Sound generator associated with the counseling in the treatment of tinnitus: evaluation of the effectiveness

Abstract Introduction: The relations between the tinnitus and the hearing loss are due to the sensory deprivation caused by hearing loss, since this is followed by the functional and structural alteration of the auditory system as a whole. The cochlear lesions are accompanied by a reduction in the activity of the cochlear nerve, and the neural activity keeps increased in mainly all the central auditory nervous system to compensate this deficit. Objective: This study aimed to verify the effectiveness of the sound generator (SG) associated with the counseling in the treatment of the tinnitus in individuals with and without hearing loss regarding the improvement of the nuisance through Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS). Methods: The sample consisted of 30 individuals of both genders divided into two groups: Group 1 (G1) was comprised of 15 individuals with tinnitus and normal hearing, adapted to SG; Group 2 (G2) was comprised of 15 individuals with complaints of hearing acuity and tinnitus, adapted with SG and an individual hearing aid device (HA). Both groups underwent the following procedures: anamnesis and history of complaint, high frequency audiometry (HFA), imitanciometry, acuphenometry with the survey of psychoacoustic pitch and loudness thresholds and application of the tools THI and VAS. All of them were adapted with HA and Siemens SG and participated in a session of counseling. The individuals were assessed in three situations: initial assessment (before the adaptation of the HA and SG), monitoring and final assessment (6 months after adaptation). Results: The comparison of the tinnitus nuisance and handicap in the three stages of assessment showed a significant improvement for both groups. Conclusion: The use of the SG was similarly effective in the treatment of the tinnitus in individuals with and without hearing loss, causing an improvement of the nuisance and handicap.

引言与摘要：耳鸣与听力损失的关联源于听力损失引发的感觉剥夺，听觉系统整体会因此出现功能与结构改变。耳蜗病变会伴随听神经活动减弱，而为弥补这一缺损，中枢听觉系统的几乎所有区域的神经活动都会持续增强。

研究目的：本研究旨在验证结合咨询干预的声发生器（Sound Generator, SG）对伴或不伴听力损失的耳鸣患者的治疗效果，通过耳鸣残障量表（Tinnitus Handicap Inventory, THI）与视觉模拟评分法（Visual Analogue Scale, VAS）评估其对耳鸣困扰的改善作用。

研究方法：本研究纳入30名不限性别的受试者，分为两组：第1组（G1）共15名伴耳鸣且听力正常的受试者，仅适配声发生器（SG）；第2组（G2）共15名存在听力减退主诉且伴耳鸣的受试者，同时适配声发生器（SG）与个性化助听器（Hearing Aid, HA）。两组受试者均接受以下流程：病史采集与主诉记录、高频听力测定（High Frequency Audiometry, HFA）、声导抗测听、耳鸣响度匹配测听（含心理声学音调与响度阈值检测），以及THI与VAS量表测评。所有受试者均适配HA与西门子SG，并接受一次咨询干预。受试者在三种场景下接受评估：初始评估（助听器与声发生器适配前）、随访评估与终期评估（适配后6个月）。

研究结果：对三个评估阶段的耳鸣困扰程度与残障情况进行比较后发现，两组受试者的症状均得到显著改善。

研究结论：声发生器（SG）的使用对伴或不伴听力损失的耳鸣患者均具有同等治疗效果，可有效改善其耳鸣困扰与残障状况。