耳鸣患者听觉皮质BOLD-fMRI研究

目的 利用血氧水平依赖（blood oxygenation leve ldependent,BOLD）功能磁共振成像（functional magnetic resonance imaging）（BOLD—fMRI）技术观察耳呜患者纯音刺激时大脑皮质区激活情况,探讨耳呜的客观检查方法。方法对7例长期耳呜患者行BOLD—fMRI检查,观察其大脑皮质区激活信号,15例健康人作为对照组。结果15例健康志愿者纯音刺激时颞叶区均出现激活,颞上回激活率最高。刺激单耳时对侧听觉皮质激活体积和信号强度明显大于同侧（P〈0．01）,表现为对侧半球传导优势。耳鸣组纯音刺激时大脑皮质激活解剖部位、激活体积和信号强度无明显规律。结论长期耳呜患者可能存在听觉皮质的异常神经活动。     

感音神经性聋患者听觉皮层BOLD-fMRI研究

目的利用血氧水平依赖的功能磁共振成像（blood oxygenation level dependent functional magnetic resonance imaging,BOLD—fMRI）技术观察感音神经性聋患者纯音刺激时大脑听觉皮层激活情况,探讨感音神经性聋的中枢客观检查方法。方法对22例单侧中重度感音神经性聋患者（耳聋组）和15例健康志愿者（对照组）行听觉刺激BOLD-fMRI检查,比较两组纯音刺激时听觉皮层激活的体积和信号强度。结果对照组纯音刺激单耳时,对侧听觉皮层激活体积和信号强度明显大于同侧（P〈0．01）,表现为对侧半球传导优势;耳聋组刺激健侧时健侧听觉皮层激活体积和信号强度大于患侧,但差异无统计学意义（P〉0．05）。结论感音神经性聋患者纯音刺激健耳时对侧听觉半球传导优势消失,其听觉皮层可能发生了结构重塑。     

Acoustic trauma-induced auditory cortex enhancement and tinnitus

There is growing evidence suggests that noise-induced cochlear damage may lead to hyperexcitability in the central auditory system (CAS) which may give rise to tinnitus. However, the correlation between the onset of the neurophysiological changes in the CAS and the onset of tinnitus has not been well studied. To investigate this relationship, chronic electrodes were implanted into the auditory cortex (AC) and sound evoked activities were measured from awake rats before and after noise exposure. The auditory brainstem response (ABR) was used to assess the degree of noise-induced hearing loss. Tinnitus was evaluated by measuring gap-induced prepulse inhibition (gap-PPI). Rats were exposed monaurally to a high-intensity narrowband noise centered at 12 kHz at a level of 120 dB SPL for 1 h. After the noise exposure, all the rats developed either permanent (>2 weeks) or temporary (<3 days) hearing loss in the exposed ear(s). The AC amplitudes increased significantly 4 h after the noise exposure. Most of the exposed rats also showed decreased gap-PPI. The post-exposure AC enhancement showed a positive correlation with the amount of hearing loss. The onset of tinnitus-like behavior was happened after the onset of AC enhancement.     

耳聋婴幼儿听觉及语言中枢等 相关脑区研究

目的 研究先天性感音神经性耳聋婴幼儿植入人工耳蜗前听觉及语言中枢等相关功能脑区 的变化.方法 采用血氧水平依赖功能磁共振成像技术(blood oxygenation level dependent-functional magnetic resonance imaging,BOLD-fMRI)对极重度感音神经性耳聋患儿和正常听力对照组进行研究.结果 ①给予震动触觉刺激后,两组被试均可见正性激活脑区,主要包括听觉皮层和其它触觉相关激活脑区,耳聋组比正常听力对照组显示更大的激活范围和强度;②两组被试均可见负性激活,并且耳聋组负性激活区范围及强度明显大于对照组.结论①耳聋婴幼儿听力丧失后双侧听觉中枢仍存在一定的功能;②聋儿听皮质及其相关脑区发生了听-触觉重组;③聋儿的皮质系统感知震动触觉刺激的敏感性明显增加;④聋儿负性激活情况可能与听力丧失后皮质系统发生重组有关.     

