Henry James A, Zaugg Tara L, Schechter Martin A
VA Medical Center, Portland, OR 97207, USA.
Am J Audiol. 2005 Jun;14(1):21-48. doi: 10.1044/1059-0889(2005/004).
This article is the first of 2 that present basic guidelines for audiologists to provide clinical management of tinnitus. The method, termed audiologic tinnitus management (ATM), was developed to incorporate management strategies that can be implemented most efficiently by audiologists.
Development of ATM has been drawn from the clinical and research experience of the authors and numerous audiologists. Certain elements of ATM are adapted from the methods of tinnitus masking and tinnitus retraining therapy. Procedures are described in the present article for performing the intake assessment, while the companion article (J. A. Henry, T. L. Zaugg, & M. A. Schechter, 2005) describes treatment methodology.
Development of ATM has resulted in defined procedures to conduct a basic tinnitus assessment that includes written questionnaires, an intake interview, audiologic evaluation, and a psychoacoustic assessment of tinnitus perceptual characteristics. If patients report a sound tolerance problem (hyperacusis), loudness discomfort levels are measured at audiometric frequencies. There are special procedures for selecting hearing aids, ear-level noise generators, combination devices (noise generator and hearing aid combined), and personal listening devices (i.e., portable radios and tape, CD, and MP3 players).
This article explains each of these assessment components in detail. Adoption of the ATM assessment protocol by audiologists can contribute to the establishment of uniform procedures for the clinical management of tinnitus patients.
本文是介绍听力学家耳鸣临床管理基本指南的两篇文章中的第一篇。该方法称为听力学耳鸣管理(ATM),旨在纳入听力学家能够最有效实施的管理策略。
ATM的制定借鉴了作者以及众多听力学家的临床和研究经验。ATM的某些要素改编自耳鸣掩蔽和耳鸣再训练疗法。本文描述了进行初次评估的程序,而配套文章(J. A. 亨利、T. L. 佐格和M. A. 谢克特,2005年)描述了治疗方法。
ATM的制定产生了明确的程序,用于进行基本的耳鸣评估,包括书面问卷、初次访谈、听力学评估以及对耳鸣感知特征的心理声学评估。如果患者报告有声音耐受性问题(听觉过敏),则在听力测试频率下测量响度不适水平。在选择助听器、耳背式噪声发生器、组合设备(噪声发生器和助听器组合)以及个人听力设备(即便携式收音机和磁带、CD和MP3播放器)方面有特殊程序。
本文详细解释了这些评估组成部分。听力学家采用ATM评估方案有助于为耳鸣患者的临床管理建立统一程序。