Kim Seung Ho, Kim Ikhee, Kim Hantai
Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon, KOR.
Cureus. 2024 Feb 25;16(2):e54861. doi: 10.7759/cureus.54861. eCollection 2024 Feb.
Many individuals seek medical attention for tinnitus, desiring relief from the distress caused by the condition; however, the treatment process is far from straightforward. The most effective treatments for chronic subjective tinnitus, such as tinnitus retraining therapy (TRT) and cognitive behavioral therapy (CBT), require considerable time and efforts. As a result, many of them express a desire for alleviation through medication. While it is true that medication is not generally recommended in treatment guidelines for chronic subjective tinnitus, in specific situations such as when accompanied by symptoms of depression or anxiety-drugs like antidepressants or anxiolytics may have a meaningful impact on symptom reduction. Additionally, medication can prove effective in certain specialized forms of tinnitus, such as typewriter tinnitus, as opposed to chronic subjective tinnitus. Although intratympanic dexamethasone injections for tinnitus have been reported to lack efficacy compared to a placebo, if patients perceive subjective satisfaction due to a placebo effect, it holds significance. From the perspective of patients suffering from tinnitus, even if the therapeutic mechanism is set aside, experiencing some degree of relief through certain medications can enhance compliance with evidence-based treatments like TRT and CBT.
许多人因耳鸣寻求医疗帮助,希望缓解该病症所带来的痛苦;然而,治疗过程绝非易事。对于慢性主观性耳鸣,最有效的治疗方法,如耳鸣习服疗法(TRT)和认知行为疗法(CBT),需要耗费大量时间和精力。因此,许多患者希望通过药物来缓解症状。虽然在慢性主观性耳鸣的治疗指南中,通常不推荐使用药物,但在某些特定情况下,如伴有抑郁或焦虑症状时,抗抑郁药或抗焦虑药等药物可能对减轻症状有显著作用。此外,药物在某些特殊类型的耳鸣中,如打字机样耳鸣,而非慢性主观性耳鸣,可能会被证明是有效的。尽管据报道,与安慰剂相比,鼓室内注射地塞米松治疗耳鸣缺乏疗效,但如果患者因安慰剂效应而感到主观满意,这也是有意义的。从耳鸣患者的角度来看,即使不考虑治疗机制,通过某些药物获得一定程度的缓解也可以提高对TRT和CBT等循证治疗的依从性。