老年性聋患者听皮层磁共振波谱分析

目的 利用氢质子磁共振波谱(hydrogen magnetic resonance spectroscopy,1H-MRS)技术观察老年性聋患者听皮层的代谢变化.方法 选取10名健康青年志愿者(青年组)、10名听力正常老年人(老年组)及8例老年性聋患者(老年性聋组),分别行1 H-MRS检测其双侧颞横回N-乙酰天门冬氨酸( N-acetylaspartic acid,NAA)、肌酸(creatine,Cr)、胆碱(choline,Cho)、γ-氨基丁酸(γ-aminobutyric acid,GABA)及谷氨酸(glutamic acid,Glu)的峰下面积,计算其NAA/Cr、Cho/Cr、GABA/Cr、Glu/Cr的比值,比较三组受试者间的代谢差异.结果 与青年组比较,老年组和老年性聋组双侧听皮层NAA/Cr降低,而Cho/Cr升高,差异具有统计学意义(P值均＜0.05);老年组GABA/Cr、Glu/Cr比值与青年组相比,差异无统计学意义(P值均＞0.05);老年性聋组GABA/Cr降低,Glu/Cr升高,与青年组相比差异具有统计学意义(P值均＜0.05).与老年组相比,老年性聋组双侧听皮层NAA/Cr、GABA/Cr比值进一步降低,Cho/Cr、Glu/Cr比值进一步升高,差异具有统计学意义(P＜值均0.05).结论1H-MRS可以为人体活体听皮层代谢物浓度改变提供有价值的信息.老年性聋患者听皮层存在NAA、GABA代谢减少及Cho、Glu代谢升高的现象.     

Frequency-dependent responses exhibited by multiple regions in human auditory cortex

Recordings in experimental animals have detailed the tonotopic organization of auditory cortex, including the presence of multiple tonotopic maps. In contrast, relatively little is known about tonotopy within human auditory cortex, for which even the number and location of tonotopic maps remains unclear. The present study begins to develop a more complete picture of cortical tonotopic organization in humans using functional magnetic resonance imaging, a technique that enables the non-invasive localization of neural activity in the brain. Subjects were imaged while listening to lower- (below 660 Hz) and higher- (above 2490 Hz) frequency stimuli presented alternately and at moderate intensity. Multiple regions on the superior temporal lobe exhibited responses that depended upon stimulus spectral content. Eight of these ‘frequency-dependent response regions’ (FDRRs) were identified repeatedly across subjects. Four of the FDRRs exhibited a greater response to higher frequencies, and four exhibited a greater response to lower frequencies. Based upon the location of the eight FDRRs, a correspondence is proposed between FDRRs and anatomically defined cortical areas on the human superior temporal lobe. Our findings suggest that a larger number of tonotopically organized areas exist (i.e., four or more) in the human auditory cortex than was previously recognized.     

c-fos及NR2A在耳鸣大鼠听皮层中的表达

目的通过检测神经元功能可塑性标记物快反应基因c-fos和N-甲基-D-天门冬氨酸受体（N-methyl-D-aspartate receptor,NMDAR）亚型NR2A在耳鸣大鼠听皮层中的表达探讨听皮层的可塑性变化及其在耳鸣产生中所起的作用.方法将30只白色Wistar大鼠随机分为3组,耳鸣模型组（12只）、生理盐水组（12只）和空白对照组（6只）.注射水杨酸钠造模并用行为学方法证实动物感受到耳鸣后,利用免疫组化技术检测动物听皮层中c-fos和NR2A的表达,并用数字图像分析系统进行分析.结果12只注射水杨酸钠的耳鸣模型组大鼠全部造模成功.c-fos基因的表达产物FOS蛋白主要存在于皮层神经元的胞核,其阳性细胞的数量及所占面积的百分比在耳鸣组显著高于对照组（P值均＜0.01）;NR2A受体主要表达在锥形细胞的胞膜上,其阳性细胞的数量、染色强度和面积百分比均显著强于对照组（P值均＜0.01）.结论耳鸣大鼠听皮层中c-fos和NR2A的表达明显增多,一方面表明神经递质及受体可能参与了耳鸣的发生;另一方面提示耳鸣大鼠听皮层中发生了功能可塑性改变,这种改变可能在耳鸣的发生发展中起重要作用.     

