷路手术对耳鸣的效用

报道迷路切除术治疗慢性迷路炎、经迷路听神经瘤切除术及经迷路岩骨胆脂瘤切除术对耳鸣的效用。迷路切除术６例，平均随访３．８年。耳鸣消失１例，减轻１例，不变２例，加重２例。听神经瘤切除术３例，平均随访３年，耳鸣消失２例，加重１例。岩骨胆脂瘤切除术２例，随访半年和１年，分别耳鸣消失及不变。显示内耳手术对根治病因及消除眩晕效果满，但难于完全治愈耳鸣，且有可能加重。对耳鸣效果不佳的机理作了初步探讨。     

耳鸣相关治疗最新研究进展

耳鸣即患者在没有相应外界声音刺激下,感觉自己耳内或者头内有嗡嗡、嘶鸣等异常声音,在安静或吵闹环境中均能听到.这种耳鸣声音可以是1种或1种以上,可以长时间存在,也可以短暂发生.大多数耳鸣患者将耳鸣描述为稳定的音调或嘶嘶声,也有患者描述为更复杂的声音,例如昆虫声、蜂鸣声、自来水声等复杂声音.此前,日本一项流行病学调查显示耳...     

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.     

耳鸣研究进展

耳鸣是指在外界无声源刺激或电刺激时耳内出现声音感觉的症状。许多全身和局部的疾病都可引起耳鸣,所以耳鸣的发生率比较高,在成年人中约为2%-7%[1],而在年龄大于55岁的人群中则高达20%-30%[2]。耳鸣通常引起烦躁、焦虑甚至抑郁,严重者可影响工作和生活。1耳鸣的形成机制耳鸣的     

颈内静脉源性耳鸣的诊断和治疗

目的：探讨颈内静脉鸣性耳鸣的诊断途径与治疗方法。方法：４例搏劝性耳鸣患者经耳镜及全身体检，扣力学１电生理、超声影像学检查确诊为颈内静脉鸣性耳鸣，进行了颈内静结扎术。结果：３例耳鸣完全消失，１例明显减轻，不影响日常生活结论：颈内静脉逗留恶性循环 耳鸣是一种无器质性病变的客观性耳鸣，但有时可严重干扰患者的下沉生活一确诊，可行颈主其属支结扎、切断术。可获迅速和永久的治疗效果。     

耳鸣治疗器治疗耳鸣患者104例报告

为探讨在保留耳鸣患者残余听力的前提下，减轻耳鸣症状的方法，我们从1987年起，研制了一种简易耳鸣治疗器，并经近10年的临床应用，收到满意效果．现介绍如下。1资料与方法1．1临床资料104例患者均为门诊病人，男48例，女56例；年龄23～58岁，平均40．2岁。左耳43例，右耳48例，双耳13例。病史2月～9年，86例病史少于6个月，18例超过2年。均有用药物治疗史。根据听力曲线与掩蔽曲线关系分类：Ⅰ型8例，Ⅱ型24例，Ⅲ型52例，Ⅳ型20例。104例患者残留抑制试验均为阳性。耳鸣音调及响度测试：采用音调匹配及响度平衡匹配法。耳鸣掩蔽听力曲线…     

Double tinnitus in a single ear

Objective: To search for distinctive clinical features of patients with double tinnitus in a single ear. Design retrospective: Study sample: Six hundred and fourteen tinnitus patients were interviewed using a detailed questionnaire. They underwent thorough audiological evaluation. Records of seven patients reporting double tinnitus in 10 ears were identified and analysed. There were three women and four men in the group (mean age 40, range 29–49?years). Results: All but two individuals declared sudden onset of the complaints. Three patients had been diagnosed with sudden sensorineural hearing loss. In all the patients, the components of double tinnitus were compared both to a pure tone and to a narrow band noise. The sounds were considered by the patients to be primary (more prominent) or secondary. All but one patient declared hypersensitivity to loud sounds. Vertigo was present in only two of the double tinnitus sufferers. Abnormal DPOAEs frequency values and audiogram notch frequencies were closer to the primary than the secondary tinnitus matches. Conclusions: In our study, double tinnitus was rare, mostly perceived by patients with a sudden onset of tinnitus. This is the first report presenting audiological findings in patients with double tinnitus in a single ear. Prospective search of cohorts of tinnitus sufferers for such patients and functional neuroimaging of their auditory pathways for determining underlying mechanisms of the complaints is advocated.     

Direct current stimulation of the ear in tinnitus treatment: a double-blind placebo-controlled study

The objectives of the study are assessment of the influence of direct current electrical stimulations of the ear in tinnitus treatment, comparison of the results with placebo group and evaluation of hearing after electrical stimulations. The study comprised 120 tinnitus and sensorineural hearing loss patients (n = 184 tinnitus ears). In group one (n = 119 tinnitus ears) the authors applied a non-invasive hydrotransmissive electrical stimulation (15) of the ear, in group two (n = 65 tinnitus ears)—placebo electrical stimulation. Direct rectangular, positive polarization current was used. The frequency of stimulation was adjusted according to tinnitus frequency. In group two, the authors used similar procedure, but no current was delivered through the active electrode. Evaluation of tinnitus and hearing was conducted. In groups one and two, directly after the treatment, the number of ears with permanent tinnitus decreased considerably. In group one in 40 ears (33.6 %) tinnitus disappeared; in group two, tinnitus disappeared in four ears (6.1 %). After 30 days, statistically significant changes were observed in group one (p < 0.05), which were comparable with results returned 90 days later (p > 0.05). Changes in group two (after 30 and 90 days) were not significant (p > 0.05). The authors recognized audiometric improvement of hearing (in pure tone audiometry). The application of direct current electrical stimulation of the hearing organ, with current frequencies similar to tinnitus frequencies (selective electrical stimulation), was an efficient method in severe tinnitus treatment. We did not observe a harmful effect of direct current on hearing organ.     

