Ahmad Nadir, Seidman Michael
Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, West Bloomfield, 6777 West Maple Road, Detroit, MI 48327, USA.
Drugs Aging. 2004;21(5):297-305. doi: 10.2165/00002512-200421050-00002.
Tinnitus is the perception of sound in the absence of an apparent acoustic stimulus. More than 35 million Americans experience tinnitus, with 2-3 million severely debilitated by this distressing symptom. The prevalence increases with age and there is a high incidence associated with both noise-induced and age-related hearing loss. Although there are several theories regarding the pathophysiology of tinnitus, the precise mechanism remains to be elucidated. The most compelling of these is the hypothesis that tinnitus occurs as a result of spontaneous and aberrant neural activity at any level along the auditory axis, even after cochlear nerve transection or labyrinthine ablation. There are numerous aetiologies associated with tinnitus. Tinnitus, in clinical practice, is characterised as either objective or subjective. The distinction is relevant in terms of both aetiology and treatment. Despite a large number of therapeutic interventions and studies claiming success in treating tinnitus, a cure remains elusive. However, there are several potential treatment options that offer patients varying degrees of symptomatic improvement and enhanced quality of life. It is imperative to formulate a rational and systematic approach in evaluating an older adult with tinnitus. An individualised treatment regimen and the creation of a strong therapeutic relationship are the hallmarks of successful management of the patient with tinnitus.
耳鸣是在没有明显声刺激时出现的声音感知。超过3500万美国人患有耳鸣，其中200万至300万人因这种令人痛苦的症状而严重衰弱。患病率随年龄增长而增加，且与噪声性听力损失和年龄相关性听力损失的高发病率相关。尽管关于耳鸣的病理生理学有几种理论，但确切机制仍有待阐明。其中最有说服力的假说是，即使在听神经横断或迷路切除术后，耳鸣也是由于听觉轴上任何水平的自发和异常神经活动所致。耳鸣有多种病因。在临床实践中，耳鸣分为客观性耳鸣和主观性耳鸣。这种区分在病因和治疗方面都很重要。尽管有大量的治疗干预措施和研究声称在治疗耳鸣方面取得了成功，但仍然难以治愈。然而，有几种潜在的治疗选择可以为患者提供不同程度的症状改善和生活质量提高。在评估老年耳鸣患者时，制定合理、系统的方法至关重要。个性化的治疗方案以及建立牢固的治疗关系是成功管理耳鸣患者的标志。
