Hearing Center, Department of Otolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China.
Department of Otolaryngology-Head and Neck Surgery, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Tujia and Miao Autonomous Prefecture, China.
Eur Arch Otorhinolaryngol. 2024 Sep;281(9):4507-4517. doi: 10.1007/s00405-024-08633-w. Epub 2024 Apr 17.
An up-to-date overview of epidemiology, etiology and pathophysiological mechanisms, diagnostic and evaluation methods, current treatment status and future directions of subjective tinnitus in adults.
Review of current evidence-based literature on subjective tinnitus in adults.
The prevalence of subjective tinnitus in the adult population is estimated to be around 14%, and it tends to increase with age. Subjective tinnitus is a complex condition with multiple factors contributing to its origin. However, the exact causes and underlying mechanisms remain unknown. Potential causes may include hearing loss, dysfunction in the somatosensory system, and auditory cortical dysfunction, although severe underlying pathology is rare. Currently, diagnosis primarily relies on patient self-reported medical history and physician-based clinical assessment due to the lack of objective testing. Various treatment and management options have been proposed, but their effectiveness varies, and there is no universally agreed-upon treatment option.
Tinnitus is a complex and heterogeneous disease with a high incidence rate and a tendency to increase with age. A holistic perspective is needed to understand the generation, perception, and emotional responses to tinnitus. Diagnosis requires a comprehensive assessment based on medical history and relevant examinations, identification of concurrent psychosomatic comorbidities, and active pursuit of objective diagnostic methods. At the same time, on the basis of existing treatment plans and combining emerging technologies, we will develop new personalized, precise, and combined treatment plans.
综述成人主观性耳鸣的流行病学、病因学和病理生理学机制、诊断和评估方法、当前治疗现状及未来方向。
对成人主观性耳鸣的现有循证文献进行综述。
成人主观性耳鸣的患病率估计在 14%左右,且随年龄增长而增加。主观性耳鸣是一种复杂的病症,多种因素与其起源有关。然而,确切的病因和潜在机制仍不清楚。潜在的原因可能包括听力损失、躯体感觉系统功能障碍和听觉皮层功能障碍,尽管严重的潜在病理很少见。目前,由于缺乏客观测试,诊断主要依赖于患者的自我报告病史和医生的临床评估。已经提出了各种治疗和管理选择,但它们的有效性各不相同,并且没有普遍认可的治疗选择。
耳鸣是一种复杂且具有异质性的疾病,发病率高,且随年龄增长而增加。需要从整体角度理解耳鸣的产生、感知和对情绪的反应。诊断需要基于病史和相关检查进行全面评估,识别并存的身心共病,并积极寻求客观的诊断方法。同时,在现有治疗方案的基础上,结合新兴技术,制定新的个性化、精准、综合的治疗方案。