Quality management will become another discipline for intensive care and research for the physician. Therefore, the first step in this process will be the need for standardised evaluation criteria and case record forms for documentation, leading to effective quality assessment and control. Only this approach may promote our attempts to improve the quality of patient care. Tinnitus is, due to the lack of objective measurable parameters and a missing rational basis of therapy, up to now a "crux medicorum" for every involved person. In this paper we reproduce a case record form and a patient's questionnaire for patients suffering from tinnitus. The presented forms are based on a consensus conference concerning the evaluation of treatment regimens held at the Fourth International Tinnitus Seminar in Bordeaux in August 1991. Epidemiological data, collected with this questionnaire, are presented and analysed. In conclusion, the presented case record form will lead to a standardised evaluation of symptoms according to tinnitus and improve our understanding of concomitant disturbances in tinnitus sufferers. Furthermore, this form of evaluation and documentation will produce comparable data in different centres allowing a pooling of patients data and history. A comparison of clinical trials in which the items are collected by the procedure shown here will be facilitated and lead us to a new understanding in determining the causes of the disease and the outcome of different therapeutic regimens.
For acute and chronic tinnitus a gradual therapeutic regimen is recommended: (1) infusions with dextrane and procaine over 5 days; (2) intravenous application of 100 mg lidocaine over 10 min; and if necessary (3) administration of glutamic diethylester and glutamic acid for 3 days. This resulted in overall tinnitus relief in 95.3% of the acute and 26.7% of the chronic tinnitus sufferers.
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