Alzahrani Lama, Sereda Magdalena, Chamouton Carla Salles, Haider Háula, Dewey Rebecca Susan, Hoare Derek J
NIHR Nottingham Biomedical Research Centre, Nottingham, United Kingdom.
Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
Front Neurol. 2022 Oct 28;13:1004059. doi: 10.3389/fneur.2022.1004059. eCollection 2022.
Tinnitus is defined as the subjective perception of sound in the absence of an external stimulus, and tinnitus disorder becomes relevant when it is associated with emotional distress, cognitive dysfunction, and/or autonomic arousal. Hearing loss is recognized as the main risk factor for the pathogenesis of tinnitus. However, clinical guidelines for tinnitus disorder provide little direction for those who have severe-to-profound hearing loss including those who are pre-lingually Deaf. The aim of this scoping review was to catalogue what is known from the existing literature regarding the experience and management of tinnitus in adults who have a severe-to-profound hearing loss.
A scoping review was conducted following the Preferred Reporting Item for Systematic Reviews and Meta-analysis extension for Scoping Reviews. Records were included if they reported an evaluation of tinnitus in adults who had severe-to-profound hearing loss. The online databases Ovid (MEDLINE, EMBASE and PsycINFO), CINAHL, ProQuest, Scopus, and Google Scholar were searched using the search terms 'tinnitus' (as a MESH term) and 'deaf' OR 'profound hearing loss. Thirty-five records met the inclusion criteria for this review and were cataloged according to three major themes: Impact of tinnitus in deaf adults; Primary treatment of tinnitus in deaf adults; and Cochlear implant studies where tinnitus was a secondary outcome. Tinnitus symptom severity was assessed before and after intervention using tinnitus validated questionnaires in 29 records, with six further records using other assessment tools to measure tinnitus severity. Participants using cochlear implants were included in 30 studies. Medication, repetitive transcranial magnetic stimulation (rTMS), electrical promontory stimulation, and behavioral self-control therapy were each reported in single records.
This scoping review cataloged the experience, assessment, and treatment of tinnitus in adults who have severe-to-profound hearing loss. It is shown that there is very limited research reported in this field. Although this review included many records, most focused on the provision of cochlear implants for severe-to-profound hearing loss, with assessment and measurement of tinnitus as a baseline or secondary outcome. Largely missing in the literature are empirical studies that seek firstly to understand the nature of the experience of tinnitus by people with no or little residual access to external sound.
耳鸣被定义为在没有外部刺激时对声音的主观感知，当耳鸣与情绪困扰、认知功能障碍和/或自主神经觉醒相关时，耳鸣障碍就变得具有重要意义。听力损失被认为是耳鸣发病机制的主要危险因素。然而，耳鸣障碍的临床指南对于那些患有重度至极重度听力损失的人，包括那些语前聋患者，几乎没有提供指导。本范围综述的目的是梳理现有文献中关于重度至极重度听力损失成人耳鸣体验及管理的已知情况。
按照系统评价与Meta分析扩展版的首选报告项目进行了范围综述。如果记录报告了对重度至极重度听力损失成人耳鸣的评估，则将其纳入。使用搜索词“耳鸣”（作为医学主题词）以及“聋”或“重度听力损失”对在线数据库Ovid（MEDLINE、EMBASE和PsycINFO）、CINAHL、ProQuest、Scopus和谷歌学术进行了检索。35条记录符合本综述的纳入标准，并根据三个主要主题进行了分类：耳鸣对成年聋人的影响；成年聋人耳鸣的主要治疗方法；以及耳鸣作为次要结果的人工耳蜗研究。在29条记录中，使用经过验证的耳鸣问卷在干预前后评估了耳鸣症状严重程度，另外6条记录使用其他评估工具来测量耳鸣严重程度。30项研究纳入了使用人工耳蜗的参与者。单一记录中分别报告了药物治疗、重复经颅磁刺激（rTMS）、电鼓岬刺激和行为自我控制疗法。
本范围综述梳理了重度至极重度听力损失成人耳鸣的体验、评估和治疗情况。结果表明，该领域报告的研究非常有限。尽管本综述纳入了许多记录，但大多数聚焦于为重度至极重度听力损失患者提供人工耳蜗，将耳鸣评估和测量作为基线或次要结果。文献中很大程度上缺少首先旨在了解几乎没有或完全没有外部声音残余听力的人耳鸣体验本质的实证研究。
