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- Cima, RFF, et al.
(författare)
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Tinnitus healthcare: a survey revealing extensive variation in opinion and practices across Europe
- 2020
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 10:1, s. e029346-
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Tidskriftsartikel (refereegranskat)abstract
- Tinnitus remains a scientific and clinical problem whereby, in spite of increasing knowledge on effective treatment and management for tinnitus, very little impact on clinical practice has been observed. There is evidence that prolonged, obscure and indirect referral trajectories persist in usual tinnitus care.It is widely acknowledged that efforts to change professional practice are more successful if barriers are identified and implementation activities are systematically tailored to the specific determinants of practice. The aim of this study was to administer a health service evaluation survey to scope current practice and knowledge of standards in tinnitus care across Europe. The purpose of this survey was to specifically inform the development process of a European clinical guideline that would be implementable in all European countries.DesignA health service evaluation survey was carried out.SettingThe survey was carried out online across Europe.ParticipantsClinical experts, researchers and policy-makers involved in national tinnitus healthcare and decision-making.Outcome measuresA survey was developed by the study steering group, piloted on clinicians from the TINNET network and underwent two iterations before being finalised. The survey was then administered to clinicians and policy-makers from 24 European countries.ResultsData collected from 625 respondents revealed significant differences in national healthcare structures, use of tinnitus definitions, opinions on characteristics of patients with tinnitus, assessment procedures and particularly in available treatment options. Differences between northern and eastern European countries were most notable.ConclusionsMost European countries do not have national clinical guidelines for the management of tinnitus. Reflective of this, clinical practices in tinnitus healthcare vary dramatically across countries. This equates to inequities of care for people with tinnitus across Europe and an opportunity to introduce standards in the form of a European clinical guideline. This survey has highlighted important barriers and facilitators to the implementation of such a guideline.
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- Kampessis, G, et al.
(författare)
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Prospective Study on the Effectiveness of Low-Laser Therapy in the Treatment of Tinnitus
- 2009
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Ingår i: Skull base. - : Georg Thieme Verlag. - 1052-1453 .- 1532-0065 .- 1531-5010. ; 19:S 02
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aim: It is estimated that 10–15% of the general population suffers from tinnitus, including 60% of all otologic patients. Quality of life is reportedly affected in approximately 0.5% of tinnitus patients. The aim of this study is to investigate the role of low-laser therapy in alleviating the symptoms of tinnitus.Material and Methods: Seventeen tinnitus patients (8 men, 9 women) were included in the study. Tinnitus was identified by the patients either as their sole complaint, or as symptom within the context of other otologic diseases. A 0–5 Visual Analogue Scale (VAS) was used to personally quantify the severity of patients' symptoms. Treatment included the use of an external laser beam in the periauricular area and the external auditory canal, which was produced either by a GaAlAs (808 nm, 450 mW), or by a GaAs (904 nm, 240 mW) laser, for 4 and 2 minutes, respectively. The mean number of sessions for each patient was 17, and the mean duration of therapy was 4 weeks.Results: With regard to the severity of symptoms, the pretreatment mean score was 4.3, and the respected number after the intervention was 3.2. There was a consistent trend toward symptom improvement; however, the results were not statistically significant due to the small sample size. No side effects or deterioration of symptoms was reported.Conclusion: Low-laser therapy does seem to have some effect in alleviating tinnitus. However, additional studies are necessary to prove the actual efficacy of this treatment mode and to establish superior outcomes compared with placebo.
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- Kyrodimos, E., et al.
(författare)
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Cartilage tympanoplasty : a reliable technique for smokers
- 2014
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Ingår i: European Archives of Oto-Rhino-Laryngology. - : Springer. - 0937-4477 .- 1434-4726. ; 271:2, s. 255-260
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to report our experience with cartilage tympanoplasty (CT) in smokers and compare it with that of non-smokers using a retrospective chart review at a tertiary referral center. Between September 2008 and September 2010, cartilage tympanoplasty was performed in 52 patients. Among them, 27 were active smokers and 25 former or non-smokers. The entire tympanic membrane was replaced with conchal cartilage, shaped either as a shield for cases with intact canal wall mastoidectomies, or crashed for cases with canal wall down procedures. The mean post-operative follow-up was 12 months (range 6-18 months). A complete pre- and post-operative audiologic evaluation was obtained in all patients. Graft take was successful in all patients. The overall average pre-operative and post-operative pure tone average air-bone gaps (PTA-ABG) was 52.2 dB +/- A 17.7 dB and 35.4 dB +/- A 17.9 dB, respectively, with an overall improvement of 16.8 dB (p < 0.001). A post-operative PTA-ABG of 25 dB or less was achieved in 39 (75 %) patients (p < 0.001). In smokers, the hearing improvement was 17.6 dB (p < 0.001) with a PTA-ABG of 25 dB or less in 19 (70 %). In non-smokers, the average hearing improvement was 16.8 dB (p < 0.0005) with a post-operative PTA-ABG of 25 dB or less in 19 (76 %), (p < 0.001). The results showed that the CT technique is a very effective procedure for smokers. Excellent graft take and satisfactory hearing results can be accomplished regardless of smoking habits.
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- Trochidis, I, et al.
(författare)
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Systematic Review on Healthcare and Societal Costs of Tinnitus
- 2021
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Ingår i: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 18:13
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Tidskriftsartikel (refereegranskat)abstract
- Tinnitus disability is a heterogeneous and complex condition, affecting more than 10% and compromising the quality of life of 2% of the population, with multiple contributors, often unknown, and enigmatic pathophysiology. The available treatment options are unsatisfactory, as they can, at best, reduce tinnitus severity, but not eliminate its perception. Given the spread of tinnitus and the lack of a standardized treatment, it is crucial to understand the economic burden of this condition. We conducted a systematic review of the literature on PubMed/MEDLINE, Embase, the Cochrane Database of Systematic Reviews (CDSR) and Google Scholar, in order to identify all the articles published on the economic burden of tinnitus before 1 April 2021 (PROSPERO—International prospective register of systematic reviews—No: CRD42020180438). Out of 273 articles identified through our search strategy, only five articles from studies conducted in the United States of America (USA), the Netherlands and the United Kingdom (UK) provided data on tinnitus’s economic costs. Three studies provided mean annual estimates per patient ranging between EUR 1544 and EUR 3429 for healthcare costs, between EUR 69 and EUR 115 for patient and family costs and between EUR 2565 and EUR 3702 for indirect costs, including productivity loss. The other two studies reported an annual mean cost of EUR 564 per patient for tinnitus-related clinical visits, and total costs of EUR 1388 and EUR 3725 for patients treated with a sound generator and Neuromonics Tinnitus Treatment, respectively. Our comprehensive review shows a gap in the knowledge about the economic burden of tinnitus on healthcare systems, patients and society. The few available studies show considerable expenses due to healthcare and indirect costs, while out-of-pocket costs appear to be less financially burdensome. Comprehensive health economic evaluations are needed to fill the gaps in current knowledge, using a unified method with reliable and standardized tools.
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