突发性聋患者听觉中枢在功能性核磁的表现

目的 利用血氧水平依赖性的功能性磁共振成像（blood oxygen level dependent functional MRI,BOLD～fMRD技术,观察突发性聋患者在接受纯音刺激时听觉中枢的变化。方法研究对象分为两组,突发性聋患者13例（均为左耳患病）为试验组,12例双耳听力正常的健康成年志愿者作为对照组。通过CoolEditPr02软件编辑1000Hz、127dB纯音,刺激模式采用ON／OFF组块设计,通过耳机分别给予右耳及双耳音频刺激,采用荷兰Philips Achieva3．0T磁共振成像系统,采集脑部的BOLD—fMRI数据,最后通过SPM2软件对数据进行统计学分析（组分析）,得到脑功能活动的图像。结果右耳接受纯音刺激时听力正常组主要中枢激活区在双侧颞上回、左枕叶、左额上回,此外还有左小脑、双侧海马及双侧旁中央小叶激活,听觉中枢表现为右侧优势偏向;突聋组见双侧颞上回,以及左侧海马、右枕叶和左侧距状裂区激活,听觉中枢表现为左侧优势偏向,突聋组听中枢激活容积小于正常组。双耳同时刺激时,听力正常组激活区主要在双侧颞中回,右侧扣带回和左胼胝体亦明显激活;突聋组双侧颞中回,以及右侧颞上回、右小脑、右侧额下回及右楔前叶激活,两组听觉中枢均表现为右侧优势偏向。听力正常组与突聋组比较,正常组左小脑、左胼胝体区明显激活,突聋组出现新的激活区右侧颞上回、右侧额下回及右小脑区：突聋组听中枢激活容积小于正常组。结论突聋患者在单耳刺激时听觉中枢出现优势偏向的改变,提示单侧耳聋的病人听觉皮质存在着结构重组;听觉中枢具有可塑性。突聋患者在双侧刺激时通过听觉重组使双耳对外界声音的感知尽量达到正常水平;突聋患者听觉中枢不仅本身存在重组现象,且同视觉皮质之间也发生了感觉交互作用。     

应用磁源性影像对健康青年人大脑听觉皮层功能区定位的初步研究

目的　探讨磁源性影像在大脑听觉皮层功能区定位的应用价值。方法　应用全头型30 6通道生物磁仪 ,对 30例健康青年人 (2 0～ 32岁 )男 16例 ,女 14例进行了大脑听皮层诱发磁场的测试 ,5例观察了 0 5、1、2、4、8kHz纯音诱发的脑磁反应波M10 0 ,另 2 5例均测试了 2kHz纯音诱发的脑磁反应波M10 0 ,并将脑磁图的电生理资料与磁共振成像的解剖结构资料叠加 ,获得大脑听觉皮层磁源性影像 ,以确定M10 0在大脑初级听觉皮层的位置。结果　 30例受试者均可诱发出M10 0 ,且重复性好 ,其位置均位于大脑的颞横回 ;不同频率的纯音诱发的M10 0在大脑颞横回有其各自的定位和分布 ;初级听觉皮层在两侧大脑半球的位置相对而言左侧靠后 ,右侧靠前 ,两侧明显不对称。M10 0潜伏期在左侧和右侧大脑半球对侧声刺激均较同侧声刺激为短 ,但M10 0等电流偶极的位置与刺激声的侧别无关。结论　由脑磁图的M10 0所获得的磁源性影像 ,具有良好的时间和空间分辨率 ,可对大脑初级听皮层功能区进行精确定位 ,将在耳科学的临床和基础研究中具有广阔的应用前景。     

青年急性耳鸣高刺激率ABR的检测及临床意义

目的研究高刺激率听觉脑干反应（Auditory brainstem response,ABR）检测对青年急性耳鸣的临床意义。方法选取青年急性耳鸣58耳与正常青年44耳,分别进行高、低刺激率ABR检测,比较波Ⅰ、Ⅲ、Ⅴ的潜伏期（peaklatency,PL）和Ⅰ～Ⅲ、Ⅲ～Ⅴ和Ⅰ～Ⅴ峰间潜伏期（interpeak latency,IPL）及两种刺激速率PL差值（ΔPL）、IPL差值（ΔIPL）。结果采用51.1次/s与11.1次/s的波PL及IPL的差值作为分析参数：耳鸣组波ⅠPL差值较正常组缩短,有统计学意义（P〈0.05）;Ⅰ～ⅤIPL差值较正常组延长,差异具有显著性（P〈0.01）。正常组与耳鸣组高、低刺激率ABRⅠ～ⅤIPL差值〉0.272ms的耳数分别为1耳和28耳。结论高刺激率ABR较常规ABR对青年急性耳鸣的检测更为敏感,可作为耳鸣患者的一种临床检查方法。     

