英国全科医生对突发性感音神经性听力损失的管理：一项横断面调查研究

文献信息

中文摘要

目的： 评估英国全科医生（GPs）如何识别、检查和治疗突发性感音神经性听力损失（SSNHL），并确定其临床实践与国家指南的一致程度。
方法： 于2025年1月至7月期间，向西米德兰兹地区所有完全合格的全科医生发放了一项横断面在线调查。问卷探讨了所使用的定义、诊断方法、管理策略以及对NICE和ENT UK建议的熟悉程度。
结果： 共有50名全科医生完成了调查。尽管84%的人尝试区分传导性听力损失与感音神经性听力损失，但只有56%的人定期使用音叉试验。紧急耳鼻喉科转诊是最常见的初始步骤（68%），而只有18%的人启动药物治疗，36%的人开具皮质类固醇。不到一半的人熟悉指南内容，但96%的人表示希望获得额外培训。
结论： SSNHL在英国初级保健中的识别和管理仍不一致。通过有针对性的耳鼻喉科教育和简化的转诊路径来提高全科医生的信心，可显著改善早期治疗和听力结局。

英文摘要

OBJECTIVE: To assess how general practitioners (GPs) in the United Kingdom recognise, investigate, and manage sudden sensorineural hearing loss (SSNHL), and to determine the extent to which their practice aligns with national guidance.
METHODS: A cross-sectional online survey was distributed between January and July 2025 to fully qualified GPs across the West Midlands. The questionnaire explored definitions used, diagnostic methods, management strategies, and familiarity with NICE and ENT UK recommendations.
RESULTS: Fifty GPs completed the survey. Although 84% attempted to distinguish conductive from sensorineural loss, only 56% regularly used tuning-fork tests. Urgent ENT referral was the most common initial step (68%), while only 18% initiated pharmacological therapy and 36% prescribed corticosteroids. Fewer than half were familiar with guideline content, yet 96% expressed a wish for additional training.
CONCLUSION: SSNHL remains inconsistently recognized and managed in UK primary care. Improving GP confidence through targeted ENT education and streamlined referral pathways could substantially enhance early treatment and hearing outcomes.