Evaluation of Tinnitus and Hearing Loss
Evaluation of tinnitus severity: Tinnitus in the patients was classified
into seven grades according to the Feldmann standard
(6): 1) 0: No tinnitus, 2) 1: Occasional
tinnitus that does not affect the patient’s daily life, 3) 2: Persistent
tinnitus that is more prominent in quiet surroundings, 4) 3: Persistent
tinnitus even in a noisy environment, 5) 4: Persistent tinnitus combined
with attention and sleep disorders, 6) 5: Persistent severe tinnitus
affecting the patient’s ability to work, and 7) 6: Severe tinnitus
provoking suicidal tendencies.
Efficacy evaluation of tinnitus: The evaluation was based on the Chinese
classification of tinnitus severity(6),:
1) Cured: Tinnitus had disappeared or improved to grade 1, 2) Markedly
effective: Tinnitus was alleviated by 1-3 grades but had not yet reached
grade 1, 3) Effective: Tinnitus was alleviated to some extent but
remained in the same grade, 4) Ineffective: Tinnitus was unchanged or
even worsened. In this study, level 1 intermittent tinnitus was also
counted as cured in this article.
Grades of hearing loss severity: The hearing thresholds at 0.50, 1.00,
2.00, and 4.00 kHz were measured. When the hearing thresholds at some
frequencies could not be detected, the frequency threshold was
considered the maximum audiometric intensity. The degrees of hearing
loss were categorized as mild (26–40 dB HL), moderate (41–60 dB HL),
severe (61–80 dB HL), and profound hearing loss (> 80 dB
HL) (17).
Classification of hearing loss: Four audiogram shapes were defined in
relation to the pattern of hearing loss
(17): ascending, flat, profound, and
descending. “Ascending” referred to cases in which the average
threshold of 0.25 to 0.5 kHz was 20 dB higher than normal. When the
difference in the hearing threshold did not exceed 20 dB at any
frequency, the audiogram shape was classified as “flat.” For patients
with a flat audiogram and a hearing threshold greater than 81 dB, the
audiogram shape was classified as “profound.” The audiogram shape was
described as “descending” when the average threshold of 4 to 8 kHz was
20 dB higher than normal.
Hearing recovery evaluation: Based the results of pure-tone audiometry
(17) patients were divided into four
groups: 1) Cured: A final hearing level less than 25 dB regardless of
the size of the gain, 2) Markedly effective: Greater than 30 dB of gain
for the average hearing threshold, 3) Effective: Gains greater than 15
dB and less than 30 dB, and 4) Ineffective: less than 15 dB of gain.