1: Tinnitus Flashcards

1
Q

Define tinnitus

A

presence of sound in absence of external auditory stimulus

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2
Q

How is tinnitus classified

A

primary or secondary

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3
Q

What is primary tinnitus

A

no identifiable underlying cause

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4
Q

What is primary tinnitus usually associated with

A

SNHL

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5
Q

What is secondary tinnitus

A

underlying cause can be identified

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6
Q

How is secondary tinnitus classified

A
  1. Subjective

2. Objective

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7
Q

What is objective tinnitus

A

Other individuals are able to hear it - usually a sound made by the body

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8
Q

What is subjective tinnitus

A

Only individual can hear it

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9
Q

what are 4 causes of objective tinnitus

A
  1. Vascular
  2. Myoclonus stapedius
  3. High-output cardiac state
  4. Patent eustachian tube
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10
Q

what vascular disorder may lead to vascular objective tinnitus

A

AV Malformation

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11
Q

what high-output cardiac states may result in objective tinnitus

A

Paget’s
Hyperthyroidism
Anaemia

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12
Q

explain stapedius as cause of objective tinnitus

A

Myoclonus of the stapedius can result in an audible clicking

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13
Q

explain patent Eustachian tube

A

If eustachian tube remains patent for long periods it can cause abnormal sounds to transmit to the ear

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14
Q

what are the otological causes of tinnitus with SNHL

A
  • Meniere’s

- Presbycusis

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15
Q

what are the otological causes of tinnitus with conductive hearing loss

A
  • Otosclerosis
  • Otitis media w/effusion
  • Cerumen impaction
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16
Q

what medications can cause tinnitus and hearing loss

A

Amino-glycosides

Aspirin

17
Q

what metabolic conditions can cause tinnitus

A

High zinc

Hyperthyroidism

18
Q

what neurological disorders may cause tinnitus

A

Acoustic neuroma

MS

19
Q

explain psychiatric aspect of tinnitus

A

Anxiety and depression may exacerbate tinnitus

20
Q

how may tinnitus present

A

can be almost any noise including whistling, buzzing, ringing, hissing

21
Q

what 5 circumstances indicate urgent referral to ENT with tinnitus

A
  1. Head trauma
  2. Sudden onset SNHL
  3. Pulsatile tinnitus
  4. Significant neurology
  5. Significant vertigo
22
Q

What should all patients with tinnitus be referred for

A

Comprehensive audiological assessment

23
Q

What does a comprehensive audiological assessment include

A
  • Audiometry
  • Tympanometry
  • BP
24
Q

What blood tests may be sent in tinnitus

A

FBC
TFT
Lipid profile
Blood glucose

25
Q

What is considered in patients with unilateral tinnitus and SNHL

A

MRI CPA

26
Q

What is the curative management of tinnitus

A

Treat underlying cause

27
Q

What is the symptomatic treatment for tinnitus

A
  • Hearing Aids
  • Psychoeducational
  • Sound therapy
  • CBT
28
Q

When would someone be offered hearing aids

A

Hearing loss >35dB

29
Q

What does tinnitus re-training therapy entail

A

Psychoeducational counselling

Sound therapy

30
Q

What is sound therapy

A

Sound is used to reduce impact of tinnitus by masking it

31
Q

Who may someone with tinnitus be referred to

A

Hearing therapist - provide emotional support