Study of the relationship between the degree of tinnitus
               annoyance and the presence of hyperacusis

Guimarães, Alexandre Caixeta; Carvalho, Guilherme Machado de; Voltolini, Márcia Maria de Freitas Dias; Zappelini, Carlos Eduardo Monteiro; Mezzalira, Raquel; Stoler, Guita; Paschoal, Jorge Rizzato

doi:10.5935/1808-8694.20140007

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Brazilian Journal of Otorhinolaryngology

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Original articles • Braz J Otorhinolaryngol. 80 (1) • Jan-Feb 2014 • https://doi.org/10.5935/1808-8694.20140007 copy

Study of the relationship between the degree of tinnitus annoyance and the presence of hyperacusis

Authorship SCIMAGO INSTITUTIONS RANKINGS

Introduction:

Hyperacusis can be defined as a manifestation of an increased of central auditory pathways gain and can be considered a pre-tinnitus state. In some cases tinnitus can be caused by such increased gain.

Aim:

To evaluate the prevalence of hyperacusis in patients with tinnitus and its relation to the annoyance of tinnitus.

Materials and methods:

Retrospective study with patients from the neurotology service complaining of tinnitus in the first consultation were submitted to clinical evaluation, a questionnaire and audiological evaluation of tinnitus and hyperacusis. The degree of annoyance of tinnitus and hyperacusis was measured using a visual analog scale.

Results:

We analyzed medical records of 309 patients, 169 (54.7%) females and 140 (45.3%) males. The mean age was 53 years. The median degree of tinnitus annoyance was 7. Hyperacusis was present in 57 (18.4%) patients, with a median degree of 5. The degree of annoyance due to tinnitus patients with hyperacusis was similar to that of patients without hyperacusis.

Conclusion:

Hyperacusis was present in 18.4% of patients with tinnitus. The degree of annoyance due to tinnitus had no correlation with the presence of hyperacusis.

Tinnitus; Hyperacusis; Audiometry; Hearing disorders

TINNITUS AND HYPERACUSIS PROTOCOL
IDENTIFICATION
Name:				Hosp. ID #
Age:	Gender	Ethnicity	Profession	Phone number
Address:
Date:
HISTORY:
1) Time of tinnitus			a) < one year						c) two to three years						e) five to ten years
1) Time of tinnitus			b) one to two years						d) three to five years						f) > ten years
2) Location			a) Right ear/left ear/ both/head						b) Worse side: right/left/ no
3) Type			a) Single/multiple						c) Pulsatile/clicking						e) Description______________
3) Type			b) Volume fluctuation						d) Objective						e) Description______________
4) Evolution			a) Sudden/progressive						b) Constant/intermittent
5) Worsening factors			a) Morning/night						c) Alcohol/cigarette						e) Exercise
5) Worsening factors			b) Noise/silence						d) Nervousness						f) Fasting
6) Improvement factors			a) Radio/TV/background noise						b) Medications						c) Cervical rotation ( ) ipsi ( ) contra
7) Interference			a) Sleep						c) Emotional
7) Interference			b) Concentration						d) Social
8) Hyperacusis			a) Right/left/bilateral/no						c) Noisy environment						e) Hyperacusis/phonophobia/recruiting
			b) Progressive/stable/fluctuating						d) Ear fullness: right/left/bilateral						e) Hyperacusis/phonophobia/recruiting
			b) Progressive/stable/fluctuating						d) Ear fullness: right/left/bilateral						f) Ear protection
9) Effect of noise			a) None						b) Improvement						c) Worsening (minutes/hours/days)
10) Otalgia/Otorrhea			a) Right ear						b) Left ear						c) No
11) Dizziness			a) Vertigo/instability						c) Worsens with________
11) Dizziness			b) Minutes/hours/days						d) Improves with________
12) Severity			Tinnitus	0	1	2	3	4	5	6	7	8	9	10
			Hypoacusis	0	1	2	3	4	5	6	7	8	9	10
			Hyperacusis	0	1	2	3	4	5	6	7	8	9	10
			Dizziness	0	1	2	3	4	5	6	7	8	9	10
13) Previous otological surgery_______________________________________________________
14) Otological diagnosis
15) Headache			a) Yes						b) No
16) Cervicalgia			a) Radiating						b) Non-radiating						c) No
17) Temporomandibular joint			a) pain						c) bruxism
17) Temporomandibular joint			b) clicking						d) no
18) Nose			a) normal						c) rhinitis
18) Nose			b) obstruction						d) snoring
19) Habits			a) smoking/alcohol consumption						b) coffee/chocolate						c) sweets/compulsion

	With hyperacusis	Without hyperacusis	Total
Male	31	109	140
Female	26	143	169
Total	57	252	309

	n	Minimum	Maximum	Median	Standard deviation
With hyperacusis	57	2	10	7	2.00
Without hyperacusis	252	1	10	7	2.01

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

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[1] Corresponding author. E-mail: alecgxl2@hotmail.com (A.C. Guimarães).