| Background:Tinnitus is one of the most common symptoms in otology,mainly divided into objective tinnitus and subjective tinnitus.Clinical tinnitus is mainly subjective tinnitus,which refers to the sound in the ear or in the brain that can be felt subjectively without external sound sources.With the increasing pressure of people’s work,life and spirit,environmental and industrial noise and aging population,the incidence rate of tinnitus is increasing year by year.According to the research,the incidence of tinnitus in China is 10%-25%,among which 4%-5%of patients suffer from tinnitus for a long time,which seriously affects people’s quality of life.The pathogenesis of tinnitus is not clear at present,but it is generally believed that tinnitus may be related to peripheral and central auditory system damage.However,our assessment and diagnosis of tinnitus can only be based on the patient’s main complaint and some subjective checks,and there is no recognized objective examination method to support the diagnosis of tinnitus.Distortion product otoacoustic emission(DPOAE)can objectively and sensitively reflect the functional state of cochlear outer hair cells,and can occur before the change of pure tone threshold.It is an objective and simple method to detect cochlear function at present.Auditory brainstem response(ABR)can objectively reflect the peripheral auditory conduction pathway and brainstem function.In this study,DPOAE and high and low stimulation rate ABR were detected in patients with acute tinnitus with normal hearing threshold,in order to detect the pathological damage of relevant parts of tinnitus patients early and provide reference for diagnosis and treatment of tinnitus.ObjectiveTo observe and analyze the characteristics of DPOAE and high stimulation rate ABR in patients with acute tinnitus with normal hearing and normal control group,and to explore its application value in tinnitus assessment.Methods31 cases(46 ears)of tinnitus patients with normal hearing who were treated in the otolaryngology Clinic of Qilu Hospital(Qingdao)of Shandong University from November 2020 to December 2021 were selected as the tinnitus group,and 25 cases(50 ears)of tinnitus patients with normal hearing without tinnitus were selected as the normal control group.Pure tone audiometry(PTA),acoustic resistance audiometry,tinnitus matching,DPOAE and high or low stimulation rate ABR were measured for the two groups of subjects.The detection rate,amplitude and signal-to-noise ratio of the frequencies of DPOAE,as well as the peak latency(PL)of ABR Ⅰ,Ⅲ and Ⅴ waves at high and low stimulus rates were compared Wave amplitude,Ⅰ-Ⅲ,Ⅲ-Ⅴ,Ⅰ-Ⅴ peak latency(IPL),and the difference between latency and peak latency(△ PL and △ IPL)under the two stimulation rates.Results1.Compared with tinnitus group and control group,there is no significant difference in DPOAE detection rates between the two groups(P>0.05).At 4KHz,6KHz and 8KHz,the amplitude of tinnitus group was significantly lower than that of control group,and the difference was statistically significant.The tinnitus group was statistically lower than the control group when signal-to-noise ratio at 8kHz.(P=0.016).2.In the ABR results of high and low stimulation rates,there was no significant difference in the amplitude of Ⅰ,Ⅲ and Ⅴ waves between the tinnitus group and the control group under different stimulation rates(P>0.05).3.At low stimulation rate,there was no significant difference in Ⅰ,Ⅲ,Ⅴ wave PL and Ⅰ-Ⅲ,Ⅲ-Ⅴ,Ⅰ-Ⅴ wave IPL between tinnitus group and control group(P>0.05).4.At high stimulation rate,the Ⅰ-Ⅴ wave IPL of tinnitus group was longer statistically than that of the control group(P<0.05).5.At different stimulation rates,the Ⅰ △PL of tinnitus group was shorter than that of the control group(P<0.05),V △PL and Ⅰ-Ⅴ △ IPL in tinnitus group were longer than those in control group(P<0.05),and the difference is statistically significant.Conclusion1.Normal PTA does not mean that tinnitus patients have no hearing function damage.Compared with PTA,DPOAE can judge the cochlear function state more sensitively,Combined with DPOAE detection,the damage of cochlear hair cells can be found earlier,and can make a preliminary judgment on the lesion site of tinnitus patients.2.ABR test has important value for the evaluation of peripheral auditory conduction pathway and brainstem functional status,and increasing the stimulation rate can improve the detection rate of subclinical lesions and improve the sensitivity of tinnitus detection.3.High and low stimulation rate ABR can sensitively detect the brainstem synaptic ischemia of patients,and combined with DPOAE detection,it can early find out whether there is hidden damage to the auditory system in tinnitus patients,which has important value for clinical diagnosis and treatment of tinnitus... |
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