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Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
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An improved system for grading and treating tinnitus.

Mariko Takahashi1, Kayoko Kabaya1, Kenichi Sekiya2

  • 1Department of Otolaryngology, Head and Neck Surgery, Nagoya City University Medical School, Japan.

Auris, Nasus, Larynx
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Summary

A new grading system effectively classifies tinnitus severity and psychological distress. This system simplifies treatment, showing significant improvements in higher grades for tinnitus handicap and anxiety/depression.

Keywords:
Catastrophic eventDepressionTRTTinnitus classification

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Area of Science:

  • Otolaryngology
  • Psychiatry
  • Clinical Psychology

Background:

  • Tinnitus, an auditory sensation, often co-occurs with psychological distress, complicating severity assessment.
  • Self-reporting of tinnitus severity can be unreliable due to associated psychological issues.
  • A novel grading system and treatment protocol were developed to address tinnitus severity, psychological comorbidities, and episode frequency.

Purpose of the Study:

  • To develop and validate a new 5-grade system for classifying tinnitus patients.
  • To implement and assess a practical treatment protocol tailored to each grade.
  • To evaluate the system's efficacy in improving tinnitus severity and psychological status.

Main Methods:

  • 113 patients were analyzed for tinnitus severity, psychological issues (HADS, DSM-IV), and catastrophic episodes, leading to a 5-grade classification.
  • A treatment protocol was designed based on historical treatment records for each grade.
  • 82 new patients were graded and treated using the new protocol, with outcomes assessed via Tinnitus Handicap Inventory (THI) and Hospital Anxiety and Depression Scale (HADS) scores post-treatment (≥6 months follow-up).

Main Results:

  • Patients were categorized into 5 grades with distinct Tinnitus Handicap Inventory (THI) and Hospital Anxiety and Depression Scale (HADS) scores.
  • Higher grades (III-V) showed increased utilization of psychotropic drugs and psychiatric consultations.
  • Significant improvements in THI scores were observed in Grades II, IV, and V; HADS scores improved in Grades IV and V. Catastrophic episode scores also improved in Grades IV and V.

Conclusions:

  • The 5-grade system reliably categorizes tinnitus patients based on severity, psychological factors, and episode frequency.
  • Treatment guided by this system led to significant improvements in tinnitus severity and psychological distress, particularly in more severe cases.
  • The system simplifies tinnitus management without compromising treatment efficacy.