Turkish adaptation and validation of the Hyperacusis Handicap Questionnaire in tinnitus patients

Zehra Aydoğan; Sevgi Kutlu; Nazife Öztürk Özdeş; Kübra Binay Bolat; Emre Ocak; Prashanth Prabhu

doi:10.5606/kbbu.2026.31

Zehra Aydoğan¹, Sevgi Kutlu¹, Nazife Öztürk Özdeş², Kübra Binay Bolat³, Emre Ocak⁴, Prashanth Prabhu⁵

¹Department of Audiology, Faculty of Health Sciences, Ankara University, Ankara, Türkiye

²Department of Audiology and Speech Disorders, Institute of Health Sciences, Ankara University, Ankara, Türkiye

³Department of Audiology, Faculty of Health Sciences, Selcuk University, Konya, Türkiye

⁴Department of Otorhinolaryngology, Faculty of Medicine, Ankara University İbni Sina Hospital, Ankara, Türkiye

⁵Department of Audiology, All India Institute of Speech and Hearing, Mysore, India

Keywords: Hyperacusis, reliability, tinnitus, Turkish adaptation, validity

Abstract

Objectives: This study aimed to evaluate the validity and reliability of the Turkish version of the Hyperacusis Handicap Questionnaire (HHQ) in individuals with tinnitus and to provide a culturally adapted instrument for clinical and research use.
Patients and Methods: This cross-sectional methodological study included 185 participants between January 2024 and January 2025 The original HHQ was translated and culturally adapted into Turkish following standardized forward-backward translation and expert panel procedures. Participants completed the Turkish version (HHQ-TR) along with the Tinnitus Handicap Inventory (THI). Internal consistency was assessed using Cronbach’s alpha, and construct validity was examined through confirmatory factor analysis.
Results: A total of 185 participants (71 males, 114 females; mean age: 48.33 ± 12.94 years; range, 18 to 65 years) with subjective tinnitus for at least six months were recruited from an audiology clinic. The HHQ-TR demonstrated high internal consistency, with a Cronbach’s alpha of 0.92 for the total score and 0.77, 0.80, and 0.84 for the functional, social, and emotional subscales, respectively. Item-total correlations supported the homogeneity of the scale. Confirmatory factor analysis confirmed a three-factor structure, with factor loadings ranging from 0.44 to 0.72. Strong correlations between HHQ-TR and THI scores further supported construct validity.
Conclusion: The Turkish version of the HHQ is a valid and reliable tool for assessing the functional, social, and emotional impacts of hyperacusis in individuals with tinnitus. Its use in clinical and research settings may facilitate more accurate evaluation of tinnitus-hyperacusis comorbidity, support treatment planning, and contribute to rehabilitation processes. Future studies should investigate the applicability of the HHQ-TR in diverse clinical populations and its sensitivity in monitoring treatment outcomes.

Citation: Aydoğan Z, Kutlu S, Öztürk Özdeş N, Binay Bolat K, Ocak E, et al. Turkish adaptation and validation of the Hyperacusis Handicap Questionnaire in tinnitus patients. Praxis Otorhinolaryngol 2026;14(3):151-158. https://doi. org/10.5606/kbbu.2026.31.