CCTV International March 3, 2004 15:50
1, Deputy Chief Physician Chen Xiuwu has been engaged in clinical and basic research on inner ear diseases in the Institute of Otolaryngology, Beijing Tongren Hospital for many years, focusing on related topics of clinical audiology. He is good at the diagnosis and treatment of tinnitus, deafness and peripheral vertigo, and has published many papers at home and abroad. The project he presided over won the Beijing Science and Technology Progress Award. (Left)
2. Deputy Chief Physician Li Yongxin is in the Department of Otolaryngology, Beijing Tongren Hospital. Li Yongxin has been engaged in the clinical and scientific research work of otoneurosurgery, especially the research progress paper of cochlear implant, which was published in national academic journals since he received his doctorate from Capital Medical University in 2000. (right)
Moderator: Hello, audience friends! This is CCTV's live program "The Road to Health". Today we will talk about tinnitus.
Today is the fifth National Ear Love Day. The theme of this activity is to prevent deafness from entering the community. In response to the government's call, the Department of Otolaryngology, Beijing Tongren Hospital and Beijing Institute of Otolaryngology organized more than 10 well-known experts in otology and audiology to go to the Foreign Affairs Street community of Jianguomen Street for free consultation, on-site consultation with residents in doubt, and on-site diagnosis of the masses by using modern sound measurement technology.
Moderator: Next is the content of the live interview. Let's watch a short film and listen to some voices around us. Sound affects our mood, and some people around us are describing the sounds that bother them.
Man: Sometimes one ear is stuffy, and sometimes it feels like the wind. Sometimes I think I'm in the bathroom.
Man: I always feel like a cicada is buzzing in my ear.
Man: There is always the sound of water to boil.
Man: I always feel a purring sound. Like a train ringing, I feel tinnitus worse than hearing it.
Moderator: Are there many patients who go to the hospital to see tinnitus?
Chen Xiuwu: Many. For example, our hearing center mainly treats patients with tinnitus, deafness and dizziness, among which tinnitus patients account for about 50% of the outpatient service.
Li Yongxin: Actually, most people have had transient tinnitus, but usually these transient tinnitus will not cause great harm to human body, which is different from the clinical tinnitus patients.
Moderator: Just now, a patient said, "I would rather not hear the sound than have tinnitus." Is tinnitus so painful?
Li Yongxin: We doctors, especially otologists, should try our best to understand the depth of patients' pain. Even so, it is difficult for us to enter the painful world of patients. This is because tinnitus is a subjective feeling of patients and a unilateral complaint of patients, which is difficult for others to feel.
Chen Xiuwu: I often meet such patients in the clinic. They are often in great pain. I met a patient a few days ago. He often practices shooting because of his work. Every time he comes back, he always feels that his ears are ringing badly all day, which is unbearable. The patient said to me, "I really want to get rid of the sound in my ears, even if I make my ears completely deaf."
Moderator: So where did this voice come from?
Chen Xiuwu: This kind of sound may be caused by abnormal nerve excitement after a certain area of the cochlea is diseased. After this excitement is felt by our cerebral cortex, it will have an impact on our limbic system, and then mobilize our emotions. After our emotions are affected, we will be more sensitive to this reaction and think it is an external stimulus. This external stimulus (sound) will make us pay more attention to tinnitus, and the cerebral cortex will form a worse mood after paying attention to this situation again. Specifically, after a certain area in the ear is damaged, it can emit sounds with different frequencies and feel tinnitus with different frequencies. For example, low-frequency tinnitus will appear when the cochlea is damaged at low frequency, and high-frequency tinnitus will appear when it is damaged at high frequency, which is the case in most patients.
Moderator: We know some friends with tinnitus through a short film:
Patient Zhang: I have been ringing in my ears, especially these two or three days. Two or three months before this symptom appeared, blood pressure fluctuated, sometimes exceeding 150.
Reporter: Hearing examination found that there were some obstacles in hearing in the right ear.
Chen Xiuwu: The reason is still nervousness and fatigue. It may still be related to blood supply, and the blood vessels are cramped, because the blood vessels in his ears are relatively small and the circulation is not good. You can check whether the blood lipid is high or not in the future.
Reporter: Another Miss Liu also rushed to the hospital early in the morning to see tinnitus.
Patient Miss Liu: I feel very loud when I lie down at night. I always want to sleep, but I can't sleep because there is always a sound beside my ear.
Reporter: The doctor arranged for her to have a hearing test according to the situation she described.
Chen Xiuwu: Judging from her hearing examination and chief complaint, she is bilateral sensorineural deafness.
Patient: I probably ate penicillin when my tonsils were inflamed when I was a child. Sometimes the batch number of penicillin is expired, so if you can't eat it, you can eat it clearly. The doctor said it might be tinnitus caused by Qingda.
Reporter: Let's look at the situation of a lady Huang. Her tinnitus is accompanied by severe hearing loss.
Patient Ms. Huang: I found it when I answered the phone, because I found the phone voice was too low. Occasionally, I changed my ear and found that it was actually quite loud.
Reporter: The examination results confirm that Ms. Huang has a tumor on her auditory nerve. For such a result, Ms. Huang and her family are somewhat surprised.
Chen Xiuwu: The first patient was due to high blood pressure. Hypertension patients have certain arteriosclerosis, which will also affect the small blood vessels in the ear. If vasospasm occurs, the peripheral resistance will increase and the blood supply to the ear will be affected.
