Introduction
The Skarzynski Tinnitus Scale (STS) is a brief self-report scale for evaluating tinnitus complaints in adults with normal or impaired hearing. Henryk Skarżyński, Elżbieta Gos, Danuta Raj-Koziak and Piotr H. Skarżyński published it in 2018 in the European Journal of Medical Research. Its 15 items measure tinnitus severity, its impact on everyday life and coping.
The authors were based at the World Hearing Center, Institute of Physiology and Pathology of Hearing, in Kajetany/Warsaw, Poland. This guide explains the STS's subscales, scoring formulas, severity norms and reliability.
Key Features of the Skarzynski Tinnitus Scale (STS)
Purpose and Use
The developers designed the STS to be brief and convenient. Specifically, it aims to:
Measure tinnitus severity and its impact on everyday lifeAssess the efficacy of treatmentHelp clinicians quickly gauge general coping difficulties, so they can refer patients who need psychological supportIt measures only tinnitus-related difficulties, not general hearing problems.
Target Population
The STS is intended for adult patients with tinnitus, whether their hearing is normal or impaired.
Structure
The developers started with 51 items, reduced them to a 33-item experimental version, and then to the final 15-item version after factor analysis and reliability testing. The items cover three factor-derived areas:
Psychological distress (items 1, 4, 7, 8, 10, 14): negative emotions such as anxiety, fear and annoyance, and intrusive thoughts about tinnitus.Functional impact (items 2, 5, 11, 13, 15): effects on everyday activities and functioning, including sleep.Coping (items 3, 6, 12): efforts and ability to reduce or manage the negative effects of tinnitus.Scoring Method
Respondents rate each item from 0 to 4: 0 = definitely not, 1 = rather not, 2 = neither yes nor no, 3 = rather yes, and 4 = definitely yes. Items 3, 6 and 12 are reverse-scored.
Score
Calculation
Range
Psychological distress
Sum of its items ÷ 24 × 100
0–100
Functional
Sum of its items ÷ 20 × 100
0–100
Coping
Sum of its items ÷ 12 × 100
0–100
Global STS score
Sum of the scored items ÷ 56 (the maximum possible score) × 100
0–100
A score of 0 means no difficulties, and higher scores indicate a greater negative impact of tinnitus.
Severity norms: the developers report norms for the global score: below 30 low or mild, 30–51 moderate, 51–72 high, and above 72 extreme.
Administration Format
The STS is a self-report questionnaire, so patients complete it themselves using the 0–4 rating scale.
Applications of the Skarzynski Tinnitus Scale (STS)
The STS suits busy clinical settings:
Severity assessment: grading tinnitus severity with clinically meaningful norms.Treatment evaluation: assessing the efficacy of tinnitus treatment.Referral decisions: spotting coping difficulties that may need psychological support.Languages and availability
Besides the original, researchers have adapted the STS into:
Brazilian Portuguese: cultural adaptation and validationArabic: validation and adaptationThe original article is open access under the Creative Commons Attribution 4.0 International License.
Reliability and Validity
The STS showed excellent test–retest reliability (ICC = 0.94) and good internal consistency overall:
Overall scale: Cronbach's alpha = 0.91Psychological distress subscale: alpha = 0.91Functional subscale: alpha = 0.84Coping subscale: alpha = 0.62Moreover, exploratory factor analysis supported a three-factor structure. The STS showed strong convergent validity with the Tinnitus Handicap Inventory and the Tinnitus Functional Index, and good discriminant validity against pure-tone audiometry.
Validation studies:
Skarzynski Tinnitus Scale: validation of a brief and robust tool for assessing tinnitus in a clinical population (2018): study linkSkarzynski Tinnitus Scale: cultural adaptation and validation to Brazilian Portuguese (2023): study linkValidation and adaptation of the Arabic version of the STS (2025): study linkLimitations and Considerations
Keep these points in mind:
Coping subscale: its internal consistency was comparatively weak (alpha = 0.62), so interpret it cautiously.Tinnitus-specific: the STS measures tinnitus-related difficulties only, not general hearing problems.Self-report: scores reflect how patients describe their own difficulties.Other Versions And Related Questionnaires
These questionnaires are related:
Tinnitus and Hearing Survey (THS)Tinnitus Handicap Inventory (THI); see the ResRef THI guideTinnitus Functional Index (TFI); see the ResRef TFI guideAdditional Resources
The original article: linkFor inquiries, contact the corresponding author, Piotr H. Skarżyński, World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany/Warsaw, Poland, at p.skarzynski@ifps.org.pl.Browse more ENT questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
What does the Skarzynski Tinnitus Scale measure?The STS measures tinnitus severity across three areas: psychological distress, functional impact on everyday life, and coping with tinnitus-related distress.
How is the STS scored?Items are rated 0 to 4, with items 3, 6 and 12 reverse-scored. Each subscale and the global score are converted to a 0–100 scale, where higher scores mean a greater impact.
What do STS scores mean?The developers report global score norms: below 30 is low or mild, 30–51 moderate, 51–72 high, and above 72 extreme tinnitus severity.
Is the STS reliable?Yes. It showed excellent test–retest reliability (ICC = 0.94) and an overall alpha of 0.91, although the Coping subscale was weaker (alpha = 0.62).
A Word from ResRef About the Skarzynski Tinnitus Scale (STS)
The STS is a brief, 15-item patient-reported tool for assessing tinnitus severity across psychological distress, functional, and coping domains in adult tinnitus patients with normal or impaired hearing. It demonstrated excellent reliability (ICC=0.94) and good internal consistency (α=0.91), with the Coping subscale showing comparatively weaker internal consistency (α=0.62). Its convenient length and clinically meaningful severity norms make it well-suited to busy clinical settings, though the Coping subscale may warrant cautious interpretation given its lower internal consistency.
References
Skarżyński, H., Gos, E., Raj-Koziak, D., & Skarżyński, P. H. (2018). Skarzynski Tinnitus Scale: validation of a brief and robust tool for assessing tinnitus in a clinical population. European Journal of Medical Research, 23(1). https://doi.org/10.1186/s40001-018-0347-4Sanfins, M. D., Donadon, C., Gos, E., Serra, A. P., Rezende, A., Ferrazoli, N., & Skarżyński, P. H. (2023). Skarzynski Tinnitus Scale: Cultural Adaptation and Validation to Brazilian Portuguese. International Archives of Otorhinolaryngology, 27(03), e400–e406. https://doi.org/10.1055/s-0042-1742351Elzayat, S., El-Shirbeny, H. A., Gehad, I., Morshedy, A., Essawy, W. M., Fayed, A., Ragab, S., & Elfarargy, H. H. (2025). Validation and Adaptation of the Arabic Version of the Skarzynski Tinnitus Scale. Audiology and Neurotology, 30(4), 347–354. https://doi.org/10.1159/000544805