Some Remarks on the Classification of Subjective Idiopathic Tinnitus (SIT) - An Essay toward Establishing a Cross-matched Grading System.

To better quantify levels of individual impairment caused by SIT, two different sets of classification were cross matched. This combination factored in the inaccuracy caused by terminologic inexactitude. Although the system which developed historically had a subjective bias, the newer tests created to analyze tinnitus specifically were far more objective. By combining the findings of both tests using a numeric score, rating tinnitus should become more exact. Classification of tinnitus began long ago in ancient Babylon. In the library of the court of King Assurbanipal (668 to 626 B.C.), clay slates were found which gave the first written classification of tinnitus. Later Pliny, Paracelsus, Itard, and Politzer developed separate systems of tinnitus classification.(2) All these systems can be broken down into the branches of epidemiology, etiology, and legal requirements. Epidemiology gives information on tinnitus in "terms of time, place, and persons." Etiology provides a means to summarize the relationships between the subjective findings of tinnitus and relationships in terms of pathoetiology. It is the large numbers of single complaints about tinnitus and possible associated relationships of pathologic relationships that cause the different clinical classification of tinnitus. In terms of legal disability, a more accurate classification will permit graduated comprehensions of the irritation experienced by the patient and related personal, social and occupational interferences. Measuring these grades of impairment will allow comparison of different types of tinnitus. Unlike other audiologic failures such as generalized hearing loss and disturbances of equilibrium resulting from vestibular affections, assessment of the intensity of tinnitus and its involvement in personal life is restricted by limitations, because each classification system contains inaccuracies per se.