Abstract
Background Patients with tinnitus may have different severity levels of tinnitus distress. Visual
analog scale (VAS) is a simple method to measure the extent of subjective distress
caused by tinnitus. It includes ratings of tinnitus loudness, awareness, annoyance,
and impact of tinnitus on life.
Purpose The purpose of this study was to evaluate what led to different distress levels in
patients with bilateral tinnitus by analyzing the relationships among all subscales
of VAS scores for tinnitus distress and the documented variables.
Research Design This study was a retrospective cohort study.
Study Sample The medical records of 268 patients who visited a tinnitus clinic between March and
December 2020 were reviewed.
Data Collection and Analysis Epidemiologic characteristics, subjective tinnitus distress factors including tinnitus
loudness, awareness, annoyance, and impact of tinnitus on life, questionnaire results
including those from the Tinnitus Handicap Inventory (THI) and Beck Depression Inventory
(BDI), and audiometric profiles were documented. Based on a bivariate analysis between
variables and subtypes of subjective tinnitus distress, stepwise logistic regression
was performed to identify potential influencing factors for aggravating each subtype.
Results Data from a total of 122 patients with bilateral tinnitus were collected. The cohort
included 77 males and 45 females with a mean age of 51.16 ± 13.50 years. Tinnitus
loudness was associated with an accompanying headache (p < 0.001), the BDI score (p = 0.001), and the duration of tinnitus (p = 0.006). A high THI (p < 0.001) and an accompanying headache (p = 0.016) were both associated with tinnitus annoyance. Hearing thresholds at 250 Hz
(p = 0.011) and 500 Hz (p = 0.002) on the left side were associated with an impact of tinnitus on life. The
hearing threshold at 4 kHz on the left side alone was associated with tinnitus awareness
(p = 0.013).
Conclusion Psychologic complaints are mainly associated with tinnitus loudness and annoyance.
On the other hand, hearing loss is linked with tinnitus awareness and its impact on
life. Thus, an individualized, sequential approach that considers different subtypes
of tinnitus severity to assess subjective tinnitus distress is needed.
Keywords
tinnitus - visual analog scale - surveys - questionnaires
