我们的目的是研究主观耳鸣和正常听力患者的特征,并调查这些特征是否与听力图上的不同形状相关。在这项回顾性研究中,研究对象为复旦大学附属耳鼻喉科医院耳鸣门诊主观性耳鸣和临床正常听力患者313例。收集了以下表型变量:年龄,显性耳鸣间距(TP),耳鸣响度,耳鸣持续时间,耳鸣严重程度,性别,教育,听力阈值,耳鸣位置,和耳鸣状况。听力正常患者的优势TP多为高音,平均值为4866.8±2579.6Hz;因此,我们推测这种情况与高频听力阈值升高有关。我们根据匹配的TP将患者进一步分为四个亚组:(i)TP≤500Hz(n=34),(ii)500Hz8,000Hz(n=5)。我们研究了不同听力图的表型分析,发现TP≤500Hz的组具有平均的“倒U形”听力图,TP在500到3,000Hz之间的组的听力图斜率缓慢上升,低于2,000Hz,其次是急剧下降的斜率听力图,范围从2,000到8,000赫兹;进一步,高频组(3,000-8,000Hz)和超高频组(>8,000Hz)在2,000Hz以下具有平坦的曲线,在2,000Hz以上具有更陡峭的斜率听力图.我们的发现证实了显性TP的分布与两只耳朵的最大听阈频率之间的一致性。显性TP与最大听阈升高频率呈正相关(左耳:r=0.277,p<0.05;右耳:r=0.367,p<0.001)。听力阈值升高,尤其是在高频,可能解释了没有临床定义的听力损失的患者中主要的高频TP的出现。这与高频编码在耳鸣产生中的因果作用是一致的。
Our objective was to study the characteristics of patients with subjective tinnitus and normal hearing and to investigate whether the features correlated to different shapes on audiograms. In this retrospective study, 313 patients with subjective tinnitus and clinically normal hearing were enrolled from the tinnitus outpatient department of the Eye and ENT Hospital of Fudan University. The following phenotypic variables were collected: age, dominant tinnitus pitch (TP), tinnitus loudness, tinnitus duration, tinnitus severity, sex, education, hearing thresholds, tinnitus position, and tinnitus condition. The dominant TPs of patients with normal hearing were mostly high-pitched, with a mean of 4866.8 ± 2579.6 Hz; thus, we speculated that the condition is related to high-frequency hearing threshold elevations. We further divided the patients into four subgroups based on the matched TP: (i) TP ≤ 500 Hz (n = 34), (ii) 500 Hz < TP ≤ 3,000 Hz (n = 15), (iii) 3,000 Hz < TP ≤ 8,000 Hz (n = 259), and (iv) TP > 8,000 Hz (n = 5). We studied the phenotypic profiling of different audiograms and found that the group with TP of ≤500 Hz had an average \"inverted-U\" shaped
audiogram, and the group with TP between 500 and 3,000 Hz had a slowly ascending slope
audiogram below 2,000 Hz, followed by a drastically descending slope
audiogram ranging from 2,000 to 8,000 Hz; further, the high-frequency (3,000-8,000 Hz) and ultra-high-frequency (>8,000 Hz) groups had flat curves below 2,000 Hz and steeper slope audiograms over 2,000 Hz. Our findings confirmed a consistency ratio between the distributions of dominant TPs and the frequencies of maximum hearing thresholds in both ears. The dominant TP was positively correlated with the maximum hearing threshold elevation frequency (left ear: r = 0.277, p < 0.05; right ear: r = 0.367, p < 0.001). Hearing threshold elevations, especially in high frequency, might explain the appearance of dominant high-frequency TP in patients without clinically defined hearing loss. This is consistent with the causal role of high-frequency coding in the generation of tinnitus.