听神经病大脑听觉皮层功能区脑磁图初步观察

目的应用脑磁图探讨听神经病患者大脑听觉皮层功能区的病变情况。方法应用全头型306通道生物磁仪，对10例（20耳）听神经病患者和15例（30耳）正常对照组进行大脑听觉皮层诱发磁场的测试，观察了左右耳分别给予0．5、1、2、4、6、8kHz纯音刺激诱发的双侧大脑半球听觉皮层磁反应波M100，将其脑磁图的电生理资料与磁共振成像的解剖结构资料叠加，获得听神经病患者大脑听觉皮层的磁源性影像。结果15例正常对照组除16耳8kHz未诱发出M100外，其他各频率双耳均可诱发出M100，而听神经病患者在0．5、1、2、4、6kHz20耳（40侧）大脑听觉皮层磁反应波M100引出率分别为27．5％（11／40）、22．5％（9／40）、7．5％（3／40）、5％（2／40）、5％（2／40）；8kHz均未引出反应。与正常对照组相比较其潜伏期明显延长，波幅明显降低（P〈0．01）。在初级听皮层1kHz纯音刺激诱发的M100位置听神经病患者较正常对照组更靠大脑半球的外侧。结论听神经病是一种临床表现主要为听力学异常的，包括耳蜗后第Ⅷ颅神经耳蜗支和听觉传导通路直至大脑听觉皮层在内的听觉系统疾患。脑磁图可作为其是否适合配带助听器和电子耳蜗植入治疗的参考。     

Silent functional magnetic resonance imaging (FMRI) of tonotopicity and stimulus intensity coding in human primary auditory cortex

OBJECTIVES: The aims of this study were to determine the feasibility of obtaining auditory cortex activation evoked by pure tones presented at threshold and suprathreshold hearing levels, to evaluate tonotopicity of the primary auditory cortex, and to determine the effect of stimulus intensity on auditory cortex activation using silent functional magnetic resonance imaging (fMRI). METHODS: Sixteen subjects with normal hearing underwent silent fMRI. An audiometer was used to deliver pure tones of 1000, 2000, and 4000 Hz to the left ear. Two levels of acoustic stimulation were used: 1). threshold, hearing level determined in the scanner room and 2). suprathreshold, 70 dB hearing loss (HL). Tonotopicity and stimulus intensity coding was assessed on the basis of the location, extent, and amount of the auditory cortex activation. RESULTS: The localization of activation moved to more medial and posterior regions of the primary auditory cortex as the frequency of the pure tone increased. Compared with a threshold stimulus, a suprathreshold stimulus evoked the same regions with increased spatial extent. The average increase in the right auditory cortex activation in response to suprathreshold stimulus was 57% at 1000, 51% at 2000, and 45% at 4000 Hz compared with that activated by the threshold stimulus. CONCLUSIONS: Silent fMRI can be used to evaluate auditory cortex activation using low-intensity stimuli. The level of stimulus intensity increases the amount of auditory cortex activation and influences the fMRI mapping of the tonotopic organization of the primary auditory cortex.     

Functional magnetic resonance imaging of activation in subcortical auditory pathway

OBJECTIVES: Functional magnetic resonance imaging (fMRI) has been used to investigate activation of the auditory cortex; however, assessment of activation in the subcortical auditory pathway has been challenging. The aim of this study was to examine neural correlates of cortical and subcortical auditory activation evoked by pure-tone stimulus using silent fMRI. STUDY DESIGN: Prospective analysis. METHODS: Seventeen normal-hearing volunteers (7 male, 10 female; age range, 14-37 yrs) underwent silent fMRI. An audiometer was used to deliver pure tones of 1000 Hz to the left ear. Pure tones were presented at hearing thresholds determined in the scanner. Brain regions showing increased activation during pure-tone stimulus presentation were mapped and auditory activations exceeding P <.001 were included in the analysis. RESULTS: Pure-tone stimuli evoked bilateral activation in cortical regions of the transverse and superior temporal gyri and the planum temporale. Activation in subcortical structures included the medial geniculate body, inferior colliculus, lateral lemniscus, superior olivary complex, and cochlear nucleus. CONCLUSIONS: Silent functional magnetic resonance imaging findings documented the feasibility of detecting activation elicited by pure tone along the cortical and subcortical auditory pathway. The use of this technique in the assessment of disorders with auditory dysfunction merits further investigation.     

