【medical-news】多种因素使耳鸣无法忍受
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Tinnitus Intolerability Influenced by Several Factors
NEW YORK (Reuters Health) Dec 18 - The extent of tinnitus loudness and distress contribute to tinnitus severity, and several factors determine the extent of loudness and distress, such as vertigo, hyperacusis and coexisting hearing loss, German investigators report in the December issue of the Archives of Otolaryngology -- Head and Neck Surgery.
Co-authors Dr. Wolfgang Hiller, from the University of Mainz, and Dr. Gerhard Goebel, from Roseneck Center of Behavioral Medicine in Prien, conducted a cross-sectional study to evaluate how individual factors contribute to subjects' perception of loudness and annoyance.
They mailed surveys to 20,000 members of the German Tinnitus League. The 4995 individuals who participated were also evaluated for audiologic, medical, and psychological factors.
Tinnitus loudness was classified into grade I (weak) that indicates that tinnitus is audible only in silent environments; grade II (moderate) tinnitus audible in ordinary acoustic environments; or grade III (severe) tinnitus is louder than all external sounds. Roughly 8.2% of subjects reported loudness as grade I, 60% as grade II, and 32% as grade 3.
Degree of annoyance, measured with the mini-version of the Tinnitus Questionnaire, was categorized as mildly distressed (39%), moderately (24%), severely (24%), and most severely distressed (13%).
Subjects were also asked questions regarding tinnitus history, tinnitus-related otologic conditions, tinnitus etiology, and psychological complaints.
The strongest influences on tinnitus loudness and annoyance were hyperacusis and continuously present tinnitus, Drs. Heller and Goebel report.
Other factors that influenced loudness and annoyance were male gender, older age, "binaural and centrally perceived tinnitus, increase in tinnitus intensity since onset, sensitivity to loud external noise, and the coexistence of hearing loss and vertigo," the investigators add.
They note that etiology of the condition - conductive hearing loss, severe head injury, or neurologic disease - seemed to be particularly associated with both loudness and annoyance.
"Although it has been shown that personal distress due to tinnitus is to some degree dependent on primary psychological factors such as cognitive appraisal or differences in coping behavior, the role of physical, audiologic, and medical properties of tinnitus should not be underestimated," the investigators conclude.
They recommend that loudness and annoyance be considered when making treatment decisions.
http://www.medscape.com/viewarticle/549559
NEW YORK (Reuters Health) Dec 18 - The extent of tinnitus loudness and distress contribute to tinnitus severity, and several factors determine the extent of loudness and distress, such as vertigo, hyperacusis and coexisting hearing loss, German investigators report in the December issue of the Archives of Otolaryngology -- Head and Neck Surgery.
Co-authors Dr. Wolfgang Hiller, from the University of Mainz, and Dr. Gerhard Goebel, from Roseneck Center of Behavioral Medicine in Prien, conducted a cross-sectional study to evaluate how individual factors contribute to subjects' perception of loudness and annoyance.
They mailed surveys to 20,000 members of the German Tinnitus League. The 4995 individuals who participated were also evaluated for audiologic, medical, and psychological factors.
Tinnitus loudness was classified into grade I (weak) that indicates that tinnitus is audible only in silent environments; grade II (moderate) tinnitus audible in ordinary acoustic environments; or grade III (severe) tinnitus is louder than all external sounds. Roughly 8.2% of subjects reported loudness as grade I, 60% as grade II, and 32% as grade 3.
Degree of annoyance, measured with the mini-version of the Tinnitus Questionnaire, was categorized as mildly distressed (39%), moderately (24%), severely (24%), and most severely distressed (13%).
Subjects were also asked questions regarding tinnitus history, tinnitus-related otologic conditions, tinnitus etiology, and psychological complaints.
The strongest influences on tinnitus loudness and annoyance were hyperacusis and continuously present tinnitus, Drs. Heller and Goebel report.
Other factors that influenced loudness and annoyance were male gender, older age, "binaural and centrally perceived tinnitus, increase in tinnitus intensity since onset, sensitivity to loud external noise, and the coexistence of hearing loss and vertigo," the investigators add.
They note that etiology of the condition - conductive hearing loss, severe head injury, or neurologic disease - seemed to be particularly associated with both loudness and annoyance.
"Although it has been shown that personal distress due to tinnitus is to some degree dependent on primary psychological factors such as cognitive appraisal or differences in coping behavior, the role of physical, audiologic, and medical properties of tinnitus should not be underestimated," the investigators conclude.
They recommend that loudness and annoyance be considered when making treatment decisions.
http://www.medscape.com/viewarticle/549559
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