Avaliação da abordagem diagnóstica e terapêutica dos acufenos na prática dos otorrinolaringologistas portugueses
DOI:
https://doi.org/10.34631/sporl.3140Palavras-chave:
Acufeno, padrão de cuidados, evidência, otologia, otoneurologia, normas de orientação clínicaResumo
O acufeno é frequentemente descrito como uma percepção auditiva na ausência de estímulo externo. Constitui uma preocupação significativa para a saúde pública, observando-se uma variação considerável nos cuidados prestados por diferentes profissionais de saúde. Realizámos um inquérito online através da lista de correio da Sociedade Portuguesa de Otorrinolaringologia, Cirurgia de Cabeça e Pescoço (SPORL), recolhendo 75 respostas entre agosto e outubro de 2024, para avaliar a abordagem dos mesmos. Os resultados revelaram que os otorrinolaringologistas portugueses avaliam normalmente menos de 10 doentes com acufeno por semana, principalmente com comorbidades cardiovasculares e psiquiátricas, em consultas de 20 a 30 minutos e em centros sem consultas especializadas. Os exames físicos e audiométricos são priorizados, com a ressonância magnética fortemente recomendada em casos unilaterais ou pulsáteis. Nenhuma ferramenta de avaliação subjetiva é empregue para avaliar o impacto dos acufenos na qualidade de vida. O estabelecimento de equipas multidisciplinares foi considerado uma prioridade. Houve uma ampla insatisfação com as opções de prescrição e o estado atual da investigação sobre o tema.
Downloads
Referências
Ellis S, Wilson R, Dolan S. Tinnitus: systematic approach to primary care assessment and management. Br J Gen Pract. 2022 Mar 31;72(717):190-192. doi: 10.3399/bjgp22X719057.
Biswas R, Lugo A, Akeroyd MA, Schlee W, Gallus S, Hall DA. Tinnitus prevalence in Europe: a multi-country cross-sectional population study. Lancet Reg Health Eur. 2021 Nov 4:12:100250. doi: 10.1016/j.lanepe.2021.100250.
Jarach CM, Lugo A, Scala M, van den Brandt PA, Cederroth CR, Odone A. et al. Global prevalence and incidence of tinnitus: a systematic review and meta-analysis. JAMA Neurol. 2022 Sep 1;79(9):888-900. doi: 10.1001/jamaneurol.2022.2189.
McCormack A, Edmondson-Jones M, Somerset S, Hall D. A systematic review of the reporting of tinnitus prevalence and severity. Hear Res. 2016 Jul:337:70-9. doi: 10.1016/j.heares.2016.05.009.
Jacobson GP, McCaslin DL. A search for evidence of a direct relationship between tinnitus and suicide. J Am Acad Audiol. 2001 Nov-Dec;12(10):493-6.
Trochidis I, Lugo A, Borroni E, Cederroth CR, Cima R, Kikidis D. et al. Systematic review on healthcare and societal costs of tinnitus. Int J Environ Res Public Health. 2021 Jun 26;18(13):6881. doi: 10.3390/ijerph18136881.
Parra PC. Tinnitus: mechanisms, measures and sound treatments. Loquens. 2015; 2(2): e024. doi.org/10.3989/loquens.2015.024
Langguth B, de Ridder D, Schlee W, Kleinjung T. Tinnitus: clinical Insights in its pathophysiology-a perspective. J Assoc Res Otolaryngol. 2024 Jun;25(3):249-258. doi: 10.1007/s10162-024-00939-0.
Fuller TE, Haider HF, Kikidis D, Lapira A, Mazurek B, Norena A. et al. Different teams, same conclusions? A systematic review of existing clinical guidelines for the assessment and treatment of tinnitus in adults. Front Psychol. 2017 Feb 22:8:206. doi: 10.3389/fpsyg.2017.00206.
Cima RFF, Kikidis D, Mazurek B, Haider H, Cederroth CR, Norena A. et al. Tinnitus healthcare: a survey revealing extensive variation in opinion and practices across Europe. BMJ Open. 2020 Jan 21;10(1):e029346. doi: 10.1136/bmjopen-2019-029346.
Newman CW, Jacobson GP, Spitzer JB. Development of the tinnitus handicap inventory. Arch Otolaryngol Head Neck Surg. 1996 Feb;122(2):143-8. doi: 10.1001/archotol.1996.01890140029007.
Portugal. Regulamento n.º 724/2019, de 17 de setembro da Ordem dos Médicos. Diário da República n.º 178 (Série II), 103-118
Mazurek B, Böcking B, Dobel C, Rose M, Brüggemann P. Tinnitus and influencing comorbidities. Laryngorhinootologie. 2023 May;102(S 01):S50-S58. doi: 10.1055/a-1950-6149.
Gomaa MA, Elmagd MH, Elbadry MM, Kader RM. Depression, anxiety and stress scale in patients with tinnitus and hearing loss. Eur Arch Otorhinolaryngol. 2014 Aug;271(8):2177-84. doi: 10.1007/s00405-013-2715-6.
Trevis KJ, McLachlan NM, Wilson SJ. Psychological mediators of chronic tinnitus: The critical role of depression. J Affect Disord. 2016 Nov 1:204:234-40. doi: 10.1016/j.jad.2016.06.055.
