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.

The data that support the findings of this study are available from the corresponding author upon reasonable request.

AI Disclosure
The authors declare that artificial intelligence (AI) tools were not used, or were used solely for language editing, and had no role in data analysis, interpretation, or the formulation of conclusions. All scientific content, data interpretation, and conclusions are the sole responsibility of the authors. The authors further confirm that AI tools were not used to generate, fabricate, or ‘hallucinate’ references, and that all references have been carefully verified for accuracy.

Z.A.: Study conceptualization, study design, planning of the study, data analysis, interpretation of the results, and manuscript writing; S.K.: Data collection and manuscript review; N.Ö.Ö.: Data collection and manuscript review; K.B.B.: Data collection and manuscript review; E.O.: Manuscript writing, editing, and critical revision of the manuscript; P.P.: Supervision, methodological guidance, and critical revision of the manuscript.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

The authors received no financial support for the research and/or authorship of this article.