| Objective:The purpose of this study was to confirm the status of hearing function and brain stem pathways of subjective tinnitus patients with different level of THI scales through the results of pure tone audiometry(PTA),auditory brainstem response(ABR)and distortion product OAE(DPOAE).And the value of the above detection methods in the process of diagnosis of tinnitus patients will be discussed in this study.Method:We retrospectively analyzed 56 patients(78 ears)with tinnitus who were admitted to the Department of Otolaryngology,Head and Neck Surgery in the First Central Hospital of Tianjin from June 2017 to January 2018.At the same time,10 cases(20 ears)of healthy persons were selected as the normal control group.All subjects in this study had the test of PTA,ABR and DPOAE.The tinnitus patients were also asked to fill out THI and VAS in order to get a scale.Then we analyzed the results of each test in the tinnitus group and the control group,performed a correlation analysis of each test result with THI and VAS scales.All data were analyzed by using SPSS21 statistical software.Result:The VAS scores had an average of 5.5±0.4 points.The THI score had an average of 33.9±4.0 points.There was a significant correlation between THI and VAS scores in tinnitus patients(P(27)0.01).According to THI classification,all tinnitus patients were divided into four groups: T1,T2,T3,and T4.1.PTA The PTA thresholds above 0.5 kHz and 0.5 kHz in the T1 group were higher compared with the control group(P(27)0.05).In addition to the 1 kHz and 4 kHz in the T2 group,the PTA thresholds were higher in the other frequencies than in the control group(P(27)0.05).In T3 group,the PTA thresholds above 0.5 kHz was higher compared with the control group(P(27)05).The PTA threshold of each frequency in the T4 group was higher than that of the control group(P(27)0.05).The correlation analysis showed that the THI scales were positively correlated with the thresholds of 0.125 kHz,0.25 kHz,0.5 kHz,and 1 kHz(P(27)0.05).The correlation analysis with VAS scales showed that VAS scales was positively correlated with the 0.125 kHz,0.25 kHz,1 kHz,and 2 kHz thresholds(P(27)0.05).2.ABR Compared with the control group,the I-III IPL in T1 group was shorter than that in the control group(P(27)0.05),and the III-V IPL in T2 group compared with the control group was prolonged(P(27)0.05).In the T3 group,the latency of I wave,III wave,V wave and III-V IPL were prolonged compared with the control group(P(27)0.05).The correlativity analysis showed that the I-III internal peak latency of the tinnitus group was positively correlated with the THI scales(P(27)0.05).3.DPOAE The amplitude of each frequency of DPOAE in the tinnitus group was decreased compared with the control group(P(27)0.05).The correlation analysis showed that when the frequency was 0.5 kHz and 0.75 kHz,the DPOAE amplitude was negatively correlated with the THI score(P(27)0.05).When the frequency was 0.5 kHz,4 kHz and 8 kHz,the DPOAE amplitude was negatively correlated with its VAS score(P(27)0.05).The correlation between DPOAE amplitude and auditory threshold showed a significant negative correlation(P(27)0.05).When the f0 was 0.5 kHz,0.75 kHz,1 kHz,1.5 kHz,2 kHz,3 kHz,4 kHz,6 kHz and 8 kHz,the coefficient correlation between the amplitude of DPOAE and PTA thresholds was the smallest when the PTA thresholds was corresponding 1 kHz,0.5 kHz,2 kHz,2 kHz,4 kHz,4 kHz,4 kHz,and 4 kHz and has the greatest negative correlation.Conclusion:PTA can reflect the severity of tinnitus patients to some extent and can make a preliminary estimate of the frequency of injury.However,normal PTA can not represent that patients have no auditory system damage.Combined with DPOAE test,the function of the cochlea hair cells can be detected early.The ABR test may be helpful in the localization diagnosis of tinnitus lesions and in judging the severity of tinnitus.However,the current research is not clear about the significance of ABR in the diagnosis of tinnitus.The DPOAE test can more sensitively determine the state of cochlear function and reflect the severity of the damaged area.The frequency f0 of DPOAE test has a certain corresponding relationship with the PTA test frequency,and it can be considered that the DPOAE test frequency is almost the same as the PTA test frequency,and the DPOAE can find the hearing loss of the patient prior to the PTA. |
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