韩国大学医院耳鸣诊疗实践模式：2025年全国性调查结果及与2013年的比较

文献信息

中文摘要

目的：
2013年的一项全国性调查描述了韩国大学医院的耳鸣管理情况。此后，概念框架有所拓展，新的治疗方法也已出现。我们旨在调查2025年韩国大学医院耳科医师的耳鸣诊疗实践模式，并与2013年的结果进行比较。
方法：
2025年10月向韩国耳科学会耳鸣研究组注册的耳科医师发放了一份横断面电子调查问卷。我们评估了分类、诊断性检查、治疗策略、助听器验配以及感知到的障碍。与2013年的比较采用了预先设定的条目层面映射；由于无法获得2013年的个体层面数据，且若干条目无法直接比较，因此未进行正式的假设检验。
结果：
来自45所大学医院中28所的34名耳科医师作出了回复。与2013年相比，2025年的实践更常涉及更广泛的分类、心理评估和结构化问卷。药物治疗、耳鸣再训练疗法和基于助听器的康复仍是主要治疗方法。认知行为疗法相关方法、数字疗法和神经调控得到更广泛的体现，但常规使用有限。听觉康复扩展到包括CROS/BiCROS和人工耳蜗植入。障碍包括缺乏有效治疗、网络错误信息、不切实际的期望以及报销限制。
结论：
与2013年相比，韩国大学医院的耳鸣诊疗似乎更加结构化和多样化，强调心理评估和听觉康复。然而，普遍使用药物治疗、频繁使用鼓室内类固醇、最小临床重要差异标准异质、真耳测量采用率低以及新模式的常规使用有限，表明持续存在证据-实践差距和结局标准化差距。这些发现凸显了需要更强的证据、标准化的结局以及卫生系统对以患者为中心照护的支持。

英文摘要

OBJECTIVES.: A 2013 nationwide survey described tinnitus management in Korean university hospitals. Since then, conceptual frameworks have broadened, and new therapies have emerged. We aimed to investigate tinnitus practice patterns among Korean university hospital otologists in 2025 and compared them with the findings in 2013.
METHODS.: A cross-sectional electronic survey was distributed in October 2025 to otologists registered with the Tinnitus Study Group of the Korean Otologic Society. We assessed classification, diagnostic work-up, treatment strategies, hearing-aid fitting, and perceived barriers. Comparisons with 2013 used a predefined item-level mapping; formal hypothesis testing was not performed because individual-level 2013 data were unavailable and several items were not directly comparable.
RESULTS.: Thirty-four otologists from 28 of 45 university hospitals responded. Compared with 2013, 2025 practice more often involved broader classification, psychological assessment, and structured questionnaires. Pharmacotherapy, tinnitus retraining therapy, and hearing-aid-based rehabilitation remained the main treatments. Cognitive behavioral therapy-related approaches, digital therapeutics, and neuromodulation were more widely represented but showed limited routine use. Auditory rehabilitation expanded to include CROS/BiCROS and cochlear implantation. Barriers included a lack of effective treatments, online misinformation, unrealistic expectations, and reimbursement limitations.
CONCLUSION.: : Korean university hospital tinnitus care appears more structured and diversified than in 2013, emphasizing psychological assessment and auditory rehabilitation. However, universal pharmacotherapy, frequent intratympanic steroid use, heterogeneous minimal clinically important difference criteria, low real-ear measurement adoption, and limited routine use of newer modalities indicate persistent evidence-practice and outcome-standardization gaps. These findings underscore the need for stronger evidence, standardized outcomes, and health-system support for patient-centered care.