Treatment options for subjective tinnitus: self reports from a sample of general practitioners and ENT physicians within Europe and the USA.
Treatment options for subjective tinnitus: self reports from a sample of general practitioners and ENT physicians within Europe and the USA.
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DOI：
10.1186/1472-6963-11-302
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发表时间：
2011-11-04
影响因子：
2.8
通讯作者：
Langguth B
中科院分区：
文献类型：
--
作者：
Hall DA;Láinez MJ;Newman CW;Sanchez TG;Egler M;Tennigkeit F;Koch M;Langguth B
耳鸣影响着大约 10-15% 的普通人群，并且通过高音量收听个人音乐播放器而增加暴露于休闲噪音的风险正在增加。这种疾病具有相当大的异质性，因此没有单一的机制可以解释所有受影响的人都出现耳鸣。因此，对于这种情况，没有标准化的管理途径，也没有单一有效的治疗方法。临床干预的选择是一个基于多种因素的多因素决策，包括对患者需求和医疗保健环境的评估。本研究调查了六个西方国家的临床医生，目的是：a）建立转诊途径的范围，b）评估急性或慢性主观耳鸣类别的典型治疗方案，以及c）寻求有关当前实践标准满意度的临床意见。对 712 名医生进行了结构化在线调查问卷，这些医生报告在过去三个月内至少见过一名耳鸣患者。他们是来自美国、德国、英国、法国、意大利和西班牙的 370 名全科医生 (GP) 和 365 名耳鼻喉专家 (ENT)。我们对耳鸣卫生系统的国际比较表明，尽管各国耳鸣的特征大致相似，但患者对临床服务的体验却存在很大差异。全科医生和耳鼻喉科总是在某种程度上参与转诊和管理，但多学科团队聘请了神经病学（德国、意大利和西班牙）或听力学（英国和美国）专业人员。对于急性主观耳鸣，药物处方很常见，而对于慢性主观耳鸣，听力学和心理方法更为典型；一些具体的治疗方案因国家而异。所有治疗选择均与低满意度相关。尽管治疗方案多种多样，但耳鸣治疗的成功率很低，导致医生和患者都感到沮丧。特别是对于主观耳鸣，迫切需要有效的治疗方案以及有关关键诊断标准的指南。
Tinnitus affects about 10-15% of the general population and risks for developing tinnitus are rising through increased exposure to leisure noise through listening to personal music players at high volume. The disorder has a considerable heterogeneity and so no single mechanism is likely to explain the presence of tinnitus in all those affected. As such there is no standardized management pathway nor singly effective treatment for the condition. Choice of clinical intervention is a multi-factorial decision based on many factors, including assessment of patient needs and the healthcare context. The present research surveyed clinicians working in six Westernized countries with the aims: a) to establish the range of referral pathways, b) to evaluate the typical treatment options for categories of subjective tinnitus defined as acute or chronic, and c) to seek clinical opinion about levels of satisfaction with current standards of practice. A structured online questionnaire was conducted with 712 physicians who reported seeing at least one tinnitus patients in the previous three months. They were 370 general practitioners (GPs) and 365 ear-nose-throat specialists (ENTs) from the US, Germany, UK, France, Italy and Spain. Our international comparison of health systems for tinnitus revealed that although the characteristics of tinnitus appeared broadly similar across countries, the patient's experience of clinical services differed widely. GPs and ENTs were always involved in referral and management to some degree, but multi-disciplinary teams engaged either neurology (Germany, Italy and Spain) or audiology (UK and US) professionals. For acute subjective tinnitus, pharmacological prescriptions were common, while audiological and psychological approaches were more typical for chronic subjective tinnitus; with several specific treatment options being highly country specific. All therapy options were associated with low levels of satisfaction. Despite a large variety of treatment options, the low success rates of tinnitus therapy lead to frustration of physicians and patients alike. For subjective tinnitus in particular, effective therapeutic options with guidelines about key diagnostic criteria are urgently needed.
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DOI：
10.1111/j.1365-2753.2011.01696.x
发表时间：
2011-08-01
影响因子：
2.4
作者：
El-Shunnar, Suliman K.;Hoare, Derek J.;Hall, Deborah A.
通讯作者：
Hall, Deborah A.
影响因子：
3.1
作者：
HALLAM, RS;JAKES, SC;HINCHCLIFFE, R
通讯作者：
HINCHCLIFFE, R
DOI：
10.3109/03005364000000114
发表时间：
2000-02-01
期刊：
BRITISH JOURNAL OF AUDIOLOGY
影响因子：
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作者：
Erlandsson, SI;Hallberg, LRM
通讯作者：
Hallberg, LRM
影响因子：
2.6
作者：
Hoare, Derek J.;Kowalkowski, Victoria L.;Kang, Sujin;Hall, Deborah A.
通讯作者：
Hall, Deborah A.
影响因子：
2.8
作者：
Ahmad, N;Seidman, M
通讯作者：
Seidman, M