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声疗法对既往治疗无效的耳鸣患者的有效性:调整的重要性。

Effectiveness of sound therapy in patients with tinnitus resistant to previous treatments: importance of adjustments.

作者信息

Barros Suzuki Flavia Alencar de, Suzuki Fabio Akira, Yonamine Fernando Kaoru, Onishi Ektor Tsuneo, Penido Norma Oliveira

机构信息

Health Sciences, Department of Otolaryngology and Head and Neck Surgery, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil.

Health Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP), São Paulo, SP, Brazil.

出版信息

Braz J Otorhinolaryngol. 2016 May-Jun;82(3):297-303. doi: 10.1016/j.bjorl.2015.05.009. Epub 2015 Oct 16.

Abstract

INTRODUCTION

The difficulty in choosing the appropriate therapy for chronic tinnitus relates to the variable impact on the quality of life of affected patients and, thus, requires individualization of treatment.

OBJECTIVE

To evaluate the effectiveness of using sound generators with individual adjustments to relieve tinnitus in patients unresponsive to previous treatments.

METHODS

A prospective study of 10 patients with chronic tinnitus who were unresponsive to previous drug treatments, five males and five females, with ages ranging from 41 to 78 years. Bilateral sound generators (Reach 62 or Mind 9 models) were used daily for at least 6h during 18 months. The patients were evaluated at the beginning, after 1 month and at each 3 months until 18 months through acuphenometry, minimum masking level, the Tinnitus Handicap Inventory, visual analog scale, and the Hospital Anxiety and Depression Scale. The sound generators were adjusted at each visit.

RESULTS

There was a reduction of Tinnitus Handicap Inventory in nine patients using a protocol with a customized approach, independent of psychoacoustic characteristics of tinnitus. The best response to treatment occurred in those with whistle-type tinnitus. A correlation among the adjustments and tinnitus loudness and minimum masking level was found. Only one patient, who had indication of depression by Hospital Anxiety and Depression Scale, did not respond to sound therapy.

CONCLUSION

There was improvement in quality of life (Tinnitus Handicap Inventory), with good response to sound therapy using customized settings in patients who did not respond to previous treatments for tinnitus.

摘要

引言

为慢性耳鸣选择合适治疗方法存在困难,这与对受影响患者生活质量的不同影响有关,因此需要个体化治疗。

目的

评估使用可个体化调节的声音发生器缓解对先前治疗无反应的患者耳鸣的有效性。

方法

对10例对先前药物治疗无反应的慢性耳鸣患者进行前瞻性研究,其中男性5例,女性5例,年龄41至78岁。在18个月期间,每天至少使用6小时双侧声音发生器(Reach 62或Mind 9型号)。在开始时、1个月后以及每3个月直至18个月时,通过测听法、最小掩蔽级、耳鸣障碍量表、视觉模拟量表和医院焦虑抑郁量表对患者进行评估。每次就诊时都对声音发生器进行调整。

结果

采用定制方法的方案使9例患者的耳鸣障碍量表得分降低,与耳鸣的心理声学特征无关。对哨声型耳鸣患者的治疗反应最佳。发现调整与耳鸣响度和最小掩蔽级之间存在相关性。只有1例通过医院焦虑抑郁量表显示有抑郁迹象的患者对声音疗法无反应。

结论

对于先前耳鸣治疗无反应的患者,使用定制设置的声音疗法可改善生活质量(耳鸣障碍量表),且反应良好。

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