Subjektif tinnituslu bireylerin çok yönlü değerlendirilerek yönetim protokolünün hazırlanması
ŞAHİN KAMİŞLİ, Gurbet İpek
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The aim of this study was to form a "tinnitus management protocol" according to the tinnitus levels by evaluating the subjects with subjective tinnitus by evaluating the multifactorial approach principle based on emotion, cognition, quality of life, sleep and decreased sound tolerance criteria. 145 subjects aged between 18-64 (45 ± 11, 78 M, 67 F) were included in the study. Tinnitus Assessment Form, Short Form-36, Beck Depression Inventory (BDI), STAI-D, STAI-S, Montreal Cognitive Assessment Scale (MoCA), Tinnitus Handicap Inventory (THI), Hearing Handicap Inventory (HHI), Pitsburgh Sleep Quality Index (PSQI) and Khalfa Hyperacusis Questionnaire were applied after audiological evaluation. In the evaluation of tinnitus, psychoacoustic measurements (loudness, picth matching, minimal masking level and residual inhibition) were performed. As a result of statistical analysis, PSQI, STAI-S and STAI-D scores were higher than normal limit values independent of tinnitus level. When the relationship between severity of tinnitus and BDI was examined, it was found that there was an increase in depression scores at severe / catastrophic levels. As the severity of tinnitus increased, the quality of life subscales decreased. As a result of the comparison of the tinnitus levels and PSQI sub-dimensions, it was determined that severe / catastrophic levels had worse scores in sleep disturbances, general sleep quality and sleep latency than the other three level (Kruskal-Wallis p <0.05). When the scores of 75 individuals with hearing loss and tinnitus complaints were compared, there was a moderate significant correlation between the HHI and THI scores (r=0.598, p=0.00). A significant relationship was found between asymmetric high frequency hearing loss and localization of tinnitus. This study demonstrated the presence of level-related factors for subjective tinnitus assessment. As a result, according to the severity (level) of tinnitus; three different protocols were prepared: very mild / mild, moderate and severe / catastrophic.
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