Zarenoe Reza, Ledin Torbjörn
Division of Oto-Rhino-Laryngology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Auris Nasus Larynx. 2013 Feb;40(1):41-5. doi: 10.1016/j.anl.2012.05.005. Epub 2012 May 29.
We aimed to describe a large cohort of patients with tinnitus and sensorineural hearing loss (SNHL) in Sweden, and also to explore the possibility of finding potential possible differences between various diagnoses within SNHL. It is also of great interest to see how a multidisciplinary team was used in the different subgroups and the frequency of hearing aids use in patients with tinnitus.
Medical records of all patients who had received the diagnosis SNHL in Östergötland County, Sweden between 2004 and 2007 were reviewed. Patients between 20 and 80 years with tinnitus and a pure tone average (PTA) lower than 70dB HL were included in the study. Patients were excluded from the analyses if they had a cochlear implantation, middle ear disorders or had a hearing loss since birth or childhood. The investigators completed a form for each included patient, covering background facts, and audiograms taken at the yearly check up.
Of a total 1672 patients' medical record review, 714 patients were included. The majority of patients (79%) were in the age group over 50 years. In male patients with bilateral tinnitus, the PTA for the left ear was significantly higher than for the right ear. The results regarding the configuration of hearing loss revealed that 555 patients (78%) had symmetric and 159 (22%) asymmetric hearing loss. Retrocochlear examinations were done in 372 patients and MRI was the most common examination. In all patients, 400 had no hearing aids and out of those 220 had unilateral tinnitus and 180 patients had bilateral tinnitus. 219 patients had a PTA>20dB HL and did not have any hearing aid. Results demonstrated that the Stepped Care model was not used widely in the daily practice. In our study, patients with bilateral-, unilateral hearing loss or Mb Ménière were the most common patients included in the Stepped Care model.
In a large cohort of patients with SNHL and tinnitus, despite their hearing loss only 39% had hearing aids. It was observed that the medical record review often showed a lack of information about many background factors, such as; patients' general health condition, which could be a quality factor that needs improvement. Our results show that the Stepped Care model could be an effective option for providing a better access for tinnitus-focused treatment, although the number of patients in this study who were included in the Stepped Care model was low.
我们旨在描述瑞典一大群患有耳鸣和感音神经性听力损失（SNHL）的患者，并探讨在SNHL的各种诊断之间发现潜在差异的可能性。观察多学科团队在不同亚组中的使用方式以及耳鸣患者使用助听器的频率也非常有趣。
回顾了2004年至2007年期间在瑞典东约特兰郡被诊断为SNHL的所有患者的病历。年龄在20至80岁之间、患有耳鸣且纯音平均听阈（PTA）低于70dB HL的患者被纳入研究。如果患者接受过人工耳蜗植入、患有中耳疾病或自出生或童年起就有听力损失，则被排除在分析之外。研究人员为每位纳入的患者填写了一份表格，涵盖背景信息以及年度检查时的听力图。
在总共1672份患者病历回顾中，有714名患者被纳入。大多数患者（79%）年龄在50岁以上。在患有双侧耳鸣的男性患者中，左耳的PTA显著高于右耳。关于听力损失类型的结果显示，555名患者（78%）为对称听力损失，159名患者（22%）为不对称听力损失。对372名患者进行了蜗后检查，其中MRI是最常见的检查。在所有患者中，400名没有使用助听器，其中220名患有单侧耳鸣，180名患有双侧耳鸣。219名患者的PTA>20dB HL且没有使用任何助听器。结果表明，阶梯式护理模式在日常实践中并未得到广泛应用。在我们的研究中，双侧、单侧听力损失或梅尼埃病患者是阶梯式护理模式中最常见的纳入患者类型。
在一大群患有SNHL和耳鸣的患者中，尽管他们有听力损失，但只有39%的患者使用了助听器。据观察，病历回顾往往显示缺乏许多背景因素的信息，例如患者的总体健康状况，这可能是一个需要改进的质量因素。我们的结果表明，阶梯式护理模式可能是一种有效的选择，可为以耳鸣为重点的治疗提供更好的途径，尽管本研究中纳入阶梯式护理模式的患者数量较少。
