【目的】：观察慢性中耳炎耳鸣的发病情况，并分析其特点及可能的影响因素。【方法】：收集2016年6月到2017年4月在空军军医大学西京医院耳鼻咽喉头颈外科住院并接受手术治疗的慢性中耳炎或中耳胆脂瘤患者309例，对耳鸣患者进行耳鸣病史调查表、耳鸣障碍量表（THI）和耳鸣严重程度评估量（ITS）表填写。根据患者是否有耳鸣将患者分为耳鸣组和非耳鸣组，采用Logistic回归分析不同因素包括性别、年龄、病史、病变侧别、病变类型、手术次数、术前气导听阈、术前骨导听阈、术前气骨导差、术中所见鼓室内病变及咽鼓管鼓口病变等因素与耳鸣的相关性。【结果】：在309例慢性中耳炎患者中有116例患者发生耳鸣（发病率为37.54%），其中97例患者完成THI和ITS量表填写，结果发现中耳炎患者的耳鸣严重程度多较轻，以I，II级为主（THI约占72.16%，ITS约占73.20%），极重度患者少（THI占3.09%，ITS占2.06%）。耳鸣平均音调匹配为1223±379.4Hz，响度为2.59±0.41dB(0-10dB)。Logistic回归分析显示性别(P=0.032，EXP(B) =1.976)、年龄（P=0.033，EXP(B)=0.978）及咽鼓管鼓口病变(P=0.005，EXP(B) =2.567)有统计学意义（P<0.05）。【结论】：本研究初步分析了慢性中耳炎耳鸣的发病特征，发现年龄、性别及咽鼓管鼓口病变与耳鸣的发生可能相关，为探讨慢性中耳炎耳鸣的发生机制提供依据，需进一步研究观察。
【关键词】慢性中耳炎；耳鸣；鼓室成形术；听力下降

Analysis of the Characteristics of Tinnitus in Chronic Otitis Media and Influence Factors
Song Yong-li, Wen Li-ting, Chen Yang, Qiu Jian-hua, Zha Ding-jun*
Abstract
Objective: To evaluate the occurrence of tinnitus in chronic otitis media, and analyze the characteristics and influence factors. Methods: Retrospectively analyzed 309 patients who accepted surgical treatments from September June 2016 to April 2017 in the Department of Otolaryngology Head and neck surgery of First Affiliated Hospital of Air Force Military Medical University. All patients were diagnosed as chronic otitis media or Cholesteatoma of the middle ear. Patients who suffered from tinnitus were required to finish the questionnaires of Tinnitus history questionnaire, tinnitus handicap index(THI), index of tinnitus serious (ITS). Then patients were divide into tinnitus group and non-tinnitus group. The relationships between tinnitus and the factors such as sex, age, disease history, side of disease, type of disease, number of operation, pre-operation air conduction(AC), pre-operation bone conduction(BC), pre-operation air-bone gap(ABG), the condition of tympanum mucosa and ostium tympanicum tubae auditivae were analyzed by Logistic regression. Results: Among the 309 patients, 116 cases suffered from tinnitus（occurrence rate: 37.54%）and 96 patients finished the questionnaires. The THI scores and ITS scores showed that most of patients who suffered tinnitus were of I, II grade (THI:72.16%, ITS 73.20%), rarely were severe (THI:3.09%, ITS: 2.06%). The mean frequency of tinnitus is 1223±379.4Hz, the mean loudness is 2.59±0.41dB(0-10dB). The Logistic regression showed that the sex (P=0.032, EXP(B) =1.976), age (P=0.033, EXP(B)=0.978) and ostium tympanicum tubae auditivae disease (P=0.005，EXP(B) =2.567) were of statically significance. Conclusion: This preliminary study analyzed the characteristics of chronic otitis of media related tinnitus. We found that sex, age and ostium tympanicum tubae auditivae disease may related with the on set of tinnitus which provided evidences for further study of the mechanism of tinnitus.
【key words】chronic otitis of media; tinnitus; tympanoplasty; hearing loss;
耳鸣是指在无外界声刺激或电刺激的情况下，在耳内或颅内出现的异常的听觉感知。耳鸣为耳科常见症状，约10%-20%的成人发生过可感知的耳鸣。耳鸣的发病机理不明，原因不清，治疗困难，已证实多种耳科疾病包括突发性耳聋，梅尼埃病、慢性中耳炎等可能与耳鸣发生有关
作者：宋勇莉，温立婷，陈阳，邱建华，查定军