耳鳴只能忍耐，一輩子都不會好？

陽明大學腦科學博士/國軍桃園總醫院耳鼻喉科主任  郭錦龍醫師

耳鳴有多常見？

嚴格來說，耳鳴不是一種病，而是一種生理現象，有時候它更是疾病的警訊。成年人罹患耳鳴的盛行率大約10%至15%，[1-3]以此估計，台灣約有300萬人有耳鳴的困擾。根據經驗，耳鼻喉科門診約有10-30%患者是因耳鳴而就醫。男性較易出現耳鳴，抽菸的人似乎也比較容易罹患耳鳴。[3]臨床的觀察發現約有2至3成的病人會被耳鳴所困擾而就醫，這種情形稱為困擾性耳鳴(bothersome tinnitus)。[2, 3]總體而言，約有25%的耳鳴患者自覺耳鳴嚴重程度會逐年增加。[4]

耳鳴只能忍耐，一輩子都不會好？

罹患耳鳴的病人很可憐，除了耳鳴本身的干擾，還有的被醫師嚇死，被告知永遠不會好，說好聽的是要病人與耳鳴和平共處，講白了就是要病人消極地坐以待斃。其實耳鳴的預後並沒有想像中的悲觀，根據國外的大型研究，耳鳴病人追蹤5年以上發現有2成的病人耳鳴沒有治療便痊癒，而3成至5成的病人會改善。換言之，有5成至7成的病人在追蹤5年後耳鳴會改善、甚至完全消失。[5, 6]僅有25%的病人耳鳴可能會隨時間加重。[4]

參考文獻

[1] Heller AJ. Classification and epidemiology of tinnitus. Otolaryngologic clinics of North America 2003;36:239-48.

[2] Henry JA, Griest S, Zaugg TL, Thielman E, Kaelin C, Galvez G, et al. Tinnitus and hearing survey: a screening tool to differentiate bothersome tinnitus from hearing difficulties. American journal of audiology 2015;24:66-77.

[3] Shargorodsky J, Curhan GC, Farwell WR. Prevalence and characteristics of tinnitus among US adults. The American journal of medicine 2010;123:711-8.

[4] Stouffer JL, Tyler RS. Characterization of tinnitus by tinnitus patients. The Journal of speech and hearing disorders 1990;55:439-53.

[5] Nondahl DM, Cruickshanks KJ, Wiley TL, Klein R, Klein BE, Tweed TS. Prevalence and 5-year incidence of tinnitus among older adults: the epidemiology of hearing loss study. Journal of the American Academy of Audiology 2002;13:323-31.

[6] Gopinath B, McMahon CM, Rochtchina E, Karpa MJ, Mitchell P. Incidence, persistence, and progression of tinnitus symptoms in older adults: the Blue Mountains Hearing Study. Ear and hearing 2010;31:407-12.