Viability of Tinnitus Handicap Inventory in Management of Idiopathic Subjective Tinnitus

Abstract

Introduction:
Idiopathic Subjective Tinnitus (IST) is an auditory condition perceived without an external stimulus and lacks identifiable cause which makes it very difficult to treat. The Tinnitus Handicap Inventory (THI) is a validated tool to assess the severity and impact of tinnitus which has been used extensively since it is practically free. This study evaluates the role of THI in monitoring treatment efficacy in IST.

Materials and Methods:
A prospective observational study was conducted at a rural South Indian hospital involving 100 patients aged 21–60 years with IST of at least one year duration. Patients had audiometry to exclude objective causes. THI scores were recorded pre- and post-treatment (12 weeks) with Caroverine, Tocopherol, Levocarnitine, Tinnitus Retraining Therapy (TRT), and Cognitive Behavioral Therapy (CBT).

Observations and Results:
The mean pre-treatment THI score was 44.92 (moderate), improving significantly to 15.78 (slight) post-treatment (p<0.01). 64.87% overall symptom improvement was observed. Notably, the symptom of "desperation" improved by 98.71%, while "insecurity" improved by 16.36%. No patients worsened or dropped out during the study.

Discussion:
The THI demonstrated excellent utility in quantifying symptom severity. Our population showed lower average age and greater occupational noise exposure than usual. The addition of adjunct therapies (TRT, CBT, antioxidants) possibly enhanced outcomes over monotherapy. THI’s ease of use and non-invasiveness make it especially suited for low-resource or community-based settings.

Conclusion:
THI is a viable, practical tool for diagnosis, grading, and follow-up of IST. Caroverine is an ideal first line drug for the management of IST.