Postoperative treatment after ear surgery

The paper gives an overview on postoperative treatment after ear surgery, especially tympanoplastic, mastoid-surgery and stapes-surgery. Suggestions for treatment are given according to the different post-operative stages and situations. Careful cleaning of the ear canal, using the operative microscope, removal of debris, granulations and polyp and drying of the canal are most important.     

Postoperative treatment after ear surgery

Postoperative treatment after ear surgery is described. Disturbances of the normal healing and their treatment in the office are especially mentioned.     

Surgical treatment for the aberrant internal carotid artery in the middle ear with pulsatile tinnitus

Many previous reports have indicated that pulsatile tinnitus caused by an aberrant internal carotid artery (ICA) should not be treated surgically because of the risk of infection or aneurysm formation. We herein describe a case of aberrant ICA treated by middle ear surgery for which we introduced a novel approach. An 84-year-old man was presented with a one-year history of tinnitus in his right ear. Otoscopic examination demonstrated a whitish mass in the antero-inferior quadrant of the tympanic membrane associated with rhythmic pulsation. Images obtained by CT, MRI and MRA revealed protrusion of the ICA into the tympanic cavity, making contact with the tympanic membrane. Surgery to separate the tympanic membrane from the ICA was performed in order to relieve the pulsatile tinnitus. After the operation, the patient's aural activity was preserved and the tinnitus did not recur within a follow-up period of one year. In the present case, delicate middle ear surgery was effective for relief of the tinnitus. When treating patients with aberrant IAC showing features similar to the present case, the surgical approach we have described is worth attempting.     

中耳胆脂瘤研究进展

中耳胆脂瘤是耳鼻咽喉科较为常见的一种慢性中耳疾病,长期外耳道流脓、鼓膜穿孔、听力下降为其主要特点,它对周围组织具有侵袭性,易引起中耳传音结构的破坏和骨质吸收,进而引起面瘫、迷路炎、耳后骨膜下脓肿及各种颅内外并发症。中耳胆脂瘤的病因及发病机制复杂,治疗方法的疗效争议较多。本文主要将近年来关于中耳胆脂瘤的病因、发病机制及治疗进展进行综述。     

Recurrent tinnitus and associated ear symptoms in adults

This study aimed to reveal in general population the prevalence, associations, and statistical model of recurrent tinnitus by means of a mailed questionnaire. The study sample consisted of 1720 randomly selected adults who were classified into three subgroups: recurrent (once a month or more often), occasional (less often than once a month), and no tinnitus. According to age and gender standardized prevalence, recurrent tinnitus was reported in 15% of the sample. It was statistically highly significantly associated with earache, fullness of ears shoulder pain, the 25-years age group, and visits to a physician. The strongest predictor of recurrent tinnitus was fullness of ears followed by earache, shoulder ache, and temporomandibular disorder pain. We conclude that recurrent tinnitus seems to be quite common in adults and associated with earache and fullness of ears In patients with tinnitus without clinical findings, the examination of the stomatognathic system and cervical spine is recommended.     

The application of direct current electrical stimulation of the ear and cervical spine kinesitherapy in tinnitus treatment

Objective

The aim of the study was to evaluate the effectiveness of electrical stimulations of the hearing organ in tinnitus treatment adapting the frequency of stimulation according to tinnitus frequency, to assess the influence of cervical spine kinesitherapy on tinnitus, as well as to evaluate hearing after electrical stimulations alone and together with cervical spine kinesitherapy.

Methods

The study comprised 80 tinnitus, sensorineural hearing loss patients (119 tinnitus ears) divided into two groups. In group I (n – 58 tinnitus ears) electrical stimulation of the hearing organ was performed, in group II (n – 61 tinnitus ears) electrical stimulation together with cervical spine kinesitherapy. Hydrotransmissive, selective electrical stimulations were conducted using direct, rectangular current. The passive electrode was placed on the forehead, the active – a silver probe – was immersed in the external ear canal in 0.9% saline solution. The treatment involved fifteen applications of electrical stimulations (each lasted for 4 min) administered three or four times a week (whole treatment lasted approximately 30 days). The evaluation of the results considered a case history (change from permanent to temporary tinnitus), questionnaires (the increase/decrease of the total points) and the audiometric evaluation of hearing level.

Results

Before the treatment, group I comprised 51 ears (87.93%) with permanent, and 7 ears (12.07%) with temporary tinnitus; group II – 55 ears (90.17%) with permanent and 6 ears (9.83%) with temporary tinnitus. After the treatment, in both groups the number of ears with permanent tinnitus decreased considerably obtaining the pauses or disappearing of tinnitus. Directly after the treatment, group I comprised 25 ears (43.11%) with permanent, and 10 ears (17.24%) with temporary tinnitus, in 23 ears (39.65%) tinnitus disappeared; group II – 33 ears (54.1%) with permanent and 11 ears (18.03%) with temporary tinnitus, in 17 ears (27.87%) tinnitus disappeared.Regarding questionnaires, improvement was observed in group I – in 43.11% of ears, in group II – 32.8%. In both groups audiometric improvement of hearing was recognized.

Conclusions

(1) Electrical stimulation of the hearing organ, with the application of current frequencies according to tinnitus frequencies (selective electrical stimulation), was an efficient method in severe tinnitus treatment. (2) Cervical spine kinesitherapy in the treatment of tinnitus, using electrical stimulation, did not have any supporting influence.