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Patient-Based Outcomes in Patients With Primary Tinnitus Undergoing Tinnitus Retraining Therapy
Julie A. Berry, MD;
Susan L. Gold, MAud, CCC SLP-A;
Ellen Alvarez Frederick, MAud, CCC-A;
William C. Gray, MD;
Hinrich Staecker, MD, PhD
Arch Otolaryngol Head Neck Surg. 2002;128:1153-1157.
Objective To determine whether the Tinnitus Handicap Inventory (THI), a validated
patient-based outcomes measure, may improve our ability to quantify impact
and assess therapy for patients with tinnitus.
Design Nonrandomized, prospective analysis of 32 patients undergoing tinnitus
retraining therapy (TRT). Assessment tools included comprehensive audiology,
a subjective self-assessment survey of tinnitus characteristics, and the THI.
Tinnitus Handicap Inventory scores were assessed at baseline and 6 months
following TRT.
Results Baseline analysis revealed significant correlation between the subjective
presence of hyperacusis and higher total, emotional, and catastrophic THI
scores. Tinnitus Handicap Inventory scores correlated with subjective perception
of overall tinnitus effect (P<.001). Mean pure-tone
threshold average was 17.4 dB, and mean speech discrimination was 97.0%. There
were no consistent correlations between baseline audiologic parameters and
THI scores. Following 6 months of TRT, the total, emotional, functional, and
catastrophic THI scores significantly improved (P<.001).
Loudness discomfort levels also significantly improved (P .02).
Conclusions There is significant improvement in self-perceived disability following
TRT as measured by the THI. The results confirm the utility of the THI as
a patient-based outcomes measure for quantifying treatment status in patients
with primary tinnitus.
From the Tinnitus and Hyperacusis Center, Division of Otolaryngology–Head
and Neck Surgery, Department of Surgery, University of Maryland Medical System,
Baltimore.
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