Abstract：
OBJECTIVE: Whiplash-associated disorder comprises of a constellation of persistent symptoms after neck trauma. Tinnitus that develops postwhiplash is termed somatosensory tinnitus. The objective is to assess the role of intermediate cervical plexus block (iCPB) in patients with somatosensory tinnitus secondary to whiplash.
METHODS: Prospective service evaluation in adults with whiplash-associated disorder and concomitant somatosensory tinnitus. Patients underwent specialist otorhinolaryngology review before pain clinic referral. Patients were offered ultrasound-guided iCPB with steroids. Intensity of tinnitus was recorded on a numerical rating scale at baseline, 3 and 6 months posttreatment. Brief Pain Inventory Short Form and Hospital Anxiety Depression Scale questionnaires were also completed.
RESULTS: Over a 36-month period, 32 patients with refractory somatosensory tinnitus following whiplash were offered iCPB(s). Two patients refused because of needle phobia. iCPB(s) was performed in 30 patients as an outpatient procedure. One patient (1/30, 3.3%) was lost to follow-up. Twenty-three patients (23/30, 77%) reported clinically significant reduction in intensity of tinnitus at 3 months postprocedure. Nineteen patients (19/30, 63%) reported ongoing benefit at 6-month follow-up. Six patients failed to report any benefit (6/30, 20%).
CONCLUSIONS: The cervical plexus could play a significant role in the development of somatosensory tinnitus after whiplash. iCPB may have a role in the management of somatosensory tinnitus in this cohort.
METHODS: Prospective service evaluation in adults with whiplash-associated disorder and concomitant somatosensory tinnitus. Patients underwent specialist otorhinolaryngology review before pain clinic referral. Patients were offered ultrasound-guided iCPB with steroids. Intensity of tinnitus was recorded on a numerical rating scale at baseline, 3 and 6 months posttreatment. Brief Pain Inventory Short Form and Hospital Anxiety Depression Scale questionnaires were also completed.
RESULTS: Over a 36-month period, 32 patients with refractory somatosensory tinnitus following whiplash were offered iCPB(s). Two patients refused because of needle phobia. iCPB(s) was performed in 30 patients as an outpatient procedure. One patient (1/30, 3.3%) was lost to follow-up. Twenty-three patients (23/30, 77%) reported clinically significant reduction in intensity of tinnitus at 3 months postprocedure. Nineteen patients (19/30, 63%) reported ongoing benefit at 6-month follow-up. Six patients failed to report any benefit (6/30, 20%).
CONCLUSIONS: The cervical plexus could play a significant role in the development of somatosensory tinnitus after whiplash. iCPB may have a role in the management of somatosensory tinnitus in this cohort.
摘要：
目的：鞭打相关疾病包括颈部创伤后一系列持续症状。发生鞭打后的耳鸣称为体感耳鸣。目的是评估中间颈丛阻滞（iCPB）在鞭打继发的体感耳鸣患者中的作用。
方法：对患有鞭打相关疾病和伴随体感耳鸣的成人进行前瞻性服务评估。患者在疼痛门诊转诊前接受了耳鼻咽喉科专科检查。为患者提供超声引导下的iCPB和类固醇。耳鸣的强度记录在基线的数字评级量表上，治疗后3个月和6个月。还完成了简短的疼痛量表和医院焦虑抑郁量表问卷。
结果：在36个月的时间里，向32例鞭打后难治性体感耳鸣患者提供iCPB（s）。两名患者因针头恐惧症而拒绝。在30例患者中进行了iCPB（s）作为门诊手术。1例患者（1/30，3.3%）失访。23例患者（23/30，77％）报告了术后3个月耳鸣强度的临床显着降低。19例患者（19/30，63%）在6个月随访时报告持续获益。6例患者未报告任何获益（6/30，20%）。
结论：颈丛在鞭打后体感耳鸣的发生发展中起重要作用。iCPB可能在该队列中的体感耳鸣管理中发挥作用。
方法：对患有鞭打相关疾病和伴随体感耳鸣的成人进行前瞻性服务评估。患者在疼痛门诊转诊前接受了耳鼻咽喉科专科检查。为患者提供超声引导下的iCPB和类固醇。耳鸣的强度记录在基线的数字评级量表上，治疗后3个月和6个月。还完成了简短的疼痛量表和医院焦虑抑郁量表问卷。
结果：在36个月的时间里，向32例鞭打后难治性体感耳鸣患者提供iCPB（s）。两名患者因针头恐惧症而拒绝。在30例患者中进行了iCPB（s）作为门诊手术。1例患者（1/30，3.3%）失访。23例患者（23/30，77％）报告了术后3个月耳鸣强度的临床显着降低。19例患者（19/30，63%）在6个月随访时报告持续获益。6例患者未报告任何获益（6/30，20%）。
结论：颈丛在鞭打后体感耳鸣的发生发展中起重要作用。iCPB可能在该队列中的体感耳鸣管理中发挥作用。
