tinnitus

Question 1

what

Answer 1

persistent addition sound that is heard but not present in surrounding environment

Question 2

thought to be due to

Answer 2

background sensory signal produced by cochlea which isn’t effectively filtered out by central auditory system

Question 3

primary tinnitus

Answer 3

no identifiable cause

often occurs with SN hearing loss

Question 4

secondary tinnitus - causes

Answer 4

impacted ear wax
ear infection 
meniere's 
noise exposure
medications: loop diuretics, gentamicin, chemo drugs 
acoustic neuroma 
MS
trauma

Question 5

what systemic conditions can it be assoc with

Answer 5

anaemia
diabetes
hypo/hyper-thyroidism
hyperlipidaemia

Question 6

objective tinnitus

Answer 6

patient can objectively hear extra sound in their head

this sound also observable on examination by auscultating with stethescope

Question 7

objective tinnitus causes

Answer 7

carotid artery stenosis
aortic stenosis
AV malformations
ET dysfunction

Question 8

if tinnitus is pulsatile

Answer 8

may indicate CV cause e.g. carotid artery stenosis with a bruit

Question 9

Ix

Answer 9

Bloods: FBC, thyroid, glucose, lipids
audiology
CT or MRI

Question 10

red flags

Answer 10

unilateral 
pulsatile
hyperacusis 
unilateral hearing loss
sudden onset hearing loss
vertigo, dizziness
headache, visual symptoms 
assoc neurology 
suicidal ideation related to tinnitus