Asnis GM, Majeed K, Henderson MA, Sylvester C, Thomas M, La Garza RD. An examination of the relationship between insomnia and tinnitus: a review and recommendations. Clinical Medicine Insights: Psychiatry. 2018;9. doi:10.1177/1179557318781078
Ausland JH, Engdahl B, Oftedal B, Hopstock LA, Johnsen M, Krog NH. Tinnitus and cardiovascular disease: the population-based Tromsø Study (2015–2016). BMJ Public Health. 2024 Aug 3;2(2):e000621. doi: 10.1136/bmjph-2023-000621.
Zhang YP, Gao QY, Gao JW, Liang XT, Guo DC, Chen ZT. et al. The association between tinnitus and risk of cardiovascular events and all-cause mortality: insight from the UK Biobank. Acta Cardiol. 2024 May;79(3):374-382. doi: 10.1080/00015385.2024.2324222.
Figueiredo RR, Azevedo AA, Penido NO. Positive association between tinnitus and arterial hypertension. Front Neurol. 2016 Oct 5:7:171. doi: 10.3389/fneur.2016.00171
Xia W, Cui J, Luo Y, Xu JJ, Chen H, Yin X. et al. Glucose control has an impact on cerebral blood flow alterations in chronic tinnitus patients. Front Neurosci. 2021 Feb 4:14:623520. doi: 10.3389/fnins.2020.623520.
Chu HT, Liang CS, Yeh TC, Hu LY, Yang AC, Tsai SJ. et al. Tinnitus and risk of Alzheimer’s and Parkinson’s disease: a retrospective nationwide population-based cohort study. Sci Rep. 2020 Jul 22;10(1):12134. doi: 10.1038/s41598-020-69243-0.
Edvall NK, Gunan E, Genitsaridi E, Lazar A, Mehraei G, Billing M. et al. Impact of temporomandibular joint complaints on tinnitus-related distress. Front Neurosci. 2019 Aug 22:13:879. doi: 10.3389/fnins.2019.00879.
Langguth B, Salvi R, Elgoyhen AB. Emerging pharmacotherapy of tinnitus. Expert Opin Emerg Drugs. 2009 Dec;14(4):687-702. doi: 10.1517/14728210903206975.
Tunkel DE, Bauer CA, Sun GH, Rosenfeld RM, Chandrasekhar SS, Cunningham ER Jr. et al. Clinical practice guideline: tinnitus. Otolaryngol Head Neck Surg. 2014 Oct;151(2 Suppl):S1-S40. doi: 10.1177/0194599814545325.
Cima RFF, Mazurek B, Haider H, Kikidis D, Lapira A, Noreña A. et al. A multidisciplinary European guideline for tinnitus: diagnostics, assessment, and treatment. HNO. 2019 Mar;67(Suppl 1):10-42. doi: 10.1007/s00106-019-0633-7.
Ogawa K, Sato H, Takahashi M, Wada T, Naito Y, Kawase T. et al. Clinical practice guidelines for diagnosis and treatment of chronic tinnitus in Japan. Auris Nasus Larynx. 2020 Feb;47(1):1-6. doi: 10.1016/j.anl.2019.09.007.
Steinmetzger K, Schiele T, Boecking B, Avraamides M, Bamidis PD, Basso L. et al. A survey-based assessment of attitudes and needs regarding tinnitus healthcare among patients and healthcare professionals in Europe. Frontiers in Audiology and Otology [Online], 2024; 2. Available from: https://doi.org/10.3389/fauot.2024.1347283
Husain FT, Gander PE, Jansen JN, Shen S. Expectations for tinnitus treatment and outcomes: a survey study of audiologists and patients. J Am Acad Audiol. 2018 Apr;29(4):313-336. doi: 10.3766/jaaa.16154.
Carmody N, Hunter M, Eikelboom RH. Help-seeker satisfaction with diagnosis and treatment of tinnitus. Int J Audiol. 2024 Dec;63(12):1019-1026. doi: 10.1080/14992027.2023.2292964.
Hall DA, Fackrell K, Li AB, Thavayogan R, Smith S, Kennedy V. et al. A narrative synthesis of research evidence for tinnitus-related complaints as reported by patients and their significant others. Health Qual Life Outcomes. 2018 Apr 11;16(1):61. doi: 10.1186/s12955-018-0888-9.
Ivansic D, Dobel C, Volk GF, Reinhardt D, Müller B, Smolenski UC. et al. Results of an interdisciplinary day care approach for chronic tinnitus treatment: a prospective study introducing the Jena interdisciplinary treatment for tinnitus. Front Aging Neurosci. 2017 Jun 16:9:192. doi: 10.3389/fnagi.2017.00192.
Carmody N, Eikelboom RH, Tegg-Quinn S. Seeking help for tinnitus and satisfaction with healthcare providers including diagnosis, clinical services, and treatment: a scoping review. Eval Health Prof. 2023 Jun;46(2):170-193. doi: 10.1177/01632787231158402.
Downloads
Publicado
Como Citar
Edição
Secção
Licença
Direitos de Autor (c) 2026 Miguel Padrão, Diogo Dias, Margarida Bulha, Sandra Augusto, José Romão, Luísa Azevedo
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição-CompartilhaIgual 4.0.
