우리나라(한국) 대학병원의 주관적 이명 치료 현황
Current Trends in the Treatment of Subjective Tinnitus at University Hospitals in Korea
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Background and Objectives The effective management of subjective tinnitus should start with an accurate diagnosis based on an appropriate classification. Since there is no gold standard for managing subjective tinnitus, clinicians can select from various treatment options after considering the multifactorial etiology of tinnitus. This study surveyed otologists at university hospitals in Korea to identify the treatments used for subjective tinnitus and to obtain basic information on evidence-based medicine for treating tinnitus. Subjects and Method A five-major-item questionnaire on current tinnitus treatments was sent by email to otologists at 37 university hospitals in Korea; 30 (81.1%) replied. Results The mean incidence of tinnitus in otology outpatient clinics was 22.7% (range 10-40%). Common treatments were oral pharmacological therapy, regular counseling with tinnitus retraining or cognitive behavioral therapy and hearing aids. Tinnitus retraining therapy and hearing aids were considered the most effective when the visual analog scale scores were 7.0 and 6.6, respectively, and considered safe when the scores were 9.9 and 9.3. Ginkgo biloba and benzodiazepines were the most frequently prescribed drugs, although their reported effectiveness was questionable. Intra-tympanic steroid injection was not considered effective (3.8) or safe (6.3). Somatosensory-based treatments such as treating neck muscle or temporomandibular joint disorders were also used to relieve a subgroup of somatic tinnitus. Conclusion Our results showed trends similar to those in other countries, yet we have not reached the level of evidence-based clinical practice due to the lack of reliable and effective treatment options. Further research on tinnitus-treatments is needed, particularly about randomized controlled studies with blinding.
Abstract
Background and Objectives The effective management of subjective tinnitus should start with an accurate diagnosis based on an appropriate classification. Since there is no gold standard for managing subjective tinnitus, clinicians can select from various treatment options after considering the multifactorial etiology of tinnitus. This study surveyed otologists at university hospitals in Korea to identify the treatments used for subjective tinnitus and to obtain basic information on evidence-based medicine for treating tinnitus. Subjects and Method A five-major-item questionnaire on current tinnitus treatments was sent by email to otologists at 37 university hospitals in Korea; 30 (81.1%) replied. Results The mean incidence of tinnitus in otology outpatient clinics was 22.7% (range 10-40%). Common treatments were oral pharmacological therapy, regular counseling with tinnitus retraining or cognitive behavioral therapy and hearing aids. Tinnitus retraining therapy and hearing aids were considered the most effective when the visual analog scale scores were 7.0 and 6.6, respectively, and considered safe when the scores were 9.9 and 9.3. Ginkgo biloba and benzodiazepines were the most frequently prescribed drugs, although their reported effectiveness was questionable. Intra-tympanic steroid injection was not considered effective (3.8) or safe (6.3). Somatosensory-based treatments such as treating neck muscle or temporomandibular joint disorders were also used to relieve a subgroup of somatic tinnitus. Conclusion Our results showed trends similar to those in other countries, yet we have not reached the level of evidence-based clinical practice due to the lack of reliable and effective treatment options. Further research on tinnitus-treatments is needed, particularly about randomized controlled studies with blinding.
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