Tinnitus Holistic Simplified Classification (THoSC): A New Assessment for Subjective Tinnitus, With Diagnostic and Therapeutic Implications.
OBJECTIVE
One of the most debated topics in tinnitus is its standard and practical classification. The most popular classification distinguishes subjective from objective tinnitus. Other classifications are based on different features. On the whole, they seem incomplete, and the diagnostic and therapeutic algorithms are often difficult for practical purposes. The aim of this work is to develop a new diagnostic and therapeutic algorithm.


METHODS
Our model is based on 10 years of experience. In particular, the starting point is the data retrieved from 212 consecutive patients in our Tinnitus Unit between May and December 2013: We found a clear auditory disorder in 74.5% of the population, muscolo-skeletal disorders and/or trigeminal disease in 57.1%, and psychiatric comorbidities in 43.8%. Different features coexisted in 59.9% of the population.


RESULTS
Following such data we propose the Tinnitus Holistic Simplified Classification, which takes into account the different tinnitogenic mechanisms and the interactions between them. It differentiates tinnitus that arises from: (1) auditory alterations (Auditory Tinnitus), (2) complex auditory-somatosensory interactions (Somatosensory Tinnitus), (3) psychopathological-auditory interactions (Psychopathology-related Tinnitus), and (4) 2 or all of the previous mechanisms (Combined Tinnitus).


CONCLUSIONS
In our opinion this classification provides an accurate and easy tailored path to manage tinnitus patients.
Department of Otorhinolayngology, Audiology and Ophtalmology, Unit of Audiology, Sapienza University of Rome, Rome, Italy giancarlo.cianfrone@uniroma1.it.
Giancarlo
G
Cianfrone
Department of Otorhinolayngology, Audiology and Ophtalmology, Unit of Audiology, Sapienza University of Rome, Rome, Italy.
Filippo
F
Mazzei
Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
Massimo
M
Salviati
Department of Otorhinolayngology, Audiology and Ophtalmology, Unit of Audiology, Sapienza University of Rome, Rome, Italy.
Rosaria
R
Turchetta
Department of Otorhinolayngology, Audiology and Ophtalmology, Unit of Audiology, Sapienza University of Rome, Rome, Italy.
Maria Patrizia
MP
Orlando
A.I.R.S. Italian Association for the Research on Deafness, Rome, Italy.
Valeria
V
Testugini
A.I.R.S. Italian Association for the Research on Deafness, Rome, Italy.
Laura
L
Carchiolo
A.I.R.S. Italian Association for the Research on Deafness, Rome, Italy.
Francesca
F
Cianfrone
Department of Otorhinolayngology, Audiology and Ophtalmology, Unit of Audiology, Sapienza University of Rome, Rome, Italy.
Giancarlo
G
Altissimi
D006801:Humans; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D014012:Tinnitus / Q000145:classification / Q000175:diagnosis / Q000628:therapy
hearing loss; psychiatric comorbidities; somatosensory tinnitus; tinnitus; tinnitus classification