1: Tinnitus Flashcards
Define tinnitus
presence of sound in absence of external auditory stimulus
How is tinnitus classified
primary or secondary
What is primary tinnitus
no identifiable underlying cause
What is primary tinnitus usually associated with
SNHL
What is secondary tinnitus
underlying cause can be identified
How is secondary tinnitus classified
- Subjective
2. Objective
What is objective tinnitus
Other individuals are able to hear it - usually a sound made by the body
What is subjective tinnitus
Only individual can hear it
what are 4 causes of objective tinnitus
- Vascular
- Myoclonus stapedius
- High-output cardiac state
- Patent eustachian tube
what vascular disorder may lead to vascular objective tinnitus
AV Malformation
what high-output cardiac states may result in objective tinnitus
Paget’s
Hyperthyroidism
Anaemia
explain stapedius as cause of objective tinnitus
Myoclonus of the stapedius can result in an audible clicking
explain patent Eustachian tube
If eustachian tube remains patent for long periods it can cause abnormal sounds to transmit to the ear
what are the otological causes of tinnitus with SNHL
- Meniere’s
- Presbycusis
what are the otological causes of tinnitus with conductive hearing loss
- Otosclerosis
- Otitis media w/effusion
- Cerumen impaction
what medications can cause tinnitus and hearing loss
Amino-glycosides
Aspirin
what metabolic conditions can cause tinnitus
High zinc
Hyperthyroidism
what neurological disorders may cause tinnitus
Acoustic neuroma
MS
explain psychiatric aspect of tinnitus
Anxiety and depression may exacerbate tinnitus
how may tinnitus present
can be almost any noise including whistling, buzzing, ringing, hissing
what 5 circumstances indicate urgent referral to ENT with tinnitus
- Head trauma
- Sudden onset SNHL
- Pulsatile tinnitus
- Significant neurology
- Significant vertigo
What should all patients with tinnitus be referred for
Comprehensive audiological assessment
What does a comprehensive audiological assessment include
- Audiometry
- Tympanometry
- BP
What blood tests may be sent in tinnitus
FBC
TFT
Lipid profile
Blood glucose
What is considered in patients with unilateral tinnitus and SNHL
MRI CPA
What is the curative management of tinnitus
Treat underlying cause
What is the symptomatic treatment for tinnitus
- Hearing Aids
- Psychoeducational
- Sound therapy
- CBT
When would someone be offered hearing aids
Hearing loss >35dB
What does tinnitus re-training therapy entail
Psychoeducational counselling
Sound therapy
What is sound therapy
Sound is used to reduce impact of tinnitus by masking it
Who may someone with tinnitus be referred to
Hearing therapist - provide emotional support
