Tinnitis Flashcards
What is tinnitus?
perception of sound in absence of auditory stimulation
Is this a dx?
no symptom
What is tinnitus a consequence of?
brain response to input deprivation from auditory periphery
What is the goal of tx?
to discover the underlying cause
What are the causes of tinnitus?
hearing loss, noise exposure, head and neck trauma, primary disorders, tumor, cerumen impaction, jaw misaglignment, CV diseae, meds
What are primary disorders that cause this?
hypo or hyper thyroidism
Lyme disease
fibromyalgia
Thoracic outlet syndrome
What meds can cause this?
ototoxic or adverse effects - high dose ASA
What is pulsatile tinnitus?
rare, hear heart beat in ear, need to rule vascular pathology - MRI, Carotid US
How do you dx tinnitis?
head and neck exam audiometry MRI MRA Carotid US medication review
What are some herbal treatment for tinnitus?
lipoflavinoids, Zinc
What are other treatments?
sound therapy, masking devices, amplification
What antidepressants can you give?
nortriptyline (10-50 mg at bedtime) - 3-4 wks of therapy before benefit
SSRI - paroxetine in low dose at bedtime, sertraline at 50 mg/day
Don’t dose to AD dose
What benzo do you give?
diazepam or alprazolam - can develop dependence
What are sleep aids?
melatonin
