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ENT > tinnitus > Flashcards

tinnitus Flashcards

1
Q

what is tinnitus ?

A

subjective perception of sound without external acoustic stimulation

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2
Q

what are the types of tinnitus ?

A

subjective and objective

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3
Q

what is the difference between subjective and objective tinnitus ?

A

subjective - can be heard by the patient only
objective - can be heard by the patient and the examiner

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4
Q

what are the subtypes of subjective tinnitus ?

A

conductive tinnitus
sensorineural tinnitus

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5
Q

wheere is the pathology in subjective conductive tinnitus ?

A

external and middle ear pathologies

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6
Q

where is the pathology in subjective sensorineural tinnitus ?

A

cochlear and auditory pathways

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7
Q

what are the subtypes of objective tinnitus ?

A

pulsatile tinnitus
non pulsatile tinnitus

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8
Q

what is the cause of pulsatile tinnitus ?

A

vascular causes

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9
Q

what are the vascular causes that can result in pulsatile tinnitus ?

A

AV malformation
Internal Carotid Artery atherosclerosis
Glomus tumors
high jugular bulb
anemia , hypertension, thyrotoxicosis

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10
Q

how is thyrotoxicosis related to pulsatile tinnitus ?

A

due to increased vascularity

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11
Q

where do glomus tumors arise from ?

A

chief cells of the paraganglia

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12
Q

what are the causes of non-pulsatile tinnitus ?

A
  1. myoclonus of the middle ear muscles or palatal muscles - recurrent clicking tinnitus
  2. TMJ arthritis - clicking sound on opening of mouth or during mastication
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13
Q

what muscles are affected causing non-pulsatile tinnitus ?

A

tensor tympani or stapedius muscle

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14
Q

which nerve is the jacobson’s nerve ?

A

the tympanic branch of the glossopharyngeal nerve

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15
Q

what is the nerve supply of tensor tympani and the stapedius muscle ?

A

tensor tympani - tensor tympani branch of the mandibular nerve of the trigeminal nerve
stapedius muscles - nerve to stapedius through the facial nerve

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16
Q

what are the required investigations for a case of tinnitus ?

A

pure tone audiometry and tympanometry if associated with hearing loss
MRI in unilateral SNHL to exclude acoustic neuroma
in pulsatile tinnitus - MR or CT angiography
Carotid duplex

17
Q

what is the treatment for cases of tinnitus ?

A

treat the underlying cause
hearing aid in cases of hearing loss
hearing aid with tinnitus masker in selected cases
noise generator at night if it is causing sleep difficulty
Behavioural therapy can be provided by audiologist to reduce perception of tinnitus sound

18
Q

what is harsh tinnitus an indication off ?

A

conductive heearing loss

19
Q

what is sharp tinnitus and indication off ?

A

sensorineural hearing loss

ENT (30 decks)

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