Razvoj personalizovanog sistema zvučne terapije i njegov terapijski efekat na pacijente sa subjektivnim tinitusom
Sažetak
Uvod/Cilj. Tinitus je rasprostranjeno auditivno stanje koje značajno utiče na kvalitet života. Uprkos nizu dostupnih tretmana, njihova delotvornost je varijabilna. Cilj rada bio je da se proceni uticaj novorazvijenog sistema zvučne terapije na pacijente sa tinitusom, posebno u smislu promena u audiologiji, testova povezanih sa tinitusom i psihoakustičkih karakteristika tinitusa. Metode. U studiju je bilo uključeno 100 pacijenata sa tinitusom. Podeljeni su u dve grupe, kontrolnu grupu (KG) (n = 48) i terapijsku grupu (TG) (n = 52). Zabeležene su različite demografske karakteristike pacijenata. Svi pacijenti imali su temeljnu audiološku procenu, koja je obuhvatila audiometriju čistih tonova i testiranje akustičke imitanse, kao i procene specifične za tinitus, kao što su određivanje frekvencije tinitusa, određivanje jačine tinitusa, ispitavanja minimalnog maskirajućeg nivoa (minimum masked level – MML) i rezidualne inhibicije (RI). Pored toga, procenjene su psihoakustičke karakteristike tinitusa, uključujući rezultate Upitnika umenjenja sposobnosti zbog tinitusa (Tinnitus Handicap Inventory – THI), Bolničke skale za anksioznost i depresiju (Hospital Anxiety and Depression Scale – HADS), Pitsburškog indeksa kvaliteta sna (Pittsburgh Sleep Quality Index – PSQI) i Vizuelne analogne skale (Visual Analog Scale – VAS). Rezultati. Nije bilo značajnih razlika u različitim demografskim karakteristikama između KG i TG pre akustičke terapije. Dodatno, nije bilo značajnih razlika između grupa u audiometrijskim procenama, testovima povezanim sa tinitusom, psihoakustičkim karakteristikama tinitusa pre tretmana, niti u distribuciji frekvencija tinitusa. Prag sluha u TG bio je znatno niži nego u KG (p = 0,0238). Jačina tinitusa značajno se smanjila u TG (p = 0,0256). MML u TG imao je tendenciju poboljšanja (p = 0,0532), iako ova razlika nije dostigla statističku značajnost i pokazala je pozitivan trend. Među podskalama THI, u grupi TG je pokazano značajno poboljšanje. Takođe, rezultati PSQI pokazali su da su skorovi u TG bili značajno niži nego u KG (p = 0,0238). Ukupni rezultati na skalama HADS (16,58 ± 2,89 vs. 16,67 ± 2,76; p = 0,8730) i VAS (4,19 ± 1,48 vs. 4,22 ± 1,37; p = 0,9160), nisu pokazali značajnu razliku. Zaključak. Akustička terapija značajno poboljšava sluh pacijenata, smanjuje jačinu tinitusa i poboljšava kvalitet sna. Naš sistem akustičke terapije je efikasna strategija za ublažavanje hroničnog subjektivnog tinitusa.
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