von Wedel H, Strahlmann U, Zorowka P
Universitäts-Hals-Nasen-Ohren-Klinik Köln.
Laryngorhinootologie. 1989 May;68(5):259-66.
To compare the benefits of different therapeutic methods in patients suffering from tinnitus persisting for more than one year, the results of a study with 462 patients are presented. Transtympanal electrical stimulation at the promontory, iontophoresis of lidocaine, EMG biofeedback and masking by hearing aids or tinnitus maskers are compared with regard to their therapeutic efficiency directly after the test period and half a year later. The results indicate the importance of controlling for placebo effect in assessing the therapeutic value of the first three methods (electrical stimulation, iontophoresis and biofeedback). For these therapies an improvement by only less than 10% could be attained compared to success rates of 60% reported in the literature. About 30% of the patients could be successfully equipped with hearing aids or tinnitus maskers, 60% showing a stable benefit over a period of three years. To compare the benefits of the different methods the features of tinnitus (pitch, loudness, type and stability of masking, residual inhibition) and the subjective scaling of the therapeutic efficiency are examined. With regard to other even more recent therapies, the fitting of hearing aids in patients with tinnitus plus hearing loss seems to be of utmost importance in combatting tinnitus.
为比较不同治疗方法对耳鸣持续一年以上患者的疗效，本文呈现了一项针对462例患者的研究结果。将鼓岬经鼓膜电刺激、利多卡因离子导入、肌电图生物反馈以及使用助听器或耳鸣掩蔽器进行掩蔽等方法，在试验期结束后及半年后，就其治疗效果进行了比较。结果表明，在评估前三种方法（电刺激、离子导入和生物反馈）的治疗价值时，控制安慰剂效应至关重要。与文献报道的60%的成功率相比，这些疗法的改善率仅不到10%。约30%的患者能够成功佩戴助听器或使用耳鸣掩蔽器，60%的患者在三年期间显示出稳定的疗效。为比较不同方法的疗效，研究了耳鸣的特征（音高、响度、掩蔽类型和稳定性、残余抑制）以及治疗效果的主观评分。关于其他更新的疗法，为耳鸣伴听力损失患者佩戴助听器在对抗耳鸣方面似乎至关重要。
