Treatment Guidelines for Doctors

[dochoppy]

Until just about a week ago, there were really no clinical guidelines for doctors to treat tinnitus. We now actually have a formal set of guidelines to go by. This does offer some hope that the medical community is waking up on the subject.

Here is the link those guidelines.

http://www.entnet.org/content/aao-hnsf-clinical-practice-guideline-tinnitus

 

[MikeA]

Interesting that the authors issue a strong recommendation against the use of diagnostic imaging studies in the absence of pulsatile tinnitus, focal neurological abnormalities, or asymmetric hearing loss.

Executive Summary:
http://oto.sagepub.com/content/151/4/533.full.pdf+html

Published Guideline:
http://oto.sagepub.com/content/151/2_suppl/S1.full.pdf+html

Several additional resources/documents in section 'For Patients'

 

[Zimichael]

Am I just missing it?

Where is the ultra-important corticosteroid treatment option for acute tinnitus???

 

[Zechariah]

Am I just missing it?

Where is the ultra-important corticosteroid treatment option for acute tinnitus???

Exactly, tbh, I was searching "how to deal with recently onset noise induced tinnitus"-section but couldn't find it. Isn't it important to deal with noise induced tinnitus asap? (although I red the guideline really fast so it might be there...)

EDIT: Corticosteroid treatment is somewhat covered in SNHL guideline (guideline) which is referenced in the tinnitus guideline. Although, I think that if a patient gets tinnitus and temporary threshold shift from noise exposure which lasts a couple of days (mine did for about 5 days - maybe permanent above 12.5 kHz - can't tell) steroid treatment should be considered. Too bad that my ENT didn't suggest anything like that back then...

 

[attheedgeofscience]

Thanks.

There has actually been guidelines around since a while. Here is the most comprehensive flowchart describing all the various types of tinnitus and how they can be diagnosed (click on image for full size).

The flowchart is taken from the 2nd page of the PDF attachment found with this post. There is also further information on the following pages of the PDF-file.

I reviewed the PDF document found with the link you provided - for sure it is comprehensive, but it "kind of" lacks the overview seen above. In my opinion.

 

[Frédéric]

Tinnitus healthcare: a survey revealing extensive variation in opinion and practices across Europe

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.

Objective 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.

Design A health service evaluation survey was carried out.

Setting The survey was carried out online across Europe.

Participants Clinical experts, researchers and policy-makers involved in national tinnitus healthcare and decision-making.

Outcome measures A 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.

Results Data 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.

Conclusions Most 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.

Full text: https://bmjopen.bmj.com/content/10/1/e029346