PERSONALIZED CLINICAL ASSESSMENT AND TINNITUS DISORDER SUBGROUPS: EVIDENCE AND CLINICAL EXPERIENCE

Abstract

This article aimed to present a review of the main aspects related to the pathophysiology and diagnosis of patients with tinnitus, with the objective of establishing etiological subgroups and highlighting the relevance of a personalized clinical speech-language pathology and audiology assessment. An integrative literature review was conducted through searches in the LILACS, SciELO, PubMed, and MEDLINE databases, encompassing articles and book chapters that were synthesized and discussed by the authors based on their clinical practice and the scientific literature. The results highlighted the generating and amplifying factors associated with the symptom, organized into the auditory, somatosensory, metabolic, emotional, and vascular subgroups. Furthermore, the applicability of systematic approaches and assessment instruments was demonstrated, including semi-structured anamnesis, the Visual Analog Scale, the Tinnitus Handicap Inventory, basic audiological assessment, emotional screening, laboratory tests, and somatosensory and vascular assessments, with emphasis on the use of the Clinical Investigation Protocol for Tinnitus. It is concluded that tinnitus disorder is multifactorial in nature and that subgroup-based clinical investigation through individualized assessments represents an appropriate approach to improving therapeutic decision-making and reducing professional uncertainty in the management of the symptom.