Moderator: We all know that improper use of drugs can lead to deafness and tinnitus. Why?
Li Yongxin: The symptoms of tinnitus and deafness will be accompanied by drug damage to the inner ear. Such patients often only pay attention to tinnitus when they see a doctor, and they can hardly feel deafness, but they can often find hearing loss after examination.
Moderator: Another patient found that his hearing in one ear was obviously worse than that in the other when he was on the phone. Why?
Li Yongxin: This patient is an acoustic neuroma patient. Acoustic neuromas usually occur on one side. The early symptoms are tinnitus, accompanied by hearing loss and even dizziness. Therefore, clinicians should attach great importance to unilateral tinnitus, deafness and dizziness.
Chen Xiuwu: Tinnitus can be caused by otogenic diseases or non-otogenic diseases. Otogenic diseases mainly include external ear diseases, middle ear diseases and inner ear diseases. There are other systemic diseases that can also cause tinnitus, such as kidney disease, diabetes, hypertension, hyperthyroidism, hypothyroidism and so on.
Li Yongxin: Tinnitus is often a precursor or alarm system of other diseases, so we must attach great importance to it.
Moderator: Can you judge what tinnitus is by its sound size or sound characteristics?
Chen Xiuwu: Sometimes. For example, if it is low-frequency tinnitus, it may be a problem with the middle ear or the inner ear. It is necessary to go to the hospital for examination in time, which cannot be ignored. There are also some patients with high-frequency tinnitus, which may be persistent or intermittent, and we should also pay attention to them. There are also some drug-induced tinnitus, because drug poisoning has a relatively large damage to the cochlea, so the range of tinnitus is relatively wide.
Moderator: Can doctors make accurate judgments through these descriptions?
Li Yongxin: It's not complete. Because every patient we see has different expression ability, different occupation and different education, the symptoms described by patients are a feeling of chief complaint after all, and the most important thing is to look at the results of objective examination. The previous examination was vestibular function examination, and other examinations included hearing examination. The most definite diagnosis should also be imaging examination, such as high-resolution CT or magnetic resonance imaging, to determine whether there is a long tumor on the auditory nerve.
Moderator: Mr. Xue from Nanjing, 59 years old. Three days ago, I suddenly felt that my left ear was blocked, with low-frequency tinnitus and hearing loss. Today, I am back to normal. In the past two years, there have been similar attacks, such as ear blockage or tinnitus, followed by hearing loss and dizziness, accompanied by nausea and vomiting. What kind of disease is this?
Chen Xiuwu: Judging from the basic information he provided, it seems a bit like Meniere's disease. There are four symptoms of this disease, namely tinnitus, deafness, dizziness and earplugs. One of the characteristics of this disease is that tinnitus can be the first complaint in acute phase.
Moderator: Ms. Qian, a 20-year-old college student in Guangzhou, has bilateral tinnitus for two months. I usually like to wear a walkman to listen to music, especially loud rock music. Often fall asleep with headphones on. Is this bad for my ears?
Li Yongxin: It must be bad for your ears. Long-term use of walkman will cause damage to cochlear hair cells. Teenagers are advised not to listen to walkman for a long time.
Moderator: Ms. Guo from Guangxi, 47 years old. I have been suffering from menopausal syndrome 1 year. Often flustered and sweaty. Tinnitus in recent months is obvious when sleeping. What's going on here? Can tinnitus disappear?
Chen Xiuwu: This may be menopausal syndrome. Because of hormone metabolism disorder, a series of symptoms will appear in clinic, including tinnitus.
Compere: Can psychological stress cause tinnitus?
Chen Xiuwu: Yes. Let's look at a picture: every organ will respond to nervous tension. For example, when people in ancient times saw wild animals, their hearts beat faster, they were short of breath, nervous, alert and nervous. People in modern society are different from those in ancient times. For example, all kinds of pressures in work and life have different forms of tension. Generally speaking, the heart does not accelerate like that, breathing does not accelerate, and it is not particularly alert. However, this kind of pressure exists for a long time and cannot be avoided. It may cause tinnitus after a long time.
Li Yongxin: Actually, otolaryngologists are not psychologists, but they are also responsible for tinnitus patients caused by psychological factors.
Chen Xiuwu: It is mainly to enlighten patients, carry out proper examination, and understand the specific situation of tinnitus through tinnitus matching, which is helpful to relieve symptoms. Specific to the treatment, we have a method (masking therapy) that uses contrast effect, such as candles are brighter in the dark and tinnitus is more obvious in a quiet environment.
Li Yongxin: There is a special masking instrument that can make patients hear pleasant sounds, thus helping them forget annoying tinnitus.
Chen Xiuwu: In fact, it is to let patients have an adaptation process to tinnitus.
Compere: Is there any medicine that can help tinnitus patients?
Chen Xiuwu: Drug therapy is also a very important aspect, such as using some sedatives to help patients adjust their sleep, as well as antidepressants, vasodilators, antipsychotics and nutritional drugs. Other Chinese medicines, such as Liuwei Dihuang Pill, can be used to treat tinnitus.
Compere: Do patients with tinnitus need surgery to solve the problem?
Li Yongxin: Yes. In our past medical history, otology surgery is actually a helpless method, and the surgical effect is not very satisfactory.
Moderator: Hospital Tel: (010) 65129911-2362; Clinic hours Chen Xiuwu Tuesday morning Friday all day Li Yongxin Tuesday Wednesday afternoon.