水杨酸钠引起耳鸣大鼠听皮层突触形态改变的透射电镜观察

目的用透射电镜观察水杨酸钠引起耳鸣大鼠听皮层突触形态的变化。方法成年健康雄性白色Wistar大鼠32只,随机平分为2组。第一组腹腔注射水杨酸钠350mg/kg,第二组腹腔注射等量生理盐水,均在每天上午9点注射,持续30天。两组所处饲养环境（包括环境噪声、12小时昼夜节律、饮食等）完全相同。1月后快速处死,取双侧听皮层组织进行透射电镜观察。结果与对照组相比,水杨酸组突触数量明显增加,许多突触形态由平型变成凹型或U型,突触界面曲率增加,突触面积增大,活性区增加,每一活性区的长度增加,突触间隙明显增宽,突触后膜致密物质厚度增加。U型突触直径平均为（1.7&#177;0.23）μm,平直型突触直径平均为（0.53&#177;0.14）μm,二者比较有显著性差异（P〈0.05）。结论水杨酸钠能够引起听皮层突触形态的改变,这种改变与长时程增强现象（Long-term potentiation,LTP）非常相似,有可能是耳鸣与突触可塑性以及与学习记忆相关的有力证据,值得深入研究。     

重度突发性聋患者急性期与恢复期听皮层磁共振波谱分析

目的 利用氢质子磁共振波谱(1H-MRS)技术,研究单侧重度突发性聋患者急性期与恢复过程中听皮层的代谢变化。方法 选取右耳重度突发性聋急性期患者15例(发病时间＜1周),经过常规治疗3个月后恢复期患者9例,健康志愿者10例作为对照组。将全部受试者行磁共振波谱检测,测定双侧颞横回N-乙酰天门冬氨酸(NAA)、肌酸(Cr)、胆碱(Cho)、γ-氨基丁酸(GABA)、谷氨酰胺及谷氨酸复合物(Glu)的峰下面积并计算NAA/ Cr、Cho/Cr、GABA/ Cr、Glu/Cr的比值。分析重度突聋急性期与3个月后双侧听皮层代谢差异。结果 与对照组相比,突聋急性期双侧NAA/Cr、双侧Cho/Cr,右侧GABA/Cr、右侧Glu/Cr比值无明显差异(P＞0.05),而左侧听皮层GABA/Cr比值明显下降,Glu/Cr明显上升(P＜0.05)。突聋3个月组双侧NAA/Cr、右侧Cho/Cr、右侧GABA/Cr、右侧Glu/Cr比值无明显差异(P＞0.05)。左侧Cho/Cr比值稍下降,GABA/Cr比值略上升但仍低于对照组,Glu/Cr比值略下降但仍高于对照组(P<0.05)。结论 磁共振波谱可以为人体活体听皮层代谢物浓度改变提供有价值的信息;突聋患者对侧听皮层GABA、Glu代谢异常,提示听觉中枢可能发生代谢改变、功能重组。     

Cortical reorganisation and tinnitus: principles of auditory discrimination training for tinnitus management

Scientific evidence has proved reorganisation processes in the auditory cortex after sensorineural hearing loss and overstimulation of certain tonotopic cortical areas, as we see in auditory conditioning techniques. Acoustic rehabilitation reduces the impact of these reorganisation changes. Recent theories explain tinnitus mechanisms as a negative consequence of neural plasticity in the central nervous system after a peripheral aggression. Auditory discrimination training (ADT) could partially reverse the wrong changes in tonotopic representation and improve tinnitus. We discuss different studies and their efficacy on tinnitus perception and annoyance. Indications, method, dose and sound strategy need to be implemented.     

纯音刺激前后正常人听皮层代谢变化~1HMRS研究

目的利用质子磁共振波谱(protonmagnetic resonance spectroscopy,1H-MRS)技术研究纯音刺激前后正常人大脑听皮层代谢变化。方法 10例健康受试者双侧听皮层在纯音刺激前后接受两次多体素磁共振波谱检查。刺激声为声强90dB、频率1000Hz的正弦波纯音脉冲,左耳给声。观察双侧听皮层N-乙酰天门冬氨酸(N-aceytlaspartate,NAA)、肌酸(creatine,Cr)、胆碱(choline,Cho)、谷氨酰胺和谷氨酸(glutamate/glutamine,Glx)等代谢物的波峰变化并进行半定量分析。结果左耳纯音刺激后双侧听皮层NAA/(Cho+Cr)、Glx/(Cho+Cr)比值均增高,Cho/Cr比值降低,NAA/(Cho+Cr)、Glx/(Cho+Cr)、Cho/Cr刺激前后差异在右侧听皮层均具有统计学意义(P<0.05),但在左侧听皮层差异无统计学意义(P>0.05)。结论 1HMRS可无创性检测听皮层中与能量代谢及神经递质有关的化合物,纯音刺激单耳时,正常人对侧听皮层代谢变化明显大于同侧,表现为对侧半球传导优势。     

