Abstract：
Tinnitus, the perception of sound without an external source, affects 15% of the population, with 2.4% experiencing significant distress. In this review, we summarize the current state of knowledge about tinnitus management with a particular focus on the translation into clinical practice. In the first section, we analyze shortcomings, knowledge gaps, and challenges in the field of tinnitus research. Then, we highlight the relevance of the diagnostic process to account for tinnitus heterogeneity and to identify all relevant aspects of the tinnitus in an individual patient, such as etiological aspects, pathophysiological mechanisms, factors that contribute most to suffering, and comorbidities. In the next section, we review available treatment options, including counselling, cognitive-behavioral therapy (CBT), hearing aids and cochlear implants for patients with a relevant hearing loss, sound generators, novel auditory stimulation approaches, tinnitus retraining therapy (TRT), pharmacological treatment, neurofeedback, brain stimulation, bimodal stimulation, Internet- and app-based digital approaches, and alternative treatment approaches. The evidence for the effectiveness of the various treatment interventions varies considerably. We also discuss differences in current respective guideline recommendations and close with a discussion of how current pathophysiological knowledge, latest scientific evidence, and patient perspectives can be translated in patient-centered care.
摘要：
耳鸣,没有外部来源的声音感知，影响了15%的人口，2.4%的人经历了严重的痛苦。在这次审查中,我们总结了有关耳鸣管理的知识现状，特别着重于将其转化为临床实践。在第一部分,我们分析缺点，知识差距，以及耳鸣研究领域的挑战。然后，我们强调了诊断过程的相关性，以解释耳鸣的异质性，并确定耳鸣在个体患者的所有相关方面，如病因方面，病理生理机制，造成痛苦的因素，和合并症。在下一节中,我们回顾了可用的治疗方案，包括咨询,认知行为疗法（CBT），为相关听力损失的患者提供助听器和人工耳蜗，声音发生器,新颖的听觉刺激方法，耳鸣再训练疗法（TRT），药物治疗,神经反馈,大脑刺激,双峰刺激,基于互联网和应用程序的数字方法，和替代治疗方法。各种治疗干预措施的有效性的证据差异很大。我们还讨论了当前各自指南建议的差异，并最后讨论了当前的病理生理学知识，最新的科学证据,患者的观点可以转化为以患者为中心的护理。
