Research Article: Clinical characteristics of patients with tinnitus evaluated with the Tinnitus Sample Case History Questionnaire in Japan: A case series

Date Published: August 25, 2017

Publisher: Public Library of Science

Author(s): Takashi Kojima, Sho Kanzaki, Naoki Oishi, Kaoru Ogawa, Berthold Langguth.


The Tinnitus Sample Case History Questionnaire was determined as a standardized questionnaire for obtaining patient case histories and for characterizing patients into subgroups at the Tinnitus Research Initiative in 2006. In this study, we developed a Japanese version of this questionnaire for evaluating the clinical characteristics of patients with tinnitus. The Japanese version of the questionnaire will be available for evaluating treatments for tinnitus and for comparing data on tinnitus in research centers.

To evaluate the clinical characteristics of patients with tinnitus in Japan using a newly developed Japanese version of Tinnitus Sample Case History Questionnaire.

This was a prospective study based on patient records.

University hospitals, general hospitals, and clinics.

We collected patient data using a Japanese translated version of the Tinnitus Sample Case History Questionnaire. In total, 584 patients who visited our institutions in Japan between August 2012 and March 2014 were included (280 males and 304 females; age 13–92 years; mean age, 60.8). We examined patients after dividing them into two groups according to the presence or absence of hyperacusis. The collected results were compared with those from the Tinnitus Research Initiative database.

Compared with the TRI database, there were significantly more elderly female patients and fewer patients with trauma-associated tinnitus. There was a statistically lower ratio of patients with hyperacusis. We found that patients with tinnitus in addition to hyperacusis had greater tinnitus severity and exhibited higher rates of various complications.

The Japanese version of the Tinnitus Sample Case History Questionnaire developed in this study can be a useful tool for evaluating patients with tinnitus in Japan. The results of this multicenter study reflect the characteristics of patients with tinnitus who require medical care in Japan. Our data provides a preliminary basis for an international comparison of tinnitus epidemiology.

Partial Text

Chronic tinnitus, the perception of sound in the absence of an acoustic external stimulus, affects 5%–15% of the total population [1, 2]. It can be a debilitating and life-altering experience [1, 2]. A clinical practice guideline for tinnitus was published recently [3]. Despite a large number of epidemiologic studies conducted in several countries [2, 4–6], no well-established specific treatment is available for tinnitus. One of the difficulties is that it is unknown which subgroups of patients with tinnitus may benefit most from any particular treatment method. Although no standardized protocol has been established in Japan, we usually manage patients with tinnitus by following strategy. At first, we take a case history by an interview and evaluate auditory function. Then, we assess tinnitus severity by Tinnitus Handicap Inventory [7, 8], and psychiatric condition by some questionnaires (e.g. Hospital Anxiety and Depression Scale [9]). Based on these results, we plan management for each. Case histories may potentially classify patients into a particular subgroup, however; there is no standardized questionnaire. The different forms of tinnitus may be grouped into subtypes based on patient data, including etiological factors, clinical appearances, and comorbid medical conditions [10–13]. Among the reasons for the current lack of a satisfactory classification system is that tinnitus is an entirely self-reported subjective phenomenon.

The overall results from the total sample of 584 patients who completed the Japanese version of the TSCHQ are shown in Table 1. Not every patient answered every question. Excluding two items with open-ended responses, the results list 34 items, including the type of medical facility. Some items permitted multiple responses, and only results with a single response were tabulated. Age at the visit was 13–92 years (median 63 years), and there were 304 females and 280 male participants. Mean tinnitus duration was 80.9 ± 132.9. For gender, our results included more women with tinnitus than the TRI database (p <0.001). The proportion of patients with trauma-associated tinnitus and hyperacusis in our study was smaller than the TRI database (p <0.001). To our knowledge, this is the first report on collecting data about patients with tinnitus using the TSCHQ in an Asian country. The data collected in the present study were obtained from various hospitals and therefore reflect the characteristics of tinnitus patients throughout Japan. Patients with hyperacusis complained of severe tinnitus from the aspects of subjective tinnitus loudness and annoyance evaluating in this questionnaire, hearing impairment, and various comorbid symptoms, including a headache, vertigo, neck pain, other pain and psychiatric problem.   Source:


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