无听力损失耳鸣患者听性脑干反应检测及意义

目的 :探讨无听力损失耳鸣患者听性脑干反应 ( ABR)的检测及意义。方法 :利用额部乳突部引导方法记录 ABR,将无听力损失耳鸣患者的 ABR与听力正常青年人进行对比观察。结果 :耳鸣患者 I波潜伏期延长占5 1.6 % , 波占 2 0 .9% ,V波占 17.9%。结论 :虽然此类耳鸣患者未发现听阈提高 ,但已有部分患者发生了耳蜗性损害     

SPET monitoring of auditory cortex activation by electric stimulation in a patient with auditory brainstem implant

Auditory cortex activation following multifrequency acoustic stimulation has been evaluated by means of single photon emission tomography (SPET) in one patient before and after an auditory brainstem implant (ABI). No activation could be observed after acoustic stimulation before ABI. After ABI stimulation in the coronal and axial slices, the activation within the temporal cortex contralateral to the stimulated ear was twice (43.76%) that of normal controls (23.94 ± 2.74%). This marked difference was not present in other selected cortical auditory areas (homolateral temporal, homolateral and contralateral parietal cortices). The temporal cortex was also examined with six consecutive sagittal slices from 18.75 mm up to 56.25 mm lateral to the midline. A very strong activation (51.20%) compared with that of normal controls (9.94 ± 7.45%) was detected in the 25.26-mm sagittal slice of the temporal cortex contralateral to ¶the stimulated side. The remaining sagittal slices showed ¶an almost normal post-stimulatory activation. As the 25.26-mm sagittal slice corresponds to the medial part of the auditory temporal cortex, its activation suggests that electrode stimulation is concentrated on the region of the cochlear nucleus in which the neurons that transduce high frequencies are located. SPET can be considered useful, in combination with electric auditory-evoked potentials, to obtain information on ABI placement and function, effectiveness of acoustic stimulation, degree of cortical stimulation and tonotopic spatial distribution of auditory cortex activation.     

慢性耳鸣急性加重时的听阈改变及其对耳鸣预后的影响

目的 探讨慢性耳鸣急性加重时患者的听阈改变及其对耳鸣预后的影响.方法 对32例在习服治疗过程中出现耳鸣急性加重的患者进行纯音听阈、声导抗、耳声发射、听性脑干反应、耳蜗电图及甘油试验等听力学检测,对新出现听阈提高者在习服治疗的同时,按照突发性聋方案治疗.对照组75例仅接受习服治疗.分析慢性耳鸣急性加重时的听阈改变,以及耳鸣加重组与对照组在习服治疗的第3、6、9、12个月时的耳鸣代偿情况.结果 慢性耳鸣急性加重时,出现3种类型的局部频率听阈提高:①既往为4～8 kHz高频下降型听力曲线,耳鸣加重时,相邻的中频区1～2个频率(含半倍频)听阈提高;②既往中频区单个频率听力损失,耳鸣加重时,紧邻的中频区新增单个频率听阈提高,听力曲线由锯齿型转变为凹槽型;③低频听力波动型,慢性耳鸣急性加重时,125～1000 Hz平均听阈较既往提高10～30 dB,而高频区听阈无改变.按照突发性聋方案治疗后,随着新出现听力损伤的恢复,25例随之实现耳鸣代偿.耳鸣加重组与对照组在习服治疗的第3、6、9个月,代偿率差异无统计学意义(X2值分别为0.005、0.005、2.587,P值均>0.05),12个月时,耳鸣加重组代偿率明显高于对照组,差异有统计学意义(X2=0.108,P<0.05).结论 慢性耳鸣急性加重时,出现了不同形式的局部频率听力损失,对新出现听力损失及时有效的治疗,在挽救听力的同时,加速了耳鸣的代偿.