碩士 / 國立臺北護理健康大學 / 聽語障礙科學研究所 / 100 / Tinnitus is the subjective perception of sound within the ears or brain in the absence of corresponding external sound or electrical stimulation. Epidemiological studies have shown that 10.1% of adults in the general population experienced long-term tinnitus which may cause various degrees of distress, and 0.5% of the population sufferred from severe tinnitus which may affect their quality of life. Tinnitus is one of the symptoms of auditory system dysfunction and closely associated with hearing loss. Aging, noise exposure and ototoxic drugs often resulted in high-frequency hearing loss which may increase the prevalence of tinnitus. Therefore, an inquiry of tinnitus and its associated symptoms may be needed.
Tinnitus retraining therapy (TRT) was developed base on the neurophysiologic model of tinnitus by Jastreboff in 1990. The therapy involved with two parts: firstly, psychological counseling which provided the patients with knowledge of tinnitus in order to minimize the conditioned reflex from negative perception. Secondly, Jastreboff proposed low-level and broadband noise masking treatment which increased the background neuronal activity and reduced the amplitude of tinnitus level which may minimize the conditioned reflex. It was believed that narrowband noise masking at lower level encompassing the main tinnitus frequency may be effective. In order to understand the response of tinnitus patients to narrowband and broadband noises, this study collected 73 patients (117 ears) with high-frequency hearing impairment and unilateral or bilateral persistent tinnitus for more than 6 months from the tinnitus counseling out-patient clinic at Kuangtien General Hospital. Patients with outer or middle ear diseases were excluded. All patients received audiological evaluation including UCL, acoustic reflex, DPOAE, pitch matching test, MML for narrowband and broadband noise stimulation, as well as RI, respectively. The purpose of audiological evaluation is to describe the characteristics of tinnitus. The data obtained from these evaluations were analyzed using SPSS 20 and R for statistical analyses includingχsquare, and Pearson’s product moment correlation coefficient.
The results showed that the poor tinnitus ears match the ears with poor hearing and the pitches of tinnitus coincide with the frequencies of hearing impairment. When comparing the responses to narrowband and broadband noise masking, broadband noise needs lower level than narrowband noise to mask tinnitus, and the level lower than the hearing thresholds of patients to MML in those who with profound high-frequency hearing loss. It was observed that broadband noise masking resulted in more patients with complete RI than narrowband noise masking, which resulted in more partial or no RI response. However, the observed RI duration is longer with narrowband noise masking than those with broadband noise masking. There is no linear relationship between the existence of RI and narrowband or broadband noise, gender, age, the varying degrees of hearing impairment in different frequencies (4000 and 8000 Hz), and the tinnitus frequencies; neither is the duration of RI with these variables.
| Identifer | oai:union.ndltd.org:TW/100NTCN0714018 |
| Date | January 2012 |
| Creators | TENG JO-CHEN, 鄧若珍 |
| Contributors | Edward Yang, 楊義良 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | zh-TW |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 57 |
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