Abbas Y, Smith G, Trinidade A
Department of Otolaryngology,Southend University Hospital NHS Foundation Trust,Westcliff-on-Sea,UK.
Department of Audiology,Southend University Hospital NHS Foundation Trust,Westcliff-on-Sea,UK.
J Laryngol Otol. 2018 Sep;132(9):786-789. doi: 10.1017/S0022215118001561. Epub 2018 Sep 10.
To determine whether patients within an otolaryngology department presenting with asymmetrical sensorineural hearing loss and/or unilateral tinnitus can be safely and cost-efficiently screened for acoustic neuroma by audiologists as a first or only point of contact.
A prospective case series and cost analysis were conducted at a tertiary referral centre. Between April 2013 and March 2017, 1126 adult patients presented to the audiology department with asymmetrical sensorineural hearing loss and/or unilateral tinnitus. All were screened for acoustic neuroma with magnetic resonance imaging, based on pre-determined criteria. The main outcome measure was the presence of acoustic neuroma or other pathology on magnetic resonance imaging.
Twenty-five patients (2.22 per cent) were found to have an acoustic neuroma (size range: 3-20 mm) and were referred to the otolaryngologist for further assessment. The remaining patients were appropriately managed and discharged by the audiologists without ENT input. This resulted in an overall cost saving of £164 850.
Patients with asymmetrical sensorineural hearing loss and/or unilateral tinnitus can be safely screened for acoustic neuroma and independently managed by audiologists as a first or only point of contact, resulting in considerable departmental cost savings.
确定在耳鼻喉科就诊的出现不对称感音神经性听力损失和/或单侧耳鸣的患者，是否可以由听力学家作为首要或唯一的接触点，安全且经济高效地进行听神经瘤筛查。
在一家三级转诊中心进行了一项前瞻性病例系列研究和成本分析。2013年4月至2017年3月期间，1126名成年患者因不对称感音神经性听力损失和/或单侧耳鸣到听力科就诊。所有患者均根据预先确定的标准接受磁共振成像听神经瘤筛查。主要结局指标是磁共振成像上是否存在听神经瘤或其他病变。
发现25名患者（2.22%）患有听神经瘤（大小范围：3 - 20毫米），并被转诊至耳鼻喉科医生处进行进一步评估。其余患者由听力学家进行适当管理并出院，无需耳鼻喉科医生介入。这导致总体节省成本164,850英镑。
对于出现不对称感音神经性听力损失和/或单侧耳鸣的患者，可以安全地进行听神经瘤筛查，并由听力学家作为首要或唯一的接触点进行独立管理，从而为科室节省大量成本。
