Medical student in the Department of Otolaryngology at Queen's University in Kingston, Ont, at the time of writing.
Audiologist in the Department of Speech Language Pathology and Audiology at Hotel Dieu Hospital in Kingston.
Can Fam Physician. 2018 Jul;64(7):491-495.
To provide family physicians with an evidence-based and practical approach to managing patients with tinnitus.
MEDLINE was searched for English-language tinnitus guidelines and reviews. All such articles published between 1980 and 2016 were reviewed, with most providing level II and III evidence.
Tinnitus affects more than 40% of Canadians at least once in their lifetimes, most commonly older adults. Tinnitus is the perception of sound without external stimulation. It can greatly affect a patient's physical and psychological quality of life. Clinical history taking is directed at eliciting whether symptoms have a pulsatile or nonpulsatile quality, whether symptoms are unilateral or bilateral, and whether there is associated hearing loss. For tinnitus that is pulsatile or unilateral, referral to an otolaryngologist is recommended, as these qualities might be associated with more serious underlying conditions. Most patients with tinnitus can be managed with reassurance, conservative measures, and hearing aids if substantial hearing loss exists.
Family physicians play the primary role in managing patients with tinnitus and are well situated to address both the physiologic and the psychological manifestations. As tinnitus is very common, helping patients cope with the symptoms through conservative measures and reassurance can prove to have the best outcomes.
为家庭医生提供一种基于证据且实用的方法来管理耳鸣患者。
在 MEDLINE 上搜索了英文的耳鸣指南和综述。回顾了 1980 年至 2016 年间发表的所有此类文章，其中大多数提供了 II 级和 III 级证据。
耳鸣影响了超过 40%的加拿大人，一生中至少会经历一次，最常见于老年人。耳鸣是指没有外部刺激时感知到的声音。它会极大地影响患者的身体和心理健康。临床病史采集旨在确定症状是否具有脉动或非脉动性质，症状是单侧还是双侧，以及是否存在相关的听力损失。对于脉动或单侧的耳鸣，建议向耳鼻喉科医生转诊，因为这些特征可能与更严重的潜在疾病有关。对于存在明显听力损失的大多数耳鸣患者，可以通过安慰、保守治疗和助听器来进行管理。
家庭医生在管理耳鸣患者方面发挥着主要作用，他们非常适合处理生理和心理表现。由于耳鸣非常常见，通过保守治疗和安慰来帮助患者应对症状可以取得最佳效果。
