{"title":"前庭神经鞘瘤患者的耳鸣及其治疗。","authors":"Rachel Knappett, Marc Fagelson, Don J McFerran","doi":"10.1016/B978-0-12-824534-7.00041-X","DOIUrl":null,"url":null,"abstract":"<p><p>Tinnitus is the second most common presenting symptom of vestibular schwannoma (VS) after hearing loss. There is conflicting evidence regarding the impact of tinnitus and its contribution to the overall quality of life in VS, and there are many theories regarding the pathogenesis of tinnitus in VS, including cochlear, neural, and central mechanisms. Assessment should include speech audiometry in addition to pure-tone audiometry, as VS patients often have worse speech discrimination than would be expected from their pure-tone thresholds. There is no objective measure of tinnitus. Questionnaires may be used to assess the impact of tinnitus and its common comorbidities. Management of VS-associated tinnitus starts with explanation and counseling. Addressing hearing loss is often helpful: if the affected ear still has useful hearing, conventional hearing aids may be used. If there is no useful hearing on the affected side, contralateral routing of signal (CROS) hearing aids, bone conduction hearing implants (BCHI), or cochlear implantation may be beneficial. For patients with bilateral profound hearing loss following VS surgery, auditory brainstem implantation may help. Psychologic therapies, including cognitive behavioral therapy and mindfulness-based cognitive therapy, are commonly recommended for use in general tinnitus clinics, although there is no evidence base supporting these modalities for VS patients.</p>","PeriodicalId":12907,"journal":{"name":"Handbook of clinical neurology","volume":"212 ","pages":"417-431"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Tinnitus and its management in patients with vestibular schwannoma.\",\"authors\":\"Rachel Knappett, Marc Fagelson, Don J McFerran\",\"doi\":\"10.1016/B978-0-12-824534-7.00041-X\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Tinnitus is the second most common presenting symptom of vestibular schwannoma (VS) after hearing loss. There is conflicting evidence regarding the impact of tinnitus and its contribution to the overall quality of life in VS, and there are many theories regarding the pathogenesis of tinnitus in VS, including cochlear, neural, and central mechanisms. Assessment should include speech audiometry in addition to pure-tone audiometry, as VS patients often have worse speech discrimination than would be expected from their pure-tone thresholds. There is no objective measure of tinnitus. Questionnaires may be used to assess the impact of tinnitus and its common comorbidities. Management of VS-associated tinnitus starts with explanation and counseling. Addressing hearing loss is often helpful: if the affected ear still has useful hearing, conventional hearing aids may be used. If there is no useful hearing on the affected side, contralateral routing of signal (CROS) hearing aids, bone conduction hearing implants (BCHI), or cochlear implantation may be beneficial. For patients with bilateral profound hearing loss following VS surgery, auditory brainstem implantation may help. Psychologic therapies, including cognitive behavioral therapy and mindfulness-based cognitive therapy, are commonly recommended for use in general tinnitus clinics, although there is no evidence base supporting these modalities for VS patients.</p>\",\"PeriodicalId\":12907,\"journal\":{\"name\":\"Handbook of clinical neurology\",\"volume\":\"212 \",\"pages\":\"417-431\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Handbook of clinical neurology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/B978-0-12-824534-7.00041-X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Handbook of clinical neurology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/B978-0-12-824534-7.00041-X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
Tinnitus and its management in patients with vestibular schwannoma.
Tinnitus is the second most common presenting symptom of vestibular schwannoma (VS) after hearing loss. There is conflicting evidence regarding the impact of tinnitus and its contribution to the overall quality of life in VS, and there are many theories regarding the pathogenesis of tinnitus in VS, including cochlear, neural, and central mechanisms. Assessment should include speech audiometry in addition to pure-tone audiometry, as VS patients often have worse speech discrimination than would be expected from their pure-tone thresholds. There is no objective measure of tinnitus. Questionnaires may be used to assess the impact of tinnitus and its common comorbidities. Management of VS-associated tinnitus starts with explanation and counseling. Addressing hearing loss is often helpful: if the affected ear still has useful hearing, conventional hearing aids may be used. If there is no useful hearing on the affected side, contralateral routing of signal (CROS) hearing aids, bone conduction hearing implants (BCHI), or cochlear implantation may be beneficial. For patients with bilateral profound hearing loss following VS surgery, auditory brainstem implantation may help. Psychologic therapies, including cognitive behavioral therapy and mindfulness-based cognitive therapy, are commonly recommended for use in general tinnitus clinics, although there is no evidence base supporting these modalities for VS patients.
期刊介绍：
The Handbook of Clinical Neurology (HCN) was originally conceived and edited by Pierre Vinken and George Bruyn as a prestigious, multivolume reference work that would cover all the disorders encountered by clinicians and researchers engaged in neurology and allied fields. The first series of the Handbook (Volumes 1-44) was published between 1968 and 1982 and was followed by a second series (Volumes 45-78), guided by the same editors, which concluded in 2002. By that time, the Handbook had come to represent one of the largest scientific works ever published. In 2002, Professors Michael J. Aminoff, François Boller, and Dick F. Swaab took on the responsibility of supervising the third (current) series, the first volumes of which published in 2003. They have designed this series to encompass both clinical neurology and also the basic and clinical neurosciences that are its underpinning. Given the enormity and complexity of the accumulating literature, it is almost impossible to keep abreast of developments in the field, thus providing the raison d''être for the series. The series will thus appeal to clinicians and investigators alike, providing to each an added dimension. Now, more than 140 volumes after it began, the Handbook of Clinical Neurology series has an unparalleled reputation for providing the latest information on fundamental research on the operation of the nervous system in health and disease, comprehensive clinical information on neurological and related disorders, and up-to-date treatment protocols.
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