Department of Communicative Disorders and Sciences, Center for Hearing and Deafness, State University of New York at Buffalo, Buffalo, New York.
Innovation Centre Toronto, Sonova Canada, Mississauga, Ontario.
J Am Acad Audiol. 2022 Feb;33(2):75-81. doi: 10.1055/s-0041-1736576. Epub 2022 Sep 1.
Tinnitus is a prevalent auditory disorder that can become severely debilitating. Despite decades of investigation, there remains no conclusive cure for tinnitus. Clinical practice guidelines (CPGs) are available for assessing and managing tinnitus. Even though such guidelines have been available for several years, the degree that audiologists adhere to them has remained unexplored.
To determine what clinical practices are commonly used by audiologists in the assessment and management of the patient population with tinnitus, we administered an online survey to audiologists practicing in the United States and Canada.
Among the audiologists that completed the survey and were included in the final analysis ( = 61), 70% were from the United States and 30% were from Canada. The audiologists represented a wide range of clinical experience (1-35 years). On average, those who completed the survey were relatively confident in their ability to assess and manage tinnitus patients indicated by a 0 to 100 Likert scale, with 0 representing no confidence (mean 72.5, ± 21.5 standard deviation). The most commonly reported tinnitus assessment tools were pure tone audiogram (0.25-8 kHz), administration of standardized questionnaires, and tinnitus pitch and loudness matching. Approximately half (55%) of audiologists indicated they include otoacoustic emissions, while less audiologists (<40%) reported measuring high-frequency thresholds, minimum masking levels, or loudness discomfort levels. The most common recommendation for tinnitus patients was amplification (87%), followed by counseling (80%) and sound therapy (79%).
Few audiologists administer a truly comprehensive tinnitus assessment and ∼20% indicated not recommending counseling or sound therapy to manage tinnitus. The results are discussed in the context of what is explicitly indicated in published CPGs, professional organization recommendations, and recent findings of peer-reviewed literature.
耳鸣是一种普遍的听觉障碍，可能会严重致残。尽管经过几十年的研究，耳鸣仍然没有明确的治愈方法。临床实践指南（CPGs）可用于评估和管理耳鸣。尽管这些指南已经存在了几年，但听力学家对它们的遵守程度仍未得到探索。
为了确定听力学家在评估和管理耳鸣患者群体时通常使用哪些临床实践，我们向在美国和加拿大执业的听力学家进行了在线调查。
在完成调查并纳入最终分析的听力学家中（ = 61），70%来自美国，30%来自加拿大。听力学家代表了广泛的临床经验（1-35 年）。平均而言，那些完成调查的人对自己评估和管理耳鸣患者的能力相对有信心，用 0 到 100 的李克特量表表示，0 表示没有信心（平均 72.5， ± 21.5 标准差）。报告的最常见耳鸣评估工具是纯音听力图（0.25-8 kHz）、标准化问卷的管理以及耳鸣音调和响度匹配。大约一半（55%）的听力学家表示他们包括耳声发射，而较少的听力学家（<40%）报告测量高频阈值、最小掩蔽水平或响度不适水平。对耳鸣患者最常见的建议是放大（87%），其次是咨询（80%）和声音疗法（79%）。
很少有听力学家进行真正全面的耳鸣评估，约 20%的听力学家表示不建议通过咨询或声音疗法来管理耳鸣。结果在发表的 CPG、专业组织建议和最近的同行评议文献中明确指出的内容的背景下进行了讨论。
